scholarly journals Exploring the Relationship Between Critical Access Hospitals and Rural County Health

2021 ◽  
Vol 9 (2) ◽  
pp. 27
Author(s):  
Kirtan Patel ◽  
Amber Maraccini ◽  
Timothy Grunert ◽  
Wei Yang ◽  
Anthony Slonim
Keyword(s):  
Critical Access Hospitals ◽  
Rural County ◽  
The Relationship

scholarly journals The COVID-19 epidemic in rural U.S. counties

2020 ◽  
Author(s):  
Philip N. Cohen
Keyword(s):  
Rural Areas ◽  
Hispanic American ◽  
Rural County ◽  
Institutional Settings ◽  
Health Infrastructure ◽  
Rural Counties ◽  
High Concentrations ◽  
Black Populations ◽  
The Impact ◽  
The Relationship

Having first reached epidemic proportions in coastal metropolitan areas, COVID-19 has spread around the country. Reported case rates vary across counties from zero to 126 per thousand population (around a state prison in the rural county of Trousdale, Tennessee). Overall, rural counties are underrepresented relative to their share of the population, but a growing proportion of all daily cases and deaths have been reported in rural counties. This analysis uses daily reports for all counties to present the trends and distribution of COVID-19 cases and deaths in rural counties, from late March to May 21, 2020. I describe the relationship between population density and case rates in rural and non-rural counties. Then I focus on noteworthy outbreaks linked to prisons, meat and poultry plants, and nursing homes, many of which are linked to high concentrations of Hispanic, American Indian, and Black populations. The growing epidemic in rural counties is apparently driven by outbreaks concentrated in these institutional settings, which are conducive to transmission. The impact of the epidemic in rural areas may be heightened due to their weaker health infrastructure and more vulnerable populations, especially due to age, socioeconomic status, and health conditions. As a result, the epidemic may contribute to the ongoing decline of health, economic, and social conditions in rural areas.

scholarly journals Gender differences in career dissatisfaction among Pennsylvanian physicians

2017 ◽  
Vol 6 (2) ◽  
pp. 44
Author(s):  
Brandon Vick
Keyword(s):  
Patient Care ◽  
Large Body ◽  
Hospital Setting ◽  
Rural Practice ◽  
Rural County ◽  
Female Physicians ◽  
Lower Odds ◽  
Significant Difference ◽  
The Relationship

Objective: The physician workforce is quickly changing from one that was once male dominated to one that is more gender equal. The relationship between being female and physician career satisfaction is unclear despite a large body of research on the subject. I analyze the relationship between gender, career dissatisfaction, and plans to leave patient care. Female-male differences are calculated for various demographic, specialty, and practice setting subgroups of physicians; particular attention is paid to how various factors interact with gender.Methods: Data comes from the 2012 Pennsylvania Health Workforce Survey of Physicians. I use multivariate, logistic regression to estimate associations between a number of covariates, including gender, and two outcomes: (1) career dissatisfaction, and (2) plans to leave patient care.Results: Female physicians have 12% lower odds than males of reporting career dissatisfaction but no statistically significant difference in plans to leave patient care. Practicing in a hospital setting and in a rural county is associated with higher odds of dissatisfaction among male physicians but lower dissatisfaction among female physicians. Although female physicians own their practice at much lower rates, female owners have much lower odds of planning to leave patient care.Conclusions: Factors associated with career dissatisfaction and plans to leave patient care affect male and female physicians differently, across race, rural practice, specialty, and practice ownership. Policy and research related to physician retention and quality of care should consider the interaction between gender and these factors in the future.

scholarly journals Tourism, Immigrants and Lifestyle Entrepreneurship: The (In)coming of People as a Key Factor for Sustainability of Low-Density Territories—A Case Study in Portugal

2021 ◽  
pp. 149-182
Author(s):  
Anabela Dinis
Keyword(s):  
Traditional Approach ◽  
Well Being ◽  
Low Density ◽  
Income Generation ◽  
Rural County ◽  
Key Factor ◽  
The Creation ◽  
The Impact ◽  
The Relationship

AbstractUsing the lens of the new patterns of mobility and lifestyle entrepreneurship in the context of counterurbanization movements, this chapter explores the relationship between tourism and immigration, beyond the traditional approach of immigrants as tourism entrepreneurs. The study focusses on a Portuguese rural county, Penamacor, which, for several decades, has suffered a continuous exodus of population and the consequent aging of the remaining population but where, recently, there was a spontaneous phenomenon of foreign people arriving and settling in the area. Thus, through the case of Penamacor, this study aims to answer the following questions: Who are these migrants, and what are their motivations for mobility and to settle in the territory? Are they all the same? How do they make a living in Penamacor? In particular, it seeks to understand whether entrepreneurship (in tourism or other sectors) is a possibility of income generation for these immigrants. Furthermore, it intends to understand what the impact of these immigrants in the territory is, concerning the creation of wealth and well-being in the community. Do they act as community entrepreneurs? Does their presence in the territory generate other mobility flows, through the attraction of other (family and friends) tourists or immigrants?

scholarly journals Group and Organizational Safety Norms Set the Stage for Good Post-Fall Huddles

2018 ◽  
Vol 26 (4) ◽  
pp. 465-475 ◽  
Author(s):  
Joseph A. Allen ◽  
Roni Reiter-Palmon ◽  
Victoria Kennel ◽  
Katherine J. Jones
Keyword(s):  
Survey Design ◽  
Leader Behavior ◽  
Critical Access Hospitals ◽  
Organizational Safety ◽  
After Action Review ◽  
Care Workers ◽  
Effective Manner ◽  
Meeting Effectiveness ◽  
After Action Reviews ◽  
The Relationship

We explored group and organizational safety norms as antecedents to meeting leader behaviors and achievement of desired outcomes in a special after-action review case—a post-fall huddle. A longitudinal survey design was used to investigate the relationship between organizational/group safety norms, huddle leader behavior, and huddle meeting effectiveness. The sample included health care workers in critical access hospitals ( N = 206) who completed a baseline safety norm assessment and an assessment of post-fall huddle experiences 3 to 6 months later. Findings indicate that organizational and group safety norms relate to perceived huddle meeting effectiveness through appropriate huddle leader behavior in a partial mediated framework. In contrast to previous research showing after-action reviews predicting group and organizational safety norms, the longitudinal study presented here suggests that group and organizational safety norms set the stage for the enactment of post-fall huddles in an effective manner.

scholarly journals Observational Study of the Distribution and Diversity of Interventional Pain Procedures Among Hospitals in the State of Iowa

2019 ◽  
Vol 3 (22;3) ◽  
pp. E157-E170
Author(s):  
Franklin Dexter
Keyword(s):  
Weighted Least Squares ◽  
The State ◽  
Critical Access Hospitals ◽  
Least Squares Regression ◽  
Pain Medicine ◽  
Hospital Size ◽  
Epidural Injections ◽  
Primary Responsibility ◽  
The Relationship ◽  
Caudal Epidural

Background: Critical access hospitals represent 61% of hospitals in the rural United States, and 68% of hospitals in Iowa. The role of small hospitals, such as critical access hospitals, in providing interventional chronic pain procedures is unknown. Objectives: We evaluated whether: a) the diversity of interventional pain procedures offered by hospitals is related to their size and is attributable principally to lumbosacral epidural injections; b) critical access hospitals contribute substantively to the count and diversity of pain procedures; and c) whether most interventional pain procedures performed at hospitals’ facilities are performed by relatively few proceduralists or by the cumulative activity of many clinicians. Study Design: This research involved an observational cohort design with a sample size of n = 283,940 interventional pain procedures. Setting: Data were collected from hospital-owned facilities in the state of Iowa from July 2012 through September 2017. Methods: The diversity of types of interventional pain procedures performed statewide was quantified in terms of the relative proportions of procedures at each hospital using the Herfindahl index. Bilinear weighted least squares regression quantified the relationship between the inverse of the Herfindahl and the percentage of procedures that were lumbar or caudal epidural. Kendall tau concordances quantified the relationship between counts of interventional pain procedures and hospital size. Using a blinded version of the National Provider Identifier of the clinician with primary responsibility for performing the principal procedure of the ambulatory visit, we calculated the percentage shares of interventional pain procedures performed by the 1% and 5% of proceduralists who performed the most procedures. Results: The diversity of types of procedures substantively differentiated among hospitals. Heterogeneity among hospitals in the proportion of procedures that were lumbar or caudal epidural injections substantively contributed to the heterogeneity among hospitals (P < .001). Hospitals performing more procedures tended to have greater diversity of types of procedures (P < .001). However, the strength of the concordance was small (Kendall τb = 0.332), showing substantial heterogeneity among hospitals. The 82 critical access hospitals statewide cumulatively accounted for 23.9% of interventional pain procedures. The critical access hospitals’ procedures were mostly (67.7%) lumbar or caudal epidural injections (P < .001), greater than the 48.9% of the other 41 hospitals (P < .001). Procedures were concentrated among proceduralists. The 1.0% of the proceduralists performing the most procedures performed 64.8% of procedures. The 5.0% of proceduralists performing the most procedures performed 87.7% of procedures. Limitations: The data are procedures were performed in hospital-owned facilities of Iowa. Conclusions: Although busier pain programs, based on procedures per week, generally performed more types of procedures, the variability was so large that the number of procedures a pain program performs per week cannot validly be used to infer the diversity of the hospital’s pain medicine practice. Hospitals with pain medicine programs that lack diversity in the types of procedures performed may provide limited options for patients and be susceptible to changes in payment for individual procedures. Relatively few proceduralists performed the vast majority of the procedures. Key words: Critical access hospitals, Herfindahl, interventional pain procedures, managerial epidemiology, pain medicine, state outpatient procedure database, lumbar epidural

Alternative Measures of ‘Fear of Crime‘: Results from Crime Audits in a Rural County of England

2007 ◽  
Vol 14 (3) ◽  
pp. 299-320 ◽  
Author(s):  
R. I. Mawby
Keyword(s):  
Fear Of Crime ◽  
Social Characteristics ◽  
Rural Crime ◽  
Rural County ◽  
Night Time ◽  
The Social ◽  
Alternative Measures ◽  
The Relationship ◽  
The Town ◽  
Academic Debate

‘Fear of crime’ has aroused considerable academic debate, with criticisms both of exactly what is being measured and analysis of the relationship between fear and risk. At the same time, national and international surveys have increased reliance on a select ‘package’ of measures of fear. Using more precise questions from a rural crime survey conducted as part of the 2001 Crime Audits, this paper argues that locally contextualised surveys offer the advantage of distinguishing fear or anxiety according to time and place. Respondents here clearly distinguished between the area where they lived and the town they most often visited, and according to daytime or night-time. In each case, levels of fear or anxiety varied according to the social characteristics, experiences and lifestyle of respondents in similar, but not identical, ways to those identified in previous research.

Interstellar gas in the central region of the Galaxy

1967 ◽  
Vol 31 ◽  
pp. 239-251 ◽  
Author(s):  
F. J. Kerr
Keyword(s):  
Central Region ◽  
Galactic Plane ◽  
Neutral Hydrogen ◽  
Continuum Emission ◽  
Galactic Centre ◽  
Interstellar Gas ◽  
Hydrogen Recombination ◽  
The Galaxy ◽  
Centre Region ◽  
The Relationship

A review is given of information on the galactic-centre region obtained from recent observations of the 21-cm line from neutral hydrogen, the 18-cm group of OH lines, a hydrogen recombination line at 6 cm wavelength, and the continuum emission from ionized hydrogen.Both inward and outward motions are important in this region, in addition to rotation. Several types of observation indicate the presence of material in features inclined to the galactic plane. The relationship between the H and OH concentrations is not yet clear, but a rough picture of the central region can be proposed.

The relationship of the scleractinian corals to the rugose corals

Paleobiology ◽  
1980 ◽  
Vol 6 (02) ◽  
pp. 146-160 ◽  
Author(s):  
William A. Oliver
Keyword(s):  
Critical Points ◽  
Scleractinian Corals ◽  
Convincing Evidence ◽  
Early Triassic ◽  
Rugose Corals ◽  
History Of ◽  
The Subject ◽  
Relationship Of ◽  
The Relationship ◽  
Biologic Factors

The Mesozoic-Cenozoic coral Order Scleractinia has been suggested to have originated or evolved (1) by direct descent from the Paleozoic Order Rugosa or (2) by the development of a skeleton in members of one of the anemone groups that probably have existed throughout Phanerozoic time. In spite of much work on the subject, advocates of the direct descent hypothesis have failed to find convincing evidence of this relationship. Critical points are:(1) Rugosan septal insertion is serial; Scleractinian insertion is cyclic; no intermediate stages have been demonstrated. Apparent intermediates are Scleractinia having bilateral cyclic insertion or teratological Rugosa.(2) There is convincing evidence that the skeletons of many Rugosa were calcitic and none are known to be or to have been aragonitic. In contrast, the skeletons of all living Scleractinia are aragonitic and there is evidence that fossil Scleractinia were aragonitic also. The mineralogic difference is almost certainly due to intrinsic biologic factors.(3) No early Triassic corals of either group are known. This fact is not compelling (by itself) but is important in connection with points 1 and 2, because, given direct descent, both changes took place during this only stage in the history of the two groups in which there are no known corals.

Choosing a Markov blanket

2020 ◽  
Vol 43 ◽  
Author(s):  
Thomas Parr
Keyword(s):  
Markov Blanket ◽  
Target Article ◽  
The Relationship

Abstract This commentary focuses upon the relationship between two themes in the target article: the ways in which a Markov blanket may be defined and the role of precision and salience in mediating the interactions between what is internal and external to a system. These each rest upon the different perspectives we might take while “choosing” a Markov blanket.

Tinkering with cognitive gadgets: Cultural evolutionary psychology meets active inference

2019 ◽  
Vol 42 ◽  
Author(s):  
Paul Benjamin Badcock ◽  
Axel Constant ◽  
Maxwell James Désormeau Ramstead
Keyword(s):  
Evolutionary Psychology ◽  
Research Program ◽  
Active Inference ◽  
Innovative Research ◽  
Cognitive Faculties ◽  
Cultural Evolutionary ◽  
The Relationship

Abstract Cognitive Gadgets offers a new, convincing perspective on the origins of our distinctive cognitive faculties, coupled with a clear, innovative research program. Although we broadly endorse Heyes’ ideas, we raise some concerns about her characterisation of evolutionary psychology and the relationship between biology and culture, before discussing the potential fruits of examining cognitive gadgets through the lens of active inference.

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