scholarly journals Preparedness of non-hospital health centers to manage patients with life-threatening emergency conditions: findings from a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Homayoun Sadeghi-Bazargani ◽  
Mehrdad Amir-Behghadami ◽  
Masoumeh Gholizadeh ◽  
Ali Janati ◽  
Farzad Rahmani
Keyword(s):  
Rural Areas ◽  
Work Experience ◽  
Healthcare Providers ◽  
Geographic Area ◽  
Health Centers ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Life Threatening ◽  
New Perspective ◽  
Urban And Rural Areas

Abstract Background Management of Life-threatening Emergency (LTE) patients in urban and rural areas is an important challenge, which can affect pre-hospital mortality rate. Therefore, Non-hospital Health Center (NHHC) must be prepared to manage such emergency cases that may occur in the geographic area where these centers act. The aim of this study was to explore domains related to the preparedness of NHHCs to manage LTE patients through resorting to healthcare providers’ and experts’ perspectives. Methods A qualitative exploratory study was applied using Semi-Structured Interviews (SSIs) and Focus Group Discussions (FGDs). Prior to beginning data collection, the study and its objectives were explained to the participants and their informed consents were obtained. Then, SSIs and FGDs were conducted by two trained researchers using an interview guide, which was developed through literature review and consulting experts. In total, 12 SSIs were done with the providers at different NHHCs in Tabriz. In addition, 2 FGDs were conducted with the specialists in Emergency Medicine (EM) and Primary Health Care (PHC), and the executives of health centers, with over 5 years of work experience, and Emergency Medical Services (EMS) experts. Purposive sampling method was used in this study. All SSIs and FGDs were audio recorded and subsequently transcribed. Framework Analysis was employed to manually analyze the interview transcripts from all the SSIs and FGDs. Results The interview transcripts analysis resulted in the emergence of 3 themes and 11 sub-themes, categorized according to Donabedian’s triple model. 5 sub-themes were related to input, including medical equipment and supplies, environmental infrastructures of the centers, emergency medicines, human resource, and protocols, guidelines and policies. 4 sub-themes were related to process, including providing clinical services, medicine storage capacity, maintenance of equipment, and management process. Finally, 2 sub-themes were related to outcome, which were patients’ satisfaction with the quality of care and improved survival of LTE patients. Conclusions The results of this study can provide a new perspective for health managers and policy makers on how to evaluate the preparedness of NHHCs in managing LTE patients. In addition, it will be used to develop instruments to measure the preparedness of these centers.

scholarly journals ALS Curriculum Implementation for Juvenile Delinquents in Urban and Rural Areas in the Philippines: A Comparative Analysis

2020 ◽  
Vol 1 (1) ◽  
pp. 1-14
Author(s):  
Vandon Borela
Keyword(s):  
Rural Areas ◽  
Juvenile Delinquents ◽  
Urban Areas ◽  
The Philippines ◽  
Learning System ◽  
Structured Interviews ◽  
Alternative Learning ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Urban And Rural Areas

Purpose: The aim of this research study is to evaluate the implementation of Alternative Learning System (ALS) curriculum offered to juvenile delinquents in urban and rural areas in the Philippines. The study also aims to determine whether the current education programs meet the needs of the juvenile delinquents with reference to Juvenile delinquency acts. The study is an attempt to highlight the aspects of Alternative Learning System (ALS) that should be developed.  Approach/Methodology/Design: The study is qualitative and conducted in Marikina City and Rizal province, the Philippines. This study used exploratory study analysis. The respondents are the Alternative Learning System (ALS) teachers. For data collection, three semi-structured interviews were employed and the respondents’ answers were categorized using analytical coding to compare and analyze the implementation of the ALS curriculum for juvenile delinquents. Findings: The interpretation and analysis of the data collected shows that the ALS teachers from both the rural and urban areas have the same experiences on the implementation of the ALS program for juvenile delinquents in terms of curriculum, instruction and assessment. Furthermore, the teachers gave an emphasis that once the juvenile delinquents undergo the program, they are given a new hope and new direction in life to pursue their dreams. Lastly, the teachers from both areas have the same suggestions for the improvement of the implementation of the program, such as additional funds for the development of quality learning materials, increasing the number of learning centers, and designing various forms of assessment.  Practical Implications: The study will contribute positively to the understanding of Alternative learning System. The significance of this study lies in the comparison of the alternative learning system curriculum and how it is implemented to the juvenile delinquents in urban and in rural areas. Originality/value: This study engages ALS teachers in assessing the ALS curriculum, reflecting actual experiences to meet the expectations and needs of the juvenile delinquents.

Basic Management of Life-Threatening Emergencies: The Importance of Developing the Instrument to Assess Nonhospital Health Centers’ Preparedness

2020 ◽  
Vol 41 (2) ◽  
pp. 159-161 ◽  
Author(s):  
Ali Janati ◽  
Mehrdad Amir-Behghadami ◽  
Homayoun Sadeghi-Bazargani ◽  
Farzad Rahmani
Keyword(s):  
Geographic Area ◽  
Health Centers ◽  
Life Threatening

We presented a commentary on published studies on the “preparedness of non-hospital centers in dealing with life-threatening emergencies” to emphasize the importance of developing, validating, and piloting an instrument to assess the preparedness of these centers when life-threatening emergencies occur in their geographic area.

Locating the locale of local food: The importance of context, space and social relations

2014 ◽  
Vol 30 (6) ◽  
pp. 563-576 ◽  
Author(s):  
Brídín E. Carroll ◽  
Frances Fahy
Keyword(s):  
Social Relations ◽  
Rural Areas ◽  
Urban Areas ◽  
Food System ◽  
Local Food ◽  
Social Contexts ◽  
Spatial Proximity ◽  
Future Research ◽  
Structured Interviews ◽  
Urban And Rural Areas

AbstractLocalization is one process/outcome that is proffered as key to the ‘grand challenges’ that currently face the food system. Consumers are attributed much agency in this potential transformation, being encouraged from all levels of society to exert their consumer muscle by buying local food. However, due to the social construction of scale it cannot be said that ‘local food’ is a definite entity and consumers understand the term ‘local food’ differently depending on their geographic and social context. As such, the research upon which this paper is based aimed to provide a nuanced understanding of how consumers in the particular spatial and social contexts of urban and rural Ireland understood the concept of ‘local food’. A specific objective was to test the theory that these consumers may have fallen into the ‘local trap’ by unquestioningly associating food from a spatially proximate place with positive characteristics. A three-phase mixed methodology was undertaken with a sample of consumers dwelling in urban and rural areas in both Dublin and Galway, Ireland: 1000 householders were surveyed; 6 focus group discussions took place; and 28 semi-structured interviews were carried out. The results presented in this paper indicate that for most participants in this study, spatial proximity is the main parameter against which the ‘localness’ of food is measured. Also, it was found that participants held multiple meanings of local food and there was a degree of fluidity in their understandings of the term. The results from the case study regions highlight how participants’ understandings of local food changed depending on the food in question and its availability. However, the paper also indicates that as consumers move from one place to another, the meaning of local food becomes highly elastic. The meaning is stretched or contracted according to the perceived availability of food, greater or lesser connections to the local producer community and the relative geographic size of participants’ locations. Our analysis of findings from all three phases of this research revealed a difference in understandings of local food among participants resident in urban and rural areas: participants dwelling in rural areas were more likely than those in urban areas to define local food according to narrower spatial limits. The paper concludes with an overview of the practical and theoretical significance of these results in addressing the current dearth of research exploring the meaning of local food for consumers and suggests avenues for future research.

scholarly journals Allergic reactions to macrolide antibiotics in a 15-year-old population

2021 ◽  
Vol 12 (2) ◽  
pp. 346-353
Author(s):  
Kanita Perić
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Total Population ◽  
Allergic Reactions ◽  
Skin Reactions ◽  
Life Threatening ◽  
Statistical Program ◽  
Study Population ◽  
Urban And Rural Areas ◽  
Almost All

Macrolides are antibiotics that can be used to treat various infections. Allergic reactions to macrolides are rare, but may include minor to severe skin reactions, as well as systemic life-threatening reactions such as anaphylaxis. Hypersensitivity reactions can occur in any mode of administration and to almost all antibiotics. The purpose of the study was to determine whether there are reactions to macrolides in the study population, and to determine statistically significant differences in the occurrence of allergic reactions to macrolides between boys and girls of the same age and whether there are differences in the occurrence of allergic reactions between respondents in urban and rural areas. The sample consists of 1605 respondents, the sample was randomly selected and stratified by sex, and all data were processed in the statistical program. The results of the research show that 9.1% of the total population of boys and girls aged 15 from the Tuzla Canton are allergic to some type of antibiotic. The percentage of allergic reactions in the total population of 15-year-olds from suburban settlements is slightly higher than among peers in urban areas, but the differences are not statistically significant. A higher rate of allergic reactions was recorded in the group of boys from urban and rural areas. Macrolide allergies were found only in a group of boys in rural areas. This study confirmed that allergies to macrolides are rare and revealed differences in the occurrence of allergic reactions between girls and boys.

scholarly journals Factors that influence enrollment in syringe services programs in rural areas: a qualitative study among program clients in Appalachian Kentucky

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Umedjon Ibragimov ◽  
Katherine E. Cooper ◽  
Evan Batty ◽  
April M. Ballard ◽  
Monica Fadanelli ◽  
...  
Keyword(s):  
Grounded Theory ◽  
Rural Areas ◽  
Healthcare Providers ◽  
Individual Characteristics ◽  
Barriers And Facilitators ◽  
Risk Environment ◽  
Structured Interviews ◽  
Meso Level ◽  
Appalachian Kentucky ◽  
Low Threshold

Abstract Background Enrolling sufficient number of people who inject drugs (PWID) into syringe services programs (SSP) is important to curtail outbreaks of drug-related harms. Still, little is known about barriers and facilitators to SSP enrollment in rural areas with no history of such programs. This study’s purpose was to develop a grounded theory of the role of the risk environment and individual characteristics of PWID in shaping SSP enrollment in rural Kentucky. Methods We conducted one-on-one semi-structured interviews with 41 clients of 5 SSPs that were established in rural counties in Appalachian Kentucky in 2017–2018. Interviews covered PWID needs, the process of becoming aware of SSPs, and barriers and facilitators to SSP enrollment. Applying constructivist grounded theory methods and guided by the Intersectional Risk Environment Framework (IREF), we applied open, axial and selective coding to develop the grounded theory. Results Stigma, a feature of IREF’s meso-level social domain, is the main factor hampering SSP enrollment. PWID hesitated to visit SSPs because of internalized stigma and because of anticipated stigma from police, friends, family and healthcare providers. Fear of stigma was often mitigated or amplified by a constellation of meso-level environmental factors related to healthcare (e.g., SSPs) and social (PWID networks) domains and by PWID’s individual characteristics. SSPs mitigated stigma as a barrier to enrollment by providing low threshold services in a friendly atmosphere, and by offering their clients program IDs to protect them from paraphernalia charges. SSP clients spread positive information about the program within PWID networks and helped their hesitant peers to enroll by accompanying them to SSPs. Individual characteristics, including child custody, employment or high social status, made certain PWID more susceptible to drug-related stigma and hence more likely to delay SSP enrollment. Conclusions Features of the social and healthcare environments operating at the meso-level, as well as PWID’s individual characteristics, appear to enhance or mitigate the effect of stigma as a barrier to SSP enrollment. SSPs opening in locations with high stigma against PWID need to ensure low threshold and friendly services, protect their clients from police and mobilize PWID networks to promote enrollment.

scholarly journals Nutrition gap in children, urban-rural

2020 ◽  
Vol 54 ◽  
pp. 111
Author(s):  
Jhael N. Bermúdez ◽  
Daniel Ayala ◽  
Oscar F. Herrán
Keyword(s):  
Rural Areas ◽  
Geographic Area ◽  
Acute Malnutrition ◽  
Cross Sectional ◽  
Stunted Growth ◽  
Urban Rural ◽  
Economic Developement ◽  
Urban And Rural Areas ◽  
Access To Food ◽  
And Control

OBJECTIVE: To analyze the nutritional situation of children under five years old from both urban and rural areas of Colombia. METHOD: Analytical study, based on cross-sectional data, collected from ENSIN-2015. The sample consisted of 12,256 children aged between 0 and 4 years old. We calculated the prevalence ratios (PR) with their respective 95% confidence interval (95%CI). PR were assessed by binomial regression models with malnutrition or overweight as the dependent variable and geographic area as the explanatory variable. We used context variables to adjust the estimated PR and control the confounder within. RESULTS: Acute malnutrition (weight-for-height) had a prevalence of 1.6%, while overweight had a 5.6% rate. No differences per geographic zone in the weight-for-height indicator were found. Stunted growth – chronic malnutrition – was higher in the rural area (PR = 1.2; 95%CI 1–1.53; p = 0.050). Prevalences adjusted by variables related to structural, social and economic developement showed that both the household chief’s educational level and the food insecurity of the area account for malnutrition. CONCLUSION: The height-for-age indicator works better to establish development level. Measures against coverage, relevance and quality of education and access to food can harm the nutritional status of the children.

scholarly journals ROSE – the learning health care system in the Osnabrück-Emsland / ROSE – das lernende Gesundheitssystem in der Region Osnabrück-Emsland

2016 ◽  
Vol 3 (1) ◽  
pp. 14-20
Author(s):  
Ursula Hübner ◽  
Birgit Babitsch ◽  
Stefanie Kortekamp ◽  
Nicole Egbert ◽  
Andrea Braun von Reinersdorff
Keyword(s):  
Rural Areas ◽  
Healthcare Providers ◽  
Feedback Mechanism ◽  
Driving Mechanism ◽  
Lower Saxony ◽  
Local Authorities ◽  
University Of Applied Sciences ◽  
Scientific Results ◽  
Urban And Rural Areas ◽  
The University

AbstractThe University Osnabrück and the University of Applied Sciences Osnabrück and regional partners recently signed a Memorandum of Understanding to establish a Healthcare Campus. The aim of the Healthcare Campus is to develop innovative concepts for delivering patient care in the Osnabrück region. It brings together academia, networks, enterprises, healthcare providers and local authorities. Financed by the State of Lower Saxony, the project „The Learning Healthcare System in the Region Osnabrück Emsland (ROSE)” is a central activity within the Healthcare Campus. This project makes use of the learning paradigm. Providing feedback is the driving mechanism to achieve progress. Research provides the feedback to the healthcare providers and local authorities, in order to optimise the current practice in urban and rural areas of the region. The feedback mechanism is based on data from practice, which play the central role in turning evidence-based-practice into practice-based-evidence and putting translation at the start, not at the end of the project. Both universities coordinate their activities within the ROSE project to attain the goals of the Healthcare Campus Osnabrück. The model with five measures for the implementation is presented. It builds upon the wealth of existing bachelor and masters programs in healthcare and unites research, PhD programs and translation of scientific results into practice.

scholarly journals Clinical Characteristics of Vulnerable Populations Hospitalized and Diagnosed with COVID‑19 during Second Wave in Buenos Aires, Argentina.

2022 ◽  
Author(s):  
Silvia Kochen ◽  
Alejandro Yacobitti ◽  
Lisandro Otero ◽  
Valeria Doldan Arruabarrena ◽  
Florencia del Marmol ◽  
...  
Keyword(s):  
Vulnerable Populations ◽  
Rural Areas ◽  
Buenos Aires ◽  
Medical Condition ◽  
Intensive Therapy ◽  
Health Centers ◽  
Levels Of Care ◽  
Number Of Patients ◽  
Urban And Rural Areas ◽  
Second Wave

Abstract There are a few in Argentina publications regarding the presentation of patients with COVID-19 requiring hospitalized and emergency care in vulnerable populations that compares the first and second wave, and it has few reports in developing countries. The objective is to determine whether in the care of vulnerable patients, to succeed against COVID-19, multiple public health tools and interventions necessary to minimize morbidity and mortality. The study is a prospective cohort investigation of 3028 patients during second wave with lab-confirmed COVID-19, who required any of the Health Centers response from April 1, 2021, to June 30, 2021. In a previous publication, our group analyzed the situation of hospitalized patients during the first wave in the same region, "Southeast Network" (SN), Buenos Aires Metropolitan Area (AMBA). SN with 1.8 million inhabitants residing in urban and rural areas. A total of 14 health centers with different levels of care complexity provide care to patients in the region. The information of each patient with COVID-19 evaluated by SN, was incorporated in an Epidemiological Dashboard. The investigation was designed and reported with consideration of observational studies in epidemiology. A total of 57.9% patients were men, and the mean age (SD) was 52.1 (13.5) years. Sixty four percent patients with pre-existing diseases, most frequent hypertension and diabetes, but diabetes, obesity, and cardiovascular disease presented higher risk. A total of 24.7% were hospitalized in Intensive Therapy Unit. The mortality of the cohort was 22.9%. Mortality was higher for patients aged 65 or more, and for those had some pre-existing disease. But, it was a slightly more than double that in the first wave, it is possible mainly due to the fact that more than doubled of patients in Second wave required hospitalization in ITU, compared to First wave. The patients presented greater severity of their medical condition at the time of their hospitalization. These findings were similar to those reported by other authors. Another possible cause of the high number of patients in the period studied is due to the fact that most of the hospitalized population had not been vaccinated. The health system was able to respond to the demand.

scholarly journals Planned early delivery for late preterm pre-eclampsia in a low- and middle-income setting: a feasibility study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Alice Beardmore-Gray ◽  
Nicola Vousden ◽  
Sergio A. Silverio ◽  
Umesh Charantimath ◽  
Geetanjali Katageri ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Controlled Trial ◽  
Healthcare Providers ◽  
Complex Interventions ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Middle Income ◽  
Resource Setting ◽  
Adverse Pregnancy ◽  
Low And Middle Income

Abstract Background Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity globally. Planned delivery between 34+0 and 36+6 weeks may reduce adverse pregnancy outcomes but is yet to be evaluated in a low and middle-income setting. Prior to designing a randomised controlled trial to evaluate this in India and Zambia, we carried out a 6-month feasibility study in order to better understand the proposed trial environment and guide development of our intervention. Methods We used mixed methods to understand the disease burden and current management of pre-eclampsia at our proposed trial sites and explore the acceptability of the intervention. We undertook a case notes review of women with pre-eclampsia who delivered at the proposed trial sites over a 3-month period, alongside facilitating focus group discussions with women and partners and conducting semi-structured interviews with healthcare providers. Descriptive statistics were used to analyse audit data. A thematic framework analysis was used for qualitative data. Results Case notes data (n = 326) showed that in our settings, 19.5% (n = 44) of women with pre-eclampsia delivering beyond 34 weeks experienced an adverse outcome. In women delivering between 34+0 and 36+6 weeks, there were similar numbers of antenatal stillbirths [n = 3 (3.3%)] and neonatal deaths [n = 3 (3.4%)]; median infant birthweight was 2.2 kg and 1.9 kg in Zambia and India respectively. Lived experience of women and healthcare providers was an important facilitator to the proposed intervention, highlighting the serious consequences of pre-eclampsia. A preference for spontaneous labour and limited neonatal resources were identified as potential barriers. Conclusions This study demonstrated a clear need to evaluate the intervention and highlighted several challenges relating to trial context that enabled us to adapt our protocol and design an acceptable intervention. Our study demonstrates the importance of assessing feasibility when developing complex interventions, particularly in a low-resource setting. Additionally, it provides a unique insight into the management of pre-eclampsia at our trial settings and an understanding of the knowledge, attitudes and beliefs underpinning the acceptability of planned early delivery.

Sign in / Sign up

Export Citation Format

Share Document