Rural challenges in a decade of crowdfunding for cancer care.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14013-e14013
Author(s):  
Ahmed Khalil ◽  
Sheetal L. Higbee ◽  
Khalid Khasawinah
Keyword(s):  
Social Network ◽  
Rural Areas ◽  
Cancer Care ◽  
Urban Areas ◽  
Metastatic Cancer ◽  
Cancer Type ◽  
Treatment Type ◽  
Significant Difference ◽  
The Us ◽  
Rural Patients

e14013 Background: Improving access and affordability to oncology care for patients in rural America is a national imperative given growing health disparities in cancer morbidity and mortality. Crowdfunding has emerged as a rescue tool for cancer patients facing difficulties paying for treatment costs. While such platforms present opportunities to increase access, patients who live in rural areas face increased challenges compared to those in urban areas. Methods: We crawled the pages of GoFundMe fundraising campaigns from 2010 – 2020 using a custom Python script. We then indexed these pages for campaigns focused on cancer treatment in the US and identified variables of interest using text analysis, including cancer type, demographics, clinical characteristics, and social network features, resulting in 151,051 campaigns. Rural status was identified by analyzing zip codes against the database provided by the US Census. Descriptive statistics, χ2, and t-tests were used to compare variables by rural status using R 3.6.3 software. Results: The 10 most prevalent types of cancer in our data were metastatic (26.8%), breast (17.0%), lung (12.4%), colorectal (6.6%), brain (6.3%), liver (4.2%), leukemia (3.2%), stomach (2.7%), pancreas (2.6%), and bone (2.1%). We found a statically significant difference between urban and rural areas in key variables including unemployment rate, insurance status, metastatic cancer rate, treatment type, social network reach, and fundraising totals. Conclusions: Since the 2011 launch of (ASCO) task force for improving cancer care of rural patients, a tremendous effort has been directed towards that. In our study of 151,051 patients over a 10-year period, we found that disparities between rural and urban America in cancer are not just limited to clinical management, but also in an era of crowdfunding, rural patients are still struggling to get the attention they need. We must increase efforts to raise awareness and find solutions to improve access to cancer care. [Table: see text]

Differences in rural versus urban cancer patients’ perception of care coordination.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 114-114
Author(s):  
Izumi Okado ◽  
Michelle Hashimoto ◽  
Randall F. Holcombe
Keyword(s):  
Cancer Patients ◽  
Care Coordination ◽  
Rural Areas ◽  
Cancer Care ◽  
Care Delivery ◽  
Self Report ◽  
Cancer Type ◽  
Rural And Urban ◽  
Perception Of Care ◽  
Rural Patients

114 Background: Although advances in anticancer treatment have improved survival of patients with cancer overall, cancer mortality rates remain disproportionately high in rural areas. Disparities in rural cancer health outcomes are partially attributed to challenges with care coordination in rural areas. However, little is known about rural-urban differences in patients’ perception of cancer care coordination. In this exploratory study, we compared rural and urban cancer patients’ perception of care coordination (CC) using a Care Coordination Instrument (CCI), a validated self-report measure. Methods: We conducted a secondary analysis of cross-sectional survey data from two community-based cancer care delivery studies from 2018 and 2019 focused on cancer patients’ perception of CC. Patients receiving active therapy for any cancer completed a 29-item CCI. The CCI assesses overall perceptions of CC (Total) and across 3 domains: Communication, Navigation, and Operational. The rural patient cohort was derived from the American Cancer Society Hope Lodge Hawaii, which provides lodging for patients from neighbor islands (rural) receiving cancer care on Oahu (urban). The urban comparison group included patients residing on Oahu. Multivariate regression analyses were conducted to compare rural and urban patients’ perception of CC with adjustment for age, gender, and cancer type. Results: Data from 243 patients were analyzed; 23 (9.5%) were rural and 220 (90.5%) were urban. The rural and urban groups were similar with respect to patient demographics (age, gender) and clinical status. Rural patients reported significantly lower overall mean CCI scores than urban patients (54.7 vs 61.6; p = .02). Rural-urban differences in patients’ perception of CC were found for Communication (29.5 vs 35.1; p = .004) and Operational (19.7 vs 22.0; p = .02) domains. There were no rural-urban differences for Navigation. Conclusions: Our results demonstrate that rural patients had significantly poorer perception of care coordination overall than urban patients. Specifically, the observed rural vs urban differences in patients’ perception of care coordination were related to communication and operational challenges. Required coordination with a patient navigator to facilitate access to Hope Lodge may have confounded analysis in the Navigation domain. These findings highlight the need for interventions to address communication and operational CC challenges for rural patients in order to improve the quality of cancer care and reduce health disparities for rural cancer patients.

scholarly journals Urban–rural disparity in cancer incidence in China, 2008–2012: a cross-sectional analysis of data from 36 cancer registers

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042762
Author(s):  
Shuai Yuan ◽  
Shao-Hua Xie
Keyword(s):  
Cancer Incidence ◽  
Rural Areas ◽  
Urban Areas ◽  
Incidence Rates ◽  
Cancer Type ◽  
Anatomic Site ◽  
Cross Sectional ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Urban Rural

ObjectiveThe substantial differences in socioeconomic and lifestyle exposures between urban and rural areas in China may lead to urban–rural disparity in cancer risk. This study aimed to assess the urban–rural disparity in cancer incidence in China.MethodsUsing data from 36 regional cancer registries in China in 2008–2012, we compared the age-standardised incidence rates of cancer by sex and anatomic site between rural and urban areas. We calculated the rate difference and rate ratio comparing rates in rural versus urban areas by sex and cancer type.ResultsThe incidence rate of all cancers in women was slightly lower in rural areas than in urban areas, but the total cancer rate in men was higher in rural areas than in urban areas. The incidence rates in women were higher in rural areas than in urban areas for cancers of the oesophagus, stomach, and liver and biliary passages, but lower for cancers of thyroid and breast. Men residing in rural areas had higher incidence rates for cancers of the oesophagus, stomach, and liver and biliary passages, but lower rates for prostate cancer, lip, oral cavity and pharynx cancer, and colorectal cancer.ConclusionsOur findings suggest substantial urban–rural disparity in cancer incidence in China, which varies across cancer types and the sexes. Cancer prevention strategies should be tailored for common cancers in rural and urban areas.

Civic Participation and Social Embeddedness: Differences Between Urban and Rural Communities

2021 ◽  
Vol 3 (1) ◽  
pp. 45-67
Author(s):  
Tuuli-Marja Kleiner
Keyword(s):  
Social Network ◽  
Rural Communities ◽  
Survey Data ◽  
Rural Areas ◽  
Urban Areas ◽  
Civic Participation ◽  
Regional Level ◽  
Social Embeddedness ◽  
The Social ◽  
Multi Level

Does civic participation lead to a large social network? This study claims that high levels of civic participation may obstruct individual social embeddedness. Using survey data from the German Survey on Volunteering (Deutscher Freiwilligensurvey; 1999–2009), this study conducts macro- as well as multi-level regressions to examine the link between civic participation and social embeddedness. Findings reveal that civic participation on the sub-national regional level is not generally associated with social embeddedness, but it affects the participants’ and non-participants’ possibilities for friendships differently. This holds especially true in urban areas, but the effect cannot be found in rural areas. The analysis has implications for further research to enhance the social embeddedness of the excluded.

Impact of adenotonsillectomy on the quality of life of patients operated on at the Hospital de Clínicas, Paraguay

2021 ◽  
pp. 1-7
Author(s):  
Carlos Mena Canata ◽  
Rebeca Noemí Ruiz Vallejos
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Rural Areas ◽  
Urban Areas ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Before And After ◽  
The Impact

The objective of this study is to determine the impact of adenotonsillectomy on the quality of life of postoperative patients.The study is observational, cross-sectional, and retrospective. The files of all postoperative adenotonsillectomy patients in Otorhinolaryngology Service, Hospital de Clínicas, San Lorenzo Paraguay. The Obstructive sleep apnea – 18 questionnaire (OSA 18) was applied, asking patients about symptoms before and after surgery. An effective sample of 143 postoperative patients was obtained. The average age was 6.05 ± 2.08 years, 55.10% (81) were male and 44.89% (66) were female, 65.30% (96) were from urban areas and 34.69% (51) from the rural areas. The t test was performed for means of two paired samples, comparing the results of the Obstructive sleep apnea – 18 questionnaire surveys before and after surgery which presented a significant difference (p <0.05) with a tendency to improve the quality of life after surgery. It has been shown that there is a significant difference, a considerable improvement in the quality of life of patients after adenotonsillectomy.

scholarly journals Pathogenicity and non-opportunistic character of Blastocystis spp.: a hospital-based survey in Central Cameroon

2018 ◽  
Vol 12 (05) ◽  
pp. 373-379 ◽  
Author(s):  
Stéphanie Jupsa-Mbiandou ◽  
Samuel Fosso ◽  
Edimo Billé ◽  
Tito T Mélachio-Tanekou ◽  
Gideon Ajeagah-Aghaindum ◽  
...  
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Age Groups ◽  
Clinical Signs ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Significant Difference ◽  
Blastocystis Spp ◽  
Stool Samples ◽  
Hiv Negative

Introduction: Blastocystis spp. is a protist found in humans. Although usually the most frequent protozoa found in stool samples of both symptomatic and healthy subjects, its pathogenic or rather opportunistic role is yet to be clearly elucidated. To attempt to fill this gap, a cross-sectional study was conducted to compare the frequency of Blastocystis spp. in HIV positive (HIV+) versus HIV negative (HIV-) individuals in four health facilities of the Center Region of Cameroon. Methodology: Stool samples were collected from 283 HIV positive and 245 HIV negative subjects and analyzed using direct diagnostic tests. Results: A total of 46 (8.7%) individuals were found infected with Blastocystis spp., including 6.7% HIV positive and 11.0% HIV negative. This species was more frequent in urban and semi-urban areas than in rural areas, but evenly distributed among genders and age groups as well as among all sectors of activity. The prevalence of Blastocystis spp. (11.3%) was higher in HIV+ patients with a CD4 count ≥ 500 cells / mm3, but no significant difference was found among HIV clinical stages. Likewise prevalence, the mean number of cysts per gram of stool was similar between HIV positive and HIV negative individuals. People infected with Blastocystis spp. showed diverse clinical signs, but only flatulence was significantly more prevalent. The frequencies of these clinical signs were not related to HIV status. Conclusion: No clear relationship links the infection with Blastocystis spp. to HIV, although its presence was associated with digestive disorder, suggesting that this parasite might not be opportunist.

scholarly journals Perbedaan Pengetahuan dan Sikap Remaja tentang Infeksi Menular Seksual di SMA/SMK Perkotaan dan Pedesaan

e-CliniC ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Erald J. Lanes ◽  
Suzanna P. Mongan ◽  
John J. E. Wantania
Keyword(s):  
High Schools ◽  
Sexually Transmitted Infections ◽  
Rural Areas ◽  
Urban Areas ◽  
Cross Sectional ◽  
Equal Distribution ◽  
Sexually Transmitted ◽  
Knowledge And Attitudes ◽  
Significant Difference ◽  
Premarital Sexual

Abstract: Premarital sexual behavior in adolescence is a high risk factor for sexually transmitted infections. Sexually transmitted infections (STIs) are infections that are generally transmitted through sexual contact. Differences in social, cultural, and economic factors were found to affect the incidence and prevalence of sexually transmitted infections between different groups in a population. These are likely caused by differences in the knowledge and attitudes of adolescents living in urban and rural areas. This study was aimed to obtain the differences in the level of knowledge and attitudes toward STIs of adolescents in urban and rural area schools. This was a descriptive study with a cross-sectional design conducted on 50 adolescents of urban senior high schools and 50 adolescents of rural senior high schools/vocational high schools. Questionnaires were distributed via email by using Google form. The results showed that adolescents living in urban areas had good knowledge about STIs meanwhile adolescents living in rural areas had fair knowledge. The attitudes about STIs of most adolescents living in urban areas and rural areas were good. In conclusion, adolescents living in urban areas had better knowledge about STIs than those living in rural areas, however, there was no significant difference in attitudes about STI between the two regions. Equal distribution of education in Indonesia is needed in urban as well as in rural areas.Keywords: sexually transmitted infections, adolescents, knowledge, attitudes, urban and rural Abstrak: Perilaku seksual pranikah pada usia remaja merupakan faktor risiko tinggi terhadap infeksi menular seksual (IMS). Infeksi menular seksual merupakan infeksi yang umumnya ditularkan melalui hubungan seksual. Perbedaan faktor sosial, kultural maupun ekonomi dapat memengaruhi insiden dan prevalensi IMS antara kelompok yang berbeda dalam suatu populasi. Hal tersebut kemungkinan besar disebabkan oleh adanya perbedaan pengetahuan dan sikap remaja yang tinggal di wilayah perkotaan dan pedesaan. Penelitian ini bertujuan untuk mengetahui perbedaan tingkat pengetahuan dan sikap remaja terhadap IMS di sekolah wilayah perkotaan dan pedesaan. Jenis penelitian ialah deskriptif dengan desain potong lintang dan kuesioner didistribusikan secara daring menggunakan Google Form. Responden ialah 50 remaja di SMA wilayah perkotaan dan 50 remaja di SMA/SMK wilayah pedesaan. Hasil penelitian mendapatkan bahwa pengetahuan remaja tentang IMS pada siswa SMA perkotaan sebagian besar berada dalam kategori baik sedangkan pada siswa SMA/SMK pedesaan sebagian besar berada dalam kategori cukup. Sikap remaja tentang IMS pada siswa SMA/SMK perkotaan dan pedesaan sebagian besar baik. Simpulan penelitian ini ialah remaja perkotaan memiliki pengetahuan yang lebih baik mengenai IMS dibandingkan remaja di pedesaan namun tidak terdapat perbedaan sikap remaja yang bermakna mengenai IMS antara kedua wilayah. Pemerataan pendidikan di Indonesia dibutuhkan di wilayah perkotaan dan pedesaan.Kata kunci: infeksi menular seksual, remaja, pengetahuan, sikap, perkotaan dan pedesaan

scholarly journals The Dynamic Impact of Nonprofit Organizations: Are Health-Related Nonprofit Organizations Associated with Improvements in Obesity at the Community Level?

2019 ◽  
Vol 10 (3) ◽  
Author(s):  
Alyson Haslam ◽  
Rebecca Nesbit ◽  
Robert K. Christensen
Keyword(s):  
Nonprofit Organizations ◽  
Rural Areas ◽  
Urban Areas ◽  
Local Community ◽  
Community Level ◽  
Positive Health ◽  
Private Organizations ◽  
The Us ◽  
Health Related ◽  
Positive Health Outcomes

AbstractNonprofit organizations have the potential to influence public health by filling voids not filled by government or private organizations. Here we investigate whether the presence of health-related nonprofit organizations at the local community level helps to improve community-level obesity. This study used a time-series design using a random effects model to determine whether the entrance or exits of health nonprofits at the county level was associated with lower obesity rates in the US one and two years following the entrance or departures of nonprofits. The effect was small but significant in urban areas, with a smaller effect in rural areas. Our findings suggest that the presence of health nonprofits is associated with positive health outcomes, in this case obesity. The plausibility may be explained through the increased role nonprofits play in fostering social capital and increased promotion of health-related issues.

scholarly journals School environment and obesity in primary schools. An analysis of the WHO European COSI in Austria

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Aufschnaiter ◽  
K Schindler ◽  
B Fuchs-Neuhold ◽  
K Maruszczak ◽  
E Pail ◽  
...  
Keyword(s):  
Nutrition Education ◽  
Rural Areas ◽  
School Environment ◽  
Urban Areas ◽  
Primary Schools ◽  
Secondary Data ◽  
Overweight And Obesity ◽  
Substantial Contribution ◽  
Significant Difference ◽  
School Playgrounds

Abstract Background Overweight and obesity in childhood and the associated secondary diseases are constantly on the increase. Studies show that the school environment can have an influence on the weight of children. The Childhood Obesity Surveillance Initiative (COSI) of the WHO is a Europe-wide epidemiological monitoring of anthropometric sizes of school children aged six to nine, with Austria participating in COSI for the first time in 2016. Methods A retrospective secondary data analysis based on two standardized questionnaires was performed. On the one hand, data on determinants specific to the school field were collected, on the other hand anthropometric data of children in third grade were measured. Across Austria, data from 97 schools and 2530 children were collected and evaluated using descriptive and inductive statistical methods. Results In 43,3 % of the schools, an existing playground can be used outside school opening hours. 73,2 % of the schools integrate nutrition education into their school curriculum either as a separate subject or in combination with another subject. Milk and dairy products are available in 60,8 % of schools, fresh fruit in 63,9 % and vegetables in 51,5 %. 28,3 % of the examined, 8 to 9-year-old children are overweight or obese (n = 658), while boys have a significant higher BMI than girls (p &lt; 0,001). Also, in urban areas children have a significant higher BMI on average than in rural areas (p = 0,025). No significant relationship could be identified between the duration of physical education lessons per week and the BMI. However, a significant difference in childreńs BMI became visible when school playgrounds were also accessible outside opening hours (p = 0,018). Conclusions The alarming number of overweight children in Austria should be diminished through policies and further interventions. Schools can make a substantial contribution to this. The course of the development could be closely observed through possible further surveys by COSI. Key messages 73,2% of the schools include nutrition education in their curricula. Yet, about every third Austrian child aged between 8 and 9 is overweight, with boys being significantly more overweight than girls. If school playgrounds are accessible outside opening hours, the childreńs BMI is significantly lower. In urban areas, children have a significantly higher BMI than in rural areas.

scholarly journals Measurement and Decomposition of Consumption Inequality in Nepal

2019 ◽  
Vol 4 (2) ◽  
pp. 53-69
Author(s):  
Pravat Uprety
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Gini Index ◽  
Household Head ◽  
Living Standard ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Significant Difference ◽  
Female Headed Households ◽  
Measures Of Inequality

This study aims at computing, comparing and decomposing the different inequality indices by rural and urban areas, sex of household head and ecological belt, so that policy maker can make the policy to reduce the inequality in Nepal. This study is based on the raw data taken from the 3rd Nepal Living Standard Survey-2011 conducted by the Central Bureau of Statistics (CBS). The study has used real consumption as the main variable to measure the inequality. In most of the cases five measures of inequality; Coefficient of variation (CV), Quantile Ratio Index, Gini Index, Generalised Entropy Index with parameter 0 and 1 were computed. The Gini index, Theil’s L and Theil’s T indices are 0.328, 0.175 and 0.194, respectively. The study has found no significant difference in inequality between male- and female-headed households; and the inequality in urban areas is higher than that in the rural areas. By ecological belts, the inequality is highest in hills and lowest in mountains. The country should place focus on urban areas and hilly belt to reduce inequality.

scholarly journals FENOMENA NOMOPHOBIA PADA ANAK USIA DINI BERDASARKAN TIPOLOGI WILAYAH DAN HUBUNGANNYA TERHADAP PERILAKU PROSOSIAL DAN ANTISOSIAL

2021 ◽  
Vol 8 (01) ◽  
pp. 91-107
Author(s):  
Dian Novita ◽  
Kenty Martiastuti
Keyword(s):  
Early Childhood ◽  
Social Behavior ◽  
Rural Areas ◽  
Urban Areas ◽  
T Test ◽  
Average Score ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
The Social ◽  
Significant Difference

Abstrak Penelitian ini bertujuan untuk mengidentifikasi fenomena nomophobia pada anak usia dini di wilayah perdesaan dan perkotaan, menganalisis perbedaan perilaku nomophobia dan perilaku sosial antara kedua wilayah, serta menganalisis hubungan perilaku nomophobia terhadap perilaku sosial. Penelitian ini dilakukan di dua wilayah yaitu di Kabupaten Kuningan (representatif wilayah perdesaan) dan Kota Depok (representatif wilayah perkotaan) dengan responden masing-masing sebanyak 50 orang, sehingga total responden adalah 100 orang. Data yang dikumpulkan dari penelitian ini adalah perilaku nomophobia yang menggunakan instrumen NMP-Q (Yildirim,2015) dan perilaku sosial diukur berdasarkan dimensi yang dikembangkan oleh Hurlock (1978) yang terdiri atas perilaku prososial dan antisosial. Melalui uji independent sample t-test, hasil penelitian menunjukkan tidak ada perbedaan signifikan pada perilaku nomophobia antara wilayah perdesaan dan perkotaan. Skor rata-rata perilaku nomophobia di perdesaan adalah 35,61 sedangkan di perkotaan adalah 35,72 yang termasuk kategori rendah. Perilaku sosial di kedua wilayah sebagian besar menunjukkan kategori tinggi (64%) dan tidak ada perbedaan perilaku sosial secara umum baik di perdesaan maupun perkotaan. Hasil uji korelasi menunjukkan tidak adanya hubungan signifikan antara perilaku nomophobia dan perilaku sosial namun koefisien korelasi negatif yaitu -0,085 menjadi indikasi bahwa semakin tinggi perilaku nomophobia maka akan semakin rendah perilaku sosial anak usia dini. Hal ini perlu mendapat perhatian bersama, mengingat dampak buruk yang dapat ditimbulkan dari adanya fenomena nomophobia terutama pada anak usia dini. Kata Kunci: anak usia dini, nomophobia, perilaku sosial   Nomophobia Phenomenons in Early Childhood based on Regional Typology and       Its Relationship to Prosocial and Antisocial Behaviors Abstract This study aims to identify the phenomenon of nomophobia in early childhood in rural and urban areas, to analyze differences in nomophobic behavior and social behavior between the two regions and to analyze the relationship between nomophobic behavior and social behavior. This research was conducted in two areas, namely Kuningan District (rural area representative) and Depok City (urban area representative) with 50 respondents each, so that the total number of respondents was 100 people. The data collected from this study were nomophobic behavior using the NMP-Q instrument (Yildirim, 2015) and social behavior was measured based on the dimensions developed by Hurlock (1978) which consisted of prosocial and antisocial behavior. Through the independent samples t-test, it was found that the results of the study showed no significant difference in nomophobic behavior between rural and urban areas. The average score of nomophobic behavior in rural areas is 35,61, while in urban areas it is 35,72 which is in the low category. Most of the social behavior in the two regions shows the high category (64%) and there is no difference in social behavior in general, both in rural and urban areas. The results of the correlation test showed that there was no significant relationship between nomophobic behavior and social behavior, but the negative correlation coefficient, namely -0,085, is an indication that the higher the nomophobic behavior, the lower the social behavior of early childhood. This needs mutual attention, considering the bad effects that can be caused by the phenomenon of nomophobia, especially in early childhood. Keywords : early childhood, nomophobia, social behavior

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