Rectal cancer patients from rural areas in northern Sweden report more pain and problems with stoma care than those from urban areas

79 Background: Approximately 20% of people diagnosed with cancer in the U.S. travel from rural areas to urban cancer centers for treatment. Rural cancer patients face unique challenges which may contribute to greater psychosocial distress when compared to urban-dwelling patients. While up to half of all cancer patients screen positive for psychosocial distress, only 25-44% of distressed patients utilize psychosocial care. Patients from rural areas may face greater barriers to utilization of psychosocial care compared to patients from urban areas. To date, few studies have focused on these concerns. Methods: Three-years of data were collected from newly diagnosed patients screened between 2015 and 2017, including the Patient Health Questionnaire-2 and the NCCN Distress Thermometer (n = 4,865). Adjusted multi-variable logistic regression, chi-square, and negative binomial regression were used to assess relationships among psychosocial outcomes and care utilization, rurality, and distance to treatment in driving miles, controlling for socio-demographic and clinical covariates. Distance to treatment based on driving miles computed in ArcGIS v10.5. Stata v15 was used for all statistical analyses, significance set at ≤.05. Results: Higher odds of depressive symptoms were detected among people living in rural areas compared to urban areas. The odds of psychosocial distress were higher in patients from rural areas and further distances from treatment compared to local distance. Patients from rural areas had lower odds of psychosocial care utilization compared to patients in urban areas. Distance to treatment had independent effects, over and above rurality, for lower odds of psychosocial care utilization. Conclusions: Distance to treatment and rurality appear to be risk factors with independent effects on depressive symptoms and psychosocial distress and appear to be associated with lower odds of psychosocial care use among cancer patients with self-reported distress when compared to patients from urban and local areas. Findings support improved detection of and response to patient reported psychosocial outcomes, and further research designed to better understand the mechanisms underlying the reported associations.

Download Full-text

Socio-economic and rural-urban differences in healthcare and catastrophic health expenditures among cancer patients in China: analysis of the China Health and Retirement Longitudinal Study

10.21203/rs.3.rs-889381/v1 ◽

2021 ◽

Author(s):

Yang Zhao ◽

Shenglan Tang ◽

Wenhui Mao ◽

Tomi F Akinyemiju

Keyword(s):

Longitudinal Study ◽

Cancer Treatment ◽

Cancer Patients ◽

Service Utilization ◽

Rural Areas ◽

Urban Areas ◽

Healthcare Service ◽

Service Use ◽

Increased Risk ◽

Chinese Cancer Patients

Abstract Background In China, cancer deaths account for one-fifth of all deaths and exert a heavy toll on patients, families, healthcare systems, and society as a whole. This study aims to examine socio-economic and rural-urban differences in treatment, healthcare service utilization and catastrophic health expenditure (CHE) among Chinese cancer patients, and to investigate the relationship between different treatment types and healthcare service use as well as incidence of CHE. Methods We analyzed a nationally representative sample from the China Health and Retirement Longitudinal Study including 17,224 participants in 2011 and 19,569 participants in 2015. Multivariable regression models were performed to investigate the association of cancer treatments with healthcare service utilization and CHE. Results The age-adjusted prevalence of cancer is 1.37% for 2011 and 1.84% for 2015. Approximately half of the cancer patients utilized treatment for their disease, with a higher proportion of urban residents (54%) than rural residents (46%) receiving cancer treatment in 2015. CHE declined by 22% in urban areas (25% in 2011 and 19% in 2015) but increased by 31% in rural areas (25% in 2011 to 33% in 2015). There was a positive relationship between cancer treatment and outpatient visit (OR = 2.098, 95% CI = 1.453, 3.029), admission to hospital (OR = 1.961, 95% CI = 1.346, 2.857) and CHE (OR = 1.796, 95% CI = 1.231, 2.620). Chemotherapy and surgery were each associated with a 2-fold increased risk of CHE. Conclusions Meaningful changes to improve health insurance benefit packages are needed to ensure universal, affordable and patient-centered health coverage for the Chinese cancer patients.

Download Full-text

Association between socioeconomic and health factors and edentulism in people aged 65 and older – a population-based survey

Scandinavian Journal of Public Health ◽

10.1177/1403494817717406 ◽

2017 ◽

Vol 46 (7) ◽

pp. 690-698 ◽

Cited By ~ 5

Author(s):

Hanna Olofsson ◽

Eva Lena Ulander ◽

Yngve Gustafson ◽

Carl Hörnsten

Keyword(s):

Low Income ◽

Rural Areas ◽

Urban Areas ◽

Oral Care ◽

Total Sample ◽

Population Based ◽

Northern Sweden ◽

Dental Services ◽

Related Factors ◽

Health Related

Aims: To study edentulism and use of dental services in a population-based sample of people aged 65 years and older from northern Sweden and western Finland. Methods: In 2010, people aged 65, 70, 75 and 80 years who were living in one of 32 municipalities in northern Sweden and western Finland were invited to answer a questionnaire as part of the Gerontological Regional Database (GERDA) study ( n = 6099). The questionnaire contained items related to socioeconomic status, general health and edentulism. Results: The prevalence of edentulism was 34.9% in Finland, compared with 20.6% in Sweden ( p < 0.001), 31.9% in rural areas, compared with 20.9% in urban areas ( p < 0.001), and 25% overall. The prevalence of edentulism rose from 17.8% in 65-year-olds, 23.8% in 70-year-olds, 33.5% in 75-year-olds and 37.3% in 80-year-olds ( p < 0.001), and was 23.8% in women, compared with 27% in men ( p < 0.001). In multivariate models, edentulism was associated with lower educational level (odds ratio (OR) 2.87, 95% confidence interval (CI) 2.31–3.58), low income level (OR 1.7, CI 1.09–1.47), residence in a rural area (OR 1.43, CI 1.23–1.66), male sex (OR 1.30, CI 1.12–1.52), dependence in instrumental activities of daily living (OR 1.48, CI 1.25–1.74), social isolation (OR 1.52, CI 1.17–1.98) and poor self-experienced health (OR 1.38, CI 1.17–1.62). Conclusions: One-quarter of the total sample was edentulous, with a higher prevalence of edentulism in Finland than in Sweden and in rural than in urban areas. Edentulism was associated with socioeconomic, psychological and health-related factors. These findings could be used to inform preventive measures and identify people aged 65 years and older who are in need of oral care.

Download Full-text

Cancer Cases Referral system in Nepal

Nepal Journal of Epidemiology ◽

10.3126/nje.v8i4.23877 ◽

2018 ◽

Vol 8 (4) ◽

pp. 748-752 ◽

Cited By ~ 1

Author(s):

Krishna Kanta Poudel ◽

Deborah Sims ◽

Dianne Morris ◽

Prakash Raj Neupane ◽

Anjani Kumar Jha ◽

...

Keyword(s):

Health Care ◽

Cancer Treatment ◽

Cancer Patients ◽

Rural Areas ◽

Urban Areas ◽

Care Delivery ◽

Health Centre ◽

Medical Doctor ◽

Primary Health ◽

Treatment Centre

The burden of cancer is estimated to be increasing in Nepal, whilst the country lacks national established guidelines or protocols for referral of cancer cases. Cancer patients are presenting many different health facilities throughout the country. In rural areas almost all cancer patients have their first diagnosis when visiting a health assistant or nurse at their nearest primary health care delivery service. If cancer is suspected, health care assistants or nurses will refer the patient to a medical doctor at the primary health centre, or refer the patient directly to the cancer treatment centre or oncology department of the closest hospital. Patients from urban areas will usually be seen for the first time by a medical doctor initially and then referred to either the cancer treatment centre or oncology department of the hospital. Both in rural and urban areas the referral for treatment is determined by both the patients’ capacity to pay for treatment own healthcare, as well as their geographical location (i.e. availability and accessibility of cancer treatment services.

Download Full-text

Analysis of Mortality and Survival Rate of Liver Cancer in Zhejiang Province in China: A General Population-Based Study

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2019/1074286 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Fang-Rong Fei ◽

Ru-Ying Hu ◽

Wei-Wei Gong ◽

Jin Pan ◽

Meng Wang

Keyword(s):

Survival Rate ◽

Mortality Rate ◽

Liver Cancer ◽

Cancer Patients ◽

Rural Areas ◽

Urban Areas ◽

Survival Rates ◽

Relative Survival ◽

Zhejiang Province ◽

World Population

Background. Few accurate up-to-date studies provide liver cancer mortality and survival information in Zhejiang province. This research aimed to depict the mortality and survival of liver cancer in Zhejiang province in China during 2005-2010. Methods. The data were collected from the Zhejiang Chronic Disease Surveillance Information and Management System, and the mortality rates of liver cancer were calculated by gender, age, and areas. Chinese population census in 2000 and Segi’s world population were used for age-standardized mortality rate. The observed and relative survival rates of liver cancer patients were analyzed. Results. The crude mortality rate of liver cancer was 32.11/105. The age-standardized mortality rate was 17.39/105 and 23.07/105 by Chinese population (ASIRC) and Segi’s world population (ASIRW), respectively. The crude liver cancer mortality rate and age-standardized rate in urban areas were lower than those of rural areas. The overall 1-, 3-, and 5-year observed survival (OS) rates of liver cancer patients were 38.61%, 21.65%, and 16.83%, respectively. The 1-, 3-, and 5-year relative survival (RS) rates of liver cancer patients were 39.49%, 23.27%, and 19.09%, respectively. Survival rate decreased obviously within 1 to 5 years and then leveled off. It was shown that the male overall survival rate was higher than the female one and the difference was statistically significant (P<0.05). Conclusions. Both lower mortality and better survival rates were observed in urban areas, compared to rural areas. Relevant parties including government, public resource, and propaganda department should devote enough attention to rural areas.

Download Full-text

Assessing the incidence, epidemiological description and associated risk factors of breast cancer in western Amhara, Ethiopia

Breast Cancer Management ◽

10.2217/bmt-2020-0024 ◽

2020 ◽

pp. BMT47

Author(s):

Lijalem M Tesfaw ◽

Teshome A Teshale ◽

Essey K Muluneh

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Cancer Patients ◽

Rural Areas ◽

Urban Areas ◽

Stage Iv ◽

Healthcare Services ◽

Breast Cancer Patients ◽

Stage Iv Cancer ◽

Associated Risk Factors

Aim: This study aimed at assessing the incidence, epidemiological description and associated risk factors of breast cancer in western Amhara, Ethiopia. Patients & methods: A total of 128 breast cancer patients being treated at Feleget Hiwot Referral Hospital (Bahir Dar, Ethiopia) were subjects of the study. Investigators controlled data quality and employed the ordinal logistic regression model to identify the effect of factors. Results: Of the 128 breast cancer patients under study, 119 (93%) were females. Most of the patients, 67 (52.34%), had advanced stage (IV) cancer that reduced their chance to recover after treatment. Conclusion: Patients who received chemotherapy and surgery for breast cancer were likely to improve than patients who received only chemotherapy. As the stage of breast cancer increased, the likelihood of the patient’s status to be improved decreases. Patients from rural areas, where healthcare services are rarely available, were less likely to recover or improve as compared with those from urban areas.

Download Full-text

Utility of EUS to identify the effective responders from rectal cancer patients who receive neo-adjuvant chemotherapy

Endoscopy ◽

10.1055/s-0031-1292223 ◽

2011 ◽

Vol 43 (S 03) ◽

Author(s):

Zhang Xiaoyin ◽

Guo Xuegang ◽

Wang Xin ◽

Du Jianjun ◽

Zhao Qingchuan ◽

...

Keyword(s):

Rectal Cancer ◽

Adjuvant Chemotherapy ◽

Cancer Patients ◽

Neo Adjuvant Chemotherapy

Download Full-text

An Epidemiological, Diagnostic and Therapeutic Study of Giardia lamblia in Anbar Province – Iraq

International Journal of Drug Delivery Technology ◽

10.25258/ijddt.9.1.7 ◽

2019 ◽

Vol 9 (01) ◽

pp. 39-45

Author(s):

Suad Shallal Shahatha

Keyword(s):

Teaching Hospital ◽

Rural Areas ◽

Giardia Lamblia ◽

Urban Areas ◽

Culture Media ◽

Age Groups ◽

Stool Samples ◽

Women And Children ◽

Teucrium Polium L ◽

Therapeutic Study

This study was carried out to investigate the epidemiology of Giardia lamblia parasites in patients who visited some of the hospitals in Anbar province, which included (Fallujah Teaching Hospital, Ramadi Teaching Hospital, Ramadi Teaching Hospital for Women and Children and Hit Hospital) during by examining 864 stool samples in a direct examination method, The results revealed the infection rate was 41.7 % and the percentage of infection among males 47.8% is higher than that of females 35.4% with significant differences (p≤0.05). The age groups (1-9) years recorded the highest rates 55.4% and the lowest rate 13.6% in the age group (40-49) years. The highest rate of infection was 62.5% during the month of June, while the month of October was the lowest rate 5% and significant differences. The incidence rate in rural areas was 50.6% higher than in the urban areas 32.5%. The study also included the effect of Teucrium polium L. on the parasite in the culture media HSP-1, the concentrations of 0.5-3 mg / mL significantly affected Giardia, it was noted whenever the greater the concentration, the greater the effect during different treatment periods (1-4) days, as the highest concentration 3 mg/ml killed all Giardia parasites on the fourth day of treatment.

Download Full-text

A Study Of Expansion Of The Fmcg Market Across Rural Areas

Restaurant Business ◽

10.26643/rb.v118i8.7094 ◽

2019 ◽

Vol 118 (8) ◽

pp. 142-151

Author(s):

Dr. Udayagiri Raghunath ◽

Dr. V.Venkateswara Rao

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Customer Choice ◽

Income Levels ◽

Rural Markets ◽

Urban Markets ◽

Tv Media ◽

Rural Clients ◽

Tv Watching

The corporate companies dealing with FMCG products have started focusing on rural markets as the urban markets have become saturated and highly competitive. Capturing the rural markets brings forth a whole new set of challenges as it is laborious to break in. This market presents the companies with gamut challenges on a new dimension which demand entirely different strategies as compared to the ones used in urban areas. Studying the rural markets for rural markets has become crucial more than ever. It is an objective learning, psychiatry of dispersion, impact of the FMCG in rural areas. This research uses diverse utensils, procedure toward analyze composed records. Several of the features used in analyzing the data are the consumer characteristics like educational qualifications, professions they are in, and the income levels. The role of TV media advertising is also analyzed. Many deals and promotions advertised on TV are investigated. The scope of authority wield by publicity happening customer choice production has looked into. The different levels of media exposure and preferable TV watching times and their favorite programs considered while analyzing the data. The spending prototype of rural clients on FMCG is examined and further categorized based on their income levels, educational qualifications, and legal awareness of consumer act. All the analyzed data, results, and suggestions presented in the visual formats.

Download Full-text

TURNING FARMERS INTO SOCIAL FARMER ENTREPRENEURS FOR DISADVANTAGED PEOPLE

NORDSCI Conference proceedings, Book 1 Volume 3 ◽

10.32008/nordsci2020/b1/v3/31 ◽

2020 ◽

Author(s):

Remus Runcan

Keyword(s):

Rural Communities ◽

Low Income ◽

Rural Areas ◽

Urban Areas ◽

Health And Safety ◽

Physical Work ◽

Healthy Environment ◽

Rural And Urban Areas ◽

Rural Development Programme ◽

Rural And Urban

According to Romania’s National Rural Development Programme, the socio-economic situation of the rural environment has a large number of weaknesses – among which low access to financial resources for small entrepreneurs and new business initiatives in rural areas and poorly developed entrepreneurial culture, characterized by a lack of basic managerial knowledge – but also a large number of opportunities – among which access of the rural population to lifelong learning and entrepreneurial skills development programmes and entrepreneurs’ access to financial instruments. The population in rural areas depends mainly on agricultural activities which give them subsistence living conditions. The gap between rural and urban areas is due to low income levels and employment rates, hence the need to obtain additional income for the population employed in subsistence and semi-subsistence farming, especially in the context of the depopulation trend. At the same time, the need to stimulate entrepreneurship in rural areas is high and is at a resonance with the need to increase the potential of rural communities from the perspective of landscape, culture, traditional activities and local resources. A solution could be to turn vegetal and / or animal farms into social farms – farms on which people with disabilities (but also adolescents and young people with anxiety, depression, self-harm, suicide, and alexithymia issues) might find a “foster” family, bed and meals in a natural, healthy environment, and share the farm’s activities with the farmer and the farmer’s family: “committing to a regular day / days and times for a mutually agreed period involves complying with any required health and safety practices (including use of protective clothing and equipment), engaging socially with the farm family members and other people working on and around the farm, and taking on tasks which would include working on the land, taking care of animals, or helping out with maintenance and other physical work”

Download Full-text