scholarly journals Spatial Accessibility Assessment of Prehospital EMS with a Focus on the Elderly Population: A Case Study in Ningbo, China

2021 ◽  
Vol 18 (19) ◽  
pp. 9964
Author(s):  
Huanhuan Zhu ◽  
Lin Pan ◽  
Yiji Li ◽  
Huiming Jin ◽  
Qian Wang ◽  
...  
Keyword(s):  
Prehospital Care ◽  
The Elderly ◽  
Spatial Accessibility ◽  
Spatial Equilibrium ◽  
Spatial Access ◽  
Empirical Bayesian Kriging ◽  
Disease Spectrum ◽  
Aging Populations ◽  
Care Capacity ◽  
Aging People

The spatial accessibility of prehospital EMS is particularly important for the elderly population’s physiological functions. Due to the recent expansion of aging populations all over the globe, elderly people’s spatial accessibility to prehospital EMS presents a serious challenge. An efficient strategy to address this issue involves using geographic information systems (GIS)-based tools to evaluate the spatial accessibility in conjunction with the spatial distribution of aging people, available road networks, and prehospital EMS facilities. This study employed gravity model and empirical Bayesian Kriging (EBK) interpolation analysis to evaluate the elderly’s spatial access to prehospital EMS in Ningbo, China. In our study, we aimed to solve the following specific research questions: In the study area, “what are the characteristics of the prehospital EMS demand of the elderly?” “Do the elderly have equal and convenient spatial access to prehospital EMS?” and “How can we satisfy the prehospital EMS demand of an aging population, improve their spatial access to prehospital EMS, and then ensure their quality of life?” The results showed that 37.44% of patients admitted to prehospital EMS in 2020 were 65 years and older. The rate of utilization of ambulance services by the elderly was 27.39 per 1000 elderly residents. Ambulance use by the elderly was the highest in the winter months and the lowest in the spring months (25.90% vs. 22.38%). As for the disease spectrum, the main disease was found to be trauma and intoxication (23.70%). The mean accessibility score was only 1.43 and nearly 70% of demand points had scored lower than 1. The elderly’s spatial accessibility to prehospital EMS had a central-outward gradient decreasing trend from the central region to the southeast and southwest of the study area. Our proposed methodology and its spatial equilibrium results could be taken as a benchmark of prehospital care capacity and help inform authorities’ efforts to develop efficient, aging-focused spatial accessibility plans.

scholarly journals Spatial Accessibility Modeling of Vaccine Deserts as Barriers to Controlling SARS-CoV-2 Transmission

2021 ◽  
Author(s):  
Benjamin Rader ◽  
Christina M Astley ◽  
Kara Sewalk ◽  
Paul L Delamater ◽  
Kathryn Cordiano ◽  
...  
Keyword(s):  
Herd Immunity ◽  
The Elderly ◽  
The United States ◽  
Spatial Accessibility ◽  
People Of Color ◽  
Spatial Access ◽  
Parameterized Model ◽  
Vaccine Distribution ◽  
And Control ◽  
Us Census

SARS-CoV-2 vaccine distribution is at risk of further propagating the inequities of COVID-19, which in the United States (US) has disproportionately impacted the elderly, people of color, and the medically vulnerable. We identify vaccine deserts - US Census tracts with localized, geographic barriers to vaccine-associated herd immunity - using a comprehensive supply database (VaccineFinder) and an empirically parameterized model of spatial access to essential resources. Incorporating high-resolution COVID-19 burden and time-willing-to-travel for vaccination, we show that early (February - March 2021) vaccine allocation disadvantaged rural and medically vulnerable populations. Data-driven vaccine distribution to vaccine deserts may improve immunization in the hesitant and control SARS-CoV-2.

scholarly journals The Effects of Urban Natural Environments on Preference and Self-Reported Psychological Restoration of the Elderly

2021 ◽  
Vol 18 (2) ◽  
pp. 509
Author(s):  
Ling Qiu ◽  
Qujing Chen ◽  
Tian Gao
Keyword(s):  
Green Space ◽  
Environmental Design ◽  
The Elderly ◽  
Urban Environments ◽  
Green Spaces ◽  
Photo Elicitation ◽  
Natural Environments ◽  
The World ◽  
Different Types ◽  
Aging Populations

The world is facing the challenge of aging populations. Urban natural environments, including green spaces and blue spaces, have been demonstrated to have great benefits to the mental restoration of the elderly. However, the study of the specific characteristics of urban environments that are popular and the most restorative for the elderly is still lacking. Photo elicitation as visual stimuli was utilized to explore the differences in preference and psychological restoration of the elderly through the perception of the eight perceived sensory dimensions (PSDs) in different types of urban environments. The results showed that: (1) The respondents had different perceptions of the eight PSDs in the different urban natural environments. Blue space and partly-closed green space were more preferred by the elderly, and also had more psychological restorative effects on the elderly. (2) There was no significant correlation between the number of highly perceived PSDs and preference, as well as between the number of highly perceived PSDs and psychological restoration. However, there was a significant correlation between preference and psychological restoration. (3) Partly-closed green space with more Serene and Refuge qualities, and blue space with more Serene, Refuge and Prospect properties were optimal characteristics for psychological restoration of the elderly. In addition, open green space with more Prospect, Serene and Social qualities, and closed green space with more Space, Refuge and less Nature properties could also increase psychological restoration of older adults. These findings can provide useful guidelines for restorative environmental design for the elderly in the future.

scholarly journals Elderly victims of falls seen by prehospital care: gender differences

2014 ◽  
Vol 17 (1) ◽  
pp. 3-16 ◽  
Author(s):  
William Campo Meschial ◽  
Dorotéia Fátima Pelissari de Paula Soares ◽  
Nelson Luiz Batista de Oliveira ◽  
Alice Milani Nespollo ◽  
Wesley Alexandre da Silva ◽  
...  
Keyword(s):  
Gender Differences ◽  
Elderly Patients ◽  
Exploratory Study ◽  
Prehospital Care ◽  
The Elderly ◽  
Cross Sectional ◽  
Significance Level ◽  
Care Services ◽  
Preventive Actions ◽  
Type Of Injury

OBJECTIVE: To identify elderly who are victims of falls, according to gender, who received care from prehospital services of Maringá, Paraná. METHODS: A cross-sectional exploratory study carried out with 1,444 elderly patients who suffered falls in Maringá in the period from 2006 to 2008. Data were gathered from prehospital care services, typed and processed using the Epi Info 6.04d(r). The χ² test was used to compare the falls in relation to gender (significance level = 0.05). RESULTS: The number of falls according to gender presented similar percentages, 51.0% for males and 49.0% for females. Significant differences between genders were observed regarding age (p < 0.001), presence of alcohol breath (p < 0.001), type of fall (p < 0.001), place of fall (p < 0.001), treatment at hospital (p = 0.023), number of injuries (p = 0.014), type of injury (p < 0.001) and injury location (p <0.001). CONCLUSION: These results show that falls happen differently among the elderly when considering gender. It highlights the importance of understanding these differences in detail and the circumstances in which the fall occurred, since this knowledge is key to plan preventive actions.

scholarly journals Age features of arterial human kidney vessels

2019 ◽  
Vol 10 (4) ◽  
pp. 51-58
Author(s):  
O. A. Kaplunova
Keyword(s):  
Old Age ◽  
Human Kidney ◽  
The Elderly ◽  
Relative Content ◽  
Adaptive Capabilities ◽  
Age Related ◽  
Cortical Substance ◽  
Age Features ◽  
Aging People ◽  
Renal Vascular

Objective: to study the structural transformations of the architectonics of intra-organ renal arterial vessels in the age aspect.Materials and methods: 150 kidneys of people of diff erent age who died from the reasons which are not connected with diseases of cardiovascular and urinary systems are investigated. The studies were carried out using a set of methods: angiographic, macromicroscopic and morphometry.Results: with increasing age, a decrease in the number of vascular glomeruli in the kidney, the proportion of glomerular mass in the cortical substance of the kidney was found. In old age and in centenarians, a rare capillary network in the cortical substance of the kidney, tortuosity, narrowing and expansion of direct arterioles and capillaries in the cerebral substance was revealed. In old age and in centenarians, compared with adolescence, the relative content of arterial vessels in the cortical substance decreases by 6 times, in the juxtamedullary zone — by 4 and in the cortical substance — by 2 times.Conclusions: the large diameters of the juxtamedullary glomeruli and a large index of the relative content of arterial vessels in the juxtamedullary zone create prerequisites for possible juxtamedullary shunting with urgent adaptation in the norm. The decrease in these indicators in old age, the elderly and centenarians, obviously, explains the age-related decline in the adaptive capacity of the arterial bed of the kidneys. With increasing age, the range of adaptive capabilities of the renal vascular bed of aging people decreases compared to those of mature age. 

scholarly journals Empty-nest elderly: mahjong and Chinese square dance for improving the cognitive function in the community

2019 ◽  
Vol 6 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Yue Zhang ◽  
Marcia A. Petrini
Keyword(s):  
Cognitive Function ◽  
Nursing Care ◽  
Psychological Health ◽  
Cognitive Disorders ◽  
The Elderly ◽  
Community Nursing ◽  
Empty Nest ◽  
China National Knowledge Infrastructure ◽  
Straightforward Method ◽  
Aging People

Abstract Objective The elderly population has proliferated worldwide. The empty-nest family pattern has become predominant among the aging people, and they are more vulnerable to the development of cognitive disorders. However, there is no standardized service in the community nursing care that includes procedures on how to improve the cognitive function of the elderly. Meanwhile, the booming number of empty-nest elderly stimulates the community nurses to assume the responsibility for their care. All of these bring more difficulties and opportunities for community nurses who are dedicated to the prevention of geriatric cognitive disorders. Methods The authors reviewed the literature related to “empty-nest elderly”, “cognitive function”, “mahjong”, and “Chinese square dance” in the Elsevier, Web of Science (WOS), China National Knowledge Infrastructure (CNKI), Springer and PubMed databases. The study illustrates the utility possibility of an efficient and straightforward method for improving the cognitive function among the elderly in the context of community nursing care in China and even in the rest of the world. Results Mental and physical activity contributes to cognitive fitness and may be beneficial in delaying cognitive decline. Mental activities, such as playing mahjong, and physical activities, such as the Chinese square dance, are common Chinese activities. Both of them can affect cognitive function in some way. Conclusions China is experiencing one of its most severe aging problems. Community health personnel and related professionals may consider using mahjong and Chinese square dance to promote psychological health in empty-nest elderly individuals in the community.

A Spatial Analysis on Charter School Access in the New York Metropolitan Area

2021 ◽  
Vol 123 (2) ◽  
pp. 1-30
Author(s):  
Jin Lee ◽  
Christopher A. Lubienski
Keyword(s):  
New York ◽  
Charter Schools ◽  
Charter School ◽  
Metropolitan Area ◽  
Spatial Accessibility ◽  
Equal Opportunities ◽  
Spatial Access ◽  
Spatial Lag ◽  
School Access ◽  
Location Strategies

Background Extant literature has consistently indicated that access to charter school markets is shaped by social geography. Given interest in location shown by charter schools and parents, estimating potential spatial access to charter schools has become instrumental in understanding equal opportunities for charter school enrollment in metropolitan areas with preexisting residential segregation. Purpose By considering the increasing significance of sociogeography, this article asks whether students have equal opportunities for potential spatial access to charter schools across communities and how disparities in charter school access are related to housing patterns. Setting This study focuses on 122 charter schools in the New York metropolitan region, a highly segregated metropolitan area in the United States where charter schools are a primary component of education reform. Research Design The first part of this study illustrates patterns of spatial accessibility of the area's charter schools, within a 20-minute commuting time, to students aged 5–13 years by employing the enhanced two-step floating catchment area method using a Gaussian function. The next part of the study tests the hypothesis that students are able to access charter schools equitably and irrespective of their place of residence. The spatial lag regression model is used to compare distributions of potential spatial accessibility with 15 demographic and socioeconomic variables. Findings Even after controlling for disproportionate population sizes by census tract, the potential need for charter schools is matched inequitably with the supply of educational service providers. The spatial lag regression results indicate that children in areas less accessible to charter schools within a convenient travel period tend to be exposed to communities with more populations of color, higher unemployed groups, and less expensive housing. Conclusions The findings offer empirical evidence that access to charter school differs depending on demographic and socioeconomic attributes, in significant combination with geography, illuminating charter school location strategies in real-world contexts. Though charter schools have been promoted as a vehicle to offer significant equity advantages across politically designed and strictly operated school attendance boundaries, charter schools in metropolitan New York exercise a distinct and profound form of pseudo-zoning by use of location strategies to exclude certain children who may be considered less desirable.

scholarly journals The geriatric canon

2019 ◽  
Vol 89 (1) ◽  
Author(s):  
Renzo Rozzini
Keyword(s):  
Elderly Patients ◽  
Clinical Significance ◽  
The Elderly ◽  
Health Conditions ◽  
Medical Language ◽  
Care Of Elderly ◽  
Aging People

Over the years Geriatrics and gerontology have developed a language shared by most clinicians and researchers who unequivocally defines the health conditions of aging people: one could speak of "geriatric canon", i.e. the set of fundamentals (paradigms, principles, standard reference vocabulary) of geriatric knowledge, the heritage from which they draw inspiration and from which the actions for the care of the elderly can be driven, the scientific works for the study of their health. The aim of this paper is to describe and report the most important terms of the geriatric canon, in a simplified way, in order to establish a more precise use of geriatric terminology that can be easily utilized by the cardiologists, or other specialists who takes care of elderly patients, without depriving them of their clinical significance, and becoming heritage of ordinary medical language.

The Initial Prehospital Management of Traumatic Brain Injuries in Kigali, Rwanda

2020 ◽  
Vol 35 (5) ◽  
pp. 533-537
Author(s):  
Ashley Rosenberg ◽  
Leoncie Mukeshimana ◽  
Alphosine Uwamahoro ◽  
Myles Dworkin ◽  
Vizir Nsengimana ◽  
...  
Keyword(s):  
Brain Injuries ◽  
Road Traffic ◽  
Prehospital Care ◽  
Descriptive Analysis ◽  
Traumatic Brain Injuries ◽  
Traffic Incidents ◽  
Middle Income ◽  
Pain Medications ◽  
Prehospital Management ◽  
Care Capacity

AbstractIntroduction:Traumatic brain injuries (TBIs) are an important cause of mortality and disability around the world. Early intervention and stabilization are necessary to obtain optimal outcomes, yet little is written on the topic in low- and middle-income countries (LMICs). The aim is to provide a descriptive analysis of patients with TBI treated by Service d’Aide Medicale Urgente (SAMU), the prehospital ambulance service in Kigali, Rwanda.Hypothesis/Problem:What is the incidence and nature of TBI seen on the ambulance in Kigali, Rwanda?Methods:A retrospective descriptive analysis was performed using SAMU records captured on an electronic database from December 2012 through May 2016. Variables included demographic information, injury characteristics, and interventional data.Results:Patients with TBIs accounted for 18.0% (n = 2,012) of all SAMU cases. The incidence of TBIs in Kigali was 234 crashes per 100,000 people. The mean age was 30.5 (SD = 11.5) years and 81.5% (n = 1,615) were men. The most common mechanisms were road traffic incidents (RTIs; 78.5%, n = 1,535), assault (10.7%, n=216), and falls (7.8%, n=156). Most patients experienced mild TBI (Glasgow Coma Score [GCS] ≥ 13; 83.5%, n = 1,625). The most common interventions were provision of pain medications (71.0%, n = 1,429), placement of a cervical collar (53.6%, n = 1,079), and administration of intravenous fluids (48.7%, n = 979). In total, TBIs were involved in 67.0% of all mortalities seen by SAMU.Conclusion:Currently, TBIs represent a large burden of disease managed in the prehospital setting of Kigali, Rwanda. These injuries are most often caused by RTIs and were observed in 67% of mortalities seen by SAMU. Rwanda has implemented several initiatives to reduce the incidence of TBIs with a specific emphasis on road safety. Further efforts are needed to better prevent these injuries. Countries seeking to develop prehospital care capacity should train providers to manage patients with TBIs.

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