33. Evaluation of Rural-Urban Differences in Hospitalization and Mortality Rates for US COVID-19 Patients in the United States

Background Rural communities are among the most vulnerable and resource-scarce populations in the United States. Rural data is rarely centralized, precluding comparability across regions, and no significant studies have studied this population at scale. The purpose of this study is to present findings from the National COVID Cohort Collaborative (N3C) to provide insight into future research and highlight the urgent need to address health disparities in rural populations. N3C Patient Distribution This figure shows the geospatial distribution of the N3C COVID-19 positive population. N3C contains data from 55 data contributors from across the United States, 40 of whom include sufficient location information to map by ZIP Code centroid spatially. Of those sites, we selected 27 whose data met our minimum robustness qualifications for inclusion in our study. This bubble map is to scale with larger bubbles representing more patients. A. shows all N3C patients. B. shows only urban N3C distribution. C. shows the urban-adjacent rural patient distribution. D. shows the nonurban-adjacent rural patient distribution, representing the most isolated patients in N3C. Methods This retrospective cohort of 573,018 patients from 27 hospital systems presenting with COVID-19 between January 2020 and March 2021, of whom 117,897 were admitted (see Data Analysis Plan diagram for inclusion/exclusion criteria), analyzes outcomes and 30-day survival for the hospitalized population by the degree of rurality. Multivariate Cox regression analysis and mixed-effects models were used to estimate the association between rurality, hospitalization, and all-cause mortality, controlling for major risk factors associated with rural-urban health discrepancies and differences in health system outcomes. The difference in distribution by rurality is described as well as supplemented by population-level statistics to confirm representativeness. Data Analysis Plan This data analysis plan includes an overview of study inclusion and exclusion criteria, the matrix for data robustness to determine potential sites to include, and our covariate selection, model building, and residual testing strategy. Results This study demonstrates a significant difference between hospital admissions and outcomes in urban versus urban-adjacent rural (UAR) and nonurban-adjacent rural (NAR) lines. Hospital admissions for UAR (OR 1.41, p< 0.001, 95% CI: 1.37 – 1.45) and NAR (OR 1.42, p< 0.001, 95% CI: 1.35 – 1.50) were significantly higher than their urban counterparts. Similar distributions were present for all-cause mortality for UAR (OR 1.39, p< 0.001, 95% CI: 1.30 – 1.49) and NAR (OR 1.38, p< 0.001, 95% CI: 1.22 – 1.55) compared to urban populations. These associations persisted despite adjustments for significant differences in BMI, Charlson Comorbidity index Score, gender, age, and the quarter of diagnosis for COVID-19. Baseline Characteristics Hospitalized COVID-19 Positive Population by Rurality Category, January 2020 – March 2021 Survival Curves in Hospitalized Patients Over 30 Days from Day of Admission This figure shows a survival plot of COVID-19 positive hospitalized patients in N3C by rural category (A), Charlson Comorbidity Index (B), Quarter of Diagnosis (C), and Age Group (D) from hospital admission through day 30. Events were censored at day 30 based on the incidence of death or transfer to hospice care. These four factors had the highest predictive power of the covariates evaluated in this study. Unadjusted and Adjusted Odds Ratios for Hospitalization and All-Cause Mortality by Rural Category, January 2020 – March 2021 This figure shows the adjusted and unadjusted odds ratios for being hospitalized or dying after hospitalization for the COVID-19 positive population in N3C. Risk is similar between adjusted and unadjusted models, suggesting a real impact of rurality on all-cause mortality. A shows the unadjusted odds ratios for admission to the hospital after a positive COVID-19 diagnosis for all N3C patients. B shows the unadjusted odds ratios for all-cause mortality at any point after hospitalization for COVID-19 positive patients. C shows the adjusted odds ratios for being admitted to the hospital after a positive COVID-19 diagnosis for all N3C patients. D shows the adjusted odds ratios for all-cause mortality for all-cause mortality at any point after hospitalization for COVID-19 positive patients. Adjusted models include adjustments for gender, race, ethnicity, BMI, age, Charlson Comorbidity Index (CCI) composite score, rurality, and quarter of diagnosis. The data provider is included as a random effect in all models. Conclusion In N3C, we found that hospitalizations and all-cause mortality were greater among rural populations when compared to urban populations after adjustment for several factors, including age and co-morbidities. This study also identified key demographic and clinical disparities among rural patients that require further investigation. Disclosures Sally L. Hodder, M.D., Gilead (Advisor or Review Panel member)Merck (Grant/Research Support, Advisor or Review Panel member)Viiv Healthcare (Grant/Research Support, Advisor or Review Panel member)

The Evident Need for Banking Reform in the Legal Marijuana Industry

Marijuana reform legislation has created a lucrative industry for legal marijuana on the local and state level in some jurisdictions. Federal laws have forced legal marijuana dispensaries to be cash-only businesses with limited banking options. The lack of normal banking services has also affected firms’ ability to manage profits earned from operations. Our hermeneutic phenomenological study was grounded by the conceptual framework of the motivations of humans and humans’ need to feel safe. The participants in this study were owners and operators in the legal marijuana industry in Colorado. Data were collected through interviews, although the Coronavirus (COVID-19) pandemic of 2020 made data collection more challenging because of the added pressure on potential participants. The data analysis plan for this study consisted of transcribing and reviewing the data, coding themes and supporting themes, and synthesizing and reporting findings from the data collected. The study’s findings included the participants’ concerns about safety in their cash-only operations, their methods for conducting business, and the banking options available to them. Common themes that emerged from the interviews were cash, banking, safety, and the limitations of business size. Findings from my study contribute to fostering positive social change on the organization and industry level by providing accounts of how owners and operators navigate the banking dilemma in the legal marijuana industry.

The Evident Need for Banking Reform in the Legal Marijuana Industry

Marijuana reform legislation has created a lucrative industry for legal marijuana on the local and state level in some jurisdictions. Federal laws have forced legal marijuana dispensaries to be cash-only businesses with limited banking options. The lack of normal banking services has also affected firms’ ability to manage profits earned from operations. Our hermeneutic phenomenological study was grounded by the conceptual framework of the motivations of humans and humans’ need to feel safe. The participants in this study were owners and operators in the legal marijuana industry in Colorado. Data were collected through interviews, although the Coronavirus (COVID-19) pandemic of 2020 made data collection more challenging because of the added pressure on potential participants. The data analysis plan for this study consisted of transcribing and reviewing the data, coding themes and supporting themes, and synthesizing and reporting findings from the data collected. The study’s findings included the participants’ concerns about safety in their cash-only operations, their methods for conducting business, and the banking options available to them. Common themes that emerged from the interviews were cash, banking, safety, and the limitations of business size. Findings from my study contribute to fostering positive social change on the organization and industry level by providing accounts of how owners and operators navigate the banking dilemma in the legal marijuana industry.

COVID-19 PANDEMIC FIGHT IN GHANA: DOMESTIC PRODUCTION OF PERSONAL PROTECTIVE EQUIPMENT (PPE) AND LINGUISTIC CHOICES IN PRESIDENTIAL ADDRESSES FROM MARCH – NOVEMBER 2020

This article does a critical discourse analysis of the first nineteen (19) addresses delivered by president Nana Addo Dankwa Akufo Addo (from March – November 2020) with regards to the fight against the Covid-19 pandemic to determine the content and context of the linguistic choices in relation to the laid-out measures in favour of developing the local fashion and textiles industry. Critical discourse analysis was used as research design and as data analysis plan. Inductive content analysis formed part of the analytical tools. The analysis revealed that specific measures put in place to curtail the importation of PPE was engagement of the local fashion designers, tailors and seamstresses some of which had begun production of some the PPE in smaller quantities for commodification. The high cost of importation of PPE, its global shortage, and proactive response of the Ghanaian sartorial workers pushed the government to do the needful by falling on local manufacturing companies to assist them in the domestic production of PPE. It recommended that the government must provide the fashion and textiles industry with credit facilities, tax waivers; and logistical support such as industrial machineries and other needed equipment for expansion of the industry in the subsequent budgets, and maintain fiscal and tactical discipline to these. This must be done with the aim of strengthening domestic production, advancing the nation’s self-reliance, stopping the imports of the PPE and at the same time creating more jobs in the multimillion sector in this time of economic hardship. <p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0771/a.php" alt="Hit counter" /></p>

Functional outcomes in rural Australia of two continuing care teams: a regional town–city comparison of the 16-item Life Skills Profile

Objective: The primary aim was to examine differences in functional health outcomes in consumers entering a regional mental health service compared with a city service. Method: A retrospective analysis of consumer outcomes and characteristics was undertaken. Consumer demographics and diagnoses were compared between the two services. Functional outcomes were measured using the 16-item Life Skills Profile (LSP-16). The data analysis plan utilised descriptive statistics. For between-clinic comparisons, relevant inferential statistics was used. Results: Patients attending the regional health service were five times more likely to be in the high impairment category on the LSP-16, independent of demographic factors and diagnosis. Other independent contributions to high impairment were being male, Indigenous and a diagnosis of schizophrenia. Of the four LSP-16 subscales, regional consumers scored relatively higher on withdrawal, compliance and anti-social but not self-care subscales. Conclusions: There was a greater level of functional impairment in consumers attending the regional service. The independent contributions did not explain the higher impairment; therefore, other factors such as socioeconomic disadvantage may explain the difference. Regional clinicians may need to consider recovery-orientated interventions that address a greater burden of functional impairments in regional services.

Environmental Ergonomics and Postural Job Analysis on Handcrafting Process of a Small-Scale Jewelry Enterprise

The Philippine Jewelry Industry has a great potential on contributing to the economic development. Large deposit of gold, abundant reserve of precious stones and cheap skilled labor of Filipino artisans are some of the country’s resources which are essential elements for jewelry making. A dying breed of artistry for the craft poses a high threat to the number of Filipino jewelry makers. Hence, a task analysis intends to help the industry by identifying ergonomic risk factors in the working environment of a typical small-scale jewelry enterprise. It focuses on the traditional ways of jewelry making mainly by handheld tools. Various physical and environmental methods are consolidated to detect risk factors which may potentially lead to occupational disorders. Data analysis plan consists of comparative assessment of actual measurements and acceptable levels for environmental variables. Also, descriptive statistics is used to interpret the results of environmental ergonomics and postural job analysis. The result shows high proportion of non-conformance in illumination and thermal condition of the workplace. The sitting postures of the workers are deviated from neutral working positions. Also, bodydiscomforts are commonly experienced in neck, shoulder, upper back and arm regions. Moreover, recommendations are established to introduce an ergonomically designed workplace.

Pre-Registration in the Undergraduate Dissertation: A Critical Discussion

Currently under review at Psychology Teaching Review. Over recent years, Psychology has become increasingly concerned with reproducibility and replicability of research findings (Munafò et al., 2017). One method of ensuring that research is hypothesis driven, as opposed to data driven, is the process of publicly pre-registering a study’s hypotheses, data analysis plan, and procedure prior to data collection (Nosek, Ebersole, DeHaven, &amp; Mellor, 2018). This paper discusses the potential benefits of introducing pre-registration to the undergraduate dissertation. The utility of pre-registration as a pedagogic practice within dissertation supervision is also critically appraised, with reference to open science literature. Here, it is proposed that encouraging pre-registration of undergraduate dissertation work may alleviate some pedagogic challenges, such as statistics anxiety, questionable research practices, and research clarity and structure. Perceived barriers, such as time and resource constraints, are also discussed.

Study Korelasi Faktor-Faktor Yang Berhubungan Dengan Kualitas Hasil Belajar Melalui Orientasi Masa Depan Pada Mahasiswa Politeknik Kesehatan Surakarta Tahun 2017

Background: Achieving a good quality of a student’s learning outcomes is influenced by many factors including intelligence, talent, interest and attention, motivation, ways and habits of learning, family and school environment. That is why the level of Intelligence Quotient (IQ) is not the only factor that determines one's success, because there are other influencing factors. This study aimed to determine the factors that influenced the quality of students' learning outcomes at Politeknik Kesehatan Surakarta. Method: This study was a correlational descriptive study which is explanatory in nature that explains the relation between study variables through hypothesis testing. The approach method used in this study was cross sectional. This research was conducted in Politeknik Kesehatan Surakarta environment which consisted of 8 Departments with a total of 3,407 students. The sampling technique used to determine the number of samples in this study was Proportional Stratified Random Sampling, with a sample size of 358 respondents. While the data analysis plan was done descriptively, bivariate with Kendall's Tau technique. Results : The results of the study show that the factors which are proven to be significantly related to the students’ learning outcomes quality in Politeknik Kesehatan Surakarta are Spiritual Intelligence (p = 0.019); Motivation (p = 0.031), Learning Habits (p = 0.037). Conclusion. Factors that are significantly related to the quality of learning outcomes in Politeknik Kesehatan Surakarta students include Spiritual Intelligence, Motivation, and Learning Habits. While the Spiritual Intelligence factor is not significantly related to the quality of students' learning outcomes at Politeknik Kesehatan Surakarta.

Protocol for a Study on the Cultural (Mis)Attribution Bias Among a Sample of College Students in the United States

Recent studies have documented a Cultural (Mis)Attribution Bias in the United States, the tendency to assume that ethnic/racial minorities are largely influenced by their membership to a cultural group, but less by psychological processes, and the belief that White people are largely influenced by individual psychological processes, but less by cultural processes (Causadias, Vitriol, &amp; Atkin, 2018a; 2018a). While these studies were conducted with samples of psychologists and developmental psychologists in the United States, less is known about the degree to which college students in the United States endorse this bias. In the proposed study, we will conduct an experiment and a survey to address this issue. In this protocol, we describe the rationale for this study, the hypotheses, sample characteristics, procedure, instrument, and data analysis plan.