urban

城市
  • 文章类型: Journal Article
    目的:评估在尼日利亚西北部城市和半农村医院就诊的育龄妇女的烧伤知识及其预测因素设计:描述性横断面研究地点:在卡诺(城市环境)的AminuKano教学医院的普通和儿科门诊和普通门诊进行,联邦医疗中心BirninKudu(半农村环境)的儿科门诊和产前诊所。
    方法:2021年,从门诊就诊者中随机抽取362名年龄在18-44岁的女性,为期6周。其中,217人来自城市医院。关于他们的社会人口统计学特征和烧伤知识的数据是使用预先测试收集的,半结构化的面试官问卷。
    方法:烧伤知识结果:约83.4%,77.1%和77.6%的受访者有足够的一般性,烧伤的初级预防和总体知识,分别。他们的平均总体知识得分为24分中的18.6分,但只有55.5%具有足够的急救知识。研究地点在烧伤急救方面没有显着差异,预防和总体知识得分。然而,城市受访者对烧伤的原因更加无知,并且知道烧伤可能是致命的。更多的半农村受访者知道火焰和化学物质会导致烧伤。总体知识的预测因素是年龄,教育水平,家庭中的孩子数量,之前看到一个烧伤的孩子,和烧伤相关信息的主要来源。
    结论:总体烧伤知识的受访者比例较高;然而,他们之间存在知识差距。总的来说,他们的急救知识相对较低。城市和半农村受访者在急救方面没有显着差异,预防,或烧伤的整体知识。然而,城市和半农村研究地点对烧伤原因和烧伤并发症的认识不同.因此,本研究的临床环境为类似的烧伤相关教育干预提供了机会.
    OBJECTIVE: To assess burn injury knowledge and its predictors among reproductive-age women attending an urban and a semi-rural hospital in Northwest Nigeria DESIGN: A descriptive cross-sectional study SETTING: It was conducted in the general and paediatric outpatient clinics of Aminu Kano Teaching Hospital in Kano (urban setting) and the general outpatient, paediatric outpatient and antenatal clinics of Federal Medical Centre Birnin Kudu (semi-rural setting).
    METHODS: In 2021, 362 women aged 18-44 years were randomly selected from clinic attendees over six weeks. Of them, 217 were from the urban hospital. Data regarding their sociodemographic characteristics and knowledge of burn injuries was collected using a pretested, semi-structured interviewer-administered questionnaire.
    METHODS: Knowledge of burn injuries RESULTS: About 83.4 %, 77.1 % and 77.6 % of respondents had adequate general, primary prevention and overall knowledge of burn injuries, respectively. Their mean overall knowledge score was 18.6 out of 24, but only 55.5 % had adequate first-aid knowledge. The study sites did not significantly differ in burns first-aid, prevention and overall knowledge scores. However, urban respondents were more ignorant about the cause of burns and knew that burn injuries could be fatal. More semi-rural respondents knew that flames and chemicals cause burn injuries. Predictors of overall knowledge were age, educational level, number of children in their household, previously seeing a burn-injured child, and primary source of burns-related information.
    CONCLUSIONS: The proportion of respondents with adequate overall burn injury knowledge was high; however, knowledge gaps exist among them. Overall, their first-aid knowledge was relatively low. The urban and semi-rural respondents had no significant differences in first-aid, prevention, or overall knowledge of burn injuries. However, knowledge of the causes of burns and burn complications differed between the urban and semi-rural study locations. Therefore, the clinical settings of this study present opportunities for similar burn-related educational interventions.
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  • 文章类型: Journal Article
    这项研究调查了加利福尼亚州七个主要城市中表征当地城市热岛(UHIs)的温度随时间变化与热相关疾病(HRI)之间的关系。UHIs,这是一种在不透水表面或缺乏绿色空间的情况下出现的现象,加剧了极端高温事件的影响,可以使用卫星产品进行纵向测量。这项研究的两个目标是:(1)确定当地温度的温度趋势,以表征22年期间七个观察城市中邮政编码制表区域(ZCTA)的UHI;(2)使用倾向评分和逆概率加权实现不同类型的ZCTA之间的可交换性,并评估记录为HRI的住院率差异,该差异可归因于UHI的时间变化。我们使用从2000年至2022年夏季(6月至9月)的MODISTerra图像得出的每月地表温度数据。我们根据ZCTAs的每月地表温度趋势将其分为三组。在这项研究中包含的216个ZCTA中,43的夏季地表温度趋势下降,161保持不变,12增加。洛杉矶减少的ZCTA数量最多,圣地亚哥和圣何塞增加的ZCTA数量最多。分析可归因于UHI变化的每月HRI数量,我们使用治疗权重的逆概率分析了2006年至2017年HRI的差异,这两年是全州的两次主要极端高温事件.与不变相比,我们观察到减少的社区每月和每个ZCTA平均减少3.2(95%CI:0.5;5.9)HRIs。这项研究强调了城市气候适应策略的重要性,以减轻UHIs的强度和患病率,以减少与热相关的健康风险。
    This study investigates the relationship between temporal changes in temperatures characterizing local urban heat islands (UHIs) and heat-related illnesses (HRIs) in seven major cities of California. UHIs, which are a phenomenon that arises in the presence of impervious surfaces or the lack of green spaces exacerbate the effects of extreme heat events, can be measured longitudinally using satellite products. The two objectives of this study were: (1) to identify temperature trends in local temperatures to characterize UHIs across zip code tabulation areas (ZCTAs) in the seven observed cities over a 22-year period and (2) to use propensity score and inverse probability weighting to achieve exchangeability between different types of ZCTAs and assess the difference in hospital admissions recorded as HRIs attributable to temporal changes in UHIs. We use monthly land surface temperature data derived from MODIS Terra imagery from the summer months (June-September) from 2000 to 2022. We categorized ZCTAs (into three groups) based on their monthly land surface temperature trends. Of the 216 ZCTAs included in this study, the summertime land surface temperature trends of 43 decreased, while 161 remained unchanged, and 12 increased. Los Angeles had the greatest number of decreased ZCTAs, San Diego and San Jose had the highest number of increased ZCTAs. To analyze the number of monthly HRI attributable to changes in UHI, we used inverse probability of treatment weighting to analyze the difference in HRI between the years of 2006 and 2017 which were two major extreme heat events over the entire State. We observed an average reduction of 3.2 (95 % CI: 0.5; 5.9) HRIs per month and per ZCTAs in decreased neighborhoods as compared to unchanged. This study emphasizes the importance of urban climate adaptation strategies to mitigate the intensity and prevalence of UHIs to reduce health risks related to heat.
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  • 文章类型: Journal Article
    目的:城市化对植物进化的影响,特别是生殖特征的进化,仍然很大程度上未知。在这项研究中,我们旨在调查城市化对日本关东地区马齿莲生殖特征的影响。马齿轮轴有一个独特的生殖系统,由遗传决定的chasmogamous(开放,CH)和cleistogamy(封闭式,CL)植物。
    方法:我们从农村地区的10个种群和城市地区的10个种群中收集了P.oleracea的种子。在一个普通的花园实验中,我们记录了花的类型(CH或CL),生殖物候和种子生产。
    结果:所有个体都产生CH或CL花,允许我们将它们分类为CH或CL植物。我们观察到农村和城市人口中CH和CL植物的患病率存在显着差异:CH植物的数量普遍较低,在城市个体中尤其低。与CH植物相比,CL植物表现出更早的物候,并产生更重的种子,这与响应城市地区高温和干旱胁迫条件的胁迫避免是一致的。
    结论:我们的研究结果表明,城市化可能推动了甘蓝的性交生殖系统的进化变化。具有较早物候和较大种子的CL植物可能会更好地适应城市环境,在那里他们受到严酷的高温和干旱压力。
    OBJECTIVE: The impact of urbanization on plant evolution, particularly the evolution of reproductive traits, remains largely unknown. In this study, we aimed to investigate the consequences of urbanization on the reproductive traits of Portulaca oleracea in the Kantō region of Japan. Portulaca oleracea has a unique cleistogamous reproductive system, which consists of genetically determined chasmogamous (open, CH) and cleistogamous (closed, CL) plants.
    METHODS: We collected seeds of P. oleracea from ten populations in rural areas and ten populations in urban areas. In a common garden experiment, we recorded the type of flowers (CH or CL), reproductive phenology and seed production.
    RESULTS: All individuals produced either CH or CL flowers, allowing us to classify them as either CH or CL plants. We observed a significant difference in the prevalence of CH and CL plants between rural and urban populations: the number of CH plants was generally low and was particularly low among urban individuals. Compared to CH plants, CL plants showed earlier phenology and produced heavier seeds, which is consistent with stress avoidance in response to heat and drought stress conditions in urban areas.
    CONCLUSIONS: Our findings suggest that urbanization may drive an evolutionary change in the cleistogamous reproductive system of P. oleracea. CL plants with earlier phenology and larger seeds might be better adapted to urban environments, where they are subjected to harsh heat and drought stress.
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  • 文章类型: Journal Article
    尽管研究经常报道肥胖的患病率,报道印度超重或肥胖发生率的社区研究很少.这些发病率数据对于改善对未来肥胖负担的预测至关重要。
    2015年在城市Vellore进行了一项非并发随访研究,泰米尔纳德邦,在两组30-40岁的女性中,2012年体重指数(BMI)<25kg/m2(正常)和BMI≥25kg/m2(超重/肥胖),以评估BMI的变化。抽样框架包括473名女性:209名BMI<25kg/m2的女性和264名BMI≥25kg/m2的女性,他们是2012年横断面调查的一部分。使用随机选择的370名女性(原始队列的80%)来追踪这些女性。随访测量包括体重,高度,饮食和其他危险因素。
    370名女性中,在三年结束时,有170人(45.9%)接受了随访,其中包括BMI<25kg/m2的82和BMI>25kg/m2的88。三年内超重(BMI≥25kg/m2)的发生率,为29.2%(24/82),2012年BMI正常(<25kg/m2)的女性。在2012年超重/肥胖的88名女性中,在随访的三年内没有恢复正常的BMI。超重的发生率与碳水化合物的摄入量(调整比值比(AORs):3,95%置信区间(CI):1.04至8.63)和蛋白质摄入量(AOR:20.0,95%CI:2.5至158.3)之间存在关联。
    这项研究发现,在Vellore的30-40岁城市女性中,高BMI(≥25.0kg/m2)的发生率接近三分之一(29.2%),这意味着年轻女性的超重和肥胖人数迅速增加。
    UNASSIGNED: Although studies often report the prevalence of obesity, community-based studies reporting the incidence of overweight or obesity in India are scarce. Such incidence data are crucial for improving projections about the future burden of obesity.
    UNASSIGNED: A non-concurrent follow-up study was done in 2015 in urban Vellore, Tamil Nadu, among two groups of women aged 30-40 years, with body mass index (BMI) <25 kg/m2 (normal) and BMI ≥25 kg/m2 (overweight/obese) in 2012, to assess changes in BMI. The sampling frame consisted of 473 women: 209 women with BMI <25 kg/m2, and 264 women with BMI ≥25 kg/m2, who were part of a cross-sectional survey in 2012. A randomly selected list of 370 women (80% of the original cohort) was used to trace the women. Measurements at follow-up included weight, height, dietary and other risk factors.
    UNASSIGNED: Of 370 women, 170 (45.9%) were followed up at the end of three years, which included 82 with BMI <25 kg/m2 and 88 with BMI >25 kg/m2. The incidence of overweight (BMI ≥25 kg/m2) in three years, was 29.2% (24/82), among women with a normal BMI (<25 kg/m2) in 2012. Among the 88 women who were overweight/obese in 2012, there was no regression to normal BMI within the three years of follow-up. There was an association between the incidence of overweight and the intake of carbohydrates (adjusted odds ratios (AORs): 3, 95% confidence interval (CI): 1.04 to 8.63) and protein intake (AOR: 20.0, 95% CI:2.5 to 158.3).
    UNASSIGNED: This study found an incidence of nearly one-third (29.2%) of developing high BMI (≥25.0 kg/m2) in 30-40-year-old urban women from Vellore, implying a rapid increase in overweight and obesity among young women.
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  • 文章类型: Journal Article
    广泛的绿色屋顶在城市环境中提供许多生态系统服务。这些服务的功效受植被结构的影响。尽管它们在工厂性能和生产力中发挥关键作用,而且它们对固氮或固碳的贡献,到目前为止,绿色屋顶微生物群落很少受到关注。没有一项研究包括时空方面来调查居住在广泛的绿色屋顶基质中的核心微生物群,尽管这些关键分类群被认为是生态上最重要的分类群之一。这里,我们确定了居住在广泛的绿色屋顶基质中的核心微生物群,并调查了微生物群落组成是否受到种植在广泛的绿色屋顶上的植被的影响。来自佛兰德斯(比利时)三个不同城市的11个绿色屋顶,要么种植草的混合物,野花和多肉植物(景天属。;景天-草药-草屋顶)或仅景天(景天-苔藓屋顶),进行季节性采样,以通过代谢编码调查原核和真菌群落。确定关键的微生物类群表明,大多数类群是全球土壤中的显性基因型。许多细菌核心类群能够固氮,大多数真菌关键分类群都是耐胁迫的腐菌,内生菌,或者两者兼而有之。考虑到适应当地土壤条件的土壤微生物已被发现可以改善植物的适应性,有必要对核心微生物组进行进一步研究,以确定这些耐受胁迫的微生物对植被层有益的程度。尽管景天草草屋顶比景天苔藓屋顶包含更多的植物物种,我们没有观察到两种屋顶类型之间的微生物群落,可能是由于共享相同的基材纹理和植被层,在整个时间内变得更加相似。建议未来的研究全面表征植被层和组成,以检查微生物群落组装过程的主要驱动因素。
    Extensive green roofs provide for many ecosystem services in urban environments. The efficacy of these services is influenced by the vegetation structure. Despite their key role in plant performance and productivity, but also their contribution to nitrogen fixation or carbon sequestration, green roof microbial communities have received little attention so far. No study included a spatiotemporal aspect to investigate the core microbiota residing in the substrates of extensive green roofs, although these key taxa are hypothesized to be amongst the most ecologically important taxa. Here, we identified the core microbiota residing in extensive green roof substrates and investigated whether microbial community composition is affected by the vegetation that is planted on extensive green roofs. Eleven green roofs from three different cities in Flanders (Belgium), planted either with a mixture of grasses, wildflowers and succulents (Sedum spp.; Sedum-herbs-grasses roofs) or solely species of Sedum (Sedum-moss roofs), were seasonally sampled to investigate prokaryotic and fungal communities via metabarcoding. Identifying the key microbial taxa revealed that most taxa are dominant phylotypes in soils worldwide. Many bacterial core taxa are capable of nitrogen fixation, and most fungal key taxa are stress-tolerant saprotrophs, endophytes, or both. Considering that soil microbes adapted to the local edaphic conditions have been found to improve plant fitness, further investigation of the core microbiome is warranted to determine the extent to which these stress-tolerant microbes are beneficial for the vegetational layer. Although Sedum-herbs-grasses roofs contained more plant species than Sedum-moss roofs, we observed no discriminant microbial communities between both roof types, likely due to sharing the same substrate textures and the vegetational layers that became more similar throughout time. Future studies are recommended to comprehensively characterize the vegetational layer and composition to examine the primary drivers of microbial community assembly processes.
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  • 文章类型: Journal Article
    目的:饮食相关疾病正在上升,不成比例地影响少数民族社区,在这些社区中,小型食品零售店淹没了超市。大流行加剧了获取健康食物的障碍。我们研究了以下内容:(1)定期在街角商店购物的巴尔的摩社区成员样本中的个人和家庭水平因素,以及(2)这些因素与饮食质量指标的关系。
    方法:使用在线调查收集横截面数据,以获取社会人口统计学,人体测量学,和食物采购,消费,和消费模式。同时在Stata18和ATLAS中进行了定量和定性分析。ti.
    方法:这项研究在巴尔的摩进行,马里兰,美国。
    方法:参与者包括在巴尔的摩生活或工作的成年人(n=127),他们被确定为附近角落商店的常客。
    结果:受访者主要是黑人和低收入,食品不安全(62.2%)和超重/肥胖(66.9%)的患病率很高。大多数人(82.76%)每周在附近的街角商店购物。三分之一(33.4%)的饮料热量归因于含糖饮料,很少有人符合水果和蔬菜或纤维的推荐份量(27.2%和10.4%,分别)。黑人和不拥有房屋与较低的饮料和纤维摄入量有关,和不拥有一个家也与较低的水果和蔬菜的摄入量。食品不安全与更高的饮料摄入量有关,而WIC注册与较高的水果和蔬菜和纤维摄入量有关。在这种情况下,不限成员名额的应对措施将大流行后的食物采购和消费背景化。
    结论:本文有助于描述复杂城市食品系统的消费者特征。这些发现将为消费者参与改善当地食品环境的未来战略提供信息。
    OBJECTIVE: Diet-related disease is rising, disproportionately affecting minority communities in which small food retail stores swamp supermarkets. Barriers to healthy food access were exacerbated by the pandemic. We examined the following: (1) individual- and household-level factors in a sample of Baltimore community members who regularly shop at corner stores and (2) how these factors are associated with indicators of dietary quality.
    METHODS: Cross-sectional data were collected using an online survey to capture sociodemographics, anthropometrics, and food sourcing, spending, and consumption patterns. Concurrent quantitative and qualitative analyses were conducted in Stata 18 and ATLAS.ti.
    METHODS: This study was set in Baltimore, Maryland, USA.
    METHODS: The participants included adults (n = 127) living or working in Baltimore who identified as regular customers of their neighborhood corner store.
    RESULTS: The respondents were majority Black and low-income, with a high prevalence of food insecurity (62.2%) and overweight/obesity (66.9%). Most (82.76%) shopped in their neighborhood corner store weekly. One-third (33.4%) of beverage calories were attributed to sugar-sweetened beverages, and few met the recommended servings for fruits and vegetables or fiber (27.2% and 10.4%, respectively). Being Black and not owning a home were associated with lower beverage and fiber intake, and not owning a home was also associated with lower fruit and vegetable intake. Food insecurity was associated with higher beverage intake, while WIC enrollment was associated with higher fruit and vegetable and fiber intakes. Open-ended responses contextualized post-pandemic food sourcing and consumption in this setting.
    CONCLUSIONS: This paper helps characterize the consumers of a complex urban food system. The findings will inform future strategies for consumer-engaged improvement of local food environments.
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  • 文章类型: Journal Article
    背景:失踪和被谋杀的土著人民是一个历史性和当代的问题,已经引起了全国的关注。2021年,凶杀是1至54岁的美洲印第安人/阿拉斯加原住民(AIAN)死亡的第八大原因。在所有1-54岁的AIAN男性中,凶杀是第六大死因。
    目标:这些数据将建立有关AIAN凶杀案的知识,并确定可以帮助全面预防失踪和被谋杀土著人民的情况。
    方法:AIAN凶杀数据来自疾病控制和预防中心的国家暴力死亡报告系统,基于州/辖区的监控系统,收集有关暴力死亡特征和情况的详细信息。我们检查了参与州/辖区2003年至2020年(所有可用年份)的数据。我们还评估了受害者和嫌疑人的社会人口统计学特征,城乡二分法的事件特征和差异。该研究于2022年进行。
    结果:国家暴力死亡报告系统提供了2003年至2020年2959起AIAN凶杀案的数据(城市占54.2%,农村占45.8%)。基于两个位置的重大差异包括使用的武器类型,受伤的位置,主要嫌疑人的种族,受害者与嫌疑人的关系,并选择引发凶杀的情况,包括引发凶杀的犯罪和源于亲密伴侣暴力的凶杀。
    结果:这些发现为加强公共卫生预防工作提供了重要信息。
    BACKGROUND: Missing and Murdered Indigenous People is a historic and contemporary issue that has gained national attention. In 2021, homicide was the eighth leading cause of death among American Indian/Alaska Native (AIAN) persons aged between 1 and 54 years old, and homicide is the sixth leading cause of death among all AIAN males aged 1-54 years old.
    OBJECTIVE: These data will build knowledge around AIAN homicides and to identify circumstances that can aid in comprehensive Missing and Murdered Indigenous People prevention efforts.
    METHODS: AIAN homicide data came from Centers for Disease Control and Prevention\'s National Violent Death Reporting System, a state/jurisdiction-based surveillance system that collects detailed information about characteristics and circumstances of violent deaths. We examined data from 2003 to 2020 (all available years) from participating states/jurisdictions. We also assessed sociodemographic characteristics of victims and suspects, incident characteristics and differences across dichotomised urban/rural status. The study was conducted in 2022.
    RESULTS: The National Violent Death Reporting System provided data on 2959 AIAN homicides from 2003 to 2020 (54.2% urban and 45.8% rural). Significant differences based on the two locations included type of weapon used, the location of the injury, race of the primary suspect, the victim\'s relationship to the suspect and select circumstances precipitating the homicide including crimes precipitating the homicide and homicides stemming from intimate partner violence.
    RESULTS: These findings provide crucial information to strengthen public health efforts for prevention.
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  • 文章类型: Journal Article
    认知技能,例如创新解决问题,假设是为了帮助城市环境中的动物。然而,创新在野生种群中的重要性,以及它在个体和社会生态条件中的表达,知之甚少。为了确定城市居住物种如何以及何时出现创新,我们使用先进的技术以及新的测试和分析方法来评估野生浣熊(Procyonlotor)的创新解决问题的能力。我们部署了具有一种或多种解决方案类型的多隔间拼图盒,并使用射频识别来识别浣熊。浣熊解决了这些新颖的提取觅食任务,他们的成功受到年龄和探索性多样性的影响。成功的浣熊总是发现多种不同的解决方案类型,突出灵活解决问题的能力。使用独特的,比较序列分析方法,我们发现浣熊解决技术的差异在个体之间比个体内部更大,这种自我相似性在竞争中加剧了。最后,在多解决方案试验中加入了更简单的解决方案,使以前不成功的浣熊能够引导他们的学习,并成功打开多个困难的解决方案.我们的研究表明,创新的问题解决可能受到许多因素的影响,并提供了新颖的领域和分析方法,以及对城市人口社会生态动态的新见解。
    Cognitive skills, such as innovative problem-solving, are hypothesized to aid animals in urban environments. However, the significance of innovation in wild populations, and its expression across individuals and socio-ecological conditions, is poorly understood. To identify how and when innovation arises in urban-dwelling species, we used advanced technologies and new testing and analytical methods to evaluate innovative problem-solving abilities of wild raccoons (Procyon lotor). We deployed multi-compartment puzzle boxes with either one or multiple solution types and identified raccoons using radio frequency identification. Raccoons solved these novel extractive foraging tasks, and their success was influenced by age and exploratory diversity. Successful raccoons always discovered multiple different solution types, highlighting flexible problem-solving. Using a unique, comparative sequence analysis approach, we found that variation in raccoon solving techniques was greater between individuals than within individuals, and this self-similarity intensified during times of competition. Finally, the inclusion of an easier solution in the multi-solution trials enabled previously unsuccessful raccoons to bootstrap their learning and successfully open multiple difficult solutions. Our study suggests that innovative problem-solving is probably influenced by many factors and has provided novel field and analytical methods, as well as new insights on the socio-ecological dynamics of urban populations.
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  • 文章类型: Journal Article
    背景:有效的医疗保健临床医生沟通是优质姑息和临终(PEOL)护理的关键组成部分。然而,当临床医生不愿意与患者及其家人进行这些对话时,沟通可能会受到阻碍。在农村地区工作的临床医生报告了提供姑息治疗的几个障碍。这项研究检查了农村和城市临床医生报告的熟悉程度与患者和家庭的关系,据报道,他们在开始PEOL对话时感到舒适,和他们的PEOL护理知识。方法:本研究使用横断面设计来检查农村和城市临床医生熟悉度之间的关系,他们在PEOL通信中的安慰,和他们的PEOL护理知识。结果:N=548名农村和城市临床医生参加。农村临床医生报告更熟悉,更多的PEOL知识,和更多的舒适与PEOL通信。PEOL知识的多元回归分析显示,知识与老年临床医生(P<0.01)和额外的姑息治疗培训(P<0.01)有显著关联;PEOL沟通的舒适度与更多姑息治疗培训(P<0.01)和提供姑息治疗的机会(P<0.01)有显著关联。结论:熟悉度的概念非常复杂,在农村和城市环境中与PEOL护理有关的了解很少。需要进行未来的研究,以探索PEOL护理和临床医生报告的熟悉程度的额外培训如何通过增加完成和遵循的预先指示的数量以及改进的预先护理计划的文档来积极影响患者的结果。
    Background: Effective healthcare clinician communication is a key component of quality palliative and end-of-life (PEOL) care. However, communication may be hampered when clinicians are not comfortable initiating these conversations with patients and their families. Clinicians working in rural areas report several barriers to providing palliative care. This study examined the relationship between rural and urban clinicians\' reported familiarity with their patients and families end-of-life, their reported comfort in initiating PEOL conversations, and their PEOL care knowledge. Method: This study used a cross-sectional design to examine the relationships between rural and urban clinicians\' familiarity, their comfort in PEOL communication, and their PEOL care knowledge. Results: N = 548 rural and urban clinicians participated. Rural clinicians reported greater familiarity, more PEOL knowledge, and more comfort with PEOL communication. Multiple regression analyses of PEOL knowledge showed significant associations in knowledge with older clinicians (P < 0.01) and additional palliative care training (P < 0.01); comfort in PEOL communication had significant associations with more palliative care training (P < 0.01) and opportunities to provide palliative care (P < 0.01). Conclusion: The concept of familiarity is highly complex and poorly understood in relation to PEOL care in both rural and urban settings. Future research is needed to explore how additional training in PEOL care and clinician reported familiarity positively impact patient outcomes by increasing the number of advance directives completed and followed and improved documentation of advance care planning.
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  • 文章类型: Journal Article
    生物资本的STS理论概念化了生物医学知识和资本如何共同形成。尽管这些生物资本组织通常位于大型城市中心,很少有学者关注他们如何改变城市空间和场所。在本文中,我们认为,细胞和城市的孪生技术发展集中了经济和符号资本,并引发了我们称为城市生物政治的有争议的实践。我们利用档案研究和近十年的人种学研究来扩展美国主要城市的生物医学校园,以显示土地开发和生物医学创新的投机逻辑如何在我们描述为投机振兴的过程中结合在一起。我们研究了投机振兴的逻辑如何想象城市和生物医学和谐地共同创造财富和健康的未来。然而,在实践中——随着新的生物医学城市校园的建设——亿万富翁慈善资本家创造全球城市的梦想与生物医学研究人员创造全球健康的计划相冲突。我们记录了分层和种族化的生物医学排除的再现,这些结果同时也强调了创建致力于在城市社区创建公平的生物医学研究和医疗保健的联盟的不太可能的机会。
    STS theories of biocapital conceptualize how biomedical knowledge and capital form together. Though these formations of biocapital often are located in large urban centers, few scholars have attended to how they are transforming urban spaces and places. In this paper we argue that the twinned technological development of cells and cities concentrates economic and symbolic capital and sets in motion contentious practices we name urban biopolitics. We draw on archival research and a nearly decade-long ethnography of the expansion of biomedical campuses in a major American city to show how the speculative logics of land development and biomedical innovation become bound together in a process we describe as speculative revitalization. We examine how the logics of speculative revitalization imagine a future in which cities and biomedicine produce wealth and health harmoniously together. However, in practice-as buildings of new biomedical urban campuses get built-the dreams of billionaire philanthrocapitalists to create global cities clash with the plans of biomedical researchers to create global health. We document the reproduction of stratified and racialized biomedical exclusions that result while also highlighting the unlikely opportunities for creating alliances committed to creating equitable biomedical research and healthcare in urban communities.
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