Medical geography

OBJECTIVE: Timely access to a lead trauma hospital (LTH) saves lives; however, the vast geography of Northern Ontario creates a barrier to equitable access to an LTH. Paramedics in Ontario follow the field trauma triage standard (FTTS) to identify which patients should be directly brought to an LTH. A pilot project was launched using a fixed wing modified scene response (MSR) to transport patients from Northern Ontario who met the FTTS directly to an LTH. This study aimed to 1) explore the impact of the fixed wing MSR pilot program on the time to LTH arrival for injured patients in Northern Ontario compared with the traditional interfacility transfer (IFT) process and 2) determine the frequency and specific FTTS criteria that were fulfilled...

CONTEXT: Rural-urban disparities have been reported in cancer care, but data are sparse on the effect of geography and location of residence on access to care in thyroid cancer. OBJECTIVE: To identify impact of rural or urban residence and distance from treatment center on thyroid cancer stage at diagnosis. METHODS: We evaluated 800 adults with differentiated thyroid cancer in the iCaRe2 bioinformatics/biospecimen registry at the Fred and Pamela Buffett Cancer Center...

OBJECTIVE: This study compared mental health treatment engagement among people with serious mental illness after release from jails that had either a for-profit (N=3 jails) or a nonprofit mental health provider (N=7 jails). METHODS: Across the 10 jails, data were collected in 2019 for 1,238 individuals with serious mental illness. Data included demographic characteristics (age, race-ethnicity, gender, geography, and jail type) and behavioral health variables (previous mental health treatment, psychotropic medication use, substance use, and receipt of jail-based mental health services)...

BACKGROUND: Pregnant individuals in incarcerated settings have unique healthcare needs. Rates of mental health, infectious diseases, and chronic disease are higher among nonpregnant incarcerated women compared with those who are not, but the prevalence of these conditions among pregnant people in custody has not been documented. OBJECTIVES: The objective of this study is to describe the prevalence of metabolic, infectious, and mental health conditions in pregnant people to identify the medical needs of high-risk pregnancies in US state prisons and local jails...

BACKGROUND: Diet intervention forms the cornerstone for cardiovascular disease (CVD) management. OBJECTIVE: The objective was to measure the frequency of dietary counseling documentation for patients recently hospitalized with CVD. DESIGN: This was an observational study. PARTICIPANTS AND SETTING: Patients were included from the Michigan Value Collaborative Multipayer Claims Registry from October 2015 to February 2020...

PURPOSE: To describe the clinical and demographic profile of herpes zoster ophthalmicus (HZO) in patients presenting to a multitier ophthalmology hospital network in India. METHODS: Cross-sectional hospital-based study included 3,004,470 new patients between August 2010 and October 2021. Patients with a clinical diagnosis of HZO in at least one eye were included. Data were collected using an electronic medical record system. RESULTS: In total, 1,752 (0...

Due to binomial classification system defined by Carl von Linné, it has been shown that living things that were thought to be independent from each other are actually in a relationship. This "binomial classification" idea corresponds to a leap in the history of human thought. Carl von Linné's original idea is a product of the specific conditions of the period, particularly the renaissance and reform movements and geographical discoveries, rather than an idea he produced alone. These movements are part of a chain of ideas that stretches from antiquity to the Medieval and then to the period called the Enlightenment...

In Britain more men participate in gambling than women, although the gender gap is narrowing; and online gambling is increasing among women and men. Gambling practices differ between men and women but also between different groups of women, with evidence that younger women are diversifying to gamble in different ways from older women. Complex and powerful spatial, socio-cultural and economic forces shape women's experiences of gambling, the problems gambling may cause, and wider societal efforts to minimise these harms...

OBJECTIVES: The objective of this analysis is to present a current view of the field of ophthalmology and vision research and artificial intelligence (AI) from topical and geographical perspectives. This will clarify the direction of the field in the future and aid clinicians in adapting to new technological developments. METHODS: A comprehensive search of four different databases was conducted. Statistical and bibliometric analysis were done to characterise the literature...

PURPOSE: Total Medicaid funds invested in graduate medical education (GME) increased from $3.78 billion in 2009 to $7.39 billion in 2022. States have flexibility in designing Medicaid GME payments to address population health needs. This study assessed states' impetus for using Medicaid funds for GME, structure of state Medicaid payments, composition and charge of advisory bodies that guide these investments, and degree of transparency and accountability to track whether Medicaid GME investments achieved desired workforce outcomes...

Mosquitoes harbor a wide diversity of microorganisms, including viruses that are human pathogens, or that are insect specific. We used metatranscriptomics, an unbiased high-throughput molecular approach, to describe the composition of viral and other microbial communities in six medically important mosquito species from across Western Australia: Aedes vigilax , Culex annulirostris , Cx. australicus , Cx. globocoxitus , Cx. pipiens biotype molestus , and Cx. quinquefasciatus . We identified 42 viral species, including 13 novel viruses, from 19 families...

Although cardiovascular diseases are the leading cause of morbidity and mortality worldwide, six billion people lack access to safe, timely and affordable cardiac surgical care when needed. The burden of cardiovascular disease and disparities in access to care vary widely based on sociodemographic characteristics, including but not limited to geography, sex, gender, race, ethnicity, indigeneity, socioeconomic status and age. To date, the majority of cardiovascular, global health and global surgical research has lacked intersectionality lenses and methodologies to better understand access to care at the intersection of multiple identities and traditions...

OBJECTIVE: To analyze the equity of human resources allocation of the Centers for Disease Control and Prevention (CDCs) and to predict the development in the next five years in China, and to provide a scientific basis for promoting the development of human resources. METHODS: The data of the CDCs from 2017 to 2021 were obtained from the "China Health Statistical Yearbook", and descriptive analysis, health resource density index (HRDI), Theil index, and health resource agglomeration degree (HRAD) were used to evaluate the equity, and the grey prediction model GM (1, 1) was used to predict the development from 2022 to 2026...

OBJECTIVES: This study aimed to investigate determinants of reperfusion within recommended time limits (timely reperfusion) for ST-segment elevation myocardial infarction patients, exploring the impact of geography, patient characteristics and socio-economy. DESIGN: National register-based cohort study. SETTING: Multilevel logistic regression models were applied to examine the associations between timely reperfusion and residency in hospital referral areas and municipalities, patient characteristics, and socio-economy...

BACKGROUND: Signet-ring cell colorectal carcinoma (SRCC) is an extremely aggressive yet uncommon histologic subtype of colorectal cancer (CRC) with an unknown etiology. There is a stark difference in the prevalence of signet cancers between Western countries and the Indian subcontinent; however, India itself is a vast and diverse country with variable cancer incidence. OBJECTIVE: To study the spatial epidemiology of SRCC in India for identifying regions with high prevalence...

BACKGROUND: Growing clinical demands, faculty retirements, fewer PhD-prepared graduates, and funding instability are challenges for nursing science. PURPOSE: The purpose of this analysis was to investigate National Institutes of Health (NIH) funding patterns in schools of nursing (SONs). METHODS: Data were extracted from the Blue Ridge Institute for Medical Research between 2006 and 2022. Growth modeling examined changes in funding over time between private and public SONs...

It is believed that >95% of people with Lynch syndrome (LS) remain undiagnosed. Within the National Health Service (NHS) in England, formal guidelines issued in 2017 state that all colorectal cancers (CRC) should be tested for DNA Mismatch Repair deficiency (dMMR). We used a comprehensive population-level national dataset to analyse implementation of the agreed diagnostic pathway at a baseline point 2 years post-publication of official guidelines. Using real-world data collected and curated by the National Cancer Registration and Analysis Service (NCRAS), we retrospectively followed up all people diagnosed with CRC in England in 2019...

Despite many countries having policies and systems for universal healthcare coverage, health disparity persists, with significant variations in disease prevalence and life expectancy between different groups of people. This focused ethnography explored the post-stroke recovery of Indigenous and non-Indigenous populations in three geographical areas in Taiwan. Forty-eight observations and 24 interviews were carried out with 12 dyads of stroke survivors and family caregivers, revealing their varied experiences of healthcare...

The rationalization of care, leading to lacking medical goods, represents a broad moral geography that encompasses important, often unarticulated social values, as well as dilemmas regarding the nature and purpose of medical care as a social good. The COVID-19 pandemic has highlighted a shortage of intensive care units, prompting health officials to develop or revise protocols for admitting patients to intensive care units. Christian bioethicists argue that the way we choose to allocate medical resources reveals our fundamental beliefs about the obligations we have to the most vulnerable, especially the sick and dying...

BACKGROUND: Monovalent booster/additional doses of COVID-19 vaccines were first authorized in August 2021 in the United States. We evaluated the real-world effectiveness of receipt of a monovalent booster/additional dose of COVID-19 vaccine compared with receiving a primary vaccine series without a booster/additional dose. METHODS: Cohorts of individuals receiving a COVID-19 booster/additional dose after receipt of a complete primary vaccine series were identified in 2 administrative insurance claims databases (Optum, CVS Health) supplemented with state immunization information system data between August 2021 and March 2022...