scholarly journals Analysis of Emergency Medical Vulnerability and Survival Rates Following Real-Time Traffic Information

2020 ◽  
Vol 10 (18) ◽  
pp. 6492
Author(s):  
Jeongbae Jeon ◽  
Solhee Kim ◽  
Gu Hyun Kang ◽  
Kyo Suh
Keyword(s):  
Survival Rate ◽  
Real Time ◽  
Rural Areas ◽  
Urban Areas ◽  
Road Traffic ◽  
Survival Rates ◽  
Emergency Patients ◽  
The Public ◽  
Emergency Medical ◽  
Medical Facilities

Providing rapid access to emergency medical services (EMS) within the “golden time” for survival is important to improve the survival rate of emergency patients. This study analyzes the accessibility of EMS based on driving speed changes following real-time road traffic conditions by time to estimate vulnerable areas for EMS and survival rates of emergency patients. The key results of the network analysis based on real-time road speed and this evaluation of vulnerable areas by village level across South Korea reveal the different characteristics of urban and rural areas to access emergency medical facilities. In urban areas, road traffic congestion during rush hour delays the patients’ access time to EMS. In contrast, in rural areas, the long geographical distance to an emergency medical facility is a hurdle for receiving care from an EMS during the “golden time” because emergency medical facilities are mostly located in urban areas. The existing standard to assess vulnerable areas of EMS accessibility is based on the speed limit of roads, but the time may be underestimated because the speed limit alone does not reflect the real road conditions. The study results show that an effective way to increase the survival rate is receiving immediate first aid treatment, which means that the government should continuously train the public to perform cardiopulmonary resuscitation (CPR) as well as install automated external defibrillators (AEDs) in populated places, and train the public to use them. Reducing assess time to emergency medical centers in urban areas and providing additional manpower to help with first aid in rural areas are reasonable ways to improve the survival rate of emergency patients.

scholarly journals An analysis of emergency response times within the public sector emergency medical services in KwaZulu-Natal

2017 ◽  
Author(s):  
◽  
Melissa Joy Finlayson
Keyword(s):  
Focus Group ◽  
Emergency Medical Services ◽  
Rural Areas ◽  
Urban Areas ◽  
Quantitative Data ◽  
Qualitative Data ◽  
Response Times ◽  
The Public ◽  
Emergency Medical ◽  
National Norms

Introduction: Response times are considered to be one of the oldest and most popular indicators which are used to measure the efficiency of Emergency Medical Services (EMS), particularly to cases in which the patient’s condition is deemed to be life threatening. Purpose: To analyse emergency response times within the public sector Emergency Medical Services in KwaZulu-Natal and to compare these to the national norms. Methods: Using a mixed method approach, the study was conducted in two phases. The first phase involved collecting quantitative data for all the cases logged in the Umgungundlovu Health District Communications Centre over a period of one week (seven days). Phase Two involved the collection of qualitative data from focus group discussions which were conducted with three groups which had been identified. These groups included the communications centre staff, operational staff and supervisory staff. The aim of these focus group discussions was to identify factors that influenced response times as well as to propose strategies which would improve these response times. Content analysis was utilised to interpret the qualitative data which had been collected. Results: Quantitative data was collected from a total of 1 503 cases of which 680 were categorised as priority 1 (P1), 270 as priority 2 (P2) and 553 as inter facility transfer (IFT). The majority of the cases (895) had occurred in urban areas. A total of 406 cases were exempted as no patient was transported. The number of these cases was greater on days when the total case load was higher as compared to days with a lower total case load. The mean response time to cases in rural areas was 129 minutes and 110 minutes to cases in urban areas. All the time intervals were found to be longer for cases in rural areas as compared to those for cases in urban areas but with the exception of the EMD response interval. P1 cases had the shortest mean response times for both urban area cases (33 minutes) and rural area cases (95 minutes) as compared to the other case categories. Nevertheless, the national norm of 15 minutes in urban areas and 40 minutes in rural areas was not achieved in the majority of the cases. The mean Emergency Medical Dispatch (EMD) response interval was 41 minutes for P1 cases, 56 minutes for P2 cases and 96 minutes for IFT cases. The qualitative data revealed factors that impacted on the response times and helped to explain and account for the quantitative data results. Challenges regarding the availability of resources, including vehicles, staff and equipment, as well as the way in which such resources are managed, were highlighted. The high demand for services compared to the available resources was raised by the focus group participants with this high demand resulting in extended EMD response intervals. This was exacerbated by the overwhelming demand for IFT cases which are serviced by the same resources as emergency cases and which have a much longer mission time, thus delaying response times continuously. Exempt cases were also found to impact negatively on response times as, although operational vehicles are committed to these cases, services are not required. Inconsistencies with regards to case prioritisation and dispatch triage also emerged. External factors, including poor road infrastructure, lack of road names and house numbers, weather conditions and long distances between EMS bases, the patient or incident location and health care facilities were also identified as factors that resulted in extended response times. Strategies to improve the situation were explored. These strategies included the effective management of resources in order to ensure optimal availability, the introduction of a formal, computer aided, dispatch system, the adoption of demand pattern analysis and dynamic location/relocation models, standardised processes and procedures to guide all areas of EMS operations and the education of both the public and staff. Conclusion: South African EMS response time national norms for both rural and urban areas are unachievable under the majority of circumstances and, thus, they may be said to be unrealistic. Until these national norms, against which the efficiency of EMS in South Africa is measured, are revised, the service will be deemed to be incompetent.

scholarly journals Factors Impacting Patient Outcomes Associated with Use of Emergency Medical Services Operating in Urban Versus Rural Areas: A Systematic Review

2019 ◽  
Vol 16 (10) ◽  
pp. 1728 ◽  
Author(s):  
Ahmed Ramdan M. Alanazy ◽  
Stuart Wark ◽  
John Fraser ◽  
Amanda Nagle
Keyword(s):  
Systematic Review ◽  
Emergency Medical Services ◽  
Patient Outcomes ◽  
Rural Areas ◽  
Urban Areas ◽  
Survival Rates ◽  
Middle Income ◽  
Middle Income Countries ◽  
Emergency Medical ◽  
Urban Versus

The goal of this systematic review was to examine the existing literature base regarding the factors impacting patient outcomes associated with use of emergency medical services (EMS) operating in urban versus rural areas. A specific subfocus on low and lower-middle-income countries was planned but acknowledged in advance as being potentially limited by a lack of available data. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed during the preparation of this systematic review. A comprehensive literature search of PubMed, EBSCO (Elton B. Stephens Company) host, Web of Science, ProQuest, Embase, and Scopus was conducted through May 2018. To appraise the quality of the included papers, the Critical Appraisal Skills Programme Checklists (CASP) were used. Thirty-one relevant and appropriate studies were identified; however, only one study from a low or lower-middle-income country was located. The research indicated that EMS in urban areas are more likely to have shorter prehospital times, response times, on-scene times, and transport times when compared to EMS operating in rural areas. Additionally, urban patients with out-of-hospital cardiac arrest or trauma were found to have higher survival rates than rural patients. EMS in urban areas were generally associated with improved performance measures in key areas and associated higher survival rates than those in rural areas. These findings indicate that reducing key differences between rural and urban settings is a key factor in improving trauma patient survival rates. More research in rural areas is required to better understand the factors which can predict these differences and underpin improvements. The lack of research in this area is particularly evident in low- and lower-middle-income countries.

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

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.

scholarly journals Mobile Road Traffic Management System Using Weighted Sensor

2017 ◽  
Vol 11 (5) ◽  
pp. 147 ◽  
Author(s):  
Solomon Adegbenro Akinboro ◽  
Johnson A Adeyiga ◽  
Adebayo Omotosho ◽  
Akinwale O Akinwumi
Keyword(s):  
Real Time ◽  
Traffic Control ◽  
Urban Areas ◽  
Traffic Management ◽  
Management System ◽  
Road Traffic ◽  
Traffic Information ◽  
Traffic Light ◽  
Real Time Traffic ◽  
Traffic Management System

<p><strong>Vehicular traffic is continuously increasing around the world, especially in urban areas, and the resulting congestion ha</strong><strong>s</strong><strong> be</strong><strong>come</strong><strong> a major concern to automobile users. The popular static electric traffic light controlling system can no longer sufficiently manage the traffic volume in large cities where real time traffic control is paramount to deciding best route. The proposed mobile traffic management system provides users with traffic information on congested roads using weighted sensors. A prototype of the system was implemented using Java SE Development Kit 8 and Google map. The model </strong><strong>was</strong><strong> simulated and the performance was </strong><strong>assessed</strong><strong> using response time, delay and throughput. Results showed that</strong><strong>,</strong><strong> mobile devices are capable of assisting road users’ in faster decision making by providing real-time traffic information and recommending alternative routes.</strong></p>

scholarly journals Decomposing Urban-rural Differences in Multimorbidity Among Older Adults in India: A Study Based on Lasi Data

2021 ◽  
Author(s):  
Shekhar Chauhan ◽  
Shobhit Srivast ◽  
Pradeep Kumar ◽  
Ratna Patel
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Urban Areas ◽  
Decomposition Analysis ◽  
The Public ◽  
Analysis Techniques ◽  
Ageing Study ◽  
Urban Rural ◽  
The Difference ◽  
Urban And Rural Areas

Abstract Background: Multimorbidity is defined as the co-occurrence of two or more than two diseases in the same person. With rising longevity, multimorbidity has become a prominent concern among the older population. Evidence from both developed and developing countries shows that older people are at much higher risk of multimorbidity, however, urban-rural differential remained scarce. Therefore, this study examines urban-rural differential in multimorbidity among older adults by decomposing the risk factors of multimorbidity and identifying the covariates that contributed to the change in multimorbidity.Methods: The study utilized information from 31,464 older adults (rural-20,725 and urban-10,739) aged 60 years and above from the recent release of the Longitudinal Ageing Study in India (LASI) wave 1 data. Descriptive, bivariate, and multivariate decomposition analysis techniques were used.Results: Overall, significant urban-rural differences were found in the prevalence of multimorbidity among older adults (difference: 16.3; p<0.001). Moreover, obese/overweight and high-risk waist circumference were found to narrow the difference in the prevalence of multimorbidity among older adults between urban and rural areas by 8% and 9.1%, respectively.Conclusion: There is a need to substantially increase the public sector investment in healthcare to address the multimorbidity among older adults, more so in urban areas, without compromising the needs of older adults in rural areas.

scholarly journals Quality of Bus Services Performance: Benefits of Real Time Passenger Information Systems

2013 ◽  
Vol 14 (2) ◽  
pp. 155-166 ◽  
Author(s):  
Andres Monzon ◽  
Sara Hernandez ◽  
Rocio Cascajo
Keyword(s):  
Real Time ◽  
Public Transport ◽  
Urban Areas ◽  
Travel Behaviour ◽  
Transport Systems ◽  
Sustainable Transport ◽  
The Public ◽  
Steady Growth ◽  
Bus Services

One of the main problems in urban areas is the steady growth in car ownership and traffic levels. Therefore, the challenge of sustainability is focused on a shift of the demand for mobility from cars to collective means of transport. For this purpose, buses are a key element of the public transport systems. In this respect Real Time Passenger Information (RTPI) systems help people change their travel behaviour towards more sustainable transport modes. This paper provides an assessment methodology which evaluates how RTPI systems improve the quality of bus services performance in two European cities, Madrid and Bremerhaven. In the case of Madrid, bus punctuality has increased by 3%. Regarding the travellers perception, Madrid raised its quality of service by 6% while Bremerhaven increased by 13%. On the other hand, the users´ perception of Public Transport (PT) image increased by 14%.

Pediatric Prehospital Care in Urban and Rural Areas

PEDIATRICS ◽  
1991 ◽  
Vol 88 (4) ◽  
pp. 681-690 ◽  
Author(s):  
James S. Seidel ◽  
Deborah Parkman Henderson ◽  
Patrick Ward ◽  
Barbara Wray Wayland ◽  
Beverly Ness
Keyword(s):  
Emergency Medical Services ◽  
Rural Areas ◽  
Urban Areas ◽  
Pediatric Patients ◽  
Life Support ◽  
Prehospital Care ◽  
Advanced Life Support ◽  
Medical Services ◽  
Care Providers ◽  
Emergency Medical

There are limited data concerning pediatric prehospital care, although pediatric prehospital calls constitute 10% of emergency medical services activity. Data from 10 493 prehospital care reports in 11 counties of California (four emergency medical services systems in rural and urban areas) were collected and analyzed. Comparison of urban and rural data found few significant differences in parameters analyzed. Use of the emergency medical services system by pediatric patients increased with age, but 12.5% of all calls were for children younger than 2 years. Calls for medical problems were most common for patients younger than 5 years of age; trauma was a more common complaint in rural areas (64%, P = .0001). Frequency of vital sign assessment differed by region, as did hospital contact (P &lt; .0001). Complete assessment of young pediatric patients, with a full set of vital signs and neurologic assessment, was rarely performed. Advanced life support providers were often on the scene, but advanced life support treatments and procedures were infrequently used. This study suggests the need for additional data on which to base emergency medical services system design and some directions for education of prehospital care providers.

scholarly journals Standard Precautions Among Emergency Medical Services in Urban and Rural Areas

2019 ◽  
Vol 68 (2) ◽  
pp. 73-80
Author(s):  
Riyadh A. Alhazmi ◽  
R. David Parker ◽  
Sijin Wen
Keyword(s):  
West Virginia ◽  
Emergency Medical Services ◽  
Rural Areas ◽  
Urban Areas ◽  
Medical Services ◽  
Cross Sectional Survey ◽  
Standard Precautions ◽  
Cross Sectional ◽  
Emergency Medical ◽  
Rural And Urban

Backround: Emergency medical services (EMS) workers are at risk of exposure to bloodborne pathogens and frequently exposed to blood and bodily fluids through percutaneous injuries. This study aimed to assess the consistency with which standard precautions (SPs) among rural and urban EMS providers were used. Methods: This study consisted of a cross-sectional survey conducted with a sample of certified EMS providers in West Virginia in which we ascertained details about sociodemographic characteristics, and the frequency of consistent SP. An email invitation was sent to a comprehensive list of agencies obtained from the Office of West Virginia EMS. Findings: A total of 248 out of 522 (47%) EMS providers completed the survey. The majority of the EMS providers (76%) consistently complied with SPs; however, more than one third (38%) of urban EMS providers indicated inconsistent use compared with 19% of rural EMS providers ( p = .002). Most EMS providers reported low prevention practices to exposure of blood and body fluids in both areas. Conclusion/Application to Practice: The results emphasize the need to enhanced safe work practices among EMS providers in both rural and urban areas through education and increasing self-awareness. Occupational health professional in municipalities that serve these workers are instrumental in ensuring these workers are trained and evaluated for their compliance with SPs while in the field.

Prostate cancer patient’s survival in Lithuania

2013 ◽  
Vol 19 (4) ◽  
pp. 439-444
Author(s):  
Giedrė Smailytė ◽  
Robertas Adomaitis ◽  
Karolis Ulinskas ◽  
Birutė Aleknavičienė
Keyword(s):  
Prostate Cancer ◽  
Survival Rate ◽  
Cancer Patients ◽  
Rural Areas ◽  
Survival Rates ◽  
Relative Survival ◽  
Care Quality ◽  
Place Of Residence ◽  
Icd 10 ◽  
Survival Differences

Background. The aim of this study was to evaluate changes in the survival of prostate cancer patients during the 12-year period and to analyze differences in survival by period of diagnosis, stage of disease, age and place of residence. Materials and methods. All newly diagnosed cases of prostate cancer (ICD-10, C61) in men were identified in the Lithuanian Cancer Registry for the period 1994–2005. Five-year relative survival estimates were computed with the Hakulinen method using the STATA software. Five-year relative survival estimates were calculated for three different periods of time when prostate cancer was diagnosed (1994–1997, 1998–2001 and 2002–2005), by age (15–59, 60–74, and 75–99), stage at diagnosis (I, II, III, IV, unknown) and place of residence (cities and towns or rural areas). Results. The survival of prostate cancer patients in Lithuania has dramatically increased. Five-year relative survival in the period 1994–1997 was 46.92% and in the period 2002–2005 it reached 86.49%. Medium age prostate cancer patients (60–74 years) compared to younger and older patients had better survival rates. Increasing survival was observed for all stages of disease. Lower five-year relative survival rate of prostate cancer patients was reported for men from villages or other rural areas compared to patients from cities and towns in all periods under study. Conclusions. The five-year survival rate of patients with prostate cancer has increased from 46.92% (95% CI 44.12–49.74) in 1994–1997 to 86.49% (95% CI 84.73–88.22) in 2002–2005 in Lithuania. The study identified survival differences by age and place of residence. Issues, such as access to care, quality of medical care, must be made equally available and accessible for the whole population with special attention to older men and men living in rural areas.

Faecal sludge management in low income areas: a case study of three districts in the Ashanti region of Ghana

2014 ◽  
Vol 4 (2) ◽  
pp. 189-199 ◽  
Author(s):  
Eugene Appiah-Effah ◽  
Kwabena Biritwum Nyarko ◽  
Samuel Fosu Gyasi ◽  
Esi Awuah
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Sludge Management ◽  
The Public ◽  
Ashanti Region ◽  
Toilet Facility ◽  
Urban And Rural Areas ◽  
Public Toilets ◽  
Faecal Sludge

The challenge of faecal sludge management (FSM) in most developing countries is acute, particularly in low income areas. This study examined the management of faecal sludge (FS) from household latrines and public toilets in three districts in the Ashanti region of Ghana based on household surveys, key informant interviews and field observations. Communities did not have designated locations for the disposal and treatment of FS. For household toilets, about 31 and 42% of peri-urban and rural respondents, respectively, with their toilets full reported that they did not consider manual or mechanical desludging as an immediate remedy, although pits were accessible. Households rather preferred to close and abandon their toilets and use public toilets at a fee or practise open defecation. For the public toilets, desludging was manually carried out at a fee of GHC 800–1,800 and the process usually lasted 8–14 days per toilet facility. The study showed that FSM has not been adequately catered for in both peri-urban and rural areas. However, respondents from the peri-urban areas relatively manage their FS better than their rural counterparts. To address the poor FSM in the study communities, a decentralized FS composting is a potential technology that could be used.

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