849 resultados para Urban-rural Differences


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Purpose: To evaluate the influence of socioeconomic factors on visual acuity before cataract surgery. ?Methods: The medical case notes of 240 consecutive patients listed for cataract surgery from January 1, 2010, at Grampian University Hospital, Aberdeen, were reviewed retrospectively. Patients with ocular comorbidity were excluded. Demographics, postal codes, and visual acuity were recorded. Scottish Index of Multiple Deprivation was used to determine the deprivation rank. Home location was classified as urban or rural. The effect of these parameters on preoperative visual acuity was investigated using chi-square tests or Fisher exact test as appropriate. ?Results: A total of 184 patients (mean 75 years) were included. A total of 127 (69%) patients had visual acuity of 6/12 or better. An association was found between affluence and preoperative visual acuity of 6/12 or better (?2trend = 4.97, p = 0.03), with a significant rising trend across quintile of deprivation. There was no evidence to suggest association between geographical region and preoperative visual acuity (p = 0.63). ?Conclusion: Affluence was associated with good visual acuity (6/12 or better) before cataract surgery. There was no difference in preoperative visual acuity between rural and urban populations.

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Some studies suggest that there are urban-rural variations in cancer incidence but whether these simply reflect urban-rural socioeconomic variation is unclear. We investigated whether there were urban-rural variations in the incidence of 18 cancers, after adjusting for socioeconomic status. Cancers diagnosed between 1995 and 2007 were extracted from the population-based National Cancer Registry Ireland and Northern Ireland Cancer Registry and categorised by urban-rural status, based on population density of area of residence at diagnosis (rural 15 people per hectare). Relative risks (RR) were calculated by negative binomial regression, adjusting for age, country and three area-based markers of socioeconomic status. Risks were significantly higher in both sexes in urban than rural residents with head and neck (males RR urban vs. rural = 1.53, 95 % CI 1.42-1.64; females RR = 1.29, 95 % CI 1.15-1.45), esophageal (males 1.21, 1.11-1.31; females 1.21, 1.08-1.35), stomach (males 1.36, 1.27-1.46; females 1.19, 1.08-1.30), colorectal (males 1.14, 1.09-1.18; females 1.04, 1.00-1.09), lung (males 1.54, 1.47-1.61; females 1.74, 1.65-1.84), non-melanoma skin (males 1.13, 1.10-1.17; females 1.23, 1.19-1.27) and bladder (males 1.30, 1.21-1.39; females 1.31, 1.17-1.46) cancers. Risks of breast, cervical, kidney and brain cancer were significantly higher in females in urban areas. Prostate cancer risk was higher in rural areas (0.94, 0.90-0.97). Other cancers showed no significant urban-rural differences. After adjusting for socioeconomic variation, urban-rural differences were evident for 12 of 18 cancers. Variations in healthcare utilization and known risk factors likely explain some of the observed associations. Explanations for others are unclear and, in the interests of equity, warrant further investigation. © 2014 The New York Academy of Medicine.

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Death of a spouse is associated with increased mortality risk for the surviving partner (the widowhood effect). We investigated whether the effect magnitude varied between urban, rural and intermediate areas, assembling death records (2001-2009) for a prospective cohort of 296,125 married couples in Northern Ireland. The effect was greatest during the first six months of widowhood in all areas and for both sexes. Subsequently, the effect was attenuated among men in rural and intermediate areas but persisted in urban areas (HRs and 95% CIs: rural 1.09 [0.99, 1.21]; urban 1.35 [1.26, 1.44]). Among women the effect was attenuated in all areas (rural 1.06 [0.96, 1.17]; urban 1.09 [1.01, 1.17]). The impacts of spousal bereavement varied between urban and more rural areas, possibly due to variation in social support provided by the wider community. We identify men in urban areas as being in greatest need of such support and a possible target for health interventions.

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Death of a spouse is associated with increased mortality risk for the surviving partner (the widowhood effect), although the mechanisms driving the effect are poorly understood. After acute stress and grief have dissipated, mortality risk may be increased by loss of emotional and instrumental support for daily living and so we investigated whether social support at both the household and community levels moderated the influence of spousal bereavement on mortality risk.

We assembled death records from the Northern Ireland Mortality Study spanning almost nine years for a prospective cohort of 296,125 married couples enumerated in the 2001 Census. Presence of other adults within the household and urban/rural residence were used as measures of support at the household and community levels, with informal social support perceived to be strongest in rural areas. We used Cox proportional hazards models to estimate the effects of widowhood, sex, household composition and urban/intermediate/rural residence on all-cause mortality.

Elevated mortality risk during the first six months of widowhood was found in all areas and for both sexes (range of hazard ratios 1.24, 1.57). After more than six months the effect among men was attenuated in rural but not urban areas (HRs and 95%CIs 1.09 [0.99, 1.21] and 1.35 [1.26, 1.44] respectively). Among women the effect was attenuated in both rural and urban areas (HRs 1.06 [0.96, 1.17] and 1.09 [1.01, 1.17]). Mortality risk post bereavement was not associated with presence of other adults in the household.

We found some support for the hypothesis that informal social support is beneficial for reducing the impacts of spousal loss. Rural residence had a positive effect especially among men but presence of other adults in the household had no effect. The reasons for this discrepancy require further investigation and we identify men in urban areas as being at greatest risk in the long term.

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The aim of the study was to assess the relation of adiponectin levels with the metabolic syndrome in Asian Indians, a high-risk group for diabetes and premature coronary artery disease. The study was conducted on 100 (50 men and 50 women) type 2 diabetic subjects and 100 age and sex matched subjects with normal glucose tolerance selected from the Chennai Urban Rural Epidemiology Study, an ongoing population study in Chennai in southern India. Metabolic syndrome was defined using modified Adult Treatment Panel III (ATPIII) guidelines. Adiponectin values were significantly lower in diabetic subjects (men: 5.2 vs 8.3 microg/mL, P=.00l; women: 7.6 vs 11.1 microg/mL, P<.00l) and those with the metabolic syndrome (men: 5.0 vs 6.8 microg/mL, P=.01; women: 6.5 vs 9.9 microg/mL, P=.001) compared with those without. Linear regression analysis revealed adiponectin to be associated with body mass index (P<.05), waist circumference (P<.01), fasting plasma glucose (P=.001), glycated hemoglobin (P<.001), triglycerides (P<.00l), high-density lipoprotein (HDL) cholesterol (P<.001), cholesterol/HDL ratio (P<.00l), and insulin resistance measured by homeostasis assessment model (P<.00l). Factor analysis identified 2 factors: factor 1, negatively loaded with adiponectin and HDL cholesterol and positively loaded with triglycerides, waist circumference, and insulin resistance measured by homeostasis assessment model; and factor 2, with a positive loading of waist circumference and systolic and diastolic blood pressure. Logistic regression analysis revealed adiponectin to be negatively associated with metabolic syndrome (odds ratio [OR], 0.365; P<.001) even after adjusting for age (OR, 0.344; P<.00l), sex (OR, 0.293; P<.001), and body mass index (OR, 0.292; P<.00l). Lower adiponectin levels are associated with the metabolic syndrome per se and several of its components, particularly, diabetes, insulin resistance, and dyslipidemia in this urban south Indian population.

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The number of visceral leishmaniasis (VL) cases has increased over the past 10 years in Brazil, especially in the North and Northeast regions of the country. The aim of this study was to evaluate the urbanisation of VL vectors in Barcarena, Pará, an area in northern Brazil where VL is endemic. Sandflies were captured using Centers for Disease Control (CDC) light traps along an urban-rural gradient. The CDC traps were installed inside hen houses at a height of 150 cm. A total of 5,089 sandflies were collected and 11 species were identified. The predominant species was Lutzomyia longipalpis (rate of 95.15%), which suggests its participation in the transmission of VL. A total of 1,451 Lu. longipalpis females were dissected and no Leishmania infections were detected. Most of the sandflies were captured at the border of a forest (88.25%) and no flies were captured in the urban area, which suggests that transmission is still restricted to rural sites. However, the fact that a specimen was collected in an intermediate area indicates that urbanisation is a real possibility and that vector monitoring is important.

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According to UN provisions in the period from 2007 to 2050 world population will grow up to 9200 million people. In fact, for the first time in history, in the year 2008 world urban population became higher than rural population. The increase of urban areas and their transport infrastructures has influenced agricultural land use due to their irreversible change, especially when they remain as periurban vacant land, losing their character and identity. In the Europe of the nineties, the traditional urban-rural gradient, characterized by a neat contact between both land types, has become so complex that it has change to a gradient in which it is difficult to separate urban and rural land uses. [Antrop 2004]. A literature review has been made on methodologies used for the urban-rural gradient analysis. One of these methodologies was selected that integrates ecological characterization based on the use of spatial metrics and geographical characterization based on spatial components. Cartographical sources used were Corine Land Cover at 1: 100000 scale and the Spanish Land Use Information System at 1:25000 scale. Urban-rural gradient paradigm is an analysis methodology, coming from landscape ecology, which enables to investigate how urbanization provokes changes in ecological patterns and processes into landscape. [Hahs and McDonnell 2006].The present research adapt this methodology to study the urban-rural gradient in the outskirts of Madrid, Toledo and Guadalajara. Both scales (1:25000 and 1:100000) were simultaneously used to reach the next objectives: 1) Analysis of landscape pattern dynamics in relation to distance to the town centre and major infrastructures. 2) Analysis of landscape pattern dynamics in the fringe of protected areas. The paper presents a new approach to the urban-rural relationship which allows better planning and management of urban áreas.

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Criminology has tended to treat crime as predominantly an urban phenomenon. A review of the available, albeit rather limited, empirical evidence regarding crime and law and order in rural New South Wales (NSW) raises some doubts about the urban-centric focus of criminology and opens up a range of other interesting questions concerning the differential social construction of crime problems in some rural localities, in particular the tendency to racialise questions of crime and law and order. Rather than simply developing an empirical and theoretical account of urban/rural differences, however, the paper suggests a conceptual framework for local and regional studies drawing on the work of Norbert Elias and Robert Putnam.