• Title/Summary/Keyword: Urban rehabilitation

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Changes in interpersonal violence and utilization of trauma recovery services at an urban trauma center in the United States during the COVID-19 pandemic: a retrospective, comparative study

  • Kevin Y. Zhu;Kristie J. Sun;Mary A. Breslin;Mark Kalina Jr.;Tyler Moon;Ryan Furdock;Heather A. Vallier
    • Journal of Trauma and Injury
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    • v.37 no.1
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    • pp.60-66
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    • 2024
  • Purpose: This study investigated changes in interpersonal violence and utilization of trauma recovery services during the COVID-19 pandemic. At an urban level I trauma center, trauma recovery services (TRS) provide education, counseling, peer support, and coordination of rehabilitation and recovery to address social and mental health needs. The COVID-19 pandemic prompted considerable changes in hospital services and increases in interpersonal victimization. Methods: A retrospective analysis was conducted between September 6, 2018 and December 20, 2020 for 1,908 victim-of-crime patients, including 574 victims of interpersonal violence. Outcomes included length of stay associated with initial TRS presentation, number of subsequent emergency department visits, number of outpatient appointments, and utilization of specific specialties within the year following the initial traumatic event. Results: Patients were primarily female (59.4%), single (80.1%), non-Hispanic (86.7%), and Black (59.2%). The mean age was 33.0 years, and 247 patients (49.2%) presented due to physical assault, 132 (26.3%) due to gunshot wounds, and 76 (15.1%) due to sexual assault. The perpetrators were primarily partners (27.9%) or strangers (23.3%). During the study period, 266 patients (mean, 14.9 patients per month) presented before the declaration of COVID-19 as a national emergency on March 13, 2020, while 236 patients (mean, 25.9 patients per month) presented afterward, representing a 74.6% increase in victim-of-crime patients treated. Interactions with TRS decreased during the COVID-19 period, with an average of 3.0 interactions per patient before COVID-19 versus 1.9 after emergency declaration (P<0.01). Similarly, reductions in length of stay were noted; the pre-COVID-19 average was 3.6 days, compared to 2.1 days post-COVID-19 (P=0.01). Conclusions: While interpersonal violence increased, TRS interactions decreased during the COVID-19 pandemic, reflecting interruption of services, COVID-19 precautions, and postponement/cancellation of elective visits. Future direction of hospital policy to enable resource and service delivery to this population, despite internal and external challenges, appears warranted.

Innovative approaches to the health problems of rural Korea (한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案))

  • Loh, In-Kyu
    • Journal of agricultural medicine and community health
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    • v.1 no.1
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    • pp.5-9
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    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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Retrofit strategy issues for structures under earthquake loading using sensitivity-optimization procedures

  • Manolis, G.D.;Panagiotopoulos, C.G.;Paraskevopoulos, E.A.;Karaoulanis, F.E.;Vadaloukas, G.N.;Papachristidis, A.G.
    • Earthquakes and Structures
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    • v.1 no.1
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    • pp.109-127
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    • 2010
  • This work aims at introducing structural sensitivity analysis capabilities into existing commercial finite element software codes for the purpose of mapping retrofit strategies for a broad group of structures including heritage-type buildings. More specifically, the first stage sensitivity analysis is implemented for the standard deterministic environment, followed by stochastic structural sensitivity analysis defined for the probabilistic environment in a subsequent, second phase. It is believed that this new generation of software that will be released by the industrial partner will address the needs of a rapidly developing specialty within the engineering design profession, namely commercial retrofit and rehabilitation activities. In congested urban areas, these activities are carried out in reference to a certain percentage of the contemporary building stock that can no longer be demolished to give room for new construction because of economical, historical or cultural reasons. Furthermore, such analysis tools are becoming essential in reference to a new generation of national codes that spell out in detail how retrofit strategies ought to be implemented. More specifically, our work focuses on identifying the minimum-cost intervention on a given structure undergoing retrofit. Finally, an additional factor that arises in earthquake-prone regions across the world is the random nature of seismic activity that further complicates the task of determining the dynamic overstress that is being induced in the building stock and the additional demands placed on the supporting structural system.

A Study on the Structural Characteristics of Marginal Village : The Case of Goheung-gun in Jeollanamdo (우리나라 한계촌락의 구조적 특성에 관한 연구 - 전라남도 고흥군을 사례로 -)

  • Jeong, Won-Gi;Ahn, Young-Jin
    • Journal of the Korean association of regional geographers
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    • v.22 no.3
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    • pp.515-528
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    • 2016
  • Since 1960s the rural population of Korea has continually decreased as a result of the rapid rural-to-urban migration and this caused an economic recession as well as the accelerated aging phenomenon in the rural communities. Such problems got worse in smaller rural villages and marginal villages began to appear among the rural communities. This study aims to analyze the structures and characteristics of rural marginal villages. A case study on the county of Goheung, Jeollanamdo, is carried out using survey and stakeholder interviews. With the survey results a series of comparative analysis are done revealing the commonalities and peculiarities between two different types of marginal villages. This study also tries to reveal the residents's perceptions on the marginal villages and the potential determinants of rural rehabilitation.

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Colonization and community changes in benthic macroinvertebrates in Cheonggye Stream, a restored downtown stream in Seoul, Korea

  • Shin, Il-Kwon;Yi, Hoon-Bok;Bae, Yeon-Jae
    • Journal of Ecology and Environment
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    • v.34 no.2
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    • pp.175-191
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    • 2011
  • Colonization patterns and community changes in benthic macroinvertebrates in the Cheonggye Stream, a functionally restored stream in downtown Seoul, Korea, were studied from November 2005 to November 2007. Benthic macroinvertebrates were quantitatively sampled 15 times from five sites in the stream section. Taxa richness (59 species in total) increased gradually over the first year, whereas the density revealed seasonal differences with significantly lower values in the winter season and after flood events. The benthic macroinvertebrate fauna may have drifted from the upstream reaches during floods and from the Han River, arrived aerially, or hitchhiked on artificially planted aquatic plants. Oligochaeta, Chironommidae, Psychodidae, and Hydropsychidae were identified as major community structure contributors in the stream. Swimmers and clingers colonized relatively earlier in the upper and middle reaches, whereas burrowers dominated particularly in the lower reaches. Collector-gatherers colonized at a relatively early period throughout the stream reaches, and collector-filterers, such as the net-spinning caddisfly (Cheumatopyche brevilineata), predominated in the upper and middle reaches after a 1-year time period. Cluster analyses and multi-response permutation procedures demonstrated that the Cheonggye Stream shares more similarities with the Jungnang Stream than with the Gapyeong Stream. Detrended correspondence analysis and nonmetric multidimensional scaling demonstrated that physical environmental factors (depth, current velocity, dissolved oxygen, and pH) as well as nutrients (total nitrogen and total phosphorous), water temperature, and conductivity could affect the distribution of benthic macroinvertebrates in the study streams.

A Study on Evaluation and Prioritization Process of Wastewater Reuse Alternative in Watershed Level (유역차원의 하수처리수 재이용 대안평가와 우선순위 결정과정에 관한 연구)

  • Chung, Eun-Sung;Jun, Sang-Mook;Lee, Jin Hee;Ahn, Jong Ho
    • Journal of Korean Society on Water Environment
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    • v.29 no.2
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    • pp.259-269
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    • 2013
  • This study aims to show the feasibility of wastewater reuse through hydrological analysis and propose a framework for planning using multi-criteria decision making technique. Ten alternatives of wastewater reuse (BOD: 3.0 mg/L & 4.7 mg/L) and two references in the urban watershed were considered and analyzed by using Hydrological Simulation Program in Fortran (HSPF). Though wastewater reuse has a positive effect on water quantity, it may degrade the water quality due to the high discharge concentration. This study showed that wastewater reuse can be a great alternative for the rehabilitation of distorted water cycle, if the quality is improved up to the natural streamflow and the quantity is increased up to the instreamflow requirement. In addition, to determine the project priority, three criteria were compared: 1) impacts on water quantity and water quality, respectively, 2) consideration of present hydrologic vulnerabilities on water quantity and quality and not, and 3) social and economic considerations and not. From the performance values to all criteria, the specific ranking can be derived and the feasibility of each wastewater reuse project can be checked with the comparison of the existing facilities. As a result, DJ and DR were derived to become effective in any evaluation conditions while SS and WG were improper alternatives if various criteria were considered. The decision making for project prioritization must be careful with the consideration of various impacts of wastewater reuse because the evaluation of wastewater reuse alternative showed very different priorities for each criteria.

Prevalence of Cigarette Smoking and Associated Factors among Male Citizens in Tehran, Iran

  • Kassani, Aziz;Baghbanian, Abdolvahab;Menati, Rostam;Hassanzadeh, Jafar;Asadi-Lari, Mohsen;Menati, Walieh
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1473-1478
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    • 2016
  • Background: Cigarette smoking is as the leading cause of cancer mortality and other chronic diseases in males worldwide. The prevalence of cigarette smoking is different across and within countries by age, education level, occupation, and so on. This study aimed to determine the prevalence of cigarette smoking and its relationship with individuals' demographic factors and BMI in adolescent men living in Tehran, Iran. Materials and Methods: This study involved secondary analysis of the 'Urban Health Equity Assessment and Response Tool-2' survey conducted in Tehran, Iran, among men aged 20+, 2011-2012. Using a multistage sampling method, 45,990 men were included in the study. The cigarette smoking status, BMI and demographic factors measured through a self-administered questionnaire. Chi-square, t-test, and logistic regression model were used to examine the relationships between the independents variables and cigarette smoking behavior, using SPSS software version 21. Results: In the total of 45,990 men, the overall prevalence of cigarette smoking was 14.6% (CI 95%: 14.29-14.94). Age (OR=0.96; CI 95%:0.94-0.98), house ownership (OR=0.68; CI 95%: 0.64-0.72), job status (OR=0.60; CI 95%: 0.46-0.86), marital status (OR=0.42; CI 95%: 0.39-0.47) and educational levels (OR=0.50; CI95%: 0.45-0.54) were associated with the prevalence of cigarette smoking. However, associations with BMI, family size, residency years, and district were not statistically significant. Conclusions: Given the relatively high prevalence of cigarette smoking in the study population, policy interventions are required to address this major public health issue, with a focus on the population demographic influences.

A Study on Estimation of Pollutant Loads in Seonakdong River Using SWAT-SWMM Model (SWAT-SWMM 연계모의를 이용한 서낙동강 오염부하량 산정 방안 연구)

  • Kim, Jeong-Min;Kim, Young-Do
    • Journal of Korean Society of Water and Wastewater
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    • v.25 no.6
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    • pp.825-837
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    • 2011
  • Seonakdong river consists of stagnant sections whose flowrate is controlled by the Daejeo and Noksan gates. As a result, there is not a minimum flow during normal times. The Daejeo and Noksan gates are located at the upstream head and the downstream end of Seonakdong river, respectively. Seonakdong river is an estuarine tributary of Nakdong river, which is a reservoir-like river used for agricultural irrigation, with the gate at the estuary of the river to prevent the intrusion of saline. Since the construction of the water gates, the water quality of the river has become degraded. This could also be due to the internal loading of pollutants, especially nutrients, from the sediments of the river because of the elongated detention time by the water gates. This study was thus conducted for the purpose of evaluating the current hydrologic-cycle system and providing measures for the rehabilitation of the hydrologic cycle. In this research, the daily outflow in Seonakdong River was simulated using the SWAT and SWMM models, and the water quality concentration including BOD, SS, TN, and TP were analyzed. The possibility of the application of SWAT-SWMM hybrid simulation was determined through the verification of both models. The error analysis shows that the results of both SWAT and SWAT-SWMM simulations make good agreements with those of field observations. For the single simulation results of SWAT, $R^{2}$ and NSE are 0.758, 0.511, respectively. For the hybrid simulation results of SWAT-SWMM, those are 0.880, 0.452, which means that the hybrid simulation can give more accurate results for the watershed where both the agricultural and urban areas exist.

Life Stress, Social support, and Depression of Arthritis Patients Living in a Rural Town (일 농촌 지역 거주 관절염 환자의 생활스트레스, 사회적 지지, 우울)

  • Suh, Moon-Ja;Kim, Keum-Soon;Noh, Kuk-Hee;Jung, Sung-Hee;Kim, Eun-Man;Kim, In-Ja
    • Journal of muscle and joint health
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    • v.9 no.1
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    • pp.68-81
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    • 2002
  • Arthritis patients living in a rural town are thought to have more problems in terms of life stress, social support, and depression than those living in an urban city. But there were few studies which investigated the status of arthritis patients living in a rural town. This study investigated how much life stress they got, which life events were perceived as stress, what kind of social support were most perceived, and how much they were depressed. Fifty six arthritis patients were surveyed using structured questionnaire. Life stress, social support, and depression were assessed using the following scales: Life changes scale, Duke's short scale to measure social support, and CES-D(Center for Epidemiologic Study- Depression), respectively. They were found to perceive life stress in home-work, health and work, in order. And they were found to perceive relatively good social support. But they sot most of social support from their family members especially their spouses and children. Lastly, it was found that they were moderately depressed. Based upon these results, it is suggested that integrative rehabilitation programs which provide professional support and reduce depression are necessary for arthritis patients living in rural towns.

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Telemedicine in Japan and Role of the Community-based Occupational Therapy (일본의 원격의료현황과 지역사회작업치료의 역할)

  • Kim, Do-Hoon;Yoon, Tae-Hyung
    • The Journal of Korean society of community based occupational therapy
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    • v.5 no.2
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    • pp.23-30
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    • 2015
  • Objective : The aim of this study is to analyze the telemedicine in Japan and discuss the role of the community-based occupational therapy. Methods : This study was collected and analyzed data on telemedicine status in Japan. It examined the definition and forms of telemedicine and analyzed for the appearance to the background telemedicine in Japan. Thus, we discussed the role of the community-based occupational therapy. Results : Due to increased medical costs, low fertility rate and aging in Japan, it had provided the telemedicine as a more efficient form of health care services. Also, telemedicine emerged due to the lack of doctors, development of medical technology, and regional deviation between rural and urban area. In the case of Korea, similar to Japan, therefore, there is a demand for the telemedicine. Conclusion : With regard to telemedicine, occupational therapy in community-based rehabilitation is expected to be able to treat for patients as health care professionals. Therefore the reform of the educational system is needed for this.