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Objective Study Setting and Design Data Sources and Analytical Sample Principal Findings Conclusion To examine differences in access to care and financial burden between Traditional Medicare (TM) and Medicare Advantage (MA) beneficiaries in rural and urban areas and then explore whether there were potential differences in MA benefits between urban and rural areas.We conducted a cross‐sectional study within the Medicare setting in the United States.Data from three distinct sources for 2017–2021: the Medicare Current Beneficiary Survey, the MA landscape data, and the Plan Benefit Package data. Our sample comprised 43,343 Medicare beneficiary‐years, including TM and MA beneficiaries in urban and rural areas.Our adjusted analysis showed that rural MA beneficiaries experienced higher rates of delayed care due to costs (10.0% [95% confidence interval (CI): 8.8–11.1]) compared with rural TM (9.5% [8.8–10.2]), urban MA (7.9% [7.4–8.4]), and urban TM (7.9% [7.5–8.2]) beneficiaries. Similarly, rural MA beneficiaries (11.4% [95% CI: 10.3–12.5]) reported more difficulty paying medical bills compared with rural TM (9.4% [8.7–10.1]), urban MA (8.1% [7.7–8.6]), and urban TM (7.8% [7.5–8.2]) beneficiaries. This disparity was associated with less generous financial structures in rural MA plans. Compared to urban MA plans, rural MA plans offered lower out‐of‐pocket maximums for in‐network care ($5918 vs. $5439), but required higher copayments ($1686 vs. $1724 for a 5‐day hospitalization, $37 vs. $41 for a specialist visit, and $35 vs. $38 for a mental health visit). However, differences in quality of care and provision of supplemental benefits were small.Rural Medicare beneficiaries reported a greater financial burden of care than urban Medicare beneficiaries, but the most significant burden was observed among MA beneficiaries in rural areas. One possible mechanism could be the less generous financial structures offered by rural MA plans. These findings suggest the need for policies addressing the affordability of care for rural MA beneficiaries. [ABSTRACT FROM AUTHOR]

Simple Summary: This study examined the outcomes of patients with gallbladder cancer over 20 years in Saskatchewan, Canada, focusing on geographic, demographic, and clinical factors. A total of 331 patients diagnosed between 2000 and 2019 were included. The majority (64%) had advanced stage 4 disease, with a significant proportion (66%) being rural residents. Key factors associated with poorer overall survival included stage 4 disease, lack of surgery, older age, a higher neutrophil-to-lymphocyte ratio, and no referral to a regional cancer center. Among early-stage patients, stage III disease and urban residence were associated with worse disease-free survival. The findings highlight the late-stage diagnosis and referral challenges impacting the outcomes of gallbladder cancer. Background: Gallbladder cancer (GBC) is an uncommon cancer. This study aimed to determine the outcomes of GBC in relation to geographic, demographic, and clinical factors in a Canadian province from 2000 to 2019. Methods: This population-based retrospective cohort study included all patients diagnosed with gallbladder cancer (GBC) in Saskatchewan, Canada, from 2000 to 2019. Cox proportional multivariate regression analysis was conducted to identify factors associated with poorer outcomes. Results: In total, 331 patients with a median age of 74 years and male–female ratio of 1:2 were identified. Of these patients, 305 (92%) had a pathological diagnosis of GBC. Among patients with documented staging data, 64% had stage IV disease. A total of 217 (66%) patients were rural residents, and 149 (45%) were referred to a cancer center. The multivariate analysis for patients with stage I–III GBC showed that stage III disease [hazard ratio (HR), 2.63; 95% confidence interval (CI), 1.09–6.34)] and urban residence (HR, 2.20; 95% CI, 1.1–4.39) were correlated with inferior disease-free survival. For all patients, stage IV disease (HR, 3.02; 95% CI, 1.85–4.94), no referral to a cancer center (HR, 2.64; 95% CI, 1.51–4.62), lack of surgery (HR, 1.63; 95% CI, 1.03–2.57), a neutrophil–lymphocyte ratio of >3.2 (HR, 1.57; 1.05–2.36), and age of ≥70 years (HR, 1.51; 95% CI, 1.04–2.19) were correlated with inferior overall survival. Conclusions: In this real-world context, the majority of patients with GBC were diagnosed at a late stage and were not referred to a cancer center. For those with early-stage GBC, living in an urban area and having stage III disease were linked to worse outcomes. Across all stages of GBC, stage IV disease, older age, absence of surgery, lack of referral to a cancer center, and a high neutrophil-to-lymphocyte ratio were associated with poorer survival. [ABSTRACT FROM AUTHOR]

Building envelope renovation solutions are critical to building performance and post-renovation economics. Building renovation is easier to carry out if the impacts of building envelope renovation solutions on building performance and post-renovation economic efficiency can be foreseen and a more sustainable and efficient renovation design can be achieved. This paper explores the optimal design of building envelope renovation using genetic optimization algorithms and statistical analysis methods, taking the performance of the renovated building and the economic efficiency of the renovation solution as the starting points. In Qingdao, a cold region of China, a survey was carried out on typical rural areas in seven regions. The selected design variables include the external wall and roof insulation material type(TWall, TRoof), external wall and roof insulation thickness(δWall, δRoof), type of window construction(TWc), and area radio of the window to the wall(WWR). Minimization of total building energy consumption(E) and renovation cost(COSTRE) and after renovation maximization of the combined incremental cost-benefit ratio over a 20-year life cycle(CICBR20-year life-cycle), effective natural daylighting illuminance(UDI), and percentage of time spent in indoor comfort(PTC) were considered in the optimization of the envelope. The results show that in cold regions, different envelope renovation solutions affect the optimization objectives to different degrees; changing the south-facing window-to-wall ratio(S_WWR) has a bigger effect on E, PTC, and UDI; and choosing different TRoof has a bigger effect on COSTRE and CICBR20-year life-cycle. Renovation of the selected typical rural residence with the optimal solution results in an energy-saving rate(Re) of 53.08 %, an increase of 940.86 h/year in annual indoor comfort hours(HIC) and 377.00 h/year in annual effective natural lighting hours(HUDI).

Sunspace is a popular strategy for enhancing the energy efficiency of buildings. This study aims to investigate the impact of sunspace on a rural residence located in a cold region of China on its total annual energy consumption. To do so, the researchers developed a benchmark model of a rural residence in Xuzhou and simulated six types of additional sunspaces using Honeybee to estimate energy consumption. The results clearly demonstrated that incorporating sunspaces into rural residences had a significant impact on reducing annual energy consumption, leading to energy savings ranging from 4.7% to 10.8% compared to the benchmark rural residence. Additionally, the study analyzed the relationship between the energy consumption of the rural residence and the location and depth of the sunspace. The findings revealed that the location of the sunspace had a greater impact on annual energy consumption than its depth. Lastly, the study also analyzed the economic viability of sunspace application in XuZhou rural residences, demonstrating that the utilization of sunspaces in XuZhou rural residences is economically feasible. The study provides valuable empirical and theoretical support for the design of sunspaces in rural residences located in cold regions of China and underscores the potential benefits of incorporating sunspaces to improve building energy efficiency.

Introduction: Disparities in dental service utilisation are substantial and pervasive worldwide. The healthcare services required to address health concerns and the services actually offered are at odds. Rural residents have poor oral health, and they frequently neglect to adopt good oral hygiene habits. Aim: To assess the oral health needs and barriers in accessing oral healthcare services among the rural population in Pulipakkam, Chengalpattu district, Tamil Nadu, India. Materials and Methods: A cross-sectional door-to-door study was conducted in Pulipakkam, Chengalpattu district, in association with Karpaga Vinayaga Institute of Dental Science, Madhuranthagam, Tamil Nadu, India. The study duration was six months, from March 2022 to August 2022. A total of 436 subjects from the rural population were included, and a structured questionnaire consisting of two domains, totalling 27 questions (24 closed-ended and three open-ended questions), was prepared and distributed among the study participants to assess the need (15 questions) and barriers (12 questions) in accessing oral healthcare. The questionnaire was administered in the local (Tamil) language. Additionally, seven demographic data questions were included, and descriptive statistics were performed for the demographic variables. Inferential statistics were used to assess needs and barriers. The World Health Organisation (WHO) oral health assessment questionnaire 2013 was used to assess dental caries and periodontal disease. The Chi-square test was carried out using Statistical Package for the Social Sciences (SPSS) version 20.0 for inferential statistics. The p-value

Abstract Background Maintaining a healthy lifestyle is an important factor in promoting positive outcomes for gynecologic cancer survivors. Methods We examined preventive behaviors among gynecologic cancer survivors (n = 1824) and persons without a history of cancer in a cross‐sectional analysis, using data from the 2020 Behavioral Risk Factor Surveillance System survey (BRFSS). BRFSS is a cross‐sectional telephone‐based survey of U.S. residents 18 years of age and older, which collects information about health‐related factors and use of preventive services. Results The prevalence rates of colorectal cancer screening were respectively 7.9 (95% CI: 4.0–11.9) and 15.0 (95% CI: 4.0–11.9) %‐points higher among gynecologic and other cancer survivors compared to that of 65.2% among those without any history of cancer. However, no differences were observed in breast cancer screening between gynecologic cancer survivors (78.5%) and respondents without any history of cancer (78.7%). Coverage of influenza vaccination among gynecologic cancer survivors were 4.0 (95% CI: 0.3–7.6) %‐points higher than that of the no cancer group, but 11.6 (95% CI: 7.6–15.6) %‐points lower than that of the other cancer group. Pneumonia vaccination rate among gynecologic cancer survivors, however, was not statistically different than that of other cancer survivors and respondents with no history of cancer. When examining modifiable risk behaviors, the prevalence of smoking among gynecologic cancer survivors was 12.8 (95% CI: 9.5–16.0) and 14.2 (95% CI: 10.8–17.7) %‐points higher than smoking prevalence among other cancer survivors and respondents without any history of cancer. The rate differentials were even higher in rural areas, 17.4 (95% CI: 7.2–27.6) and 18.4 (95% CI: 7.4–29.4) %‐points respectively. There were no differences in the prevalence of heavy drinking across the groups. Lastly, gynecologic and other cancer survivors were less likely to be physically active (Δ = −12.3, 95% CI: −15.8 to −8.8 and Δ = −6.9, 95% CI: −8.5 to −5.3, respectively) than those without any history of cancer. Conclusion Smoking prevalence among gynecologic cancer survivors is alarmingly high. Intervention studies are needed to identify effective ways to assist gynecologic cancer survivors to quit smoking and refrain from hazardous alcohol consumption. In addition, women with gynecologic malignancies should made aware of the importance of physical activity.

The fine particulate matter (PM2.5) emitted during cooking is a significant contributor to household air pollution in rural China, resulting in millions of premature deaths annually. Since cooking is an internal pollution source, the indoor concentration of cooking-generated PM2.5 can vary among different rooms in multizone rural residences. This study provides a comprehensive understanding of indoor PM2.5 from cooking in rural residences by utilizing on-site investigations to gather information on cooking behavior and dwelling layout in three Chinese villages, and subsequently simulating indoor spatiotemporal concentrations of cooking-generated PM2.5 using a multizone model. Our findings indicate that the type of zone significantly influences the zonal concentration of PM2.5, with the highest concentrations found in kitchens (i.e., 13.9 to 188.0 µg/m3) and lowest in non-adjacent zones to the kitchen (i.e., 0.01 to 7.5 µg/m3) among all the modeled conditions. More importantly, the study also assesses the resulting personal exposures for occupants with different time-spent patterns, revealing that the main cook at home and preferring to stay in the adjacent rooms to the kitchen are at the highest risk for personal exposure. The highest personal exposure levels of cooking-generated PM2.5 are 28.5 ± 30.1 µg/m3, which is 34 times that of occupants who stay away from the kitchen. The study provides a deeper scientific insight into the indoor spatial distribution and personal exposure to cooking-generated PM2.5 in rural residences, which is crucial for developing effective interventions to mitigate the detrimental health impacts of household air pollution in rural areas. [ABSTRACT FROM AUTHOR]

Background: Maintaining a healthy lifestyle is an important factor in promoting positive outcomes for gynecologic cancer survivors. Methods: We examined preventive behaviors among gynecologic cancer survivors (n = 1824) and persons without a history of cancer in a cross‐sectional analysis, using data from the 2020 Behavioral Risk Factor Surveillance System survey (BRFSS). BRFSS is a cross‐sectional telephone‐based survey of U.S. residents 18 years of age and older, which collects information about health‐related factors and use of preventive services. Results: The prevalence rates of colorectal cancer screening were respectively 7.9 (95% CI: 4.0–11.9) and 15.0 (95% CI: 4.0–11.9) %‐points higher among gynecologic and other cancer survivors compared to that of 65.2% among those without any history of cancer. However, no differences were observed in breast cancer screening between gynecologic cancer survivors (78.5%) and respondents without any history of cancer (78.7%). Coverage of influenza vaccination among gynecologic cancer survivors were 4.0 (95% CI: 0.3–7.6) %‐points higher than that of the no cancer group, but 11.6 (95% CI: 7.6–15.6) %‐points lower than that of the other cancer group. Pneumonia vaccination rate among gynecologic cancer survivors, however, was not statistically different than that of other cancer survivors and respondents with no history of cancer. When examining modifiable risk behaviors, the prevalence of smoking among gynecologic cancer survivors was 12.8 (95% CI: 9.5–16.0) and 14.2 (95% CI: 10.8–17.7) %‐points higher than smoking prevalence among other cancer survivors and respondents without any history of cancer. The rate differentials were even higher in rural areas, 17.4 (95% CI: 7.2–27.6) and 18.4 (95% CI: 7.4–29.4) %‐points respectively. There were no differences in the prevalence of heavy drinking across the groups. Lastly, gynecologic and other cancer survivors were less likely to be physically active (Δ = −12.3, 95% CI: −15.8 to −8.8 and Δ = −6.9, 95% CI: −8.5 to −5.3, respectively) than those without any history of cancer. Conclusion: Smoking prevalence among gynecologic cancer survivors is alarmingly high. Intervention studies are needed to identify effective ways to assist gynecologic cancer survivors to quit smoking and refrain from hazardous alcohol consumption. In addition, women with gynecologic malignancies should made aware of the importance of physical activity. Maintaining a healthy lifestyle is an important factor in promoting positive outcomes for gynecologic cancer survivors. We examined preventive behaviors among gynecologic cancer survivors in a cross‐sectional analysis, using data from the 2020 Behavioral Risk Factor Surveillance System. Smoking prevalence among gynecologic cancer survivors is alarmingly high. Intervention studies are needed to identify effective ways to assist gynecologic cancer survivors to quit smoking and refrain from alcohol consumption. [ABSTRACT FROM AUTHOR]

Introduction: Disparities in dental service utilisation are substantial and pervasive worldwide. The healthcare services required to address health concerns and the services actually offered are at odds. Rural residents have poor oral health, and they frequently neglect to adopt good oral hygiene habits. Aim: To assess the oral health needs and barriers in accessing oral healthcare services among the rural population in Pulipakkam, Chengalpattu district, Tamil Nadu, India. Materials and Methods: A cross-sectional door-to-door study was conducted in Pulipakkam, Chengalpattu district, in association with Karpaga Vinayaga Institute of Dental Science, Madhuranthagam, Tamil Nadu, India. The study duration was six months, from March 2022 to August 2022. A total of 436 subjects from the rural population were included, and a structured questionnaire consisting of two domains, totalling 27 questions (24 closed-ended and three open-ended questions), was prepared and distributed among the study participants to assess the need (15 questions) and barriers (12 questions) in accessing oral healthcare. The questionnaire was administered in the local (Tamil) language. Additionally, seven demographic data questions were included, and descriptive statistics were performed for the demographic variables. Inferential statistics were used to assess needs and barriers. The World Health Organisation (WHO) oral health assessment questionnaire 2013 was used to assess dental caries and periodontal disease. The Chi-square test was carried out using Statistical Package for the Social Sciences (SPSS) version 20.0 for inferential statistics. The p-value<0.05 was considered statistically significant. Results: The mean age of the study participants was 53.6±2.02 years, and 402 (92%) were married, while 34 (7.8%) were unmarried. Among the total population (N=436), the perceived need was 217 (49.8%), and the barrier was 399 (91.5%). There was no statistically significant difference in the distribution of dental caries among the population with and without perceived need (p=0.909) and with and without barriers to accessing oral healthcare (p=0.542). The majority (N=261, 89.4%) of the population with periodontal diseases (N=292) reported having barriers in accessing oral healthcare services, and there was a statistically significant difference in the distribution of periodontal diseases among the rural population with and without barriers to accessing oral healthcare (p=0.027*). Conclusion: According to the study findings, oral diseases affect individuals who have no needs or barriers, suggesting that they are unaware of their oral health. It is therefore important to increase oral health awareness among rural people. [ABSTRACT FROM AUTHOR]

This study explored the daylight performance, thermal comfort, and energy-saving level of enclosed-courtyard rural residences with covered roofs in a cold IIA region of China. Using daylight autonomy (DA), annual mean value of PMV (AUMPMV), and total energy consumption of heating, cooling and lighting (Ehcl) in a performance evaluation index, a courtyard roof was optimized in a multi-objective fashion and analyzed for its effect on residential performance. This was achieved through field investigation and mapping, setting the prototype building model in the Rhino platform, and carrying out the iterative optimization design of the roof with a Ladybug tool component. The results show that appropriate roof form can significantly improve daylight performance, thermal comfort, and energy savings. Compared to the open-courtyard rural residence prototype model, the spatial daylight autonomy (sDA) of a flat-skylight-enclosed-courtyard residence decreased by only 0.94%, and AUMPMV improved significantly from −0.774 to 0.87. The Ehcl decreased by 19.7%, and compared with setting a large area of flat skylights on the roof, a reasonable clerestory window roof can achieve better residence performance. [ABSTRACT FROM AUTHOR]

Simple Summary: Breast cancer is rare in men. This study compared the outcomes of rural men to urban men who were diagnosed with breast cancer over a 20-year period in the province of Saskatchewan, Canada. Most men were diagnosed with hormone receptor-positive early-stage breast cancer. Although rural men numerically had shorter survival, it was not statistically significant. Stage of the disease, poor performance status, node-positive disease, older age, and lack of adjuvant systemic therapy were associated with poor outcomes. Adjuvant therapy should be offered to men with breast cancer to reduce the risk of recurrent breast cancer. Future research is warranted to determine whether the numerical differences seen in rural residence survival are observed in a larger patient population. Background: Breast cancer is rare in men. This population-based study aimed to determine outcomes of male breast cancer in relation to residence and other variables. Methods: In this retrospective cohort study, men diagnosed with breast cancer in Saskatchewan during 2000–2019 were evaluated. Cox proportional multivariable regression analyses were performed to determine the correlation between survival and clinicopathological and contextual factors. Results: One hundred-eight eligible patients with a median age of 69 years were identified. Of them, 16% had WHO performance status ≥ 2 and 61% were rural residents. The stage at diagnosis was as follows: stage 0, 7%; I, 31%; II, 42%; III, 11%; IV, 8%. Ninety-eight percent had hormone receptor-positive breast cancer. The median disease-free survival of urban patients was 97 (95% CI: 50–143) vs. 64 (46–82) months of rural patients (p = 0.29). The median OS of urban patients was 127 (94–159) vs. 93 (32–153) months for rural patients (p = 0.27). On multivariable analysis, performance status ≥ 2, hazard ratio (HR) 2.82 (1.14–6.94), lack of adjuvant systemic therapy, HR 2.47 (1.03–5.92), and node-positive disease, HR 2.32 (1.22–4.40) were significantly correlated with inferior disease-free survival in early-stage invasive breast cancer. Whereas stage IV disease, HR 7.8 (3.1–19.5), performance status ≥ 2, HR 3.25 (1.57–6.71), and age ≥ 65 years, HR 2.37 (1.13–5.0) were correlated with inferior overall survival in all stages. Conclusions: Although residence was not significantly correlated with outcomes, rural men had numerically inferior survival. Poor performance status, node-positive disease, and lack of adjuvant systemic therapy were correlated with inferior disease-free survival. [ABSTRACT FROM AUTHOR]

Rates of neonatal abstinence syndrome/neonatal opioid withdrawal syndrome (NAS/NOWS), a withdrawal syndrome from opioids and other substances resulting from intrauterine exposure, have been increasing exponentially in the U.S. To improve health outcomes, it is important to understand population health risks, including rehospitalization and related diagnoses, using current data. This study will compare and describe the rates of rehospitalization, the demographic characteristics and the rehospitalization diagnoses and age at diagnosis between the infants affected by NAS/NOWS to those sampled who were unaffected. This study will also describe the frequency of NAS/NOWS births per year along with a yearly comparison of readmissions in those affected by NAS/NOWS to those who were not (2016–2020). Health claims data were used to conduct a case/control study. Diagnosis codes for neonatal withdrawal syndrome/NAS/NOWS (P04.49 or P96.1 and P96.1 alone) from 1 October 2015 to 1 June 2021 were extracted, and controls were case-matched based on month/year of birth. Rehospitalizations following birth and the related diagnoses were described and grouped using the Agency of Healthcare Research Quality Clinical Classifications Software Refined Frequency distribution. The chi-square test of association and generalized estimating equation modeling were used for data analysis. Infants affected by NAS/NOWS are 2.7 times more likely to have a rehospitalization. White, non-Hispanic neonates (OR = 1.5; p =.007) and those infants residing in rural areas (OR = 1.9; p <.001) were disproportionately affected. We identified a host of admission diagnoses with increased prevalence in infants affected by NAS/NOWS when compared to those who were not affected (e.g. infectious diseases, feeding disorders). Infants with NAS/NOWS are at increased risk of rehospitalization with a host of diagnoses, and specific demographic groups (White, rural) are more highly affected. [ABSTRACT FROM AUTHOR]

Background: Telemedicine is a useful tool that connects patients to their care team remotely and improves access to medical care for rural residents. This study aimed to determine the telemedicine experience of both rural patients with cancer and their physicians, and to explore factors associated with a positive patient experience. Methods: In this cross-sectional study, cancer patients and physicians in Saskatchewan completed a paper-based survey composed of 32 items or an electronic survey of 18 items, respectively. Logistic regression analysis was performed to assess patient satisfaction in relation to various sociodemographic and cancer-related factors. Results: Overall, 25 physicians and 165 patients participated in the study. Among the physicians, 94% were confident in their telemedicine assessment, 58% agreed that telemedicine improved clinical efficiency, and 73% agreed that doctor–patient rapport was unimpaired with telemedicine. Of 165 patients, 61% had used telemedicine for the first time, 81% felt that their needs were met, 83% were satisfied with the quality of their care, and 88% had a positive experience. Overall, 83% patients vs. 45% physicians preferred telemedicine to a face-to-face clinic visit (p = 0.005). On univariate analysis, patients ≥ 65 years old had a greater positive telemedicine experience compared to patients < 65 years old (odds ratio 4.1 [1.2–13.8], p = 0.02). Conclusion: Both patients and physicians have a high rate of positive experiences with telemedicine. However, patients have a higher preference for telemedicine over face-to-face visits compared to physicians. In addition, elderly patients have more positive telemedicine experiences compared to younger patients.

The retrofit of building envelopes in rural areas is a necessary measure to reduce building energy consumption. However, the traditional retrofit strategy is mostly a subjective decision, therefore, a scientific and objective evaluation method is proposed, which is a multi-factor and multi-objective preferred method based on orthogonal tests and entropy weights. The construction strategy for an additional sunspace of a typical rural residence in severe cold areas is studied. The results show that the glass type and the window-to-wall ratio have a remarkable influence on the optimization of the sunspace, accounting for 64.03 % and 17.42 %, respectively. Compared with the original rural building, the heating energy consumption of building with retrofit sunspace reduces by 12.82 %. Considering comprehensive energy saving, incremental cost, cost-benefit ratio and carbon emission reduction, the optimal construction strategy is the scheme 13, which has three layers of insulating glass with a window-to-wall ratio of 0.9, a depth of 0.9 m, 60 mm foamed concrete insulation board on the roof, 20 mm extruded polystyrene thermal insulation board on the ground and 120 mm foamed concrete insulation board on the adjacent south wall. The weights of the aforementioned parameters are 0.2967, 0.1916, 0.2021, and 0.3095, respectively, which are calculated by the entropy weight method. • Using orthogonal test and entropy weight method to evaluate building retrofits • Optimized 18 groups of retrofit schemes for the sunshine space • The weights of the four evaluation objectives were determined. • The best choice for retrofitting was obtained. [ABSTRACT FROM AUTHOR]

Background: Telemedicine is a useful tool that connects patients to their care team remotely and improves access to medical care for rural residents. This study aimed to determine the telemedicine experience of both rural patients with cancer and their physicians, and to explore factors associated with a positive patient experience. Methods: In this cross-sectional study, cancer patients and physicians in Saskatchewan completed a paper-based survey composed of 32 items or an electronic survey of 18 items, respectively. Logistic regression analysis was performed to assess patient satisfaction in relation to various sociodemographic and cancer-related factors. Results: Overall, 25 physicians and 165 patients participated in the study. Among the physicians, 94% were confident in their telemedicine assessment, 58% agreed that telemedicine improved clinical efficiency, and 73% agreed that doctor–patient rapport was unimpaired with telemedicine. Of 165 patients, 61% had used telemedicine for the first time, 81% felt that their needs were met, 83% were satisfied with the quality of their care, and 88% had a positive experience. Overall, 83% patients vs. 45% physicians preferred telemedicine to a face-to-face clinic visit (p = 0.005). On univariate analysis, patients ≥ 65 years old had a greater positive telemedicine experience compared to patients < 65 years old (odds ratio 4.1 [1.2–13.8], p = 0.02). Conclusion: Both patients and physicians have a high rate of positive experiences with telemedicine. However, patients have a higher preference for telemedicine over face-to-face visits compared to physicians. In addition, elderly patients have more positive telemedicine experiences compared to younger patients. [ABSTRACT FROM AUTHOR]

This study is part of a programmatic investigation of rural disparities in cigarette smoking examining disparities in smoking prevalence and for the first-time quit ratios among adult women of reproductive age (18–44 years), a highly vulnerable population due to risk for multigenerational adverse effects. Data came from 18 years (2002–2019) of the U.S. National Survey on Drug Use and Health (NSDUH) among women (n = 280,626) categorized by rural-urban residence, pregnancy status, using weighted logistic regression models testing time trends and controlling for well-established sociodemographic predictors of smoking (race/ethnicity, education, income). Concerns regarding changes in survey methods used before 2002 and after 2019 precluded inclusion of earlier and more recent survey years in the present study. Overall smoking prevalence across years was greater in rural than urban residents (adjusted odds ratio [AOR] = 1.11; 95%CI, 1.07–1.15; P <.001) including those not-pregnant (AOR = 1.10; 1.07–1.14; P <.001) and pregnant (AOR = 1.29; 1.09–1.52; P <.001). Overall quit ratios across years were lower in rural than urban residents (AOR = 0.93; 0.87–0.99; P <.001) including those not-pregnant (AOR = 0.93; 0.88–1.00, P =.035) and pregnant (AOR = 0.78; 0.62–0.99; P =.039). Interactions of rural versus urban residence with study years for prevalence and quit ratios overall and by pregnancy status are detailed in the main text. These results support a longstanding and robust rural disparity in smoking prevalence among women of reproductive age including those currently pregnant and provides novel evidence that differences in smoking cessation contribute to this disparity further underscoring a need for greater access to evidence-based tobacco control and regulatory interventions in rural regions. • Rural disparities in smoking extend to women of reproductive age. • These disparities are evident throughout the 18-year study period (2002–2019). • The disparities are evident across analyses of smoking prevalence and quit ratios. • Lower rates of quitting among rural women contribute to these disparities. • Greater access to effective smoking cessation for rural women should be prioritized. [ABSTRACT FROM AUTHOR]

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The importance of the research is showing the environmental, cultural and social value of the Arab rural Mediterranean Residence as a regional heritage, where the concept of heritage brings aesthetic and functional values, and is characterized by persistence and continuity together, as it is an honest record of community culture, unity of its human and intellectual features throughout the ages, and a Physical fact imposed its acceptance and respect. Where the word (Tradition) expresses two aspects: the intellectual aspect and the physical aspect. The research presented the (Shade Architecture) specifically, which is open spaces that connect the interior to the exterior, an expressive spaces with a local concept linking house to environment, It distributes shade and light to the harsh Mediterranean style, Whether it is from a solid construction or soft plant arbors, Where the house is the nucleus for practicing several vital activities. The problem of research lies in ignoring the architectural heritage of the Arab rural Mediterranean Residence in building and designing our dwellings, so that our dwellings has become as a building without identity papers, and it has become described as a minor or exotic architecture, in line with the name of global design, which led to obliterate the identity of our society. The research aims to evoke (Shade Architecture) and the meanings of residential construction related to the traditions in the Arab Mediterranean area and its closely relation to the surrounding nature, and also aims to conclude architectural, environmental, social criteria that can contribute to design contemporary residence associated with the heritage. The research presented the concept of (family contracture) as a basic factor in planning, and showed how one living style produced multiple housing patterns, it presented three solutions describes the relationship between dwelling and surrounded nature (Domesticating External Area) (Shade architecture) of Permanent Structure through an analytical approach, then it linked the old to the modern by studying some contemporary installations, Then the results were presented and discussed where the research was able to devise architectural, environmental and social criteria, and it confirmed the existence of social, functional, environmental integration through the design thought of the Arab rural Mediterranean Residence, through shade architecture and its elements: (Patio - Courtyard - garden), it believes that opening to the outside should not be confined to specific cultures, but it is a real demand for all world.

Abstract Background Cardiovascular (CV) disease is the leading cause of death among United States women. Rural residence and ethnic-minority status are individually associated with increased CV mortality. Managing dyslipidemia is important in the prevention of CV mortality. However, the impact of race/ethnicity and location of residence on sex differences in dyslipidemia management is not well understood. Therefore, we sought to understand the joint effects of race/ethnicity and location of residence on lipid management differences between veteran men and women with type 2 diabetes (T2D). Methods Veterans Health Administration and Centers for Medicare and Medicaid Services data were used to perform a longitudinal cohort study of veterans with T2D (2007–2016). Mixed effects logistic regression with a random intercept was used to model the association between sex and low-density lipoprotein (LDL) > 100 mg/dL and its interaction with race/ethnicity and location of residence after adjusting for all measured covariates. Results When female sex and rural location of residence were both present, they were associated with an antagonistic harmful effect on LDL. Similar antagonistic harmful effects on LDL were observed when the joint effect of female sex and several minority race/ethnicity groups were evaluated. After adjusting for measured covariates, the odds of LDL > 100 mg/dL were higher for urban women (OR = 2.66, 95%CI 2.48–2.85) and rural women (OR = 3.26, 95%CI 2.94–3.62), compared to urban men. The odds of LDL > 100 mg/dL was the highest among non-Hispanic Black (NHB) women (OR = 5.38, 95%CI 4.45–6.51) followed by non-Hispanic White (NHW) women (OR = 2.59, 95%CI 2.44–2.77), and Hispanic women (OR = 2.56, 95%CI 1.79–3.66). Conclusion Antagonistic harmful effects on LDL were observed when both female sex and rural location of residence were present. These antagonistic effects on LDL were also present when evaluating the joint effect of female sex and several minority race/ethnicity groups. Disparities were most pronounced in NHB and rural women, who had 5.4 and 3.3 times the odds of elevated LDL versus NHW and urban men after adjusting for important covariates. These striking effect sizes in a population at high cardiovascular risk (i.e., older with T2D) suggest interventions aimed at improving lipid management are needed for individuals falling into one or more groups known to face health disparities.

Abstract Background Integration of mental healthcare into non-specialist settings is advocated to expand access to care for people with severe mental disorders (SMD) in low-income countries. However, the impact upon equitable access for disenfranchised members of society has not been investigated. The purpose of this study was to (1) estimate contact coverage for SMD of a new service in primary healthcare (PHC) in a rural Ethiopian district, and (2) investigate equity of access for rural residents, women, people with physical impairments and people of low socio-economic status. Methods Community key informants were trained to identify and refer people with probable SMD in Sodo district, south-central Ethiopia, using vignettes of typical presentations. Records of those referred to the new PHC-based service were linked to healthcare records to identify people who engaged with care and non-engagers over a 6 month period. Standardised interviews by psychiatric nurses were used to confirm the diagnosis in those attending PHC. Non-engagers were visited in their homes and administered the Psychosis Symptom Questionnaire. Socio-economic status, discrimination, disability, substance use, social support and distance to the nearest health facility were measured. Results Contact coverage for the new service was estimated to be 81.3% (300 engaged out of 369 probable cases of SMD identified). Reimbursement for transport and time may have elevated coverage estimates. In the fully adjusted multivariable model, rural residents had 3.81 increased odds (95% CI 1.22, 11.89) of not accessing care, in part due to geographical distance from the health facility (odds ratio 3.37 (1.12, 10.12)) for people living more than 180 min away. There was no association with lower socioeconomic status, female gender or physical impairment. Higher levels of functional impairment were associated with increased odds of engagement. Amongst non-engagers, the most frequently endorsed barriers were thinking the problem would get better by itself and concerns about the cost of treatment. Conclusion Integrating mental healthcare into primary care can achieve high levels of coverage in a rural African setting, which is equitable with respect to gender and socio-economic status. Service outreach into the community may be needed to achieve better contact coverage for rural residents.

In order to meet the needs of the development of low-rise assembly structure in rural areas, a fabricated light-weight steel frame-composite light wall structure is proposed in this paper. The light-weight steel frames are used to bear the vertical loads. The single-row-reinforced recycled concrete wall-boards are used as lateral members to resist most of the horizontal earthquake loads. The wall-board, EPS (Expanded Polystyrene) insulation modules,and fly ash blocks form the thermally insulated wall. Four fabricated lightweight steel frame-composite light wall structures and one light-weight steel frame(FRA)structure were tested under the low cyclic loads. The influence of wall reinforcement spacing and structural form (be it fly ash block or not) on the seismic performance of this new structure was analysed and the damage process of the specimen was simulated using the ABAQUS®software. The results show that the light steel frames and the single-row-reinforced recycled concrete wall-board can work well together. Furthermore, the structure has two clear seismic lines. Due to the use of EPS insulation modules and fly ash blocks, thestructure has good anti-seismic and thermal insulation abilities. Reducing the spacing of bars or compositing fly ash blocks can significantly improve the seismic performance of the structure. The finite element method (FEM) calculations agreed well with the experimental results, which validates the proposed model

Objective: This study is part of a programmatic investigation of rural disparities in cigarette smoking examining disparities in smoking prevalence and for the first-time quit ratios among adult women of reproductive age (18-44 years), a highly vulnerable population due to risk for multigenerational adverse effects., Methods: Data came from 18 years (2002-2019) of the U.S. National Survey on Drug Use and Health (NSDUH) among women (n = 280,626) categorized by rural-urban residence, pregnancy status, using weighted logistic regression models testing time trends and controlling for well-established sociodemographic predictors of smoking (race/ethnicity, education, income). Concerns regarding changes in survey methods used before 2002 and after 2019 precluded inclusion of earlier and more recent survey years in the present study., Results: Overall smoking prevalence across years was greater in rural than urban residents (adjusted odds ratio [AOR] = 1.11; 95%CI, 1.07-1.15; P < .001) including those not-pregnant (AOR = 1.10; 1.07-1.14; P < .001) and pregnant (AOR = 1.29; 1.09-1.52; P < .001). Overall quit ratios across years were lower in rural than urban residents (AOR = 0.93; 0.87-0.99; P < .001) including those not-pregnant (AOR = 0.93; 0.88-1.00, P = .035) and pregnant (AOR = 0.78; 0.62-0.99; P = .039). Interactions of rural versus urban residence with study years for prevalence and quit ratios overall and by pregnancy status are detailed in the main text., Conclusions: These results support a longstanding and robust rural disparity in smoking prevalence among women of reproductive age including those currently pregnant and provides novel evidence that differences in smoking cessation contribute to this disparity further underscoring a need for greater access to evidence-based tobacco control and regulatory interventions in rural regions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Copyright of Architectural Journal / Jian Zhu Xue Bao is the property of Architectural Journal Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Appropriate management and optimization of energy consumption provides great support for the sustainable development of rural buildings. Although some research results are helpful for the energy-saving design and transformation of rural residential buildings, there is no systematic analysis of the impact of energy consumption parameters on energy-saving, which is not conducive to further optimization of energy-saving design. Based on more than 200 groups of field survey data, a typical initial rectangle model of rural residence in the severe cold area of northern China is established, and the orientation, aspect ratio, south window-wall ratio (WWR), north WWR, and enclosure structure are five main factors affecting the energy consumption in heating period. The method to evaluate the heating energy consumption of buildings was proposed based on EnergyPlus and analytic hierarchy process (AHP) from different functional parameters. The climate conditions of four cities of three secondary severe cold areas (1A, 1B, 1C) in northern China are selected for the building model, and the change rates and weights of energy consumption related parameters are analyzed. The results from the energy consumption simulation analysis show that the weight of enclosure structure is the largest, followed by the South WWR, the ratio of length to width is the third, and the orientation is the smallest in the four cities, which provides a good reference for the prediction and optimization of energy consumption in the rural residences in severe cold area.

AbstractPurpose: The prevalence of diabetes in U.S. veterans (20.5%) is nearly three times that of the general population. Minority veterans have higher rates of diabetes compared with their counterparts and urban/rural residence is also associated with uncontrolled cholesterol. However, the interplay between urban/rural residence and race/ethnicity on cholesterol control is unclear. Methods: Veterans Health Administration Corporate Data Warehouse and Centers for Medicare and Medicaid data were used to create unique dataset and perform longitudinal study of veterans with type 2 diabetes from 2006 to 2016. Logistic regression was used to model the association between low-density lipoprotein (LDL) control and the primary exposures (race/ethnicity and location of residence) after adjusting for all measured covariates, including the interaction between location of residence and race/ethnicity. Results: There was a significant interaction between race/ethnicity and rural residence. Rural non-Hispanic Black (NHB) veterans had higher odds for LDL >100?mg/dL (odds ratio [OR]=1.70, 95% confidence interval [CI] 1.50?1.60) and for LDL >70?mg/dL (OR=1.59, 95% CI 1.53?1.64) compared with urban non-Hispanic White (NHW) veterans. Similarly, compared with urban NHW, urban NHB veterans had higher odds of LDL >100?mg/dL (OR=1.45, 95% CI 1.43?1.47) and LDL >70?mg/dL (OR=1.36, 95% CI 1.34?1.38). Conclusion: This study highlights health disparities for veterans with type 2 diabetes. Future research is needed to evaluate interventions for mitigating these disparities in cholesterol management among veterans with diabetes.

Taking a rural residence of Beijing which is undergoing "coal to clean energy" reforming as the research object, a typical residence energy consumption simulation model is established by using DeST-h. The influence of door-windows air-tight grade on heating and air-conditioning energy consumption of the building is simulated. The initial investment and energy saving of different air-tight grade door-windows are analyzed, and the air-tight grade enclosure suitable for energy-saving and economic construction of rural residence in north China is obtained. [ABSTRACT FROM AUTHOR]

Our paper presents the results of a questionnaire-based inquiry aimed to investigate the level of intercultural sensitivity concerning respondents’ workplace background, namely urban versus rural. The main purpose of our research is to highlight possible differences in intercultural sensitivity levels at teachers working in urban and rural schools, which constitutes our contribution to the research existing in the field. The general hypotheses of our research are: the workplace background (urban/rural) impacts the level of manifesting intercultural sensitivity; the urban workplace of respondents is connected to a higher level of manifesting intercultural sensitivity. This investigation is part of wider research that aims to identify teacher training practices that may raise pre- and in-service teachers’ levels of intercultural sensitivity and better prepare them to work with groups of students characterized by diversity, as well as solutions to educational issues in the Romanian context by considering the two different contexts in which education takes place, namely urban and rural. Our findings have revealed higher levels of intercultural sensitivity at teachers working in urban schools, compared to those working in rural schools and the results obtained for each specific hypothesis and objective reveal the particularities involved for each scale dimension [ABSTRACT FROM AUTHOR]

As a design theory on energy-saving housing, Self-sufficiency house is suited to the environment conditions of cold rural areas in China. Investigation on the rural residence form and energy use is the important foundation to carry out the research and design practice on self-sufficiency house. Taking Beijing and its surrounding rural areas as target, the paper combs current situation and technical requirements of rural residence based on self-sufficiency perspective. After surveying general residential condition and data, it analyzes the form, function, energy use and heating technology of rural residence, which will provide basic data and reference for post-study.

Abstract Background Successful tuberculosis (TB) treatment is essential to effective TB control. TB-HIV coinfection, social determinants and access to services influenced by rural residence can affect treatment outcome. We examined the separate and joint effects of rural residence and HIV infection on poor treatment outcome among patients enrolled in a large TB treatment centre in Kano, Nigeria. Methods We retrospectively analysed a cohort of patients with TB enrolled in a large urban TB clinic in northern Nigeria, from January 2010 to December 2014. Poor treatment outcome was defined as death, default or treatment failure. We used Poisson regression to model rates and determine the relative risks (and 95% confidence intervals, CI) of poor treatment outcomes. Results Among 1381 patients included in the analysis, 28.4% were rural residents; 39.8% were HIV-positive; and 46.1% had a poor treatment outcome. Approximately 65 and 38% of rural and urban residents, respectively, had a poor treatment outcome. Rural residents had 2.74 times (95% CI: 2.27–3.29) the risk of having a poor treatment outcome compared to urban residents. HIV-positive patients had 1.4 times (95% CI: 1.16–1.69) the risk of poor treatment outcome compared to HIV-negative patients. The proportion of poor treatment outcome attributable to rural residence (population attributable fraction, PAF) was 25.6%. The PAF for HIV infection was 11.9%. The effect of rural residence on poor treatment outcome among HIV-negative patients (aRR:4.07; 95%CI:3.15–5.25) was more than twice that among HIV-positive patients (aRR:1.99; 95%CI:1.49–2.64). Conclusion Rural residents attending a large Nigerian TB clinic are at increased risk of having poor treatment outcomes, and this risk is amplified among those that are HIV-negative. Our findings indicate that rural coverage of HIV services may be better than TB services. These findings highlight the importance of expanding coverage of TB services to ensure prompt diagnosis and commencement of treatment, especially among rural-dwellers in resource-limited settings.

Trombe wall (also called T-Wall) as a reliable renewable energy system has attracted increasing attention from both academics and engineers under the current energy crisis. This study then focused on a Tibetan dwelling retrofitting in the Sichuan-Tibet Alpine Valley, adopting T-wall as a passive heating solution. We investigated a classic T-wall in the target building based on field measurement, orthogonal experiment, and numerical simulation methods. It was known that the maximum average indoor temperature of the master room can reach 18.87 °C in the coldest month (January) of the Sichuan-Tibet Alpine Valley. Six key influencing factors were analyzed accordingly, including the south T-wall-to-wall ratio, inlet/outlet height, glazing inclination angle, storage wall thickness, storage wall material and cavity gap. Among those analyzed factors, it was obtained that the highly significant factors are the south T-wall-to-wall ratio and glazing inclination angle. The larger the proportion of the south T-wall-to-wall ratio, the better the indoor temperature is. The best glazing inclination angle was obtained as 100 for the target residential building under the local conditions. Solar passive technology as a cost-effective solution can improve the indoor thermal environment of the Tibetan dwellings in the Qinghai-Tibet Plateau. The total annual energy consumption of the Tibetan dwelling using the optimal combination can be reduced by about 72% compared to that of the existing Tibetan houses. The research outcomes can provide a practical guide on the future design of passive solar technologies. • A case study on Trombe wall was taken in a building in Sichuan-Tibet Alpine Valley. • The maximum average indoor temperature can reach 18.87 °C in the coldest month. • The significant factors are south T-wall-to-wall ratio and glazing inclination angle. • The best glazing inclination angle was obtained as 100 under the local conditions. • The optimal combination can about 72% energy compared to the existing Tibetan houses. [ABSTRACT FROM AUTHOR]

This research was conducted to measure the nomophobia levels of young people. The sample of the study consisted of 400 young people living in rural districts of Bursa province in Turkey. The results show that 8.5% of the youth was severely nomophobic, 71.5% were moderate and 20.0% were mildly nomophobic. There was no statistically significant difference between gender and working status and nomophobia level but statistically significant differences were encountered between age and educational status. As young people's age increased, the levels of nomophobia they suffer decreased. They asserted a higher level of nomophobia during high school years. Despite a slight decrease in university years, students' nomophobia levels were higher than the graduates and working youth. When the sub-dimensions of the scale were examined, the 'avoidance' and 'conflict' factors were above the NoSmartPhone Scale (NSPS) mean score, but the interwind identity and attachment factors were below the mean score. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Dalian University of Technology / Dalian Ligong Daxue Xuebao is the property of Journal of Dalian University of Technology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Integration of mental healthcare into non-specialist settings is advocated to expand access to care for people with severe mental disorders (SMD) in low-income countries. However, the impact upon equitable access for disenfranchised members of society has not been investigated. The purpose of this study was to (1) estimate contact coverage for SMD of a new service in primary healthcare (PHC) in a rural Ethiopian district, and (2) investigate equity of access for rural residents, women, people with physical impairments and people of low socio-economic status. Methods: Community key informants were trained to identify and refer people with probable SMD in Sodo district, south-central Ethiopia, using vignettes of typical presentations. Records of those referred to the new PHC-based service were linked to healthcare records to identify people who engaged with care and non-engagers over a 6 month period. Standardised interviews by psychiatric nurses were used to confirm the diagnosis in those attending PHC. Non-engagers were visited in their homes and administered the Psychosis Symptom Questionnaire. Socio-economic status, discrimination, disability, substance use, social support and distance to the nearest health facility were measured. Results: Contact coverage for the new service was estimated to be 81.3% (300 engaged out of 369 probable cases of SMD identified). Reimbursement for transport and time may have elevated coverage estimates. In the fully adjusted multivariable model, rural residents had 3.81 increased odds (95% CI 1.22, 11.89) of not accessing care, in part due to geographical distance from the health facility (odds ratio 3.37 (1.12, 10.12)) for people living more than 180 min away. There was no association with lower socioeconomic status, female gender or physical impairment. Higher levels of functional impairment were associated with increased odds of engagement. Amongst non-engagers, the most frequently endorsed barriers were thinking the problem would get better by itself and concerns about the cost of treatment. Conclusion: Integrating mental healthcare into primary care can achieve high levels of coverage in a rural African setting, which is equitable with respect to gender and socio-economic status. Service outreach into the community may be needed to achieve better contact coverage for rural residents. [ABSTRACT FROM AUTHOR]

In order to meet the needs of the development of low-rise assembly structure in rural areas, a fabricated light-weight steel frame-composite light wall structure is proposed in this paper. The light-weight steel frames are used to bear the vertical loads. The single-row-reinforced recycled concrete wall-boards are used as lateral members to resist most of the horizontal earthquake loads. The wall-board, EPS (Expanded Polystyrene) insulation modules, and fly ash blocks form the thermally insulated wall. Four fabricated lightweight steel frame-composite light wall structures and one light-weight steel frame (FRA) structure were tested under the low cyclic loads. The influence of wall reinforcement spacing and structural form (be it fly ash block or not) on the seismic performance of this new structure was analysed and the damage process of the specimen was simulated using the ABAQUS® software. The results show that the light steel frames and the single-row-reinforced recycled concrete wall-board can work well together. Furthermore, the structure has two clear seismic lines. Due to the use of EPS insulation modules and fly ash blocks, the structure has good anti-seismic and thermal insulation abilities. Reducing the spacing of bars or compositing fly ash blocks can significantly improve the seismic performance of the structure. The finite element method (FEM) calculations agreed well with the experimental results, which validates the proposed model. [ABSTRACT FROM AUTHOR]

The rural residences of Northwest China are characterized by a state of high energy consumption and low comfort due to the limited economic level and awareness of energy-saving compared with the urban residences. To remedy this, appropriate passive design strategies should be adopted first, in order to provide a design mode with low energy consumption and low cost for rural residences under the premise of thermal comfort. In this paper, taking Hanzhong region (Shaanxi Province, China) as an example, we establish a benchmark model based on a field survey and develop an optimization process by combining EnergyPlus simulation software, the MOBO optimization engine, and weighted sum method. The action mechanisms of passive design parameters, including the building orientation, length–width ratio, building envelope parameters, external shading system, and window–wall ratio, on heating, cooling, and total energy consumption are analyzed, and the quantitative relationships between single-parameter and energy consumption are established. Then, the mutually restricted indices of total energy consumption and initial investment cost are taken as optimization objectives, and 17 design parameters are selected as the optimization variables. The NSGA-II algorithm is adopted to conduct the multi-parameter, multi-objective optimization design for rural houses in Hanzhong area, through coupling of the EnergyPlus and MOBO software. In this way, Pareto solutions are obtained and the value distributions of the multi-objectives and design parameters are analyzed. Based on the actual requirements of decision-makers and using the weight method, three design schemes focusing on different performance tendencies are proposed. The results indicate that by using the proposed optimization process, the building energy consumption can be significantly reduced while taking initial investment costs into account, where the energy-saving rate is in the range of 31.9–61.5%. When the EC/IC ratio is 1:1, 2:1, and 1:2, the energy-saving rate can reach 51.5%, 57.8%, and 43.5%, respectively. It can provide a beneficial pattern for the energy-saving design and renovation of rural residences in Hanzhong area of China.

Objectives: To quantify inequalities in the prevalence of elevated depressive symptoms by rural childhood residence and the extent to which childhood socioeconomic conditions and educational attainment contribute to this disparity.Methods: We identified the prevalence of depressive symptoms among US-born adults ages 50 years and older in the 1998 to 2014 waves of the Health and Retirement Study (n = 16 022). We compared prevalence of elevated depressive symptoms (>4/8 symptoms) by rural versus nonrural childhood residence (self-report) and the extent to which own education mediated this disparity. We used generalized estimating equations and marginal standardization to calculate predicted probabilities of elevated depressive symptoms.Results: In age, race/ethnicity, and sex-adjusted models, rural childhood residence was associated with elevated depressive symptoms (OR = 1.20; 95% CI, 1.12-1.29; marginal predicted probability 10.5% for rural and 8.9% for nonrural childhood residence). Adjusting for US Census birth region and parental education attenuated this association (OR = 1.07; 95% CI, 0.99-1.15; marginal predicted probability 9.9% for rural and 9.3% for nonrural). After additional adjustment for own education, rural childhood residence was not associated with elevated depressive symptoms (OR = 0.94; 95% CI, 0.87-1.01; marginal predicted probability 9.2% for rural and 9.8% for nonrural).Conclusions: Rural childhood residence was associated with elevated depressive symptoms in middle-aged and older adults; birth region, parental education, and own education appear to contribute to this disparity. [ABSTRACT FROM AUTHOR]

Copyright of New Architecture is the property of New Architecture Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Shape coefficient (SC) is an important factor affecting energy consumption of residential buildings. Due to lack of suitable and efficient methods for building three-dimensional data acquisition, there are few studies on the regional characteristics of rural residential SC. In view of this, taking the rural residential buildings in Hangzhou as the case, a new analysis method for regional similarity of rural residential shape coefficient at the municipal level is presented in this paper. This method contains four steps of work. Firstly, the applicability tests need to be conducted for the selected remote sensing images in Google Earth. Secondly, Hangzhou is divided into several sub-regions and the sample villages are selected in each sub-region. Thirdly, SC of rural residences in each sample village can be obtained based on Google Earth. Lastly, regional similarity of residential SC can be analyzed at municipal level by cluster analysis method. The case study shows that there are obvious regional similarity characteristics for the SC of rural residences. When the clustering distance is 10, the sample villages can be divided into three types, namely type A villages, type B villages and type C villages which have different mean and standard deviation. The new method makes it feasible to assess the geographical distribution characteristics of SC of a certain type of buildings, which can provide basic reference data not only for policymakers to make the most suitable building retrofit policy but also for building designers to conduct energy efficiency designs at regional scale. [ABSTRACT FROM AUTHOR]

Background Literature suggests that factors such as rural residence and low socioeconomic status (ses) might contribute to disparities in survival for Canadian cancer patients because of inequities in access to care. However, evidence specific to brain cancer is limited. The present research estimates the effects of rural or urban residence and ses on survival for Canadian patients diagnosed with brain cancer. Methods Adults diagnosed with primary malignant brain tumours during 1996-2008 were identified through the Canadian Cancer Registry. Brain tumours were classified using International Classification of Diseases for Oncology (3rd edition) site and histology codes. Hazard ratios (hrs) and 95% confidence intervals (cis) were estimated using Cox proportional hazards models. Events were restricted to individuals whose underlying cause of death was cancerrelated. Postal codes were used to match patient records with Statistics Canada data for rural or urban residence and neighbourhood income as a surrogate measure of ses. Results Of 25,700 patients included in the analysis, 78% died during the study period, 21% lived in rural areas, and 19% were in the lowest income group. A modest variation in survival by rural compared with urban residence was observed for patients with glioblastoma (first 5 weeks after diagnosis hr: 0.86; 95% ci: 0.79 to 0.99) and oligoastrocytoma (first 3 years after diagnosis hr: 1.41; 95% ci: 1.03 to 1.93). Small effects of low compared with high income were seen for patients with glioblastoma (first 1.5 years after diagnosis hr: 1.15; 95% ci: 1.08 to 1.22) and diffuse astrocytoma (first 6 months after diagnosis hr: 1.17; 95% ci: 1.00 to 1.36). Conclusions Our analysis did not yield evidence of strong effects of rural compared with urban residence or ses strata on survival in brain cancer. However, some variation in survival for patients with specific histologies warrants further research into the mechanisms by which rural or urban residence and income stratum influences survival. [ABSTRACT FROM AUTHOR]

Objective: Diagnosis of laryngeal cancer is dependent on awareness that persistent hoarseness needs to be investigated as well as access to an otolaryngologist. This study aimed to better classify and understand 3 factors that may lead to variability in stage at presentation of laryngeal cancer: (1) socioeconomic status (SES), (2) differences in access to health care by location of residence (rural vs urban or by province), and (3) access to an otolaryngologist (by otolaryngologists per capita).Study Design: Registry-based multicenter cohort analysis.Setting: This was a national study across Canada, a country with a single-payer, universal health care system.Subjects: All persons 18 years or older who were diagnosed with laryngeal cancer from 2005 to 2013 inclusive were extracted from the Canadian Cancer Registry (CCR).Methods: Ordered logistic regression was used to determine the effect of income, age, sex, province of residence, and rural vs urban residence on stage at presentation.Results: A total of 1550 cases were included (1280 males and 265 females). The stage at presentation was earlier in the highest income quintile (quintile 5) compared to the lower income quintiles (quintiles 1-4) (odds ratio [OR], 0.68; P < .05). There was a statistically significant difference in stage at presentation based on rural or urban residence within the highest income quintile (OR, 1.73; P < .005).Conclusion: There is a relationship between SES and stage at presentation for laryngeal cancer even in the Canadian universal health care system. [ABSTRACT FROM AUTHOR]

A combined system of refrigeration and heating unit with seasonal solar thermal storage was presented in this paper. Based on the climate character of the Zhongyuan region, China, the system's performance in rural residences was studied. A computational program was established based on the DEST software, the solar heat collecting capacity, heat collecting efficiency, and other parameters were analyzed. The results showed that the system can supply 76.28% heating load and 40.14% cooling load, when the total collector surface area equals to 40 m2 and heat collecting temperature is 80 °C. The results will provide theoretical support for the system's optimization. [ABSTRACT FROM AUTHOR]

Background: Successful tuberculosis (TB) treatment is essential to effective TB control. TB-HIV coinfection, social determinants and access to services influenced by rural residence can affect treatment outcome. We examined the separate and joint effects of rural residence and HIV infection on poor treatment outcome among patients enrolled in a large TB treatment centre in Kano, Nigeria. Methods: We retrospectively analysed a cohort of patients with TB enrolled in a large urban TB clinic in northern Nigeria, from January 2010 to December 2014. Poor treatment outcome was defined as death, default or treatment failure. We used Poisson regression to model rates and determine the relative risks (and 95% confidence intervals, CI) of poor treatment outcomes. Results: Among 1381 patients included in the analysis, 28.4% were rural residents; 39.8% were HIV-positive; and 46.1% had a poor treatment outcome. Approximately 65 and 38% of rural and urban residents, respectively, had a poor treatment outcome. Rural residents had 2.74 times (95% CI: 2.27-3.29) the risk of having a poor treatment outcome compared to urban residents. HIV-positive patients had 1.4 times (95% CI: 1.16-1.69) the risk of poor treatment outcome compared to HIV-negative patients. The proportion of poor treatment outcome attributable to rural residence (population attributable fraction, PAF) was 25.6%. The PAF for HIV infection was 11.9%. The effect of rural residence on poor treatment outcome among HIV-negative patients (aRR:4.07; 95%CI:3.15-5.25) was more than twice that among HIV-positive patients (aRR:1.99; 95%CI:1.49-2.64). Conclusion: Rural residents attending a large Nigerian TB clinic are at increased risk of having poor treatment outcomes, and this risk is amplified among those that are HIV-negative. Our findings indicate that rural coverage of HIV services may be better than TB services. These findings highlight the importance of expanding coverage of TB services to ensure prompt diagnosis and commencement of treatment, especially among rural-dwellers in resource-limited settings. [ABSTRACT FROM AUTHOR]

The development of green building is an important way to solve the environmental problems of China's construction industry. Energy conservation and energy utilization are important for the green building evaluation criteria (GBEC). The objective of this study is to evaluate the quantitative relationship between building shape parameter, envelope parameters, shading system, courtyard and the energy consumption (EC) as well as the impact on indoor thermal comfort of rural residential buildings in the hot summer and warm winter zone (HWWZ). Taking Quanzhou (Fujian Province of China) as an example, based on the field investigation, EnergyPlus is used to build the building performance model. In addition, the classical particle swarm optimization algorithm in GenOpt software is used to optimize the various factors affecting the EC. Single-objective optimization has provided guidance to the multi-dimensional optimization and regression analysis is used to find the effects of a single input variable on an output variable. Results shows that the energy saving rate of an optimized rural residence is about 26-30% corresponding to the existing rural residence. Moreover, the payback period is about 20 years. A simple case study is used to demonstrate the accuracy of the proposed optimization analysis. The optimization can be used to guide the design of new rural construction in the area and the energy saving transformation of the existing rural houses, which can help to achieve the purpose of energy saving and comfort. [ABSTRACT FROM AUTHOR]