Why Crime Victims Do Not Seek Help: Perceived and Systematic Barriers Across Geographic Context

As urbanization progresses, the flow of population, capital, and other resources between urban and rural areas accelerates, leading to evolving urban-rural interactions. This study examines the spatiotemporal characteristics of the “urban-suburban-rural” interactions in the Shanghai metropolis from 2017 to 2020, focusing on commuting flows. The results indicate that interactions among urban, suburban, and rural areas in Shanghai metropolis have generally strengthened, characterized by increasingly distinct commuting structures and more pronounced strong connections. Urban commuting patterns predominantly rely on intra-urban flows, while suburban and rural areas demonstrate varying degrees of employment dependence on urban areas. Notably, rural areas exhibit stronger dependence on suburban areas than on urban centers. Despite these interactions, significant differences persist in the commuting structures among the three areas. The development of employment centers, such as the central city, urban peripheries, new towns, and industrial parks, has enhanced connections within urban areas, as well as between urban and suburban areas and between urban and rural areas. However, the commuting structures within rural areas and between rural and suburban areas have shown little change, reflecting lagging functional development in these areas. Shanghai metropolis should focus on unlocking the potential of suburban and rural areas by advancing functional development and establishing employment centers.

Patients with out-of-hospital cardiac arrest (OHCA) in rural areas experience longer emergency response times and have lower survival rates compared with patients in urban areas. Volunteer responders might improve care and outcomes for patients with OHCA specifically in rural areas. Therefore, we investigated volunteer responder interventions based on the degree of urbanization. We included 1310 OHCAs from 3 different regions in Denmark where volunteer responders had arrived at the OHCA location. The location was classified as urban, suburban, or rural according to the Eurostat Degree of Urbanization Tool. A logistic regression model was used to examine associations between the degree of urbanization and volunteer responder arrival before emergency medical services, cardiopulmonary resuscitation, or defibrillation. We found the odds for volunteer responder arrival before emergency medical services more than doubled in rural areas (odds ratio [OR], 2.60 [95% CI, 1.91-3.53]) and suburban areas (OR, 2.05 [95% CI, 1.56-2.69]) compared with urban areas. In OHCA cases where volunteer responders arrived first, odds for bystander cardiopulmonary resuscitation was tripled in rural areas (OR, 3.83 [95% CI, 1.64-8.93]) and doubled in suburban areas (OR, 2.27 [95% CI, 1.17-4.41]) compared with urban areas. Bystander defibrillation was more common in suburban areas (OR, 1.53 [95% CI, 1.02-2.31]), where almost 1 out of 4 patients received bystander defibrillation, compared with urban areas. Volunteer responders are significantly more likely to arrive before emergency medical services in rural and suburban areas than in urban areas. Patients with OHCA received more cardiopulmonary resuscitation in rural and suburban areas and more defibrillation in suburban areas than in urban areas.

To understand the genetic basis of the adaptation of Culex tritaeniorhynchus to different environmental ecology in Jining City, Shandong Province, so as to provide insights into understanding of the population structure or isolation pattern of Cx. tritaeniorhynchus in the city. Seven sampling sites were selected from urban, suburban and rural areas of Jining City, Shandong Province from June to August 2023, and mosquitoes were collected using mosquito-trapping lamps. All collected adult mosquitoes were identified morphologically. Genomic DNA was extracted from a single female Cx. tritaeniorhynchus mosquito, and the mitochondrial cytochrome C oxidase I (COI) gene was amplified using a PCR assay, sequenced and subjected to molecular identification. The number of haplotypes, haplotype diversity (Hd), nucleotide diversity (Pi), and average number of nucleotide differences (K) of Cx. tritaeniorhynchus DNA sequences were estimated among different sampling sites using the software DnaSP 6, and a neutrality test was performed. The fixation index (FST), and gene flow (number of migrants, Nm) of Cx. tritaeniorhynchus populations were calculated using the software Arlequin 3.5.2, and subjected to analysis of molecular variance (AMOVA). In addition, a haplotype network diagrams and a phylogenetic tree of Cx. tritaeniorhynchus populations were created using the software PopART and MEGA 11, respectively. A total of 420 sequences were successfully amplified from the COI gene of Cx. tritaeniorhynchus samples collected from 7 sampling sites in Jining City, and a gene fragment sequence with a length of 603 bp was obtained, with 55 variable sites and 46 haplotypes and without insertion or deletion mutations. Of the 46 haplotypes, H01 was the dominant shared haplotype, and the haplotype frequency increased gradually from urban areas (34.00%) to rural areas (47.00%). The mean Hd, Pi and K values of Cx. tritaeniorhynchus COI genes were 0.814, 0.024 and 14.129, 0.489, 0.016 and 7.941 and 0.641, 0.016 and 10.393 in suburban, urban, and rural areas, respectively, with the highest population diversity of Cx. tritaeniorhynchus in suburban areas and the lowest in urban areas. Paired FST analysis among different types of sampling sites showed that the mean FST value was 0.029 between urban and suburban areas, indicating more frequent inter-population communication. AMOVA revealed that the percentage of intra-population variation (95.74%) was higher than that of inter-population variation (4.26%). Neutrality tests showed deviation from neutrality in Cx. tritaeniorhynchus populations collected from Nanyang Township (Tajima's D = 2.793, Fu's Fs = 6.429, both P values < 0.05). In addition, the mismatch distribution curves of Cx. tritaeniorhynchus COI gene appeared bimodal or multimodal patterns in Jining City, indicating a relatively stable overall population size. The mitochondrial COI gene may be used as a molecular marker to investigate the population genetic diversity of Cx. tritaeniorhynchus. The population genetic diversity of Cx. tritaeniorhynchus is higher in the suburban areas of Jining City than in rural and urban areas, and there are frequent genetic exchanges between Cx. tritaeniorhynchus populations from urban and suburban areas.

Introduction: The implementation of Indonesia National Health Insurance (NHI) for oral health needs to be evaluated by observing the dental disease patterns and dental therapy patterns from community health centers (CHCs) in the rural area, suburban area, and urban area. The aim of the study is to describe the characteristics of dental services in rural, suburban, and urban areas after the implementation of NHI on CHCs in the Special Region of Yogyakarta in 2014.Materials and methods: This is an observational study with a cross-sectional research design. The study used quantitative data obtained from dental records at selected CHCs. Using a purposive sampling method, 30 CHCs as unit analysis were collected from rural, suburban, and urban areas. The data were collected from January 2014 to December 2014.Results: Data from 26,554 patients were collected from dental records of dental clinics at CHCs. There were 5829 patient dental records from rural areas, 12,327 from suburban areas, and 8938 from urban areas. The primary dentist tends to provide services without clinical intervention on periodontal problems, abscesses, and lesions. Clinical interventions were mostly provided for prolonged retention and deposits on teeth. Primary dentists in suburban areas tend to provide clinical intervention on caries disease compared to those in rural and urban areas. Statistically significant differences (p < 0.05) were observed among locations in the pattern of providing clinical interventions on caries, abscess, lesion, prolonged retention, deposits on teeth, and other problems. No difference was recorded only on periodontal disease.Discussion: This study found that each area has different characteristics of dental disease and dental therapy patterns. Each area has a significant difference in the pattern of the clinical intervention of dental disease except in periodontal problems.

Background Survival from out-of-hospital cardiac arrest (OHCA) varies across regions. The aim of this study was to evaluate the association between urbanization (rural, suburban, and urban areas), bystander interventions (cardiopulmonary resuscitation and defibrillation), and 30-day survival from OHCAs in Denmark. Methods and Results We included OHCAs not witnessed by ambulance staff in Denmark from January 1, 2016, to December 31, 2020. Patients were divided according to the Eurostat Degree of Urbanization Tool in rural, suburban, and urban areas based on the 98 Danish municipalities. Poisson regression was used to estimate incidence rate ratios. Logistic regression (adjusted for ambulance response time) tested differences between the groups with respect to bystander interventions and survival, according to degree of urbanization. A total of 21 385 OHCAs were included, of which 8496 (40%) occurred in rural areas, 7025 (33%) occurred in suburban areas, and 5864 (27%) occurred in urban areas. Baseline characteristics, as age, sex, location of OHCA, and comorbidities, were comparable between groups. The annual incidence rate ratio of OHCA was higher in rural areas (1.54 [95% CI, 1.48-1.58]) compared with urban areas. Odds for bystander cardiopulmonary resuscitation were lower in suburban (0.86 [95% CI, 0.82-0.96]) and urban areas (0.87 [95% CI, 0.80-0.95]) compared with rural areas, whereas bystander defibrillation was higher in urban areas compared with rural areas (1.15 [95% CI, 1.01-1.31]). Finally, 30-day survival was higher in suburban (1.13 [95% CI, 1.02-1.25]) and urban areas (1.17 [95% CI, 1.05-1.30]) compared with rural areas. Conclusions Degree of urbanization was associated with lower rates of bystander defibrillation and 30-day survival in rural areas compared with urban areas.

To investigate the prevalence and incidence of asthma among children aged 0-14 years, with different living environments, economic levels, and sanitary conditions, in the urban and rural areas of Chengdu, China, and their influential factors. Children aged 0-14 years who were selected from urban, suburban, and rural areas of Chengdu were included in the study. The subjects were selected from all children aged 0-14 years in schools, kindergartens, and communities by random, cluster and non-proportional sampling. Parents were surveyed by questionnaire to find out suspected cases, which were then confirmed by inquiry and physical examination in the departments of respiratory medicine. All the obtained data were analyzed using SPSS statistical software. A total of 12,082 children from the urban areas, 5,677 from suburban areas, and 5,590 from the rural areas were included in the study. Of all the subjects, 551 (4.56%) had confirmed asthma, 150 (2.64%) had cough variant asthma (CVA), and 142 (2.54%) had suspected asthma. The prevalence rate of asthma was significantly higher in the urban areas than in the suburban and rural areas. The correct rate of diagnosis of asthma and CVA was highest in the urban areas, followed by the suburban and rural areas. Use of antibiotics and systemic corticosteroids was most common in the rural areas, followed by the suburban and urban areas, but this pattern was reversed for use of inhaled corticosteroids and leukotriene modifier. All the results in the three areas demonstrated that sex, age, age at which the first attack occurred, respiratory tract infection, inhalation/intake of allergens, and genetic factors were significantly associated with asthmatic attack. Population density, living environment, medical and health resources and economic level are associated with the prevalence and treatment of asthma.

Between 1982 and 1986 several surveys were carried out to determine the levels of lead and cadmium in blood, urine, and shed deciduous teeth (incisors only) of children living in rural, suburban, urban, and industrial areas of North-West Germany. Blood lead (PbB) and blood cadmium (CdB) were measured in about 4000 children. In rural, suburban and urban areas the median PbB levels vary between 5.5 and 7 micrograms/dl, with 98th percentiles varying between 10 and 13 micrograms/dl. The median CdB levels are between 0.1 and 0.2 microgram/dl, with 95th percentiles between 0.3 and 0.4 microgram/l. Children from urban areas have significantly higher PbB levels than children from rural and suburban areas. Regarding CdB no differences could be detected. Children living in areas around lead and zinc smelters, particularly those living very close to the smelters, have substantially increased PbB and CdB levels. Children from lead worker families also have substantially increased PbB and CdB levels. The lead levels in shed milk teeth (PbT) were determined in about 3000 children. In rural, suburban and urban areas the median PbT levels are between 2 and 3 micrograms/g, with 95th percentiles between 4 and 7 micrograms/g. Children from urban areas have significantly higher PbT levels than children from rural and suburban areas. The highest PbT levels (on a group basis) are in children from nonferrous smelter areas. The median levels of lead in urine (PbU) are between 6 and 10 micrograms/g creatinine, with 95th percentiles between 20 and 30 micrograms/g creatinine. Children from polluted areas have higher PbU levels than children from less polluted areas. The median levels of cadmium in urine (CdU) are in the order of 0.1 microgram/g creatinine, with 95th percentiles being in the range of 0.5 and 1.0 microgram/g creatinine. Girls have higher CdU levels than boys. There are no differences between groups of children from different areas. Children from lead worker families have higher PbU and CdU levels than otherwise comparable children. The results of the present studies indicate a further decrease of PbB in children from North-West Germany since the CEC blood lead campaigns carried out in 1979 and 1981. The decrease of lead exposure also seems to be reflected by a decrease of tooth lead levels.

India is facing triple epidemic of Non communicable diseases (NCDs) including high body mass index (BMI), high blood pressure and high blood glucose, contributing to more than half of deaths of all mortality, however, information in different demographics is limited, especially, in India. The aim of the study is to compare the prevalence of overweight, obesity, hypertension, and diabetes, along with the occurrence of multi-morbidity, across gender-specific populations in rural, suburban, and urban regions of India. This was a cross-sectional, population-based study including adults aged 20 and above in rural, suburban, and urban areas near Coimbatore, India. All participants were interviewed using a detailed questionnaire and had their anthropometric measurements, including height, weight, blood pressure, and blood samples collected. Gender specific and location specific prevalence of overweight, obesity, hypertension, diabetes, and multimorbidity were assessed. This study included 2976 individuals, of which 865 were from rural areas, 1030 from sub-urban areas, and 1081 from metropolitan areas. The mean systolic and diastolic blood pressure were higher in rural participants than in sub-urban and urban participants, despite the fact that the prevalence of hypertension was higher in sub-urban (47.1%) than in rural (36.4%) and urban (39.7%, p < 0.001). In sub-group analysis, sub-urban areas had a greater prevalence of hypertension in both men and women (53.5% and 41.7%, p < 0.001) than rural areas (41.9% and 31.3%, p = 0.001) or urban areas (45.9% and 35.5%, p < 0.001). Compared to rural (16.1%) and urban (23%), sub-urban areas had a greater prevalence of diabetes (25.8%, p < 0.001). Urban residents (47.5%) had higher rates of overweight and obesity than rural (31.4%) and sub-urban (34.1%, p < 0.001) residents. The association between diabetes and hypertension was present in the unadjusted model and persisted even after age and BMI adjustments. Though not in men, higher levels of education were associated to a higher prevalence of diabetes in women. Diabetes was associated to being overweight or obese in women, however this association was significantly reduced once BMI was taken into account. The overall multimorbidity was 3.8%, however, women had a higher overlapping prevalence (2.8%) compared to men (1%, p < 0.001). Diabetes and hypertension were prevalent comorbidities across all demographics, with higher rates in suburban and urban areas. Women exhibited higher rates of multimorbidity than men, regardless of the demographic area.

BackgroundDue to the high prevalence of diabetes risk factors in rural areas, it is important to identify whether differences in diabetes screening rates between rural and urban areas exist. Thus, the purpose of this study is to examine if living in a rural area, rurality, has any influence on diabetes screening across the US.MethodsParticipants from the 2011, 2013, 2015, and 2017 nationally representative Behavioral Risk Factor Surveillance System (BRFSS) surveys who responded to a question on diabetes screening were included in the study (n = 1,889,712). Two types of marginal probabilities, average adjusted predictions (AAPs) and average marginal effects (AMEs), were estimated at the national level using this data. AAPs and AMEs allow for the assessment of the independent role of rurality on diabetes screening while controlling for important covariates.ResultsPeople who lived in urban, suburban, and rural areas all had comparable odds (Urban compared to Rural Odds Ratio (OR): 1.01, Suburbans compared to Rural OR: 0.95, 0.94) and probabilities of diabetes screening (Urban AAP: 70.47%, Suburban AAPs: 69.31 and 69.05%, Rural AAP: 70.27%). Statistically significant differences in probability of diabetes screening were observed between residents in suburban areas and rural residents (AMEs: − 0.96% and − 1.22%) but not between urban and rural residents (AME: 0.20%).ConclusionsWhile similar levels of diabetes screening were found in urban, suburban, and rural areas, there is arguably a need for increased diabetes screening in rural areas where the prevalence of diabetes risk factors is higher than in urban areas.

Extreme Risk Protection Orders (ERPOs) are a tool used to temporarily remove access to firearms from those who may pose a risk of violence to themselves or others. Little research on ERPOs has examined variation in use of the law between urban and rural jurisdictions. Data abstracted from Maryland ERPO casefiles between October 2018 and June 2020 were paired with ZIP code-level Rural Area Commuting Area codes and American Community Survey population data. Rate of ERPO use was tabulated for 3 urbanicity categories (urban, suburban, and rural). Chi-squared and 1-way ANOVA tests were used to determine between-urbanicity variation in respondent characteristics, precipitating threat, petitioner type, and court outcomes. Univariate logistic regression supplemented these analyses when a statistically significant difference was evident. The observed rate of ERPO use was 1% higher in rural areas and 66% higher in suburban areas than urban areas. Racial demographics of respondents appeared to reflect underlying distributions of race in each urbanicity category. The types of threats precipitating ERPOs were overall similar, although suicide attempts were more common in non-urban petitions and interpersonal violent threats were most common in urban petitions. Family members and minors were more frequent targets of violence in the events precipitating rural petitions compared with non-rural petitions. Law enforcement officers were over twice as likely to petition in rural areas than in suburban or urban areas. Interim hearings occurred more frequently in suburban and rural areas than urban areas (although this result was not statistically significant for rural petitions). ERPOs are used in urban, suburban, and rural areas to address largely similar forms of violence. While the rate of ERPO use is higher in less urban areas, civilians comprise a smaller proportion of rural petitioners than urban or suburban petitions. Implications for implementation practice and further research are discussed.

Illicit drug use in rural and suburban areas of China has not been studied extensively, as most studies have focused on illicit drug use in urban areas. To compare the differences between urban, suburban, and rural drug use, we collected influent samples from 19 urban, 9 suburban, and 18 rural wastewater treatment plants in Dalian, respectively. A method using solid-phase extraction combined with derivatization for gas chromatography -mass spectrometry analysis was applied to detect biomarker concentrations. The concentrations of methamphetamine and morphine ranged from 3.12 to 605ng/L and < 2.35 to 198ng/L, respectively. Norketamine was found in only four samples (5.56 to 14.5ng/L), while 3,4-methylenedioxymethamphetamine and benzoylecgonine were not detected in any samples. Methamphetamine use in rural areas (16.3mg/day/1000 inhabitant (inh), prevalence: 0.06%) was significantly lower than those in urban (77.1mg/day/1000 inh, prevalence: 0.23%) and suburban (234mg/day/1000 inh, prevalence: 0.70%) areas. Heroin use in suburban areas (57.6mg/day/1000 inh, prevalence: 0.10%) was significantly higher than that in urban (13.9mg/day/1000 inh, prevalence: 0.02%) and rural (8.68mg/day/1000 inh, prevalence: 0.02%) areas. The results indicate relatively low levels of illicit drug use in rural areas of Dalian, related to low incomes and outflow of the working-age population. Illicit drug use was most prevalent in suburban areas of Dalian, which may be influenced by large floating populations and few anti-drug efforts in suburban areas.

Reducing human immunodeficiency virus (HIV) infection rates in persons who inject drugs (PWID) has been one of the major successes in HIV prevention in the United States. Estimated HIV incidence among PWID declined by approximately 80% during 1990-2006 (1). More recent data indicate that further reductions in HIV incidence are occurring in multiple areas (2). Research results for the effectiveness of risk reduction programs in preventing hepatitis C virus (HCV) infection among PWID (3) have not been as consistent as they have been for HIV; however, a marked decline in the incidence of HCV infection occurred during 1992-2005 in selected U.S. locations when targeted risk reduction efforts for the prevention of HIV were implemented (4). Because syringe service programs (SSPs)* have been one effective component of these risk reduction efforts for PWID (5), and because at least half of PWID are estimated to live outside major urban areas (6), a study was undertaken to characterize the current status of SSPs in the United States and determine whether urban, suburban, and rural SSPs differed. Data from a recent survey of SSPs(†) were analyzed to describe program characteristics (e.g., size, clients, and services), which were then compared by urban, suburban, and rural location. Substantially fewer SSPs were located in rural and suburban than in urban areas, and harm reduction services(§) were less available to PWID outside urban settings. Because increases in substance abuse treatment admissions for drug injection have been observed concurrently with increases in reported cases of acute HCV infection in rural and suburban areas (7), state and local jurisdictions could consider extending effective prevention programs, including SSPs, to populations of PWID in rural and suburban areas.

Anthropogenic impacts on Aedes mosquito community dynamics in Côte d'Ivoire

Synanthropy of the Australian Magpie: A Comparison of Populations in Rural and Suburban Areas of Southeast Queensland, Australia

Assessment of foliar dust deposition and elemental concentrations in foliar dust and long rows of grand tamarind leaves along two major roads of Coimbatore, India