Adult Visitors Research Articles

Segmenting visitors of a Greek recreational theme park using factors that motivate attendance

ABSTRACT Purpose This study aims to segment visitors to a Greek theme park using factors that motivate attendance. Research methods Three hundred and twenty-two young and adult visitors of an outdoor recreational theme park, located in the midlands of Greece, completed a questionnaire that measured four dimensions: motivation, service quality perceptions, intention to revisit, and word-of-mouth communication. Results and Findings A principal component analysis of the motivation items revealed a clear five-factor structure. Thereafter, a cluster analysis of the five factors was performed. This classified participants into three psychographic segments: “incurious to activities and social life”, “recreation and nature oriented”, and “outdoor activities enthusiast”. An analysis of variance test successfully validated the three segments relative to visitors’ perceptions of service quality and future behavioural intentions. Practical implications Theme park management can use this study’s newly developed visitor segmentation to better understand, commercialise, and personalise their services. Managers can more effectively execute visitor management strategies to attract customers and develop marketing techniques to create new competitors’ advantages. Research contribution The study successfully developed three validated psychographic theme park visitor segments: “incurious to activities and social life”, “recreation and nature oriented”, and “outdoor activities enthusiast”.

Stress and perceived health among primary care visitors in two corners of Europe: Scandinavia and Greece

BackgroundThe global financial crisis emerging in 2008 struck Greece especially hard, whereas Scandinavian countries were less affected. This has created a unique opportunity to study the long-term effect of community stress on populations. Increasing frequencies of mental health issues and poorer perceived health among the Greek population have been reported. The physiological marker of long-term stress, cortisol in hair, is applied in this study together with measures of perceived health and stress, depression and anxiety. Our aim was to study self-reported and physiological stress, perceived health, including mental health, in the general population of Greece compared to Scandinavia, in order to assess long-term effects of the economic crisis on these parameters.MethodsA cross-sectional comparative study of adult (18–65 years) Primary Health Care visitors from semi-rural areas in Greece (n = 84) and Scandinavia (n = 140). Data collection was performed in 2012, and encompassed a questionnaire with a variety of health and stress indicators as well as hair samples for analyzes of cortisol levels.ResultsThe Greek sample reported significantly poorer overall health (p < 0.0001) than the Scandinavians and a significantly higher perceived stress (p < 0.0001). The Greeks were also less hopeful of the future (p < 0.0001), and to a larger extent fulfilled the HAD criteria for depression (p < 0.0001) and anxiety (p = 0.002). The strongest predictors explaining ill health in logistic regressions were being Greek (p = 0.001) and feeling hopeless about the future p = 0.001, OR = 6.00 (CI 2.10–14.88). Strong predictors in logistic regressions for high perceived stress were anxiety: high (p < 0.0001) and medium (p = 0.0001), as well as medium depression (p = 0.02).ConclusionsGreek adult Primary Health Care visitors perceived their health more negatively than the Scandinavians, including a higher presence of depression, anxiety, and a lower hope for the future. The Greeks also reported higher perceived stress, but this was not reflected in higher cortisol levels. The findings presented here, identify possible adverse long-term effects of the economic crisis in the examined Greek population that are not seen in the Scandinavian cohort. These differences may also be interpreted against the background of socio-cultural differences in the northern and south-eastern corners of Europe.

42 Advanced Fibrosis Is Unlikely in the Majority of Patients from an Appalachian Emergency Department’s Non-Targeted Hepatitis C Virus Screening

We have previously demonstrated a high prevalence of Hepatitis C Virus (HCV), particularly among young, publicly insured patients, reflecting the escalating syndemic of opioid injection and HCV transmission. We aim to describe the degree of hepatic fibrosis among patients with evidence of HCV infection identified from an adult academic emergency department (ED) non-targeted HCV screening program. The study was a retrospective cohort analysis of ED systematic, non-targeted, opt-out HCV testing outcomes from July 2018 through January 2019. To assess the degree of liver disease as evidenced by fibrosis, Fibrosis-4 (FIB4) and aspartate transaminase to platelet ratio (APRI) scores were calculated from available AST, ALT and Platelet lab values pulled from the electronic medical record, collected on the same day as the initial ED visit. The absence or presence of advanced fibrosis or cirrhosis was determined using validated cut-offs: FIB4 < 1.45, APRI < 1; FIB4 > 3.25, APRI > 2 respectively. As previously reported there were 21,359 unique adult visitors during the time period studied. Of these, 16,700 individuals were verbally engaged and did not opt out of testing. A total of 11,635 individuals received HCV Ab testing with 1,459 patients (12.5%) having reactive results. Newly identified information shows that 1,241 (85%) of these patients had concomitant labs as part of routine ED care sufficient to calculate a FIB4 and APRI score. Data indicate that advanced fibrosis or cirrhosis was not likely in the majority of patients (FIB4 56%, 707/1241 patients; APRI 72.6%, 901/1241 patients). Those with available FIB4 and APRI were more likely to be born after 1965 (857/1241 patients, 69.1%), of whom 90.9% (779) had government insurance or were uninsured (Medicaid 85.6%, 667 patients; Medicare 8.5%, 66 patients; Uninsured 5.9%, 46 patients). Of these, advanced fibrosis or cirrhosis was not likely in the majority of patients : medicaid (FIB4 64.9%, 433/667 patients; APRI 67.2%, 462/667 patients), medicare ( FIB4 57.6%, 38/66 patents; APRI 71% 47/66 patients), uninsured (FIB4 69.6%, 32/46 patients; APRI 71.7%, 33/46 patients). ED non-targeted, opt-out testing identified a high prevalence of HCV infection among adult visitors in whom the majority do not have evidence of advanced fibrosis or cirrhosis. The majority of those patients were young and insured. For a curable disease that carries severe morbidity and mortality, along with known financial costs of inaction, our program has demonstrated that the ED may be a prime location to identify and treat viremic HCV patients.

Interest and learning in informal science learning sites: Differences in experiences with different types of educators.

This study explored topic interest, perceived learning and actual recall of exhibit content in 979 children and adolescents and 1,184 adults who visited informal science learning sites and interacted with an adult or youth educator or just the exhibit itself as part of family visits to the sites. Children in early childhood reported greater topic interest and perceived learning, but actually recalled less content, than participants in middle childhood or adolescence. Youth visitors reported greater interest after interacting with a youth educator than just the exhibit, and perceived that they learn more if they interact with an educator (youth or adult). Participants in middle childhood recall more when they encounter a youth educator. Adult visitors reported greater interest after interaction with a youth educator than with the exhibit alone or an adult educator. They also perceived that they learn more if they interact with an educator (youth or adult) than just the exhibit and perceived that they learned more if they interacted with a youth educator than an adult educator. Results highlight the benefits of educators in informal science learning sites and document the importance of attention to developmental needs.

National identities and war heritage: acceptance and resistance of an authorised heritage discourse among visitors to the Australian War Memorial

ABSTRACT This paper examines the convergence of national identities and war heritage, among first-, second- and third-plus-generation Australians. In Australia, interpretation of a First World War event, the Anzac story, is promoted as war heritage central to national identity. What meaning might this discourse have in today’s multicultural Australia? Qualitative interviews were conducted with 93 adult visitors to the Australian War Memorial, 37 of whom had recent migrant backgrounds from 20 countries of origin. The analysis applied ‘authorised heritage discourse’ (AHD) as a theoretical framework. Visitors displayed three different orientations to an AHD that merged war heritage with national identity. The dominant group positively aligned with the war heritage/national identity AHD. In this group, national identity is reinforced by those qualities typically ascribed as being forged out of the ANZAC’s experience. Those consciously aligned critique the mythological status of the Anzac legacy yet embrace it as important for national identities. Those resisting the war heritage/national identity AHD disrupt the often-assumed links between history, heritage and identities. These three orientations appear to be independent of the participants’ country of birth or cultural background, showing the constructed nature of heritage and fluidity of national identities.

Comunicación y Educación en los Museos, espacios de interacción en la Zona de Desarrollo Próximo en España

The interactivity with the public in museums as a result of the development of Information and Communication Technologies has revolutionized the informative possibilities in these cultural spaces: digitization of contents, virtual visit, interactive screens and social applications, among others, so more museums have begun to integrate them into their communication strategies. The objective of this research is to analyze the habits of digital use and consumption of users of the museums of Castilla y Leon, and to reveal the impact of digital applications on the Internet in the public of these cultural spaces in a learning context. It is a statistical - descriptive study where the results of a questionnaire made by 619 visitors of the Museum of Human Evolution and The Art Nouveau and Art Deco Museum - Casa Lis are presented. Among the main results, there is a lack of interest shown by the young public regarding the resources of the website of the museums in the sample; the great value that the respondents give to the informative task of the digital tools for the acquisition of new knowledge; and a greater impact of use and interaction between web and adult visitors with respect to younger audiences, which may be due to the lack of adaptability of the museums studied to the new forms of cultural consumption of the new generations.

Comunicación y Educación en los Museos, espacios de interacción en la Zona de Desarrollo Próximo en España

La interactividad con el público en los museos fruto del desarrollo de las Tecnologías de la Información y Comunicación ha revolucionado las posibilidades divulgativas en estos espacios culturales: digitalización de contenidos, visita virtual, pantallas interactivas y aplicaciones sociales, entre otros, por lo que más museos han comenzado a integrarlas en sus estrategias de comunicación. El objetivo de la presente investigación es analizar los hábitos de uso y consumo digitales de los usuarios de los museos de Castilla y León, y desvelar el impacto de las aplicaciones digitales en Internet en el público de estos espacios culturales en un contexto de aprendizaje. Se trata de un estudio de carácter estadístico-descriptivo donde se presentan los resultados de un cuestionario realizado a 619 visitantes del Museo de La Evolución Humana y El Museo Art Nouveau y Art Decó – Casa Lis. Entre los principales resultados destaca el escaso interés mostrado por el público joven ante los recursos de la página web de los museos de la muestra; el gran valor que los encuestados otorgan a la tarea divulgativa de las herramientas digitales para la adquisición de nuevos conocimientos; y un mayor impacto de uso e interacción entre web y visitantes adultos respecto a los públicos más jóvenes que puede deberse a la falta de adaptabilidad de los museos estudiados a las nuevas formas de consumo cultural de las nuevas generaciones.

Exploring How Awareness-making Elicits Meaning-making in Museum Visitors: A Mixed-methods Study

ABSTRACT Awareness-making (AM) describes a process by which visitors bring with them past experiences and knowledge, all of which help them make sense of museum exhibits. Meaning-making (MM) is when museum visitors’ memories transform their museum experience into new knowledge and meaning. This article explores how AM elicits MM in museum visitors. We conducted research at a natural history museum exhibition called Minnesota Journeys, based on a moose natural habitat display and accompanying touchscreen. The exhibition was developed in Minnesota by the Bell Museum for all ages. We report findings from a mixed-methods study incorporating surveys (n = 243) and interviews (n = 30) with adult museum visitors. The findings of this paper (1) describe how, after visiting both the moose habitat display and touchscreen, most visitors learned to identify specific moose biology and ecology characteristics, such as behavior and habitat and (2) demonstrate how in a natural history museum setting visitor awareness-making can facilitate visitor meaning-making. We discuss implications for how to utilize these findings in other museum settings and exhibits.

Knowledge level of cancer symptoms and risk factors in the Gaza Strip: a cross-sectional study

BackgroundIn low-income settings, cancer is often diagnosed in advanced stages due to late presentation. Good public awareness of cancer signs and symptoms has a positive impact on the time patients take before they present to healthcare professionals. Therefore, this study examined public knowledge of cancer signs and symptoms as well as risk factors in Gaza.MethodsThis was a cross-sectional study. Participants were recruited from adult visitors (≥18 years) to governmental hospitals covering all five governorates of Gaza, and adolescent students (15 to 17 years) from 10 high schools in corresponding locations. An Arabic version of the Cancer Awareness Measure (CAM) was completed in a face-to-face interview. It described demographic data and knowledge of: cancer prevalence, age-related risk, signs and symptoms as well as risk factors both in recall and recognition questions.ResultsOf 3033 participants invited, 2886 completed the CAM (response rate = 95.2%). Adult mean age ± standard deviation was 33.7 ± 11.7 years and that of adolescents was 16.3 ± 0.8 years. Half of the participants (n = 1457, 50.5%) were adolescent (781 females; 53.6%) and 1429 (49.5%) were adult (702 females; 49.1%). About two thirds (n = 1885) thought about cancer as unrelated to age. Only 196 participants (6.8%) identified colorectal cancer as the most common cancer among men. Awareness of cancer signs/symptoms was poor to fair, where ‘lump’ was most commonly recognized (n = 2227, 77.2%) and ‘change of bowel habit’ the least (n = 670, 23.2%). Only 217 participants (7.5%) had a good level of recognizing risk factors with ‘smoking’ being the most identified and ‘eating less than five portions of fruits and vegetables a day’ the least. There was a higher likelihood for adults to identify most cancer signs/symptoms and risk factors than adolescents, except for recalling ‘unexplained pain’, ‘persistent cough/hoarseness’, ‘non-healing ulcer’, ‘smoking’, and ‘eating less than five portions of fruits and vegetables a day’.ConclusionPublic awareness of cancer signs/symptoms and risk factors needs to improve to facilitate early presentation and diagnosis in Gaza. Combining the delivery of public campaigns with tailored education to population groups, including the youth, may increase their knowledge and maintain its impact.

Investigating the Qualities of a Recreational Forest: Findings from the Cross-Sectional Hallerwald Case Study.

Prior research shows that forests contribute to human health and well-being. In this sense, this cross-sectional case study, adopting the principles of citizen science, assessed the restorative potential of places in the Hallerwald, an Austrian community forest. A convenience sample of adult forest visitors (n = 99, 64% females) completed a survey during a guided 2.5 h forest tour. The German questionnaire assessed the qualities of defined places in the forest. We also investigated changes in mood states, perceived stress, restoration, connectedness, and mindfulness before and after visiting the forest. In cooperation with a local working group, we developed the new Widen One’s Mind (WOM) scale, which showed good scale characteristics. All places received high scores in their potential to increase restoration and vitality and to widen one’s mind. Positive affect, restoration, connectedness with nature and the forest, and mindfulness increased pre- versus post-visits, whereas negative affect and perceived stress decreased. The findings of this study suggest that in recreational forests, visitors experience beneficial mental effects such as stress reduction in addition to physical exercise. To facilitate regional development goals, we recommend evaluating places in forests regarding the potential effects on the health and well-being as well as citizen participation before initiating extensive remodeling.

Socialising over fruits and vegetables: the biocultural importance of an open-air market in Bandar Seri Begawan, Brunei Darussalam

BackgroundEarth’s biocultural diversity comprising biological, cultural and linguistic diversities is being eroded quickly. Our ability to recognise and appreciate what is remaining is crucial for its survival. However, not all forms of diversity are appreciated equally and a growing trend in plant blindness indicates that humans ignore plants in the environment. In this context, open-air markets emerge as cultural spaces that bring people closer to each other, as well as with local biodiversity represented by fruits, vegetables and medicinal plants.MethodsWe conducted a cross-sectional survey with 160 people visiting Tamu Kianggeh of Bandar Seri Begawan, Brunei Darussalam. We randomly interviewed every fifth adult visitor (> 18 years) leaving the market on Fridays and Sundays continuously for a month, using a structured questionnaire. The questionnaire had 18 questions related to demographic particulars, reasons for visiting the market, vendor preference, social networking and visits to open-air markets and supermarkets.Results and discussionPeople visit the market for the diversity of vegetables/fruits; local fruits and vegetables; socialising; cheap prices; ability to bargain; freshness of the products; convenience; medicinal plants; snacks; leisure etc. The ethnic diversity represented at the market comprised chiefly of Malay, Kedayan, Iban, Dusun, Tutong, Chinese communities and foreigners. Majority of the respondents chose ‘availability of a wide range of fruits and vegetables’ as the primary reason for the visit, followed by ‘availability of local fruits and vegetables’. Tamu Kianggeh sold larger number of fruits and vegetables (104 taxa, 26 natives, 2 endemics) compared to the nearest supermarket (85 taxa, 14 natives and 1 endemic). A significant number of respondents also reported that they had made friends at the market.ConclusionTamu Kianggeh is a meeting ground for ethnic and biological diversities, a property that makes them important centres of biocultural diversity at the local level. Open-air markets such as Tamu Kianggeh bring people closer to a diverse range of vegetables and fruits. They also bring people closer to each other by serving as platforms for socialising. We propose that strategies developed to counter plant blindness should also consider the potential of open-air markets.

Effect of Escalator Use on Mall Love among Adult Pakistani Visitors

The study examines the role of escalator-use in the generation of mall love among adult Pakistani visitors. It assesses the influence of hedonic and utilitarian value on mall love through visitors’ attitude and emotional experience. The theoretical foundation of this research is founded on Technology Acceptance Model by Davis (1986). Around 1000 mall visitors were approached through the mall-intercept method in thirteen shopping malls in major cities of Pakistan. Among them, 500 responses were utilized for data analysis. Non-probability convenience sampling was considered as the best choice. Proposed relationships between the constructs were tested through Confirmatory Factor Analysis. The findings revealed that ‘hedonic value’ has a direct positive influence on visitors’ mall love. While testing mediation, the results indicated that emotional experience, attitude and escalator use strengthen the relationship between hedonic and utilitarian value and mall love. It is interesting to observe that the use of escalators in shopping mall results in developing mall love among visitors in Pakistan. This study will benefit the entire gamut of stakeholders including shopping mall managers, academic researchers, and practitioners. This study will benefit mall management by offering them practical suggestions regarding attracting visitors through better management of the mall environment.

Utilization of an Automated Internet-Based Safety Plan

Suicide is a public health crisis, yet few online resources that specifically target suicidality are available. The aim of the present study was to develop an automated, self-guided Internet-Based Safety Plan (IBSP) and to explore how intended users – members of the Internet community who endorsed past or current suicidality – utilized this resource. Participants (N = 150) were adult visitors to an automated Internet-based depression/suicidality screening website, who were either invited to take part in the present study or redirected to the present study from the referring website. Participants were offered comprehensive prompts to guide them through creating a personalized Safety Plan. Participants provided feedback regarding their use of IBSP; data entered in the Safety Plan itself were also analyzed. Participants gave largely positive ratings regarding website navigation, explanations, and examples and reported an overall positive impression of IBSP. Qualitative analysis of the responses suggested that several aspects of IBSP could be enhanced; these included making the IBSP even more predictable and modifying instructions for specific steps. These data will be critical for creating future versions of IBSP, to develop a highly usable and effective Internet-based safety plan to help individuals during crises.

Implementation of Ontario’s emergency department asthma care pathway for adults: determinants of uptake

Objective The Ontario Government funded the development and implementation of a standardized adult emergency department (ED) asthma care pathway (EDACP). We aimed to describe baseline patterns of ED use by adults for asthma in Ontario, Canada, and determine site characteristics associated with the EDACP implementation workshop attendance and subsequent pathway implementation. Methods All Ontario EDs were offered EDACP implementation workshops by the Lung Assocation-Ontario between 2008 and 2011, and were surveyed regarding site implementation status as of October, 2013. Survey data were linked by site to Ontario’s administrative health databases. Logistic regression models investigated the association between site and patient characteristics and: a) workshop attendance; b) pathway implementation. Results In the 2 years prior to EDACP implementation, there were 41 143 asthma visits to 167 sites by adults (62.3% female). Asthma-related return visits within 72 h varied by hospital type (teaching 2.1%, community 2.8%, small 4.0%; p < 0.05). Implementation workshops were attended by staff from 122 sites (72.6%). Implementation status was known for 108 sites and varied by hospital type (p < 0.001), but not workshop attendance (p = 0.11). By 2013, 47% of all hospitals were using or planning to use the EDACP. Uptake was more likely in community hospitals. Conclusions Ontario adult asthma ED visitors are more often women. Asthma-related return visits are uncommon, but significantly higher in small community hospitals. This provincial QI initiative reached almost 75% of Ontario EDs, and achieved almost 50% implementation rate within 2 years. Factors other than workshop attendance, such as hospital size, were associated with EDACP implementation.

Measuring visitor learning outcomes from showcases, video installations, and interactive tablets: an empirical investigation

ABSTRACT Museums employ a diverse range of display models. The most common forms are ‘showcases’ and ‘multimedia displays’, which include video installations and the use of interactive tablets. This poses the question of how the learning outcomes differ between showcase and multimedia displays. Focusing on 308 adult visitors across four typologies, this research explores how the learning outcomes differ when similar information is displayed using showcase and multimedia (video installation and interactive tablet) approaches in two exhibitions. Participants were randomly divided into three groups: namely, the showcase, video, and interactive groups. Interviews, questionnaires, and follow-up interviews were conducted to determine the learning outcomes. Results show statistically different learning outcomes between showcase and video installation, but no significant difference between showcase and interactive tablets. Moreover, results confirm a correlation between visitor gender and learning outcome, as well as visitor gender and typologies, but no evident correlation between learning outcomes and visitor typologies. Besides, this study explores the interaction impact on learning outcomes of 120 visitors who watched both showcase and multimedia and results show a correlation between visitors’ learning outcomes and different display models (showcase, multimedia and double-channel display).

Abstract 462: Medical Emergency Team Replaces Code Blue Activations at Pediatric Hospital

Introduction: In free-standing pediatric hospitals, the Code Blue team may be activated for events in adults to provide triage, resuscitation, medical screening exams, EMTALA documentation and disposition decisions. However, activation of the Code Blue team can require significant time and critical care resources and may delay patient care if the activation is external to the building. Hypothesis: Development of a small triage team focused on specific adult triage algorithms will provide a safe, effective and efficient alternative to Code Blue team response. Methods: 407 bed tertiary pediatric hospital, within metropolitan area. Collaborative multi-disciplinary QI process to design and simulate the roles, workflow and documentation of the Medical Emergency Team (MET). Education and communication to hospital-wide staff on MET, as well as MET responders completion of Advanced Cardiac Life Support course. Collaboration with local EMS leadership to coordinate transfer of patient was also undertaken. Results: MET roles were developed and two configurations of the MET team were implemented July 2018: one inside the footprint of the building and anther outside the footprint of the building, including the hospital grounds. The teams consisted of a mid-level provider, charge nurse, two security officers and a shift administrator: inside team relied on ICU provider and charge nurse, while outside team led by Emergency Medicine provider and charge nurse. Each team had a backpack with supplies, and transport gurney. Since inception, 199 activations occurred, 191 inside and 8 outside the facility. The activations included 45 staff or volunteers, 84 adult visitors, 75 pediatric visitors. Outcome for the activations: 57 transported to the hospital ED, 47 transported to another facility, 21 refused treatment and 68 had resolution of concerns. EMTALA documentation was complete in 112/137 (82%). Conclusions: Pediatric hospitals have substantial adult populations, where medical emergencies that arise rely on Code Blue in medical emergencies for simplicity. Development of a response team for nonpatients allows specific training, triage, and processes to improve care and reduce drain on ICU resources.

EDUCATION, GERONTOLOGY, AND MUSEUMS

Many adult museum visitors welcome the invitation to make personal connections to works of art. Time for individual reflection and sharing with others may enable relationships to deepen and new insights to emerge. This presentation describes an approach to gallery teaching that honors the memories, associations, and emotions that visitors bring to their encounters with works of art. The approach has been particularly effective with groups of health care professionals, and as a reminder to docents of the powerful affective experiences that will naturally occur for some members of the public. Drawing on the experiences of collaborative networks of museum and medical educators, we outline the basis of rich opportunities for developing lifespan and gerontological educational projects in museums.

14 Nontargeted Hepatitis C Virus Screening in an Appalachian Emergency Department Identifies a High Prevalence of Infection Among Adult Emergency Department Visitors

We describe the initial results of an adult academic emergency department (ED) non-targeted hepatitis C virus (HCV) screening program serving Appalachia, which is disproportionately affected by the opioid epidemic. The study was a retrospective cohort analysis of ED systematic, non-targeted, opt-out HCV testing outcomes from July 2018 through January 2019. Those eligible for “non-targeted” HCV testing included: adults (greater than 17 years), verbally able to communicate, receiving blood work already as part of routine clinical care, and not opting-out of testing. For eligible individuals who did not opt-out of testing, an HCV antibody (Ab) test was performed. Reactive Ab tests were confirmed with reflexive RNA testing. The primary study outcome was the characterization of HCV Ab and RNA prevalence. There were 21,359 unique adult visitors during the time period studied. Of these, 16,700 individuals were verbally engaged about testing and did not opt out. A total of 11,635 individuals received HCV Ab testing with 1,459 patients (12.5%) having reactive results. RNA confirmatory testing was reflexively performed in all Ab positive patients with 830 (56.9%) being positive. Of those Ab positive: 43% (627/1453) had a documented history of injection drug use, 27 (1.9%) were born before 1945, 410 (28.1%) were born between 1945 and 1965, and 1022 (70.0%) were born after 1965. The birth decade with the greatest burden of disease included those born between 1976 and 1985, of whom 20.1% (398/1981) were Ab positive. The seroprevalence for baby boomers was 11.2% (410/3646), and was higher in blacks than whites (17%, 75/441 vs. 10%, 334/3145; p<0.0001 ), males than females (14.3%, 270/1886 vs. 8%; p<0.0001) and those uninsured or with government vs. commercial insurance (medicare: 10.2%, 178/1746; medicaid: 20.0% 158/789; commercial: 5%, 10/201; uninsured: 19.2%, 15/78; p<0.0001). The seroprevalence for those born after 1965 was 14.8% (1,022/6901), and was higher in whites than blacks (16.8%, 961/5737 vs. 4.6%, 44/956; p<0.0001 ), males than females (18.5%, 556/3013 vs. 12.0%, 466/3888; p<0.0001) and those uninsured or with government vs. commercial insurance (medicare: 13.8%, 69/500; medicaid: 23.3%, 755/3242; uninsured: 14.5%, 84/580; commercial: 2.7%, 15/548; p<0.0001). ED non-targeted, opt-out testing identified a high prevalence of HCV infection among adult visitors - approximately six times the estimated regional adult prevalence. HCV infection was disproportionately high among younger, white individuals likely reflecting the escalating syndemic of opioid injection and HCV transmission in Appalachia.

Experiences of long-distance visitors to intensive care units at a regional major trauma centre in the United Kingdom: A cross-sectional survey

ObjectivesThis study aimed to investigate the experiences of long-distance visitors of major trauma patients admitted to intensive care units at a regional major trauma centre. Research methodology/designPostal survey. SettingSurvey participants (n = 103) at a regional major trauma centre in England, United Kingdom, were identified from hospital records. Included were adult visitors (next of kin) of major trauma patients admitted to intensive care at the study site between January 2016 and July 2018, with ordinary residence located more than one hour’s drive from the major trauma centre. FindingsResponse rate was 45.6%. Median (range) driving distance between respondents’ residence and the major trauma centre was 57.8 km (28.8–331.5). Median (range) number of days respondents visited at the major trauma centre was 18 (1–200). The quality of care at the centre was rated highly. Visitors described their often-challenging circumstances, negotiating the emotional, psychological, physical and financial impact of the situation. Suggested areas for improvement included car parking, signposting on and around the site, information provision, waiting areas and accommodation at or nearby the major trauma centre. ConclusionsThis study has described experiences of long-distance visitors at one regional major trauma centre in England and identified opportunities to ameliorate visitors’ stress points locally. Replication at other regional centres may be warranted.

Older adults are prioritized in terms of waiting time under the emergency triage system in Guangzhou, China.

To assess whether elderly patients are prioritized under the emergency triage system in Guangzhou, China. This was a cross-sectional survey of clinical data from adult visitors to the emergency department of the Third Affiliated Hospital of Sun Yat-sen University between 1 August 2015 and 31 December 2017. The primary end-point was receiving the first medical service within the target waiting time, which varied according to the triage level of the patient. Multivariate logistic regression was used to determine whether age was an independent predictor of a shorter waiting time. Data from 262 282 emergency patients were analyzed. The mean age of patients was 35.97 years, and 7.5% were aged ≥65 years. In total, 88.3% of patients received medical service within the target waiting time, and 87.4% of elderly patients received medical service within the target waiting time. Multivariate logistic regression analysis showed that advanced age was independently associated with receiving medical service within the target waiting time (adjusted odds ratio 1.258, 95% confidence interval 1.198-1.321; P < 0.001). The triage level, type of emergency subdivision, availability of outpatient services and time of day were also associated with receiving medical service within the target waiting time. Under the emergency triage system of the hospital, older adults are more likely to receive medical service within the target waiting time than younger patients. Geriatr Gerontol Int 2019; 19: 786-791.