Effects Of Community Type Research Articles

The Effect of Community Type on Access to Orthopedic Services for Medicaid-Insured Patients

Purpose Medicaid-insured patients have less access to specialty care compared to those who are privately insured. Limited and delayed access to orthopaedic services can affect patient outcomes, especially for patients living in rural areas. The purpose of this study was to evaluate the effect of community setting in access to orthopaedic care for Medicaid-insured patients. Methods The study population included board-certified orthopaedic specialists obtained from the American Academy of Orthopaedic Surgeons (AAOS) within five Florida counties, representing urban and rural communities. Investigators used the Secret Shopper methodology to schedule an appointment for a rotator cuff repair. Medicaid acceptance rate, wait time, and average distance to clinics accepting Medicaid were calculated and compared between urban and rural counties. Results Of the 108 clinics identified, 76.9% performed arthroscopic rotator cuff repair. The appointment rate across all counties was 100% (n=83) for privately insured patients and 9.6% (n=8) for Medicaid patients. There was no significant difference in access when comparing access to care with Medicaid in urban and rural counties (p=0.984). Medicaid patients had significantly shorter wait times in rural counties compared to urban counties (p=0.021). Rural counties encountered a significantly greater average travel distance to clinics accepting Medicaid compared to urban counties (p=0.042). Conclusion Medicaid-insured patients have limited access to orthopaedic care, regardless of community setting. Medicaid-insured patients in rural counties were more likely to have shorter wait times to the appointment and travel longer distances to clinics.

Growing Old in the Bible Belt: Resources for Aging LGBT Adults Living in the South

ABSTRACT There has been an increase in the literature about LGBT older adults in recent years; however, there is a need for further sociological quantitative research examining the impact of geographic region on LGBT aging. Utilizing data from a nationwide survey, this study focuses on the availability of LGBT-specific resources for LGBT aging adults living in the South. We examine the effects of community type and sociodemographics on the availability of LGBT-specific resources as well as the type of resources available. Findings reveal that in the South, community type, having a partner, household income, and education affect the LGBT-specific resources available. Of particular interest, LGBT-affirming faith organizations are identified as the resource most frequently available for LGBT aging adults in this region often referred to as the Bible Belt. Overall, this study sheds light on the LGBT-specific resources that are available to provide social support and help meet the unique needs of LGBT adults aging in the South.

Geographical distribution of soil transmitted helminths and the effects of community type in South Asia and South East Asia - A systematic review.

BackgroundSoil-transmitted helminth (STH) infections are among the most prevalent neglected tropical diseases (NTD) worldwide. Since the publication of the WHO road map to combat NTD in 2012, there has been a renewed commitment to control STH. In this study, we analysed the geographical distribution and effect of community type on prevalence of hookworm, Trichuris and Ascaris in south Asia and south east Asia.MethodologyWe conducted a systematic review of open-access literature published in PubMed Central and the Global Atlas of Helminth Infection. A total of 4182 articles were available and after applying selection criteria, 174 studies from the region were retained for analysis.Principal findingsAscaris was the commonest STH identified with an overall prevalence of 18% (95% CI, 14–23%) followed by Trichuris (14%, 9–19%) and hookworm (12%, 9–15%). Hookworm prevalence was highest in Laos, Vietnam and Cambodia. We found a geographical overlap in countries with high prevalence rates for Trichuris and Ascaris (Malaysia, Philippines, Myanmar, Vietnam and Bangladesh). When the effect of community type was examined, prevalence rates of hookworm was comparable in rural (19%, 14–24%) and tribal communities (14%, 10–19%). Tribal communities, however, showed higher prevalence of Trichuris (38%, 18–63%) and Ascaris (32%, 23–43%) than rural communities (13%, 9–20% and 14%, 9–20% respectively). Considerable between and within country heterogeneity in the distribution of STH (I2 >90%) was also noted. When available data from school aged children (SAC) were analysed, prevalence of Ascaris (25% 16–31%) and Trichuris (22%, 14–34%) were higher than among the general population while that of hookworm (10%, 7–16%) was comparable.Conclusions/SignificanceOur analysis showed significant variation in prevalence rates between and within countries in the region. Highlighting the importance of community type in prevalence and species mix, we showed that tribal and rural communities had higher hookworm infections than urban communities and for ascariasis and trichuriasis, tribal populations had higher levels of infection than rural populations. We also found a higher prevalence of ascariasis and trichuriasis in SAC compared to the general population but comparable levels of hookworm infections. These key findings need to be taken into account in planning future MDA and other interventions.

An Application of Plant Functional Types for Predicting Restoration Outcomes

We evaluated the restoration of native plant assemblages by topsoil translocation in the Hunter Valley, south‐east Australia. Species' responses were characterized by defining nine plant functional types (PFTs) based on combinations of four response mechanisms (seed bank persistence, germination cues, resprouting mechanisms, and longevity) through which species were predicted to persist or decline following translocation. The effects of community type and delay in topsoil restoration on restoration outcomes were tested in an orthogonal experiment. Changes in species' frequency were detected using Bayesian statistics with prior probabilities derived from pre‐clearing data. Few species failed to reestablish following translocation; these were offset by recruitment of other native species not detected prior to clearing. Compositional changes were more pronounced when topsoil was stockpiled (cf direct reinstatement), although there was no trend related to the period of stockpiling. The PFT response model correctly predicted the rank probability of decline in three of the nine PFTs, while a further three were correctly placed in the top ranks but in the incorrect order. Three PFTs were incorrectly ranked because the response model was incorrect. Resprouters declined more frequently than seeders; however, species with physical seed dormancy declined less frequently than those with either transient seed banks or physiological, morphological, or morpho‐physiological dormancy, irrespective of resprouting ability. Species with short juvenile periods were more likely to increase. We conclude that PFTs based on fire‐response traits represent a practical means of predicting species' responses to translocation and a basis for prioritizing species for supplementary planting.

Weed species radiation-use efficiency as affected by competitive environment

Plant canopy radiation-use efficiency (RUE), defined as unit of dry biomass produced per unit of absorbed photosynthetically active radiation (APAR), has been widely studied both in experimental and theoretical contexts because the use of this relationship greatly simplifies estimating biomass production in plant growth models. Previous studies have indicated that RUE may be sensitive to changes in the fractions of diffuse and direct radiation; RUE has been shown experimentally to increase under conditions of increased diffuse light caused either by atmospheric conditions or by shading from other plants in intercrops. Therefore, we hypothesized that weed species RUE would be greater for weeds grown in mixed weed–crop communities than for weeds grown in more uniform and less dense monotypic communities. To address this question, field experiments were conducted during 2001 and 2002 to determine the vegetative-stage RUE of giant ragweed, velvetleaf, woolly cupgrass, and wild-proso millet grown in monotypic communities or in corn. ANOVA indicated that the effect of community type on RUE was significant (P < 0.0001) and that the interaction between species and year effects was significant (P = 0.0152). Paired comparisons showed that giant ragweed RUE differed from velvetleaf RUE in 2001 (P = 0.0381) and that giant ragweed RUE differed between years (P = 0.0455). Pooled across species types and years, RUE was approximately 50% greater for weeds grown in weed–corn communities than for weeds grown in monotypic communities. These results indicate that more complex canopy architecture in mixed-species communities (i.e., greater total leaf area index [LAI] and heterogeneity of height among individuals) was associated with greater weed RUE. Including weed RUE response to the competitive environment may be one approach to improving the predictive accuracy of process-based growth models for weed biomass accumulation in mixed-species communities.

The Effects of Community Type on the Use and Availability of Marijuana among Illinois Adults

Previous research on adult marijuana use shows that younger adults, males, unmarried persons, and adults with higher education have the highest usage rates. National studies on adult drug use, furthermore, report that marijuana use is highest in large metropolitan areas. As Fischer (1976) points out, however, younger, unmarried, better educated adults tend to live in large urban centers. Thus, the effects of living in large cities on marijuana use may be an artifact of the demographic composition of large urban areas as suggested by proponents of the compositionalist theory of urban behavior (Fischer, 1976). Using data from a statewide survey of Illinois adults, the effects of community type on ever use, current use, and the availability of marijuana are examined. Logistic multiple regression analyses are used to examine the effects of community type on these use and availability variables after controlling the effects of the socio-demographic characteristics of the adults. The results lend support to Fischer's (1975; 1976) subcultural theory of behavior for both the use and the availability of marijuana.