Reply to Editorial Comment Regarding "Y:X Sperm Ratio in Boron-Exposed Men" by Wendie A. Robbins, Fusheng Wei, David A. Elashoff, Guoping Wu, Lin Xun, and Juan Jia. J Androl 2008; 29:115-121. DOI: 10.2164/jandrol.107.003541.

Editorial Comment Regarding "Y:X Sperm Ratio in Boron-Exposed Men" by Wendie A. Robbins, Fusheng Wei, David A. Elashoff, Guoping Wu, Lin Xun, and Juan Jia. J Androl 2008; 29:115-121. DOI: 10.2164/jandrol.107.003541.

The prevalence of spinal pathologies in sub-saharan Africa has received little attention so far. The aim of the survey was to investigate and compare the prevalence pattern of spinal lesions in two different populations of Tanzania, one coming from the urban and semi-urban catchment area of Aga Khan Hospital in ...

RATIONALE: This article presents a study of junior doctor supervision at a rural hospital. The objective of the present study was to gain insight into the types of supervision events experienced, the quality of supervisory relationships, the frequencies of supervision contact in a rural hospital setting, and the implications of ...

Many small, rural critical access hospitals are reaching out to each other and to larger hospitals as a way of setting up affordable health information technology systems that will meet meaningful use requirements. CIOs who have followed this strategy weigh in on its benefits and potential pitfalls.

Morbidity and mortality data are important for planning and implementing healthcare strategies of a country. To understand the major causes for hospitalizations in rural Bangladesh, demographic and clinical data were collected from the hospital-records of five government-run rural health facilities (upazila health complexes) situated at different geographical regions of the ...

A major factor in rural physician burnout is the demand of providing emergency room and hospital coverage in addition to running a clinic practice. The creation of the PEERist helps solve this problem without causing economic hardship for either the hospital or the physician. The PEERist has particular applications to ...

The winners of H & HN's annual survey of information technology use among hospitals and health systems. Plus: the Most Wired-Small and Rural, Most Improved and Most Wireless. And we consider how leaders of top IT hospitals plan to make "meaningful use" a guide for improvement.

In some western countries, market-driven reforms to improve efficiency and quality have harmed the performance of some hospitals, occasionally leading to their closure, mostly in rural areas. This paper seeks to explore whether these reforms affect urban and rural hospitals differently in a European health service. Rural and urban hospital ...

AIM: To describe the variety and range of work that New Zealand rural hospitals perform, and to examine the factors that might influence either of these, including: the characteristics of the doctors who work in rural hospitals; the facilities available; and environmental factors (such as geographical isolation and the size ...

PURPOSE: Despite continued federal and state efforts to increase the number of physicians in rural areas, disparities between the supply of rural and urban physicians persist. The authors examined the training of the rural physician workforce in the United States. METHOD: Using a national cross-sectional analysis of the 2005 American ...

Hospital CEOs wear many hats, but those in rural areas often lead two or even three different institutions.

INTRODUCTION: Hospital re-admissions for patients with congestive heart failure (CHF) are relatively common and costly occurrences within the US health infrastructure, including the Veterans Affairs (VA) healthcare system. Little is known about CHF re-admissions among rural veteran patients, including the effects of socio-demographics and follow-up outpatient visits on these re-admissions. ...

Brucellosis remains a diagnostic puzzle. We retrospectively studied the case notes of 105 patients with brucellosis who were admitted in the Department of Internal Medicine of the University of Patras Hospital, a tertiary care institution serving an extended rural area in western Greece, from 2003 to 2006. Five unusual causes ...

OBJECTIVE: To determine the sufficiency of stock levels of 13 antidotes in Queensland hospitals. DESIGN: A self-report survey was sent to 128 Queensland hospitals with acute care facilities. The stock level of the following antidotes was determined: acetylcysteine, anti-digoxin Fab antibodies (digibind), atropine, calcium gluconate, cyanokit, desferrioxamine, flumazenil, glucagon, intravenous ...

The provision of specialist anaesthetic services to rural and remote locations in Australia poses an ongoing challenge. Initiatives to improve delivery of specialist anaesthetic services include the provision of anaesthesia training opportunities at rural hospitals. Previous surveys of trainees demonstrated the positive effect of rural training on attitudes toward subsequent ...

Referrals from rural health centers to urban hospitals join waiting lists as outpatients for hospital admission and hospital treatment. This influences quality of life (QoL) of the rural population and retired people who require medical attention without traveling, provided no risks are involved. For this reason, a rural region of ...

It's been the trend for some years that, with their own particular set of challenges and constraints, hospital-based home health agencies have struggled to maintain profitability and efficiency in their operations. That can especially be true for hospital-based agencies operating in more rural areas, even as such agencies have been ...

The Medicare prospective payment system (PPS) contains incentives for hospitals to improve efficiency by placing them at financial risk to earn a positive margin on services rendered to Medicare patients. Concerns about the financial viability of small rural hospitals led to the implementation of the Medicare Rural Hospital Flexibility Program ...

Emergency pre-hospital treatment of haemorrhage includes immediate fluid replacement therapy to restore circulating blood volume, reverse hypotension to perfuse vital organs and reduce the risk of death (National Institute for Clinical Excellence 2004). In remote or rural settings, however, a lack of sterile fluids, intravenous equipment or the knowledge to ...

Zithulele Hospital is a deeply rural district hospital in the Eastern Cape province. Beset by staffing, procurement and infrastructure problems, the maternity service in 2005 was poorly organised and offered an inadequate standard of care. By our estimates, nearly 50% of women were still delivering at home. Three years of ...

In the mid-1990s, significant gaps existed in the quality of acute myocardial infarction (AMI) care between rural and urban hospitals. Since then, overall AMI care quality has improved. This study uses more recent data to determine whether rural-urban AMI quality gaps have persisted. Using inpatient records data for 34,776 Medicare ...

Ningxia is located in western People's Republic of China, which is hyperendemic for human cystic echinococcosis (CE) throughout the entire area with alveolar echinococcosis (AE) hyperendemic in the south. This is in part due to its underdeveloped economy. Despite the recent rapid growth in P.R. China's economy, medical expenditure for ...

In 2008, the Canadian Medical Association (CMA) conducted a survey of rural practitioners. The survey covered incentives to choose rural medicine, current satisfaction, plans for future migration and strategies for retention. The CMA Canadian Collaborative Centre for Physician Resources, in collaboration with the Society of Rural Physicians of Canada, surveyed ...

Teleradiology can be used to provide health care to rural populations, especially where there is a scarcity of resources, including on-site radiologists. We have established a network link between a commercial teleradiology provider in Bangalore, south India and the Ramakrishna Mission Hospital (RKMH), located over 3000 km away in the ...

We present two cases of juvenile form of paracoccidioidomycosis (PCM), a systemic mycosis frequently found in rural areas, whose prognosis is poor in children and young adults. They are a 14-year-old boy and a 25-year-old woman, both residents in an urban area in São Paulo - Brazil, without any history ...

Though tetanus is a major cause of preventable morbidity and mortality in Nigeria, there is a paucity of data on the pattern and outcome of the disease among the sub-urban and rural populations. This retrospective study of adult tetanus at a suburban tertiary hospital in Nigeria reports a high case ...

INTRODUCTION: In population-based studies, transfers into hospitals and hospital deaths are typically considered to be indicators of potentially inappropriate care settings at the end of life. Despite a plethora of research into where people die, few studies have examined whether hospital transfers at the end of life differ in rural ...

RATIONALE: Home oxygen is the most expensive equipment item that Medicare purchases ($1.7 billion/year). OBJECTIVES: To assess geographic differences in supplemental oxygen use. METHODS: Retrospective cohort analysis of oxygen claims for a 20% random sample of Medicare patients hospitalized for obstructive lung disease in 1999 and alive at the end ...

To examine how local health care resources impact travel patterns of patients age 65 and older across the rural urban continuum. Information on inpatient hospital discharges was drawn from complete 2004 hospital discharge files from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID) for New York, California, ...

To assess patient safety outcomes in small urban and small rural hospitals and to examine the relationship of hospital and patient factors to patient safety outcomes. The Nationwide Inpatient Sample and American Hospital Association annual survey data were used for analyses. To increase comparability, the study sample was restricted to ...

Small rural hospitals face considerable financial and personnel resource shortages which hinder their efforts to implement complex health information technology (HIT) systems. A survey on the use of HIT was completed by 85% of Iowa's 82 Critical Access Hospitals (CAH). Analyses indicate that low IT staffing in CAHs is a ...

Rural hospitals and communities often profit from the ability to provide surgical services. There can also be substantial financial costs for individuals, hospitals, and communities associated with not having access to surgical care in rural areas. Despite these advantages, limitations that include a shortage of rural general surgeons and other ...

Previous studies have suggested that patients with coronary artery disease (CAD) in rural areas may have worse outcomes due to limited availability of specialists, fewer resources, and less institutional funding. Data were collected from hospitals participating in the Get With the Guidelines-Coronary Artery Disease Program (GWTG-CAD) from January 2000 to ...

PURPOSE: To examine and describe neonatal resuscitation preparedness, presence of connections to wider systems of care, continuing education activities, presence of trained staff, and other indicators of high performance in rural perinatal microsystems. STUDY DESIGN AND METHODS: A nonexperimental, retrospective, descriptive, cross-sectional design was utilized. Rural hospitals (n = 124) ...

This study examined disaster preparedness, risk perception, and their association in rural hospitals in the United States. The focus of disaster preparedness largely has been centered on urban areas, in part because of the perception that more concentrated areas have an increased risk of a disastrous event. Therefore, it was ...

OBJECTIVES: To compare the demographic and geographic patterns of pneumonia and influenza (P&I) hospitalizations in older adults with dementia with those of the U.S. population and to examine the relationship between healthcare accessibility and P&I. DESIGN: Observational study using historical medical claims from the Centers for Medicare and Medicaid Services ...

INTRODUCTION: The aim of this article is to report on a study of the expansion of specialist rehabilitation services in central New South Wales, Australia, through the introduction of rehabilitation as a new service type at 2 small rural multi-casemix hospitals, within an integrated area-wide model of rehabilitation service delivery. ...

Shortages of health care professionals have plagued rural areas of the USA for more than a century. Programs to alleviate them have met with limited success. These programs generally focus on factors that affect recruitment and retention, with the supposition that poor recruitment drives most shortages. The strongest known influence ...

In this ethnographic study, undergraduate nursing students' experience of a rural-hospital-based preceptorship was a team effort that involved all members of the hospital staff. Daily and intimate interaction with the interdisciplinary hospital team had a significant impact on these students' ability to develop a professional identity. Indeed, for students to ...

BACKGROUND: Data from national surveillance shows significant regional variation in the respiratory syncytial virus (RSV) season. To enable accurate recommendations for surveillance and prophylaxis at a local level, we examined this variation in detail and determined predictors for the duration of the RSV season. METHODS: Statewide hospitalization data for the ...

This study measures the effect of TennCare, a Medicaid managed care reform initiated in 1994, on the efficiency of hospitals in Tennessee. We apply a multiple-output stochastic frontier approach to a panel dataset that represents all short-term acute care hospitals operating in Tennessee for 1990-2001 and find a modest gain ...

OBJECTIVE: This study examined whether rural and urban hospitals differ in their level of responsiveness to community health needs. DESIGN: This study used a multivariate, longitudinal research design. RESEARCH SETTING: A cross-sectional survey was the setting for this study. PARTICIPANTS: The participants were rural or urban hospitals in the United ...

Rural hospitals play a crucial role in providing health care to rural Americans, a vulnerable and underserved population; however, rural hospitals have faced threats to their financial viability and many have closed as a result. This paper examines the hospital characteristics that are associated with patients choosing rural hospitals, and ...

The challenges faced and the methods implemented by the Apollo Hospitals Group in introducing telemedicine in the Indian setting are discussed in this article. Using Information and Communication Technology (ICT) to make available secondary and tertiary medical expertise to suburban and rural India was thought of as early as 1997. ...

BACKGROUND: Rural citizens die more frequently because of trauma than their urban counterparts. Skill maintenance is a potential issue among rural surgeons because of infrequent exposure to severely injured patients. The primary goal was to evaluate the outcomes of multiple injuries patients who required a laparotomy after referral from level ...

Over a period of twelve years, the author's vision of improving the health of rural Ecuadorians has evolved from an initial emphasis on primary health care to secondary care. The local community convinced him of the critical need for an efficiently managed, high-quality, and affordable rural secondary care hospital. Exploring ...

OBJECTIVE: To examine variation in the practice patterns of individual general surgeons and how they differ between rural and urban areas of North Carolina. SUMMARY OF BACKGROUND DATA: Traditional physician supply analyses often rely on "head counts" and do not take into account how physicians' practice patterns differ. Practice characteristics ...

BACKGROUND: Little research has been conducted to observe the impact that rural settings have on the structure and function of hospital ethics committees. Additionally, studies need to focus on ethics committees, as it is often the body which protects the values of the community as globalization increases. The purpose of ...

BACKGROUND: Smoking is the largest single cause of preventable death and disease in Australia. This study describes smoking prevalence and the characteristics of rural smokers to guide general practitioners in targeting particular groups. METHODS: Cross sectional surveys in the Greater Green Triangle region of southeast Australia using a random population ...