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ObjectiveRural cancer patients have unique care needs which may impact upon treatment decision-making. Our aim was to conduct a qualitative systematic review and meta-synthesis to understand their perspectives and experiences of making treatment decisions.MethodsA systematic search of MEDLINE, PsycINFO, CINAHL and RURAL was conducted for qualitative studies in rural cancer patients regarding treatment decision-making. Articles were screened for relevance, and data from the included articles were extracted and analysed using meta-thematic synthesis.ResultsTwelve studies were included, with 4 themes and 9 subthemes identified. Many studies reported patients were not given a choice regarding their treatment. Choice, if given, was influenced by personal factors such as finances, proximity to social supports, convenience, and their personal values. Patients were also influenced by the opinions of others and cultural norms. Finally, it was reported that patients made choices in the context of seeking the best possible medical care and the patient-clinician relationship.ConclusionsIn the rural context, there are universal and unique factors that influence the treatment decisions of cancer patients.Practical implicationsOur findings are an important consideration for clinicians when engaging in shared decision-making, as well as for policymakers, to understand and accommodate the unique rural perspective.  相似文献   
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目的 调查中国农村居民的体力活动状况及其影响因素。方法 采用国际体力活动短问卷对分别代表中国东、中、西部的山东省、山西省和云南省3个省一共6个县的3 834名15岁以上农村居民的体力活动状况进行调查。结果 调查获得有效问卷3 780份,其中山东省1 251人(33.1%),山西省1 256人(33.2%),云南省1 273人(33.7%)。男性1 867人(49.4%),女性1 913人(50.6%)。农村居民高、中、低水平体力活动人数分别为1 691人(44.7%)、1 248人(33%)、841人(22.3%)。多因素非条件logistic回归分析结果显示,性别、年龄、职业、是否患慢性病以及地区是体力活动的影响因素。其中,男性(OR = 0.832,95%CI: 0.704~0.985)、年龄36~59岁的人群(OR = 0.760,95%CI: 0.625~0.925)为农村居民体力活动的保护因素;机关、企事业单位及离退休人员(OR = 1.469,95%CI: 1.017~2.124)、在校学生(OR = 1.925,95%CI: 1.127~3.286)、失业、无业人员(OR = 3.062,95%CI: 2.470~3.796)、患慢性病的人群(OR = 1.366,95%CI:1.133~1.645)为农村居民体力活动不足的危险因素。结论 女性、老年人、机关、企事业单位及离退休人员、在校学生、失业、无业人员、患慢性病的人群发生体力活动不足的可能性更高,针对中国不同地区农村居民体力活动的干预,应重点关注此类人群。  相似文献   
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Tremendous progress in the ability to identify and test the function of microorganisms in recent years has led to a much better understanding of the role of environmental and host microbiome in the development of immune function, allergic sensitization and asthma. In this review, the most recent findings on the relationships between environmental microbiota, respiratory, intestinal microbiome, the consequences of early-life microbial exposure type and gut–lung microbial axis and the development of asthma and atopy are summarized. The current perspective on gut and airway microbiome manipulation for the primary prevention of allergic diseases and asthma is also discussed.  相似文献   
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BackgroundRural populations face many health disadvantages compared to urban areas. There is a critical need to better understand the current lung cancer screening landscape in these communities to identify targeted areas to improve the impact of this proven tool.MethodsData from the County Health Rankings of New Hampshire and Vermont was reviewed for population density, distribution of adult smokers, and level of education compared to the distribution of Lung Cancer Screening Facilities throughout these two states.ResultsScreening programs in southern counties of Vermont with lower levels of education have decreased access. In New Hampshire, there are no programs within 30 miles of the areas with the largest distribution of smokers, and decreased access in some areas with the lowest levels of education.ConclusionsImproving equitable access to high-quality screening services in rural regions and the creation of targeted interventions to address decreased access in areas of high tobacco use and low education is vital to decreasing the incidence of latestage presentations of lung cancer within these populations.  相似文献   
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