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Sample records for geocoding rural addresses

  1. Geocoding rural addresses in a community contaminated by PFOA: a comparison of methods

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    Gallagher Lisa G

    2010-04-01

    Full Text Available Abstract Background Location is often an important component of exposure assessment, and positional errors in geocoding may result in exposure misclassification. In rural areas, successful geocoding to a street address is limited by rural route boxes. Communities have assigned physical street addresses to rural route boxes as part of E911 readdressing projects for improved emergency response. Our study compared automated and E911 methods for recovering and geocoding valid street addresses and assessed the impact of positional errors on exposure classification. Methods The current study is a secondary analysis of existing data that included 135 addresses self-reported by participants of a rural community study who were exposed via public drinking water to perfluorooctanoate (PFOA released from a DuPont facility in Parkersburg, West Virginia. We converted pre-E911 to post-E911 addresses using two methods: automated ZP4 address-correction software with the U.S. Postal Service LACS database and E911 data provided by Wood County, West Virginia. Addresses were geocoded using TeleAtlas, an online commercial service, and ArcView with StreetMap Premium North America NAVTEQ 2008 enhanced street dataset. We calculated positional errors using GPS measurements collected at each address and assessed exposure based on geocoded location in relation to public water pipes. Results The county E911 data converted 89% of the eligible addresses compared to 35% by ZP4 LACS. ArcView/NAVTEQ geocoded more addresses (n = 130 and with smaller median distance between geocodes and GPS coordinates (39 meters than TeleAtlas (n = 85, 188 meters. Without E911 address conversion, 25% of the geocodes would have been more than 1000 meters from the true location. Positional errors in TeleAtlas geocoding resulted in exposure misclassification of seven addresses whereas ArcView/NAVTEQ methods did not misclassify any addresses. Conclusions Although the study was limited by small

  2. Geocoding rural addresses in a community contaminated by PFOA: a comparison of methods.

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    Vieira, Verónica M; Howard, Gregory J; Gallagher, Lisa G; Fletcher, Tony

    2010-04-21

    Location is often an important component of exposure assessment, and positional errors in geocoding may result in exposure misclassification. In rural areas, successful geocoding to a street address is limited by rural route boxes. Communities have assigned physical street addresses to rural route boxes as part of E911 readdressing projects for improved emergency response. Our study compared automated and E911 methods for recovering and geocoding valid street addresses and assessed the impact of positional errors on exposure classification. The current study is a secondary analysis of existing data that included 135 addresses self-reported by participants of a rural community study who were exposed via public drinking water to perfluorooctanoate (PFOA) released from a DuPont facility in Parkersburg, West Virginia. We converted pre-E911 to post-E911 addresses using two methods: automated ZP4 address-correction software with the U.S. Postal Service LACS database and E911 data provided by Wood County, West Virginia. Addresses were geocoded using TeleAtlas, an online commercial service, and ArcView with StreetMap Premium North America NAVTEQ 2008 enhanced street dataset. We calculated positional errors using GPS measurements collected at each address and assessed exposure based on geocoded location in relation to public water pipes. The county E911 data converted 89% of the eligible addresses compared to 35% by ZP4 LACS. ArcView/NAVTEQ geocoded more addresses (n = 130) and with smaller median distance between geocodes and GPS coordinates (39 meters) than TeleAtlas (n = 85, 188 meters). Without E911 address conversion, 25% of the geocodes would have been more than 1000 meters from the true location. Positional errors in TeleAtlas geocoding resulted in exposure misclassification of seven addresses whereas ArcView/NAVTEQ methods did not misclassify any addresses. Although the study was limited by small numbers, our results suggest that the use of county E911 data in rural

  3. Positional error in automated geocoding of residential addresses

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    Talbot Thomas O

    2003-12-01

    Full Text Available Abstract Background Public health applications using geographic information system (GIS technology are steadily increasing. Many of these rely on the ability to locate where people live with respect to areas of exposure from environmental contaminants. Automated geocoding is a method used to assign geographic coordinates to an individual based on their street address. This method often relies on street centerline files as a geographic reference. Such a process introduces positional error in the geocoded point. Our study evaluated the positional error caused during automated geocoding of residential addresses and how this error varies between population densities. We also evaluated an alternative method of geocoding using residential property parcel data. Results Positional error was determined for 3,000 residential addresses using the distance between each geocoded point and its true location as determined with aerial imagery. Error was found to increase as population density decreased. In rural areas of an upstate New York study area, 95 percent of the addresses geocoded to within 2,872 m of their true location. Suburban areas revealed less error where 95 percent of the addresses geocoded to within 421 m. Urban areas demonstrated the least error where 95 percent of the addresses geocoded to within 152 m of their true location. As an alternative to using street centerline files for geocoding, we used residential property parcel points to locate the addresses. In the rural areas, 95 percent of the parcel points were within 195 m of the true location. In suburban areas, this distance was 39 m while in urban areas 95 percent of the parcel points were within 21 m of the true location. Conclusion Researchers need to determine if the level of error caused by a chosen method of geocoding may affect the results of their project. As an alternative method, property data can be used for geocoding addresses if the error caused by traditional methods is

  4. Modeling the probability distribution of positional errors incurred by residential address geocoding

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    Mazumdar Soumya

    2007-01-01

    Full Text Available Abstract Background The assignment of a point-level geocode to subjects' residences is an important data assimilation component of many geographic public health studies. Often, these assignments are made by a method known as automated geocoding, which attempts to match each subject's address to an address-ranged street segment georeferenced within a streetline database and then interpolate the position of the address along that segment. Unfortunately, this process results in positional errors. Our study sought to model the probability distribution of positional errors associated with automated geocoding and E911 geocoding. Results Positional errors were determined for 1423 rural addresses in Carroll County, Iowa as the vector difference between each 100%-matched automated geocode and its true location as determined by orthophoto and parcel information. Errors were also determined for 1449 60%-matched geocodes and 2354 E911 geocodes. Huge (> 15 km outliers occurred among the 60%-matched geocoding errors; outliers occurred for the other two types of geocoding errors also but were much smaller. E911 geocoding was more accurate (median error length = 44 m than 100%-matched automated geocoding (median error length = 168 m. The empirical distributions of positional errors associated with 100%-matched automated geocoding and E911 geocoding exhibited a distinctive Greek-cross shape and had many other interesting features that were not capable of being fitted adequately by a single bivariate normal or t distribution. However, mixtures of t distributions with two or three components fit the errors very well. Conclusion Mixtures of bivariate t distributions with few components appear to be flexible enough to fit many positional error datasets associated with geocoding, yet parsimonious enough to be feasible for nascent applications of measurement-error methodology to spatial epidemiology.

  5. VT E911 ESITE geocoder - address points

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    Vermont Center for Geographic Information — VT E911 ESITE geocoder - address points. VCGI, in collaboration with the VT E911 Board, has created a suite of geocoding services that can be used to batch geocode...

  6. The effects of local street network characteristics on the positional accuracy of automated geocoding for geographic health studies

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    Zimmerman Dale L

    2010-02-01

    Full Text Available Abstract Background Automated geocoding of patient addresses for the purpose of conducting spatial epidemiologic studies results in positional errors. It is well documented that errors tend to be larger in rural areas than in cities, but possible effects of local characteristics of the street network, such as street intersection density and street length, on errors have not yet been documented. Our study quantifies effects of these local street network characteristics on the means and the entire probability distributions of positional errors, using regression methods and tolerance intervals/regions, for more than 6000 geocoded patient addresses from an Iowa county. Results Positional errors were determined for 6376 addresses in Carroll County, Iowa, as the vector difference between each 100%-matched automated geocode and its ground-truthed location. Mean positional error magnitude was inversely related to proximate street intersection density. This effect was statistically significant for both rural and municipal addresses, but more so for the former. Also, the effect of street segment length on geocoding accuracy was statistically significant for municipal, but not rural, addresses; for municipal addresses mean error magnitude increased with length. Conclusion Local street network characteristics may have statistically significant effects on geocoding accuracy in some places, but not others. Even in those locales where their effects are statistically significant, street network characteristics may explain a relatively small portion of the variability among geocoding errors. It appears that additional factors besides rurality and local street network characteristics affect accuracy in general.

  7. Using an Optimized Chinese Address Matching Method to Develop a Geocoding Service: A Case Study of Shenzhen, China

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    Qin Tian

    2016-05-01

    Full Text Available With the coming era of big data and the rapid development and widespread applications of Geographical Information Systems (GISs, geocoding technology is playing an increasingly important role in bridging the gap between non-spatial data resources and spatial data in various fields. However, Chinese geocoding faces great challenges because of the complexity of the address string format in Chinese, which contains no delimiters between Chinese words, and the poor address management resulting from the existence of multiple address authorities spread among different governmental agencies. This paper presents a geocoding service based on an optimized Chinese address matching method, including address modeling, address standardization and address matching. The address model focuses on the spatial semantics of each address element, and the address standardization process is based on an address tree model. A geocoding service application is implemented in practice using a large quantity of data from Shenzhen Municipality. More than 1,460,000 data records were used to test the geocoding service, and good matching rates were achieved with good adaptability and intelligence.

  8. Integrating address geocoding, land use regression, and spatiotemporal geostatistical estimation for groundwater tetrachloroethylene.

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    Messier, Kyle P; Akita, Yasuyuki; Serre, Marc L

    2012-03-06

    Geographic information systems (GIS) based techniques are cost-effective and efficient methods used by state agencies and epidemiology researchers for estimating concentration and exposure. However, budget limitations have made statewide assessments of contamination difficult, especially in groundwater media. Many studies have implemented address geocoding, land use regression, and geostatistics independently, but this is the first to examine the benefits of integrating these GIS techniques to address the need of statewide exposure assessments. A novel framework for concentration exposure is introduced that integrates address geocoding, land use regression (LUR), below detect data modeling, and Bayesian Maximum Entropy (BME). A LUR model was developed for tetrachloroethylene that accounts for point sources and flow direction. We then integrate the LUR model into the BME method as a mean trend while also modeling below detects data as a truncated Gaussian probability distribution function. We increase available PCE data 4.7 times from previously available databases through multistage geocoding. The LUR model shows significant influence of dry cleaners at short ranges. The integration of the LUR model as mean trend in BME results in a 7.5% decrease in cross validation mean square error compared to BME with a constant mean trend.

  9. Comparing a single-stage geocoding method to a multi-stage geocoding method: how much and where do they disagree?

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    Rice Kenneth

    2007-03-01

    Full Text Available Abstract Background Geocoding methods vary among spatial epidemiology studies. Errors in the geocoding process and differential match rates may reduce study validity. We compared two geocoding methods using 8,157 Washington State addresses. The multi-stage geocoding method implemented by the state health department used a sequence of local and national reference files. The single-stage method used a single national reference file. For each address geocoded by both methods, we measured the distance between the locations assigned by each method. Area-level characteristics were collected from census data, and modeled as predictors of the discordance between geocoded address coordinates. Results The multi-stage method had a higher match rate than the single-stage method: 99% versus 95%. Of 7,686 addresses were geocoded by both methods, 96% were geocoded to the same census tract by both methods and 98% were geocoded to locations within 1 km of each other by the two methods. The distance between geocoded coordinates for the same address was higher in sparsely populated and low poverty areas, and counties with local reference files. Conclusion The multi-stage geocoding method had a higher match rate than the single-stage method. An examination of differences in the location assigned to the same address suggested that study results may be most sensitive to the choice of geocoding method in sparsely populated or low-poverty areas.

  10. [Who Hits the Mark? A Comparative Study of the Free Geocoding Services of Google and OpenStreetMap].

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    Lemke, D; Mattauch, V; Heidinger, O; Hense, H W

    2015-09-01

    Geocoding, the process of converting textual information (addresses) into geographic coordinates is increasingly used in public health/epidemiological research and practice. To date, little attention has been paid to geocoding quality and its impact on different types of spatially-related health studies. The primary aim of this study was to compare 2 freely available geocoding services (Google and OpenStreetMap) with regard to matching rate (percentage of address records capable of being geocoded) and positional accuracy (distance between geocodes and the ground truth locations). Residential addresses were geocoded by the NRW state office for information and technology and were considered as reference data (gold standard). The gold standard included the coordinates, the quality of the addresses (4 categories), and a binary urbanity indicator based on the CORINE land cover data. 2 500 addresses were randomly sampled after stratification for address quality and urbanity indicator (approximately 20 000 addresses). These address samples were geocoded using the geocoding services from Google and OSM. In general, both geocoding services showed a decrease in the matching rate with decreasing address quality and urbanity. Google showed consistently a higher completeness than OSM (>93 vs. >82%). Also, the cartographic confounding between urban and rural regions was less distinct with Google's geocoding API. Regarding the positional accuracy of the geo-coordinates, Google also showed the smallest deviations from the reference coordinates, with a median of Google that nearly 95% and for OSM 50% of the addresses were geocoded within Google is superior to OSM regarding completeness and positional accuracy of the geocoded addresses. On the other hand, Google has several restrictions, such as the limitation of the requests to 2 500 addresses per 24 h and the presentation of the results exclusively on Google Maps, which may complicate the use for scientific purposes.

  11. Geographic Variability in Geocoding Success for West Nile Virus Cases in South Dakota

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    Wey, Christine L.; Griesse, Jennifer; Kightlinger, Lon; Wimberly, Michael C.

    2009-01-01

    Background Geocoding, the process of assigning each case a set of coordinates that closely approximates its true location, is an important component of spatial epidemiological studies. The failure to accurately geocode cases adversely affects the validity and strength of conclusions drawn from the analysis. We investigated whether there were differences among geographic locations and demographic classes in the ability to successfully geocode West Nile virus (WNV) cases in South Dakota. We successfully geocoded 1,354 cases (80.8%) to their street address locations and assigned all 1,676 cases to ZIP code tabulation areas (ZCTAs). Using spatial scan statistics, significant clusters of non-geocoded cases were identified in central and western South Dakota. Geocoding success rates were lower in areas of low population density and on Indian reservations than in other portions of the state. Geocoding success rates were lower for Native Americans than for other races. Spatial epidemiological studies should consider the potential biases that may result from excluding non-geocoded cases, particularly in rural portions of the Great Plains that contain large Native American populations. PMID:19577505

  12. Quantifying geocode location error using GIS methods

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    Gardner Bennett R

    2007-04-01

    Full Text Available Abstract Background The Metropolitan Atlanta Congenital Defects Program (MACDP collects maternal address information at the time of delivery for infants and fetuses with birth defects. These addresses have been geocoded by two independent agencies: (1 the Georgia Division of Public Health Office of Health Information and Policy (OHIP and (2 a commercial vendor. Geographic information system (GIS methods were used to quantify uncertainty in the two sets of geocodes using orthoimagery and tax parcel datasets. Methods We sampled 599 infants and fetuses with birth defects delivered during 1994–2002 with maternal residence in either Fulton or Gwinnett County. Tax parcel datasets were obtained from the tax assessor's offices of Fulton and Gwinnett County. High-resolution orthoimagery for these counties was acquired from the U.S. Geological Survey. For each of the 599 addresses we attempted to locate the tax parcel corresponding to the maternal address. If the tax parcel was identified the distance and the angle between the geocode and the residence were calculated. We used simulated data to characterize the impact of geocode location error. In each county 5,000 geocodes were generated and assigned their corresponding Census 2000 tract. Each geocode was then displaced at a random angle by a random distance drawn from the distribution of observed geocode location errors. The census tract of the displaced geocode was determined. We repeated this process 5,000 times and report the percentage of geocodes that resolved into incorrect census tracts. Results Median location error was less than 100 meters for both OHIP and commercial vendor geocodes; the distribution of angles appeared uniform. Median location error was approximately 35% larger in Gwinnett (a suburban county relative to Fulton (a county with urban and suburban areas. Location error occasionally caused the simulated geocodes to be displaced into incorrect census tracts; the median percentage

  13. An analysis of the process and results of manual geocode correction

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    McDonald, Yolanda J.; Schwind, Michael; Goldberg, Daniel W.; Lampley, Amanda; Wheeler, Cosette M.

    2018-01-01

    Geocoding is the science and process of assigning geographical coordinates (i.e. latitude, longitude) to a postal address. The quality of the geocode can vary dramatically depending on several variables, including incorrect input address data, missing address components, and spelling mistakes. A dataset with a considerable number of geocoding inaccuracies can potentially result in an imprecise analysis and invalid conclusions. There has been little quantitative analysis of the amount of effort (i.e. time) to perform geocoding correction, and how such correction could improve geocode quality type. This study used a low-cost and easy to implement method to improve geocode quality type of an input database (i.e. addresses to be matched) through the processes of manual geocode intervention, and it assessed the amount of effort to manually correct inaccurate geocodes, reported the resulting match rate improvement between the original and the corrected geocodes, and documented the corresponding spatial shift by geocode quality type resulting from the corrections. Findings demonstrated that manual intervention of geocoding resulted in a 90% improvement of geocode quality type, took 42 hours to process, and the spatial shift ranged from 0.02 to 151,368 m. This study provides evidence to inform research teams considering the application of manual geocoding intervention that it is a low-cost and relatively easy process to execute. PMID:28555477

  14. An analysis of the process and results of manual geocode correction

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    Yolanda J. McDonald

    2017-05-01

    Full Text Available Geocoding is the science and process of assigning geographical coordinates (i.e. latitude, longitude to a postal address. The quality of the geocode can vary dramatically depending on several variables, including incorrect input address data, missing address components, and spelling mistakes. A dataset with a considerable number of geocoding inaccuracies can potentially result in an imprecise analysis and invalid conclusions. There has been little quantitative analysis of the amount of effort (i.e. time to perform geocoding correction, and how such correction could improve geocode quality type. This study used a low-cost and easy to implement method to improve geocode quality type of an input database (i.e. addresses to be matched through the processes of manual geocode intervention, and it assessed the amount of effort to manually correct inaccurate geocodes, reported the resulting match rate improvement between the original and the corrected geocodes, and documented the corresponding spatial shift by geocode quality type resulting from the corrections. Findings demonstrated that manual intervention of geocoding resulted in a 90% improvement of geocode quality type, took 42 hours to process, and the spatial shift ranged from 0.02 to 151,368 m. This study provides evidence to inform research teams considering the application of manual geocoding intervention that it is a low-cost and relatively easy process to execute.

  15. A DIFFERENT WEB-BASED GEOCODING SERVICE USING FUZZY TECHNIQUES

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    P. Pahlavani

    2015-12-01

    Full Text Available Geocoding – the process of finding position based on descriptive data such as address or postal code - is considered as one of the most commonly used spatial analyses. Many online map providers such as Google Maps, Bing Maps and Yahoo Maps present geocoding as one of their basic capabilities. Despite the diversity of geocoding services, users usually face some limitations when they use available online geocoding services. In existing geocoding services, proximity and nearness concept is not modelled appropriately as well as these services search address only by address matching based on descriptive data. In addition there are also some limitations in display searching results. Resolving these limitations can enhance efficiency of the existing geocoding services. This paper proposes the idea of integrating fuzzy technique with geocoding process to resolve these limitations. In order to implement the proposed method, a web-based system is designed. In proposed method, nearness to places is defined by fuzzy membership functions and multiple fuzzy distance maps are created. Then these fuzzy distance maps are integrated using fuzzy overlay technique for obtain the results. Proposed methods provides different capabilities for users such as ability to search multi-part addresses, searching places based on their location, non-point representation of results as well as displaying search results based on their priority.

  16. A multifaceted comparison of ArcGIS and MapMarker for automated geocoding

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    Sanjaya Kumar

    2012-11-01

    Full Text Available Geocoding is increasingly being used for public health surveillance and spatial epidemiology studies. Public health departments in the United States of America (USA often use this approach to investigate disease outbreaks and clusters or assign health records to appropriate geographic units. We evaluated two commonly used geocoding software packages, ArcGIS and MapMarker, for automated geocoding of a large number of residential addresses from health administrative data in New York State, USA to better understand their features, performance and limitations. The comparison was based on three metrics of evaluation: completeness (or match rate, geocode similarity and positional accuracy. Of the 551,798 input addresses, 318,302 (57.7% were geocoded by MapMarker and 420,813 (76.3% by the ArcGIS composite address locator. High similarity between the geocodes assigned by the two methods was found, especially in suburban and urban areas. Among addresses with a distance of greater than 100 m between the geocodes assigned by the two packages, the point assigned by ArcGIS was closer to the associated parcel centroid (“true” location compared with that assigned by MapMarker. In addition, the composite address locator in ArcGIS allows users to fully utilise available reference data, which consequently results in better geocoding results. However, the positional differences found were minimal, and a large majority of addresses were placed on the same locations by both geocoding packages. Using both methods and combining the results can maximise match rates and save the time needed for manual geocoding.

  17. A multifaceted comparison of ArcGIS and MapMarker for automated geocoding.

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    Kumar, Sanjaya; Liu, Ming; Hwang, Syni-An

    2012-11-01

    Geocoding is increasingly being used for public health surveillance and spatial epidemiology studies. Public health departments in the United States of America (USA) often use this approach to investigate disease outbreaks and clusters or assign health records to appropriate geographic units. We evaluated two commonly used geocoding software packages, ArcGIS and MapMarker, for automated geocoding of a large number of residential addresses from health administrative data in New York State, USA to better understand their features, performance and limitations. The comparison was based on three metrics of evaluation: completeness (or match rate), geocode similarity and positional accuracy. Of the 551,798 input addresses, 318,302 (57.7%) were geocoded by MapMarker and 420,813 (76.3%) by the ArcGIS composite address locator. High similarity between the geocodes assigned by the two methods was found, especially in suburban and urban areas. Among addresses with a distance of greater than 100 m between the geocodes assigned by the two packages, the point assigned by ArcGIS was closer to the associated parcel centroid ("true" location) compared with that assigned by MapMarker. In addition, the composite address locator in ArcGIS allows users to fully utilise available reference data, which consequently results in better geocoding results. However, the positional differences found were minimal, and a large majority of addresses were placed on the same locations by both geocoding packages. Using both methods and combining the results can maximise match rates and save the time needed for manual geocoding.

  18. Geographic bias related to geocoding in epidemiologic studies

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    Siadaty Mir

    2005-11-01

    Full Text Available Abstract Background This article describes geographic bias in GIS analyses with unrepresentative data owing to missing geocodes, using as an example a spatial analysis of prostate cancer incidence among whites and African Americans in Virginia, 1990–1999. Statistical tests for clustering were performed and such clusters mapped. The patterns of missing census tract identifiers for the cases were examined by generalized linear regression models. Results The county of residency for all cases was known, and 26,338 (74% of these cases were geocoded successfully to census tracts. Cluster maps showed patterns that appeared markedly different, depending upon whether one used all cases or those geocoded to the census tract. Multivariate regression analysis showed that, in the most rural counties (where the missing data were concentrated, the percent of a county's population over age 64 and with less than a high school education were both independently associated with a higher percent of missing geocodes. Conclusion We found statistically significant pattern differences resulting from spatially non-random differences in geocoding completeness across Virginia. Appropriate interpretation of maps, therefore, requires an understanding of this phenomenon, which we call "cartographic confounding."

  19. Geocoding accuracy and the recovery of relationships between environmental exposures and health

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    Zimmerman Dale L

    2008-04-01

    Full Text Available Abstract Background This research develops methods for determining the effect of geocoding quality on relationships between environmental exposures and health. The likelihood of detecting an existing relationship – statistical power – between measures of environmental exposures and health depends not only on the strength of the relationship but also on the level of positional accuracy and completeness of the geocodes from which the measures of environmental exposure are made. This paper summarizes the results of simulation studies conducted to examine the impact of inaccuracies of geocoded addresses generated by three types of geocoding processes: a addresses located on orthophoto maps, b addresses matched to TIGER files (U.S Census or their derivative street files; and, c addresses from E-911 geocodes (developed by local authorities for emergency dispatch purposes. Results The simulated odds of disease using exposures modelled from the highest quality geocodes could be sufficiently recovered using other, more commonly used, geocoding processes such as TIGER and E-911; however, the strength of the odds relationship between disease exposures modelled at geocodes generally declined with decreasing geocoding accuracy. Conclusion Although these specific results cannot be generalized to new situations, the methods used to determine the sensitivity of results can be used in new situations. Estimated measures of positional accuracy must be used in the interpretation of results of analyses that investigate relationships between health outcomes and exposures measured at residential locations. Analyses similar to those employed in this paper can be used to validate interpretation of results from empirical analyses that use geocoded locations with estimated measures of positional accuracy.

  20. Evaluation of the positional difference between two common geocoding methods

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    Dustin T. Duncan

    2011-05-01

    Full Text Available Geocoding, the process of matching addresses to geographic coordinates, is a necessary first step when using geographical information systems (GIS technology. However, different geocoding methodologies can result in different geographic coordinates. The objective of this study was to compare the positional (i.e. longitude/latitude difference between two common geocoding methods, i.e. ArcGIS (Environmental System Research Institute, Redlands, CA, USA and Batchgeo (freely available online at http://www.batchgeo.com. Address data came from the YMCA-Harvard After School Food and Fitness Project, an obesity prevention intervention involving children aged 5-11 years and their families participating in YMCAadministered, after-school programmes located in four geographically diverse metropolitan areas in the USA. Our analyses include baseline addresses (n = 748 collected from the parents of the children in the after school sites. Addresses were first geocoded to the street level and assigned longitude and latitude coordinates with ArcGIS, version 9.3, then the same addresses were geocoded with Batchgeo. For this analysis, the ArcGIS minimum match score was 80. The resulting geocodes were projected into state plane coordinates, and the difference in longitude and latitude coordinates were calculated in meters between the two methods for all data points in each of the four metropolitan areas. We also quantified the descriptions of the geocoding accuracy provided by Batchgeo with the match scores from ArcGIS. We found a 94% match rate (n = 705, 2% (n = 18 were tied and 3% (n = 25 were unmatched using ArcGIS. Forty-eight addresses (6.4% were not matched in ArcGIS with a match score ≥80 (therefore only 700 addresses were included in our positional difference analysis. Six hundred thirteen (87.6% of these addresses had a match score of 100. Batchgeo yielded a 100% match rate for the addresses that ArcGIS geocoded. The median for longitude and latitude

  1. A multi-stage approach to maximizing geocoding success in a large population-based cohort study through automated and interactive processes

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    Jennifer S. Sonderman

    2012-05-01

    Full Text Available To enable spatial analyses within a large, prospective cohort study of nearly 86,000 adults enrolled in a 12-state area in the southeastern United States of America from 2002-2009, a multi-stage geocoding protocol was developed to efficiently maximize the proportion of participants assigned an address level geographic coordinate. Addresses were parsed, cleaned and standardized before applying a combination of automated and interactive geocoding tools. Our full protocol increased the non-Post Office (PO Box match rate from 74.5% to 97.6%. Overall, we geocoded 99.96% of participant addresses, with only 5.2% at the ZIP code centroid level (2.8% PO Box and 2.3% non-PO Box addresses. One key to reducing the need for interactive geocoding was the use of multiple base maps. Still, addresses in areas with population density 920 persons/km2 (odds ratio (OR = 5.24; 95% confidence interval (CI = 4.23, 6.49, as were addresses collected from participants during in-person interviews compared with mailed questionnaires (OR = 1.83; 95% CI = 1.59, 2.11. This study demonstrates that population density and address ascertainment method can influence automated geocoding results and that high success in address level geocoding is achievable for large-scale studies covering wide geographical areas.

  2. Influence of geocoding quality on environmental exposure assessment of children living near high traffic roads

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    Zandbergen Paul A

    2007-03-01

    Full Text Available Abstract Background The widespread availability of powerful geocoding tools in commercial GIS software and the interest in spatial analysis at the individual level have made address geocoding a widely employed technique in epidemiological studies. This study determined the effect of the positional error in street geocoding on the analysis of traffic-related air pollution on children. Methods For a case-study of a large sample of school children in Orange County, Florida (n = 104,865 the positional error of street geocoding was determined through comparison with a parcel database. The effect of this error was evaluated by analyzing the proximity of street and parcel geocoded locations to road segments with high traffic volume and determining the accuracy of the classification using the results of street geocoding. Of the original sample of 163,886 addresses 36% were not used in the final analysis because they could not be reliably geocoded using either street or parcel geocoding. The estimates of positional error can therefore be considered conservative underestimates. Results Street geocoding was found to have a median error of 41 meters, a 90th percentile of 100 meters, a 95th percentile of 137 meters and a 99th percentile of 273 meters. These positional errors were found to be non-random in nature and introduced substantial bias and error in the estimates of potential exposure to traffic-related air pollution. Street geocoding was found to consistently over-estimate the number of potentially exposed children at small distances up to 250 meters. False positives and negatives were also found to be very common at these small distances. Conclusion Results of the case-study presented here strongly suggest that typical street geocoding is insufficient for fine-scale analysis and more accurate alternatives need to be considered.

  3. Geocoding police collision report data from California: a comprehensive approach

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    Park Shin

    2009-12-01

    Full Text Available Abstract Background Collision geocoding is the process of assigning geographic descriptors, usually latitude and longitude coordinates, to a traffic collision record. On California police reports, relative collision location is recorded using a highway postmile marker or a street intersection. The objective of this study was to create a geocoded database of all police-reported, fatal and severe injury collisions in the California Statewide Integrated Traffic Records System (SWITRS for years 1997-2006 for use by public agencies. Results Geocoding was completed with a multi-step process. First, pre-processing was performed using a scripting language to clean and standardize street name information. A state highway network with postmile values was then created using a custom tool written in Visual Basic for Applications (VBA in ArcGIS software. Custom VBA functionality was also used to incorporate the offset direction and distance. Intersection and address geocoding was performed using ArcGIS, StreetMap Pro 2003 digital street network, and Google Earth Pro. A total of 142,007 fatal and severe injury collisions were identified in SWITRS. The geocoding match rate was 99.8% for postmile-coded collisions and 86% for intersection-coded collisions. The overall match rate was 91%. Conclusions The availability of geocoded collision data will be beneficial to clinicians, researchers, policymakers, and practitioners in the fields of traffic safety and public health. Potential uses of the data include studies of collision clustering on the highway system, examinations of the associations between collision occurrence and a variety of variables on environmental and social characteristics, including housing and personal demographics, alcohol outlets, schools, and parks. The ability to build maps may be useful in research planning and conduct and in the delivery of information to both technical and non-technical audiences.

  4. Ensuring Confidentiality of Geocoded Health Data: Assessing Geographic Masking Strategies for Individual-Level Data.

    Science.gov (United States)

    Zandbergen, Paul A

    2014-01-01

    Public health datasets increasingly use geographic identifiers such as an individual's address. Geocoding these addresses often provides new insights since it becomes possible to examine spatial patterns and associations. Address information is typically considered confidential and is therefore not released or shared with others. Publishing maps with the locations of individuals, however, may also breach confidentiality since addresses and associated identities can be discovered through reverse geocoding. One commonly used technique to protect confidentiality when releasing individual-level geocoded data is geographic masking. This typically consists of applying a certain amount of random perturbation in a systematic manner to reduce the risk of reidentification. A number of geographic masking techniques have been developed as well as methods to quantity the risk of reidentification associated with a particular masking method. This paper presents a review of the current state-of-the-art in geographic masking, summarizing the various methods and their strengths and weaknesses. Despite recent progress, no universally accepted or endorsed geographic masking technique has emerged. Researchers on the other hand are publishing maps using geographic masking of confidential locations. Any researcher publishing such maps is advised to become familiar with the different masking techniques available and their associated reidentification risks.

  5. Ensuring Confidentiality of Geocoded Health Data: Assessing Geographic Masking Strategies for Individual-Level Data

    Directory of Open Access Journals (Sweden)

    Paul A. Zandbergen

    2014-01-01

    Full Text Available Public health datasets increasingly use geographic identifiers such as an individual’s address. Geocoding these addresses often provides new insights since it becomes possible to examine spatial patterns and associations. Address information is typically considered confidential and is therefore not released or shared with others. Publishing maps with the locations of individuals, however, may also breach confidentiality since addresses and associated identities can be discovered through reverse geocoding. One commonly used technique to protect confidentiality when releasing individual-level geocoded data is geographic masking. This typically consists of applying a certain amount of random perturbation in a systematic manner to reduce the risk of reidentification. A number of geographic masking techniques have been developed as well as methods to quantity the risk of reidentification associated with a particular masking method. This paper presents a review of the current state-of-the-art in geographic masking, summarizing the various methods and their strengths and weaknesses. Despite recent progress, no universally accepted or endorsed geographic masking technique has emerged. Researchers on the other hand are publishing maps using geographic masking of confidential locations. Any researcher publishing such maps is advised to become familiar with the different masking techniques available and their associated reidentification risks.

  6. An effective and efficient approach for manually improving geocoded data

    Directory of Open Access Journals (Sweden)

    Knoblock Craig A

    2008-11-01

    Full Text Available Abstract Background The process of geocoding produces output coordinates of varying degrees of quality. Previous studies have revealed that simply excluding records with low-quality geocodes from analysis can introduce significant bias, but depending on the number and severity of the inaccuracies, their inclusion may also lead to bias. Little quantitative research has been presented on the cost and/or effectiveness of correcting geocodes through manual interactive processes, so the most cost effective methods for improving geocoded data are unclear. The present work investigates the time and effort required to correct geocodes contained in five health-related datasets that represent examples of data commonly used in Health GIS. Results Geocode correction was attempted on five health-related datasets containing a total of 22,317 records. The complete processing of these data took 11.4 weeks (427 hours, averaging 69 seconds of processing time per record. Overall, the geocodes associated with 12,280 (55% of records were successfully improved, taking 95 seconds of processing time per corrected record on average across all five datasets. Geocode correction improved the overall match rate (the number of successful matches out of the total attempted from 79.3 to 95%. The spatial shift between the location of original successfully matched geocodes and their corrected improved counterparts averaged 9.9 km per corrected record. After geocode correction the number of city and USPS ZIP code accuracy geocodes were reduced from 10,959 and 1,031 to 6,284 and 200, respectively, while the number of building centroid accuracy geocodes increased from 0 to 2,261. Conclusion The results indicate that manual geocode correction using a web-based interactive approach is a feasible and cost effective method for improving the quality of geocoded data. The level of effort required varies depending on the type of data geocoded. These results can be used to choose between

  7. Geocoding routinely collected administrative data to measure access to alcohol outlets in Wales

    Directory of Open Access Journals (Sweden)

    Richard Fry

    2017-04-01

    All authorities were able to provide an actual or approximate license issue date, allowing us to summarise the number of outlets annually. Several authorities were unable to provide precise outlet closure dates, so the date of the last interaction with the outlet was used to generate an approximate end date. One-half of the unitary authorities were able to provide the On/Off sales status of outlets, and 9 were able to provide opening hours. From these data we were able to geocode 53% (range 28% to 72% by local authority using GIS, the remaining 47% were matched using Google products to verify and extract a precise geographic location. Conclusions The collation and processing of retrospective alcohol outlet data was successfully completed to enable the building of a longitudinal exposure dataset. There was considerable variation between the unitary authorities in the quality of address data, and data related to the availability of alcohol, for example opening hours. The lack of address structure required us to devise a manual address matching process to capture the addresses that could not be geocoded. To aid future data linkage based evaluations to provide policy evidence in a timely manner, local government datasets should use standardised data fields, including addresses and Point-of-Capture address verification.

  8. Assessing bias associated with geocoding of historical residence in epidemiology research

    Directory of Open Access Journals (Sweden)

    Daikwon Han

    2013-05-01

    Full Text Available The use of geocoded historical residence as proxy for retrospective assessment of exposure in early life is increasing in epidemiological studies of chronic health outcomes. Dealing with historical residence poses challenges, primarily due to higher uncertainties associated with data collection and processing. A possible source of bias is connected with the exclusion of subjects, who cannot, for various reasons, be geocoded. We evaluated the potential bias that may arise due to incomplete geocoding, using birth residence data collected as part of a population-based case-control study of breast cancer in western New York state. We found that geocoded and non-geocoded populations did not differ in the distribution of most risk factors compared, and that the geocoding status did not modify the spatial patterns of the study populations. However, the results emphasize the need for epidemiological studies to consider the potential biases that may be introduced by geocoding of historical residence when investigating retrospectively chronic disease and early-life exposure.

  9. VT E911 Composite geocoder - uses ESITE, RDSNAME, and RDSRANGE

    Data.gov (United States)

    Vermont Center for Geographic Information — VT E911 Composite geocoder - uses ESITE, RDSNAME, and RDSRANGE. VCGI, in collaboration with the VT E911 Board, has created a suite of geocoding services that can be...

  10. New indices for home nursing care resource disparities in rural and urban areas, based on geocoding and geographic distance barriers: a cross-sectional study.

    Science.gov (United States)

    Lin, Shyang-Woei; Yen, Chia-Feng; Chiu, Tzu-Ying; Chi, Wen-Chou; Liou, Tsan-Hon

    2015-10-08

    Aging in place is the crucial object of long-term care policy worldwide. Approximately 15.6-19.4% of people aged 15 or above live with a disability, and 15.3% of them have moderate or severe disabilities. The allocation of home nursing care services is therefore an important issue. Service providers in Taiwan vary substantially across regions, and between rural and urban areas. There are no appropriate indices for describing the capacity of providers that it is due to the distances from care recipients. This study therefore aimed to describe and compare distance barriers for home nursing care providers using indices of the "profit willing distance" and the "tolerance limited distance". This cross-sectional study was conducted during 2012 and 2013 using geocoding and a geographic information system to identify the distance from the providers' locations to participants' homes in urban (Taipei City) and rural (Hualien County) areas in Taiwan. Data were collected in-person by professionals in Taiwanese hospitals using the World Health Organization Disability Assessment Schedule 2.0. The indices were calculated using regression curves, and the first inflection points were determined as the points on the curves where the first and second derivatives equaled 0. There were 5627 participants from urban areas and 956 from rural areas. In urban areas, the profit willing distance was 550-600 m, and we were unable to identify them in rural areas. This demonstrates that providers may need to supply services even when there is little profit. The tolerance limited distance were 1600-1650 m in urban areas and 1950-2000 m in rural areas. In rural areas, 33.3% of those living inside the tolerance limited distance and there was no provider within this distance, but this figure fell to just 13.9% in urban areas. There were strong disparities between urban and rural areas in home nursing care resource allocation. Our new "profit willing distance" and the "tolerance limited distance" are

  11. Smartphone-assisted spatial data collection improves geographic information quality: pilot study using a birth records dataset

    Directory of Open Access Journals (Sweden)

    Xiaohui Xu

    2016-11-01

    Full Text Available It is well known that the conventional, automated geocoding method based on self-reported residential addresses has many issues. We developed a smartphone-assisted aerial image-based method, which uses the Google Maps application programming interface as a spatial data collection tool during the birth registration process. In this pilot study, we have tested whether the smartphone-assisted method provides more accurate geographic information than the automated geocoding method in the scenario when both methods can get the address geocodes. We randomly selected 100 well-geocoded addresses among women who gave birth in Alachua county, Florida in 2012. We compared geocodes generated from three geocoding methods: i the smartphone-assisted aerial image-based method; ii the conventional, automated geocoding method; and iii the global positioning system (GPS. We used the GPS data as the reference method. The automated geocoding method yielded positional errors larger than 100 m among 29.3% of addresses, while all addresses geocoded by the smartphoneassisted method had errors less than 100 m. The positional errors of the automated geocoding method were greater for apartment/condominiums compared with other dwellings and also for rural addresses compared with urban ones. We conclude that the smartphone-assisted method is a promising method for perspective spatial data collection by improving positional accuracy.

  12. Local indicators of geocoding accuracy (LIGA: theory and application

    Directory of Open Access Journals (Sweden)

    Jacquez Geoffrey M

    2009-10-01

    Full Text Available Abstract Background Although sources of positional error in geographic locations (e.g. geocoding error used for describing and modeling spatial patterns are widely acknowledged, research on how such error impacts the statistical results has been limited. In this paper we explore techniques for quantifying the perturbability of spatial weights to different specifications of positional error. Results We find that a family of curves describes the relationship between perturbability and positional error, and use these curves to evaluate sensitivity of alternative spatial weight specifications to positional error both globally (when all locations are considered simultaneously and locally (to identify those locations that would benefit most from increased geocoding accuracy. We evaluate the approach in simulation studies, and demonstrate it using a case-control study of bladder cancer in south-eastern Michigan. Conclusion Three results are significant. First, the shape of the probability distributions of positional error (e.g. circular, elliptical, cross has little impact on the perturbability of spatial weights, which instead depends on the mean positional error. Second, our methodology allows researchers to evaluate the sensitivity of spatial statistics to positional accuracy for specific geographies. This has substantial practical implications since it makes possible routine sensitivity analysis of spatial statistics to positional error arising in geocoded street addresses, global positioning systems, LIDAR and other geographic data. Third, those locations with high perturbability (most sensitive to positional error and high leverage (that contribute the most to the spatial weight being considered will benefit the most from increased positional accuracy. These are rapidly identified using a new visualization tool we call the LIGA scatterplot. Herein lies a paradox for spatial analysis: For a given level of positional error increasing sample density

  13. Using imputation to provide location information for nongeocoded addresses.

    Directory of Open Access Journals (Sweden)

    Frank C Curriero

    2010-02-01

    Full Text Available The importance of geography as a source of variation in health research continues to receive sustained attention in the literature. The inclusion of geographic information in such research often begins by adding data to a map which is predicated by some knowledge of location. A precise level of spatial information is conventionally achieved through geocoding, the geographic information system (GIS process of translating mailing address information to coordinates on a map. The geocoding process is not without its limitations, though, since there is always a percentage of addresses which cannot be converted successfully (nongeocodable. This raises concerns regarding bias since traditionally the practice has been to exclude nongeocoded data records from analysis.In this manuscript we develop and evaluate a set of imputation strategies for dealing with missing spatial information from nongeocoded addresses. The strategies are developed assuming a known zip code with increasing use of collateral information, namely the spatial distribution of the population at risk. Strategies are evaluated using prostate cancer data obtained from the Maryland Cancer Registry. We consider total case enumerations at the Census county, tract, and block group level as the outcome of interest when applying and evaluating the methods. Multiple imputation is used to provide estimated total case counts based on complete data (geocodes plus imputed nongeocodes with a measure of uncertainty. Results indicate that the imputation strategy based on using available population-based age, gender, and race information performed the best overall at the county, tract, and block group levels.The procedure allows for the potentially biased and likely under reported outcome, case enumerations based on only the geocoded records, to be presented with a statistically adjusted count (imputed count with a measure of uncertainty that are based on all the case data, the geocodes and imputed

  14. Using Geocoded Databases in Teaching Urban Historical Geography.

    Science.gov (United States)

    Miller, Roger P.

    1986-01-01

    Provides information regarding hardware and software requirements for using geocoded databases in urban historical geography. Reviews 11 IBM and Apple Macintosh database programs and describes the pen plotter and digitizing table interface used with the databases. (JDH)

  15. Spatial Quality of Manually Geocoded Multispectral and Multiresolution Mosaics

    Directory of Open Access Journals (Sweden)

    Andrija Krtalić

    2008-05-01

    Full Text Available The digital airborne multisensor and multiresolution system for collection of information (images about mine suspected area was created, within European commission project Airborne Minefield Area Reduction (ARC, EC IST-2000-25300, http://www.arc.vub.ac.be to gain a better perspective in mine suspected areas (MSP in the Republic of Croatia. The system consists of a matrix camera (visible and near infrared range of electromagnetic spectrum, 0.4-1.1 µm, thermal (thermal range of electromagnetic spectrum, 8-14 µm and a hyperspectral linear scanner. Because of a specific purpose and seeking object on the scene, the flights for collecting the images took place at heights from 130 m to 900 m above the ground. The result of a small relative flight height and large MSPs was a large number of images which cover MSPs. Therefore, the need for merging images in largest parts, for a better perspective in whole MSPs and the interaction of detected object influences on the scene appeared. The mentioned system did not dispose of the module for automatic mosaicking and geocoding, so mosaicking and after that geocoding were done manually. This process made the classification of the scene (better distinguishing of objects on the scene and fusion of multispectral and multiresolution images after that possible. Classification and image fusion can be even done by manually mosaicking and geocoding. This article demonstrated this claim.

  16. Towards Introducing a Geocoding Information System for Greenland

    Science.gov (United States)

    Siksnans, J.; Pirupshvarre, Hans R.; Lind, M.; Mioc, D.; Anton, F.

    2011-08-01

    Currently, addressing practices in Greenland do not support geocoding. Addressing points on a map by geographic coordinates is vital for emergency services such as police and ambulance for avoiding ambiguities in finding incident locations (Government of Greenland, 2010) Therefore, it is necessary to investigate the current addressing practices in Greenland. Asiaq (Asiaq, 2011) is a public enterprise of the Government of Greenland which holds three separate databases regards addressing and place references: - list of locality names (towns, villages, farms), - technical base maps (including road center lines not connected with names, and buildings), - the NIN registry (The Land Use Register of Greenland - holds information on the land allotments and buildings in Greenland). The main problem is that these data sets are not interconnected, thus making it impossible to address a point in a map with geographic coordinates in a standardized way. The possible solutions suffer from the fact that Greenland has a scattered habitation pattern and the generalization of the address assignment schema is a difficult task. A schema would be developed according to the characteristics of the settlement pattern, e.g. cities, remote locations and place names. The aim is to propose an ontology for a common postal address system for Greenland. The main part of the research is dedicated to the current system and user requirement engineering. This allowed us to design a conceptual database model which corresponds to the user requirements, and implement a small scale prototype. Furthermore, our research includes resemblance findings in Danish and Greenland's addressing practices, data dictionary for establishing Greenland addressing system's logical model and enhanced entity relationship diagram. This initial prototype of the Greenland addressing system could be used to evaluate and build the full architecture of the addressing information system for Greenland. Using software engineering

  17. Geocoding uncertainty analysis for the automated processing of Sentinel-1 data using Sentinel-1 Toolbox software

    Science.gov (United States)

    Dostálová, Alena; Naeimi, Vahid; Wagner, Wolfgang; Elefante, Stefano; Cao, Senmao; Persson, Henrik

    2016-10-01

    One of the major advantages of the Sentinel-1 data is its capability to provide very high spatio-temporal coverage allowing the mapping of large areas as well as creation of dense time-series of the Sentinel-1 acquisitions. The SGRT software developed at TU Wien aims at automated processing of Sentinel-1 data for global and regional products. The first step of the processing consists of the Sentinel-1 data geocoding with the help of S1TBX software and their resampling to a common grid. These resampled images serve as an input for the product derivation. Thus, it is very important to select the most reliable processing settings and assess the geocoding uncertainty for both backscatter and projected local incidence angle images. Within this study, selection of Sentinel-1 acquisitions over 3 test areas in Europe were processed manually in the S1TBX software, testing multiple software versions, processing settings and digital elevation models (DEM) and the accuracy of the resulting geocoded images were assessed. Secondly, all available Sentinel-1 data over the areas were processed using selected settings and detailed quality check was performed. Overall, strong influence of the used DEM on the geocoding quality was confirmed with differences up to 80 meters in areas with higher terrain variations. In flat areas, the geocoding accuracy of backscatter images was overall good, with observed shifts between 0 and 30m. Larger systematic shifts were identified in case of projected local incidence angle images. These results encourage the automated processing of large volumes of Sentinel-1 data.

  18. Intelligent geocoding system to locate traffic crashes.

    Science.gov (United States)

    Qin, Xiao; Parker, Steven; Liu, Yi; Graettinger, Andrew J; Forde, Susie

    2013-01-01

    State agencies continue to face many challenges associated with new federal crash safety and highway performance monitoring requirements that use data from multiple and disparate systems across different platforms and locations. On a national level, the federal government has a long-term vision for State Departments of Transportation (DOTs) to report state route and off-state route crash data in a single network. In general, crashes occurring on state-owned or state maintained highways are a priority at the Federal and State level; therefore, state-route crashes are being geocoded by state DOTs. On the other hand, crashes occurring on off-state highway system do not always get geocoded due to limited resources and techniques. Creating and maintaining a statewide crash geographic information systems (GIS) map with state route and non-state route crashes is a complicated and expensive task. This study introduces an automatic crash mapping process, Crash-Mapping Automation Tool (C-MAT), where an algorithm translates location information from a police report crash record to a geospatial map and creates a pinpoint map for all crashes. The algorithm has approximate 83 percent mapping rate. An important application of this work is the ability to associate the mapped crash records to underlying business data, such as roadway inventory and traffic volumes. The integrated crash map is the foundation for effective and efficient crash analyzes to prevent highway crashes. Published by Elsevier Ltd.

  19. Near real-time geocoding of SAR imagery with orbit error removal.

    NARCIS (Netherlands)

    Smith, A.J.E.

    2003-01-01

    When utilizing knowledge of the spacecraft trajectory for near real-time geocoding of Synthetic Aperture Radar (SAR) images, the main problem is that predicted satellite orbits have to be used, which may be in error by several kilometres. As part of the development of a Dutch autonomous mobile

  20. Partnering with Communities to Address the Mental Health Needs of Rural Veterans

    Science.gov (United States)

    Kirchner, JoAnn E.; Farmer, Mary Sue; Shue, Valorie M.; Blevins, Dean; Sullivan, Greer

    2011-01-01

    Purpose: Many veterans who face mental illness and live in rural areas never obtain the mental health care they need. To address these needs, it is important to reach out to community stakeholders who are likely to have frequent interactions with veterans, particularly those returning from Operations Enduring and Iraqi Freedom (OEF/OIF). Methods:…

  1. Teaching Ethics When Working with Geocoded Data: A Novel Experiential Learning Approach

    Science.gov (United States)

    van den Bemt, Vera; Doornbos, Julia; Meijering, Louise; Plegt, Marion; Theunissen, Nicky

    2018-01-01

    Research ethics are not the favourite subject of most undergraduate geography students. However, in the light of increasing mixed-methods research, as well as research using geocodes, it is necessary to train students in the field of ethics. Experiential learning is an approach to teaching that is potentially suitable for teaching ethics. The aim…

  2. Community health workers as cultural producers in addressing gender-based violence in rural South Africa.

    Science.gov (United States)

    de Lange, Naydene; Mitchell, Claudia

    2016-01-01

    South Africa has been experiencing an epidemic of gender-based violence (GBV) for a long time and in some rural communities health workers, who are trained to care for those infected with HIV, are positioned at the forefront of addressing this problem, often without the necessary support. In this article, we pose the question: How might cultural production through media making with community health workers (CHWs) contribute to taking action to address GBV and contribute to social change in a rural community? This qualitative participatory arts-based study with five female CHWs working from a clinic in a rural district of South Africa is positioned as critical research, using photographs in the production of media posters. We offer a close reading of the data and its production and discuss three data moments: CHWs drawing on insider cultural knowledge; CHWs constructing messages; and CHWs taking action. In our discussion, we take up the issue of cultural production and then offer concluding thoughts on 'beyond engagement' when the researchers leave the community.

  3. Rural and Urban Differences in the Associations between Characteristics of the Community Food Environment and Fruit and Vegetable Intake

    Science.gov (United States)

    Dean, Wesley R.; Sharkey, Joseph R.

    2011-01-01

    Objective: To examine the relationship between measures of the household and retail food environments and fruit and vegetable (FV) intake in both urban and rural environmental contexts. Design: A cross-sectional design was used. Data for FV intake and other characteristics were collected via survey instrument and geocoded to the objective food…

  4. Strategies to address learner aggression in rural South African secondary schools

    Directory of Open Access Journals (Sweden)

    Gunam D. Singh

    2013-11-01

    Full Text Available Managing learner aggression in the school system is central to learners’ academic performance and holistic development. In order to manage learner aggression, it is important to understand the contributory factors and the forms of learner aggression. This article reports on an investigation of factors contributing to learner aggression in rural secondary schools in the Empangeni district of KwaZulu-Natal in order to identify the forms of learner aggression and to establish strategies to manage such aggression in these secondary schools. A qualitative research design was adopted to investigate the phenomenon through an interview process with participants from five rural secondary schools. The findings showed that the factors contributing to learner aggression include family factors, environmental factors and school-related factors whilst the most common forms of learner aggression in schools are verbal aggression, physical aggression and bullying. The article concludes with the role that the school, parents and the Department of Education can play in addressing learner aggression in schools.

  5. Generative Street Addresses from Satellite Imagery

    Directory of Open Access Journals (Sweden)

    İlke Demir

    2018-03-01

    Full Text Available We describe our automatic generative algorithm to create street addresses from satellite images by learning and labeling roads, regions, and address cells. Currently, 75% of the world’s roads lack adequate street addressing systems. Recent geocoding initiatives tend to convert pure latitude and longitude information into a memorable form for unknown areas. However, settlements are identified by streets, and such addressing schemes are not coherent with the road topology. Instead, we propose a generative address design that maps the globe in accordance with streets. Our algorithm starts with extracting roads from satellite imagery by utilizing deep learning. Then, it uniquely labels the regions, roads, and structures using some graph- and proximity-based algorithms. We also extend our addressing scheme to (i cover inaccessible areas following similar design principles; (ii be inclusive and flexible for changes on the ground; and (iii lead as a pioneer for a unified street-based global geodatabase. We present our results on an example of a developed city and multiple undeveloped cities. We also compare productivity on the basis of current ad hoc and new complete addresses. We conclude by contrasting our generative addresses to current industrial and open solutions.

  6. Geocoding of SAR Image Using the Orbit and Attitude Determination of RADARSAT

    Directory of Open Access Journals (Sweden)

    Jin Wook So

    1998-06-01

    Full Text Available The Synthetic Aperture Radar (SAR image and the Digital Elevation Model (DEM of an target area are put into use to generate three dimensional image map. An method of image map generation is explained. The orbit and attitude determination of satellite makes it possible to model signal acquisition configuration precisely, which is a key to mapping image coordinates to geographic coordinates of concerned area. An application is made to RADARSAT in the purpose of testing its validity. To determine the orbit, zero Doppler range is used. And to determine the attitude, Doppler centroid frequency, which is the frequency observed when target is in the center of antenna's view, is used. Conventional geocoding has been performed on the basis of direct method(mapping image coordinates to geographic coordinates, but in this research the inverse method (mapping from geographic coordinates to image coordinates is taken. This paper shows that precise signal acquisition modeling based on the orbit and attitude determination of satellite as a platform leads to a satellite-centered accurate geocoding process. It also shows how to model relative motion between spaceborne radar and target. And the relative motion is described in ECIC (earth-centered initial coordinates using Doppler equation and signal acquisition geometry.

  7. Homeless Children: Addressing the Challenge in Rural Schools. ERIC Digest.

    Science.gov (United States)

    Vissing, Yvonne M.

    Despite stereotypes to the contrary, homelessness is as prevalent in rural as urban areas. This digest examines the implications of homelessness for rural children and youth and discusses possible actions by rural educators. An estimated half of the rural homeless are families with children. Compared to urban counterparts, rural homeless families…

  8. 75 FR 41790 - Address Management Services-Elimination of the Manual Card Option for Address Sequencing Services

    Science.gov (United States)

    2010-07-19

    .... The authority citation for 39 CFR Part 111 continues to read as follows: Authority: 5 U.S.C. 552(a... addresses (including rural address conversions to city-style addressing). For each 5-digit ZIP Code grouping... customer includes a rural-style address (RR/box number) in an address file submitted for sequencing, and a...

  9. Views of adolescents on addressing violence in semi-rural secondary schools in Mafikeng, North West province

    Directory of Open Access Journals (Sweden)

    Connie Mosome

    2011-11-01

    Purpose: The purpose of this study was to explore and describe adolescents’ views on addressing violence in semi-rural secondary schools in Mafikeng. Research design and method: A qualitative, explorative, descriptive and contextual research design was utilised. Purposive sampling was used to select adolescents from semi-rural secondary schools in Mafikeng who fell between the ages of 13 and 20 years and who were involved in community youth groups or associations. In-depth focus group discussion using audiotape, reflexive notes and naïve sketches were used for data collection. The central question which was asked was ‘What are the adolescents’ views on addressing violence in semi-rural secondary schools?’ Data were analysed by means of open coding. Results: The results showed that adolescents understood the complexities associated with violence in this country, and they suggested multiple approaches and interventions. The adolescents were of the opinion that responsible communication patterns in the school environment could build healthy relationships between learners and educators and lead to a decrease in violence in the school setting. They also felt that enforcement of a secure teaching environment through encouragement of behavioural and attitudinal change guided by school codes of conduct and provision of firm security will help reduce violence in schools.

  10. Views of adolescents on addressing violence in semi-rural secondary schools in Mafikeng, North West province.

    Science.gov (United States)

    Mosome, Connie; Poggenpoel, Marie; Myburgh, Chris

    2011-11-17

    Violence is a public health problem and often an issue of criminal justice.Violence in schools is a worldwide phenomenon and exposes adolescents to premature death. The purpose of this study was to explore and describe adolescents' views on addressing violence in semi-rural secondary schools in Mafikeng. A qualitative, explorative, descriptive and contextual research design was utilised. Purposive sampling was used to select adolescents from semi-rural secondary schools in Mafikeng who fell between the ages of 13 and 20 years and who were involved in community youth groups or associations. In-depth focus group discussion using audiotape, reflexive notes and naïve sketches were used for data collection. The central question which was asked was 'What are the adolescents' views on addressing violence in semi-rural secondary schools?' Data were analysed by means of open coding. The results showed that adolescents understood the complexities associated with violence in this country, and they suggested multiple approaches and interventions. The adolescents were of the opinion that responsible communication patterns in the school environment could build healthy relationships between learners and educators and lead to a decrease in violence in the school setting. They also felt that enforcement of a secure teaching environment through encouragement of behavioural and attitudinal change guided by school codes of conduct and provision of firm security will help reduce violence in schools.

  11. Project GRACE: a staged approach to development of a community-academic partnership to address HIV in rural African American communities.

    Science.gov (United States)

    Corbie-Smith, Giselle; Adimora, Adaora A; Youmans, Selena; Muhammad, Melvin; Blumenthal, Connie; Ellison, Arlinda; Akers, Aletha; Council, Barbara; Thigpen, Yolanda; Wynn, Mysha; Lloyd, Stacey W

    2011-03-01

    The HIV epidemic is a health crisis in rural African American communities in the Southeast United States; however, to date little attention has been paid to community-academic collaborations to address HIV in these communities. Interventions that use a community-based participatory research (CBPR) approach to address individual, social, and physical environmental factors have great potential for improving community health. Project GRACE (Growing, Reaching, Advocating for Change and Empowerment) uses a CBPR approach to develop culturally sensitive, feasible, and sustainable interventions to prevent the spread of HIV in rural African American communities. This article describes a staged approach to community-academic partnership: initial mobilization, establishment of organizational structure, capacity building for action, and planning for action. Strategies for engaging rural community members at each stage are discussed; challenges faced and lessons learned are also described. Careful attention to partnership development has resulted in a collaborative approach that has mutually benefited both the academic and community partners.

  12. Identifying risk factors for healthcare-associated infections from electronic medical record home address data

    Directory of Open Access Journals (Sweden)

    Rosenman Marc B

    2010-09-01

    Full Text Available Abstract Background Residential address is a common element in patient electronic medical records. Guidelines from the U.S. Centers for Disease Control and Prevention specify that residence in a nursing home, skilled nursing facility, or hospice within a year prior to a positive culture date is among the criteria for differentiating healthcare-acquired from community-acquired methicillin-resistant Staphylococcus aureus (MRSA infections. Residential addresses may be useful for identifying patients residing in healthcare-associated settings, but methods for categorizing residence type based on electronic medical records have not been widely documented. The aim of this study was to develop a process to assist in differentiating healthcare-associated from community-associated MRSA infections by analyzing patient addresses to determine if residence reported at the time of positive culture was associated with a healthcare facility or other institutional location. Results We identified 1,232 of the patients (8.24% of the sample with positive cultures as probable cases of healthcare-associated MRSA based on residential addresses contained in electronic medical records. Combining manual review with linking to institutional address databases improved geocoding rates from 11,870 records (79.37% to 12,549 records (83.91%. Standardization of patient home address through geocoding increased the number of matches to institutional facilities from 545 (3.64% to 1,379 (9.22%. Conclusions Linking patient home address data from electronic medical records to institutional residential databases provides useful information for epidemiologic researchers, infection control practitioners, and clinicians. This information, coupled with other clinical and laboratory data, can be used to inform differentiation of healthcare-acquired from community-acquired infections. The process presented should be extensible with little or no added data costs.

  13. Place of residence and primary treatment of prostate cancer: examining trends in rural and nonrural areas in Wisconsin.

    Science.gov (United States)

    Cetnar, Jeremy P; Hampton, John M; Williamson, Amy A; Downs, Tracy; Wang, Dian; Owen, Jean B; Crouse, Byron; Jones, Nathan; Wilson, J Frank; Trentham-Dietz, Amy

    2013-03-01

    To determine whether rural residents were at a disadvantage compared with urban residents with regard to the receipt of curative therapy for prostate cancer. Using the Breast and Prostate Cancer Data Quality and Patterns of Care Study II, patients with prostate cancer who were diagnosed in 2004 were identified. Registrars reviewed the medical records of randomly selected patients with incident prostate cancer (n = 1906). The patients' residential address was geocoded and linked to the census tract from the 2000 U.S. Census. The place of residence was defined as rural or nonrural according to the census tract and rural-urban commuting area categorization. The distance from the residence to the nearest radiation oncology facility was calculated. The odds ratio and 95% confidence intervals associated with receipt of noncurative treatment was calculated from logistic regression models and adjusted for several potential confounders. Of the incident patients, 39.1% lived in urban census tracts, 41.5% lived in mixed tracts, and 19.4% lived in rural tracts. Hormone-only or active surveillance was received by 15.4% of the patients. Relative to the urban patients, the odds ratio for noncurative treatment was 1.01 (95% confidence interval 0.59-1.74) for those living in mixed tracts and 0.96 (95% confidence interval 0.52-1.77) for those living in rural tracts. No association was found for noncurative treatment according to the Rural-Urban Commuting Area categorization. The linear trend was null between noncurative treatment and the distance to nearest radiation oncology facility (P = .92). The choice of curative treatment did not significantly depend on the patient's place of residence, suggesting a lack of geographic disparity for the primary treatment of prostate cancer. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Utilizing Chair Massage to Address One Woman's Health in Rural Ghana West Africa: a Case Report.

    Science.gov (United States)

    Meryanos, Cathy J

    2016-12-01

    There is limited access to health care in rural Ghana and virtually no rehabilitative services available. This situation presents a unique opportunity to utilize chair massage in addressing women's health in rural Ghana, particularly when it comes to muscle pain and fatigue from heavy labor. The objective of this case report is to determine the results of chair massage as a strategy to reduce neck, shoulder, and back pain, while increasing range of motion. The patient is a 63-year-old Ghanaian female, who was struck by a public transport van while carrying a 30-50 pound load on her head, two years prior. The accident resulted in a broken right humerus and soft tissue pain. A traditional medicine practitioner set the bone, however there was no post-accident rehabilitation available. At the time of referral, she presented complaints of shoulder, elbow, and wrist pain. In addition, she was unable to raise her right hand to her mouth for food intake. The results of this case report include an increase in range of motion, as well as elimination of pain in the right shoulder, elbow, and hand. Visual assessments showed an approximate increase of ROM within the ranges of 45-65 degrees in the right arm, as well as 10-15 degrees in 4th and 5th fingers. There was also a decrease in muscle hypertonicity in the thoracic and cervical areas, and a profound increase in quality of life for the patient. This case report illustrates how therapeutic chair massage was utilized to address a common health concern for one woman in rural Ghana. It also demonstrates that pre-existing musculoskeletal disorders and pain may be eliminated with massage intervention. Massage therapy may be important to ameliorating certain types of health problems in remote rural villages in low income countries.

  15. Views of adolescents on addressing violence in semi-rural secondary schools in Mafikeng, North West province

    Directory of Open Access Journals (Sweden)

    Connie Mosome

    2011-09-01

    Full Text Available Background: Violence is a public health problem and often an issue of criminal justice.Violence in schools is a worldwide phenomenon and exposes adolescents to premature death.Purpose: The purpose of this study was to explore and describe adolescents’ views on addressing violence in semi-rural secondary schools in Mafikeng.Research design and method: A qualitative, explorative, descriptive and contextual research design was utilised. Purposive sampling was used to select adolescents from semi-rural secondary schools in Mafikeng who fell between the ages of 13 and 20 years and who were involved in community youth groups or associations. In-depth focus group discussion using audiotape, reflexive notes and naïve sketches were used for data collection. The central question which was asked was ‘What are the adolescents’ views on addressing violence in semi-rural secondary schools?’ Data were analysed by means of open coding.Results: The results showed that adolescents understood the complexities associated with violence in this country, and they suggested multiple approaches and interventions. The adolescents were of the opinion that responsible communication patterns in the school environment could build healthy relationships between learners and educators and lead to a decrease in violence in the school setting. They also felt that enforcement of a secure teaching environment through encouragement of behavioural and attitudinal change guided by school codes of conduct and provision of firm security will help reduce violence in schools.

  16. Neighbourhood walkability, leisure-time and transport-related physical activity in a mixed urban-rural area.

    Science.gov (United States)

    de Sa, Eric; Ardern, Chris I

    2014-01-01

    Objectives. To develop a walkability index specific to mixed rural/suburban areas, and to explore the relationship between walkability scores and leisure time physical activity. Methods. Respondents were geocoded with 500 m and 1,000 m buffer zones around each address. A walkability index was derived from intersections, residential density, and land-use mix according to built environment measures. Multivariable logistic regression models were used to quantify the association between the index and physical activity levels. Analyses used cross-sectional data from the 2007-2008 Canadian Community Health Survey (n = 1158; ≥18 y). Results. Respondents living in highly walkable 500 m buffer zones (upper quartiles of the walkability index) were more likely to walk or cycle for leisure than those living in low-walkable buffer zones (quartile 1). When a 1,000 m buffer zone was applied, respondents in more walkable neighbourhoods were more likely to walk or cycle for both leisure-time and transport-related purposes. Conclusion. Developing a walkability index can assist in exploring the associations between measures of the built environment and physical activity to prioritize neighborhood change.

  17. Challenges Addressing Unmet Need for Contraception: Voices of Family Planning Service Providers in Rural Tanzania.

    Science.gov (United States)

    Baraka, Jitihada; Rusibamayila, Asinath; Kalolella, Admirabilis; Baynes, Colin

    2015-12-01

    Provider perspectives have been overlooked in efforts to address the challenges of unmet need for family planning (FP). This qualitative study was undertaken in Tanzania, using 22 key informant interviews and 4 focus group discussions. The research documents perceptions of healthcare managers and providers in a rural district on the barriers to meeting latent demand for contraception. Social-ecological theory is used to interpret the findings, illustrating how service capability is determined by the social, structural and organizational environment. Providers' efforts to address unmet need for FP services are constrained by unstable reproductive preferences, low educational attainment, and misconceptions about contraceptive side effects. Societal and organizational factors--such as gender dynamics, economic conditions, religious and cultural norms, and supply chain bottlenecks, respectively--also contribute to an adverse environment for meeting needs for care. Challenges that healthcare providers face interact and produce an effect which hinders efforts to address unmet need. Interventions to address this are not sufficient unless the supply of services is combined with systems strengthening and social engagement strategies in a way that reflects the multi-layered, social institutional problems.

  18. Addressing health workforce distribution concerns: a discrete choice experiment to develop rural retention strategies in Cameroon.

    Science.gov (United States)

    Robyn, Paul Jacob; Shroff, Zubin; Zang, Omer Ramses; Kingue, Samuel; Djienouassi, Sebastien; Kouontchou, Christian; Sorgho, Gaston

    2015-03-01

    Nearly every nation in the world faces shortages of health workers in remote areas. Cameroon is no exception to this. The Ministry of Public Health (MoPH) is currently considering several rural retention strategies to motivate qualified health personnel to practice in remote rural areas. To better calibrate these mechanisms and to develop evidence-based retention strategies that are attractive and motivating to health workers, a Discrete Choice Experiment (DCE) was conducted to examine what job attributes are most attractive and important to health workers when considering postings in remote areas. The study was carried out between July and August 2012 among 351 medical students, nursing students and health workers in Cameroon. Mixed logit models were used to analyze the data. Among medical and nursing students a rural retention bonus of 75% of base salary (aOR= 8.27, 95% CI: 5.28-12.96, Pimpact measurements were also estimated to identify combination of incentives that health workers would find most attractive. Based on these findings, the study recommends the introduction of a system of substantial monetary bonuses for rural service along with ensuring adequate and functional equipment and uninterrupted supplies. By focusing on the analysis of locally relevant, actionable incentives, generated through the involvement of policy-makers at the design stage, this study provides an example of research directly linked to policy action to address a vitally important issue in global health.

  19. Geocoding location expressions in Twitter messages: A preference learning method

    Directory of Open Access Journals (Sweden)

    Wei Zhang

    2014-12-01

    Full Text Available Resolving location expressions in text to the correct physical location, also known as geocoding or grounding, is complicated by the fact that so many places around the world share the same name. Correct resolution is made even more difficult when there is little context to determine which place is intended, as in a 140-character Twitter message, or when location cues from different sources conflict, as may be the case among different metadata fields of a Twitter message. We used supervised machine learning to weigh the different fields of the Twitter message and the features of a world gazetteer to create a model that will prefer the correct gazetteer candidate to resolve the extracted expression. We evaluated our model using the F1 measure and compared it to similar algorithms. Our method achieved results higher than state-of-the-art competitors.

  20. Utilizing Chair Massage to Address One Woman’s Health in Rural Ghana West Africa: a Case Report

    Science.gov (United States)

    Meryanos, Cathy J.

    2016-01-01

    Background and Objectives There is limited access to health care in rural Ghana and virtually no rehabilitative services available. This situation presents a unique opportunity to utilize chair massage in addressing women’s health in rural Ghana, particularly when it comes to muscle pain and fatigue from heavy labor. The objective of this case report is to determine the results of chair massage as a strategy to reduce neck, shoulder, and back pain, while increasing range of motion. Case Presentation The patient is a 63-year-old Ghanaian female, who was struck by a public transport van while carrying a 30–50 pound load on her head, two years prior. The accident resulted in a broken right humerus and soft tissue pain. A traditional medicine practitioner set the bone, however there was no post-accident rehabilitation available. At the time of referral, she presented complaints of shoulder, elbow, and wrist pain. In addition, she was unable to raise her right hand to her mouth for food intake. Results The results of this case report include an increase in range of motion, as well as elimination of pain in the right shoulder, elbow, and hand. Visual assessments showed an approximate increase of ROM within the ranges of 45–65 degrees in the right arm, as well as 10–15 degrees in 4th and 5th fingers. There was also a decrease in muscle hypertonicity in the thoracic and cervical areas, and a profound increase in quality of life for the patient. Discussion This case report illustrates how therapeutic chair massage was utilized to address a common health concern for one woman in rural Ghana. It also demonstrates that pre-existing musculoskeletal disorders and pain may be eliminated with massage intervention. Massage therapy may be important to ameliorating certain types of health problems in remote rural villages in low income countries. PMID:27974948

  1. Addressing post-stroke care in rural areas with Peru as a case study. Placing emphasis on evidence-based pragmatism.

    Science.gov (United States)

    Miranda, J Jaime; Moscoso, Miguel G; Yan, Lijing L; Diez-Canseco, Francisco; Málaga, Germán; Garcia, Hector H; Ovbiagele, Bruce

    2017-04-15

    Stroke is a major cause of death and disability, with most of its burden now affecting low- and middle-income countries (LMIC). People in rural areas of LMIC who have a stroke receive very little acute stroke care and local healthcare workers and family caregivers in these regions lack the necessary knowledge to assist them. Intriguingly, a recent rapid growth in cell-phone use and digital technology in rural areas has not yet been appropriately exploited for health care training and delivery purposes. What should be done in rural areas, at the community setting-level, where access to healthcare is limited remains a challenge. We review the evidence on improving post-stroke outcomes including lowering the risks of functional disability, stroke recurrence, and mortality, and propose some approaches, to target post-stroke care and rehabilitation, noting key challenges in designing suitable interventions and emphasizing the advantages mHealth and communication technologies can offer. In the article, we present the prevailing stroke care situation and technological opportunities in rural Peru as a case study. As such, by addressing major limitations in rural healthcare systems, we investigate the potential of task-shifting complemented with technology to utilize and strengthen both community-based informal caregivers and community healthcare workers. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. An Entitlement Approach to Address the Water-Energy-Food Nexus in Rural India

    Science.gov (United States)

    Siegfried, T. U.; Fishman, R.; Modi, V.; Lall, U.

    2008-12-01

    prices and rainfall patterns due to climate change only enhance these concerns. Given these deficiencies, any corrective strategy should at least target the following long-term policy goals: a) increase the efficiency of rural electricity consumption in terms of grain production and rural income, b) providing the farmers greater flexibility with timely, high quality energy and more efficient means of production, c) enable proper energy accounting on the use side so as to recover costs at sufficient levels for the SEBs and thus enable long-term investments in energy infrastructure and d) secure and eventually increase agricultural production without depleting groundwater resources over the long run. We will present an entitlement approach with which the above issues can be addressed in the future. A case study example from the semi-arid Telangana Region in Andhra Pradesh will be discussed in depth and preliminary results shown.

  3. Neighbourhood walkability, leisure-time and transport-related physical activity in a mixed urban–rural area

    Directory of Open Access Journals (Sweden)

    Eric de Sa

    2014-07-01

    Full Text Available Objectives. To develop a walkability index specific to mixed rural/suburban areas, and to explore the relationship between walkability scores and leisure time physical activity.Methods. Respondents were geocoded with 500 m and 1,000 m buffer zones around each address. A walkability index was derived from intersections, residential density, and land-use mix according to built environment measures. Multivariable logistic regression models were used to quantify the association between the index and physical activity levels. Analyses used cross-sectional data from the 2007–2008 Canadian Community Health Survey (n = 1158; ≥18 y.Results. Respondents living in highly walkable 500 m buffer zones (upper quartiles of the walkability index were more likely to walk or cycle for leisure than those living in low-walkable buffer zones (quartile 1. When a 1,000 m buffer zone was applied, respondents in more walkable neighbourhoods were more likely to walk or cycle for both leisure-time and transport-related purposes.Conclusion. Developing a walkability index can assist in exploring the associations between measures of the built environment and physical activity to prioritize neighborhood change.

  4. Exploring the potential of geocoding the impact of disasters: The experience of global and national databases

    Science.gov (United States)

    Guha-Sapir, Debarati; Davis, Rhonda; Gall, Melanie; Wallemacq, Pascaline; Cutter, Susan

    2015-04-01

    As extreme climate events such as precipitation driven flooding, storms and droughts are increasingly devastating, assessing impacts accurately becomes critically important in guiding decisions and investments on disaster risk reduction. Capturing disaster impacts includes not only quantitative information such as the economic and human effects but also the determination of where and when the impacts occurred. Among the most commonly used impact indicators are the number of deaths and the number of people affected or homeless, and the economic damages. Unfortunately, these figures are typically used in their raw form and conclusions are drawn without due consideration to denominators. For example, key parameters such as the population base or the size of the region affected are often not factored in when judging the severity of the event or calculating increases or decreases in an indicator. To increase the meaningfulness and comparability of disaster impacts across time and space, however, it is important to mathematically standardize indicators and utilize common denominators such as number of population exposed, area affected, GDP, and so forth. Geospatial techniques such as geo-referencing and spatial overlays are coming into greater use to facilitate this process. In 2013, EM-DAT, one of the main providers of global disaster impact data, launched an effort to enhance its contents through spatial analyses. The challenge was to develop a sustainable methodology and protocol for a large dataset and to systematically collect and enter geocoded profiles for each event that is registered in EM-DAT. Along with specialists in geography from different institutions EM-DAT launched an effort to geocode each disaster event working backwards in time starting from the most recent. For geo-referencing purposes, EM-DAT requires a standardized dataset of sub-national administrative boundaries. Though a number of such initiatives exist, the Food and Agriculture Organization

  5. Historical Post Office Directory Parser (POD Parser Software From the AddressingHistory Project

    Directory of Open Access Journals (Sweden)

    Nicola Osborne

    2014-07-01

    Full Text Available The POD Parser is Python software for parsing the OCR’d (optical character recognised text of digitised historical Scottish Post Office Directories (PODs to produce a consistent structured format for the data and for geocoding each address. The software was developed as part of the AddressingHistory project which sought to combine digitised historic directories with digitised and georeferenced historic maps.  The software has potential for reuse in multiple research contexts where historical post office directory data is relevant, and is therefore particularly of use in historical research into social, economic or demographic trends. The POD Parser is currently designed for use with Scottish directories but is extensible, perhaps with some adaptation, to use with other similarly formatted materials such as the English Trade Directories.

  6. Urban-rural migration and cultural transformation of rural areas

    DEFF Research Database (Denmark)

    Nørgaard, Helle

    Rural areas are presently challenged by various restructuring processes; functionally and economically with changes in employment structure etc. as well as social and cultural transformations due to demographic change, population loss but also due to in-migration. This paper addresses how rural...

  7. Addressing Health Workforce Distribution Concerns: A Discrete Choice Experiment to Develop Rural Retention Strategies in Cameroon

    Directory of Open Access Journals (Sweden)

    Paul Jacob Robyn

    2015-03-01

    Full Text Available Background Nearly every nation in the world faces shortages of health workers in remote areas. Cameroon is no exception to this. The Ministry of Public Health (MoPH is currently considering several rural retention strategies to motivate qualified health personnel to practice in remote rural areas. Methods To better calibrate these mechanisms and to develop evidence-based retention strategies that are attractive and motivating to health workers, a Discrete Choice Experiment (DCE was conducted to examine what job attributes are most attractive and important to health workers when considering postings in remote areas. The study was carried out between July and August 2012 among 351 medical students, nursing students and health workers in Cameroon. Mixed logit models were used to analyze the data. Results Among medical and nursing students a rural retention bonus of 75% of base salary (aOR= 8.27, 95% CI: 5.28-12.96, P< 0.001 and improved health facility infrastructure (aOR= 3.54, 95% CI: 2.73-4.58 respectively were the attributes with the largest effect sizes. Among medical doctors and nurse aides, a rural retention bonus of 75% of base salary was the attribute with the largest effect size (medical doctors aOR= 5.60, 95% CI: 4.12-7.61, P< 0.001; nurse aides aOR= 4.29, 95% CI: 3.11-5.93, P< 0.001. On the other hand, improved health facility infrastructure (aOR= 3.56, 95% CI: 2.75-4.60, P< 0.001, was the attribute with the largest effect size among the state registered nurses surveyed. Willingness-to-Pay (WTP estimates were generated for each health worker cadre for all the attributes. Preference impact measurements were also estimated to identify combination of incentives that health workers would find most attractive. Conclusion Based on these findings, the study recommends the introduction of a system of substantial monetary bonuses for rural service along with ensuring adequate and functional equipment and uninterrupted supplies. By focusing on

  8. Culture and rural health.

    Science.gov (United States)

    Farmer, Jane; Bourke, Lisa; Taylor, Judy; Marley, Julia V; Reid, John; Bracksley, Stacey; Johnson, Nicole

    2012-10-01

    This paper considers the role of culture in rural health, suggesting that the concept and its impacts are insufficiently understood and studied. It reviews some of the ways that culture has been considered in (rural) health, and states that culture is either used ambiguously and broadly - for example, suggesting that there is a rural culture, or narrowly - indeed perhaps interchangeably with ethnicity, for example Aboriginal culture as a unity. The paper notes that, although culture is a dynamic social concept, it has been adopted into a biomedical research paradigm as though it is fixed. Culture is often treated as though it is something that can be addressed simplistically, for example, through cultural sensitivity education. Authors suggest that culture is an unaddressed 'elephant in the room' in rural health, and that exploring cultural differences and beliefs and facing up to cultural differences are vital in understanding and addressing rural health and health system challenges. © 2012 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  9. Prisons as Panacea or Pariah? The Countervailing Consequences of the Prison Boom on the Political Economy of Rural Towns

    Directory of Open Access Journals (Sweden)

    John M. Eason

    2017-01-01

    Full Text Available The nascent literature on prison proliferation in the United States typically reveals negative impacts for communities of color. Given that Southern rural communities were the most likely to build during the prison boom (1970–2010, however, a more nuanced understanding of prison impact is warranted. Using a dataset matching and geocoding all 1663 U.S. prisons with their Census-appointed place, this study explores the countervailing consequences of the prison boom on rural towns across multiple periods. For example, locales that adopted prisons at earlier stages of the prison boom era received a short-term boom compared to those that did not, but these effects were not lasting. Furthermore, later in the boom, prison-building protected towns against additional economic decline. Thus, neither entirely pariah nor panacea, the prison functions as a state-sponsored public works program for disadvantaged rural communities but also supports perverse economic incentives for prison proliferation. Methodological, substantive, theoretical, and policy implications regarding the intersection of race and punishment are explored.

  10. Reconstruction of Building Outlines in Dense Urban Areas Based on LIDAR Data and Address Points

    Science.gov (United States)

    Jarzabek-Rychard, M.

    2012-07-01

    The paper presents a comprehensive method for automated extraction and delineation of building outlines in densely built-up areas. A novel approach to outline reconstruction is the use of geocoded building address points. They give information about building location thus highly reduce task complexity. Reconstruction process is executed on 3D point clouds acquired by airborne laser scanner. The method consists of three steps: building detection, delineation and contours refinement. The algorithm is tested against a data set that presents the old market town and its surroundings. The results are discussed and evaluated by comparison to reference cadastral data.

  11. Historical measures of social context in life course studies: retrospective linkage of addresses to decennial censuses

    Directory of Open Access Journals (Sweden)

    Whitsel Eric A

    2004-11-01

    Full Text Available Abstract Background There is evidence of a contribution of early life socioeconomic exposures to the risk of chronic diseases in adulthood. However, extant studies investigating the impact of the neighborhood social environment on health tend to characterize only the current social environment. This in part may be due to complexities involved in obtaining and geocoding historical addresses. The Life Course Socioeconomic Status, Social Context, and Cardiovascular Disease Study collected information on childhood (1930–1950 and early adulthood (1960–1980 place of residence from 12,681 black and white middle-aged and older men and women from four U.S. communities to link participants with census-based socioeconomic indicators over the life course. Results Most (99% participants were linked to 1930–50 county level socioeconomic census data (the smallest level of aggregation universally available during this time period corresponding to childhood place of residence. Linkage did not vary by race, gender, birth cohort, or level of educational attainment. A commercial geocoding vendor processed participants' self-reported street addresses for ages 30, 40, and 50. For 1970 and 1980 censuses, spatial coordinates were overlaid onto shape files containing census tract boundaries; for 1960 no shape files existed and comparability files were used. Several methods were tested for accuracy and to increase linkage. Successful linkage to historical census tracts varied by census (66% for 1960, 76% for 1970, 85% for 1980. This compares to linkage rates of 94% for current addresses provided by participants over the course of the ARIC examinations. Conclusion There are complexities and limitations in characterizing the past social context. However, our results suggest that it is feasible to characterize the earlier social environment with known levels of measurement error and that such an approach should be considered in future studies.

  12. Rural Elementary School Teachers' Technology Integration

    Science.gov (United States)

    Howley, Aimee; Wood, Lawrence; Hough, Brian

    2011-01-01

    Based on survey responses from more than 500 third-grade teachers, this study addressed three research questions relating to technology integration and its impact in rural elementary schools. The first analyses compared rural with non-rural teachers, revealing that the rural teachers had more positive attitudes toward technology integration. Then…

  13. In-Place Training: Optimizing Rural Health Workforce Outcomes through Rural-Based Education in Australia

    Science.gov (United States)

    May, Jennifer; Brown, Leanne; Burrows, Julie

    2018-01-01

    The medical workforce shortfall in rural areas is a major issue influencing the nature of undergraduate medical education in Australia. Exposing undergraduates to rural life through rural clinical school (RCS) placements is seen as a key strategy to address workforce imbalances. We investigated the influence of an extended RCS placement and rural…

  14. The Use of Exhaustive Micro-Data Firm Databases for Economic Geography: The Issues of Geocoding and Usability in the Case of the Amadeus Database

    Directory of Open Access Journals (Sweden)

    Moritz Lennert

    2015-01-01

    Full Text Available Economic geography has begun to explore the options involved in micro-data. New databases have become available and new techniques and an increase in computer power allow their treatment. However, two major issues impede the use of these datasets: the lack of geocoded spatial location and lack of exhaustivity in coverage. In this article, I explore the possibilities of using large micro-scale firm databases for economic geography in Europe. I show that current evolution in European official spatial data dissemination alows for geocoding of such databases using means that are accessible for researchers with minimal programming knowledge. For the specific case of the Amadeus database of the Bureau Van Dijk, I show that its limitations in terms of coverage have to be taken into acount, but do not hinder its use for analysis. Resulting maps show how the data allows to go further than classic databases such as the Eurostat Structural Business Statistics.

  15. Visual analysis of geocoded twin data puts nature and nurture on the map.

    Science.gov (United States)

    Davis, O S P; Haworth, C M A; Lewis, C M; Plomin, R

    2012-09-01

    Twin studies allow us to estimate the relative contributions of nature and nurture to human phenotypes by comparing the resemblance of identical and fraternal twins. Variation in complex traits is a balance of genetic and environmental influences; these influences are typically estimated at a population level. However, what if the balance of nature and nurture varies depending on where we grow up? Here we use statistical and visual analysis of geocoded data from over 6700 families to show that genetic and environmental contributions to 45 childhood cognitive and behavioral phenotypes vary geographically in the United Kingdom. This has implications for detecting environmental exposures that may interact with the genetic influences on complex traits, and for the statistical power of samples recruited for genetic association studies. More broadly, our experience demonstrates the potential for collaborative exploratory visualization to act as a lingua franca for large-scale interdisciplinary research.

  16. Rural Youth: The Policy Agenda.

    Science.gov (United States)

    Dey, Ian; Jentsch, Birgit

    With the advent of a Scottish Parliament and a Minister and Parliamentary Committee for Rural Affairs, there is now a broad consensus that policies are needed to generate "quality jobs" for young people in rural Scotland. This agenda is politically appealing, since it addresses various rural problems, including retention of young people…

  17. Determining the efficacy of national strategies aimed at addressing the challenges facing health personnel working in rural areas in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Mburu, Grace; George, Gavin

    2017-07-31

    Shortages of Human Resources for Health (HRH) in rural areas are often driven by poor working and living conditions, inadequate salaries and benefits, lack of training and career development opportunities amongst others. The South African government has adopted a human resource strategy for the health sector in 2011 aimed at addressing these challenges. This study reviews the challenges faced by health personnel against government strategies aimed at attracting and retaining health personnel in these underserved areas. The study was conducted in six primary health care service sites in the Hlabisa sub-district of Umkhanyakude, located in northern KwaZulu-Natal, South Africa. The study population comprised 25 health workers including 11 professional nurses, 4 staff nurses and 10 doctors (4 medical doctors, 3 foreign medical doctors and 3 doctors undertaking community service). Qualitative data were collected from semi-structured interviews and analysed using thematic analysis. Government initiatives including the rural allowance, deployment of foreign medical doctors and the presence of health personnel undertaking their community service in rural areas are positively viewed by health personnel working in rural health facilities. However, poor living and working conditions, together with inadequate personal development opportunities, remain unresolved challenges. It is these challenges that will continue to dissuade experienced health personnel from remaining in these underserved areas. South Africa's HRH strategy for the Health Sector 2012/13-2015/16 had highlighted the key challenges raised by respondents and identified strategies aimed at addressing these challenges. Implementation of these strategies is key to improving both living and working conditions, and providing health personnel with opportunities for further development will require inter-ministerial collaboration if the HRH 2030 objectives are to be realised.

  18. Designing snacks to address micronutrient deficiencies in rural Kenyan schoolchildren

    NARCIS (Netherlands)

    Murphy, S.P.; Gewa, C.; Grillenberger, M.; Bwibo, N.O.; Neumann, C.G.

    2007-01-01

    Three snacks were designed to improve nutrient intakes among school-age children living in rural Kenya. Snacks containing animal-source foods (milk and meat) provided more nutrients than an equicaloric vegetarian snack. The vegetarian snack provided extra vitamin A (primarily from fortified cooking

  19. Rural Communatcation: legitimizing digital inclusion in rural field

    Directory of Open Access Journals (Sweden)

    Juliana Correa Bernardes

    2016-03-01

    Full Text Available Through contemporary analysis, it was noted that the countryside of São Paulo experienced drastic transformation and demanded rural family farmers to adapt themselves to technological innovations, where the most striking is the use of the internet in search of information to the sustainable development of rural property.  The research adopted a methodological way of exploratory, through the case study, which analyzed the general objective the dissemination and usability of information and communication technologies in rural areas in the interior of forms-based applied to farmers in the family farms belonging to theAssociation of banana growers of Tupã. In seeking to achieve this goal, reflected on the use of internet in rural areas and measured-factors that enhance digital communication barriers in rural addressing the digital divide becomes a limiting factor to access. In this sense, the rural communication emerges as relational link mediating solutions and incorporating the diffusion of innovations in the pursuit of digital literacy of farmers contributing to the democratization of society in the information age.

  20. Determining and addressing obstacles to the effective use of long-lasting insecticide-impregnated nets in rural Tanzania

    Directory of Open Access Journals (Sweden)

    Benziger Peter W

    2009-12-01

    Full Text Available Abstract Background The objective of this project was to achieve high, sustainable levels of net coverage in a village in rural Tanzania by combining free distribution of long-lasting insecticide-impregnated nets (LLINs with community-tailored education. In Tanzania, malaria is the leading cause of morbidity and mortality. Although malaria bed nets have a well-established role in reducing disease burden, few rural households have access to nets, and effective use depends on personal practices and attitudes. Methods Five practices and attitudes inconsistent with effective LLIN use were identified from household interviews (n = 10. A randomized survey of villagers (n = 132 verified local prevalence of these practices and attitudes. Community leaders held an educational session for two members of every household addressing these practice and attitudes, demonstrating proper LLIN use, and emphasizing behaviour modification. Attendees received one or two LLINs per household. Surveys distributed three weeks (n = 104 and 15 months (n = 104 post-intervention assessed corrected practices and attitudes. Project efficacy was defined by correction of baseline practices and attitudes as well as high rates of reported daily net use, with statistical significance determined by chi-square test. Results Baseline interviews and surveys revealed incorrect practices and attitudes regarding 1 use of nets in dry season, 2 need to retreat LLINs, 3 children napping under nets, 4 need to repair nets, and 5 net procurement as a priority, with 53- 88.6% incorrect responses (11.4-47% correct responses. A three-week follow-up demonstrated 83-95% correct responses. Fifteen-month follow-up showed statistically significant (p Conclusions Results suggest that addressing community-specific practices and attitudes prior to LLIN distribution promotes consistent and correct use, and helps change attitudes towards bed nets as a preventative health measure. Future LLIN distributions

  1. Why Rural Matters 2011-12: The Condition of Rural Education in the 50 States. A Report of the Rural School and Community Trust Policy Program

    Science.gov (United States)

    Strange, Marty; Johnson, Jerry; Showalter, Daniel; Klein, Robert

    2012-01-01

    "Why Rural Matters 2011-12" is the sixth in a series of biennial reports analyzing the contexts and conditions of rural education in each of the 50 states and calling attention to the need for policymakers to address rural education issues in their respective states. While it is the sixth in a series, this report is not simply an…

  2. MATCHING ALTERNATIVE ADDRESSES: A SEMANTIC WEB APPROACH

    Directory of Open Access Journals (Sweden)

    S. Ariannamazi

    2015-12-01

    Full Text Available Rapid development of crowd-sourcing or volunteered geographic information (VGI provides opportunities for authoritatives that deal with geospatial information. Heterogeneity of multiple data sources and inconsistency of data types is a key characteristics of VGI datasets. The expansion of cities resulted in the growing number of POIs in the OpenStreetMap, a well-known VGI source, which causes the datasets to outdate in short periods of time. These changes made to spatial and aspatial attributes of features such as names and addresses might cause confusion or ambiguity in the processes that require feature’s literal information like addressing and geocoding. VGI sources neither will conform specific vocabularies nor will remain in a specific schema for a long period of time. As a result, the integration of VGI sources is crucial and inevitable in order to avoid duplication and the waste of resources. Information integration can be used to match features and qualify different annotation alternatives for disambiguation. This study enhances the search capabilities of geospatial tools with applications able to understand user terminology to pursuit an efficient way for finding desired results. Semantic web is a capable tool for developing technologies that deal with lexical and numerical calculations and estimations. There are a vast amount of literal-spatial data representing the capability of linguistic information in knowledge modeling, but these resources need to be harmonized based on Semantic Web standards. The process of making addresses homogenous generates a helpful tool based on spatial data integration and lexical annotation matching and disambiguating.

  3. Welfare service in rural areas

    DEFF Research Database (Denmark)

    Nørgaard, Helle

    Many rural municipalities are challenged due to overall population decline and demographic changes and thus need to make adjustment to municipal services. Demographic profiles are central for assessing both needs, place bound resources and development potential of individual localities.Assessment......Many rural municipalities are challenged due to overall population decline and demographic changes and thus need to make adjustment to municipal services. Demographic profiles are central for assessing both needs, place bound resources and development potential of individual localities.......Assessment of development potential for individual localities using a place-based approach is in line with EU policies for rural development thereby setting a competitive framework for local development. This paper addresses place bound approaches in relation to service adjustment and discusses how local resources...... and place bound potentials are identified and how they are addressed in plans for future development. The paper draws on a study on service adjustments in rural municipalities in Denmark examining how service adjustments e.g. closing of local schools are decided, how they are managed by rural communities...

  4. Empowering Rural Women through Mobile Services

    Science.gov (United States)

    Nagarajan, P.; Jiji, G. Wiselin

    2010-01-01

    This paper is intended as a gender issue to the rural finance practitioners. It highlights the questions that need to be asked and addressed to the gender mainstream. It will also be useful to gender experts to wish to increase their understanding on specific gender issues in rural finance through mobile services. It focuses on rural microfinance…

  5. Growing partners: building a community-academic partnership to address health disparities in rural North Carolina.

    Science.gov (United States)

    De Marco, Molly; Kearney, William; Smith, Tosha; Jones, Carson; Kearney-Powell, Arconstar; Ammerman, Alice

    2014-01-01

    Community-based participatory research (CBPR) holds tremendous promise for addressing public health disparities. As such, there is a need for academic institutions to build lasting partnerships with community organizations. Herein we have described the process of establishing a relationship between a research university and a Black church in rural North Carolina. We then discuss Harvest of Hope, the church-based pilot garden project that emerged from that partnership. The partnership began with a third-party effort to connect research universities with Black churches to address health disparities. Building this academic-community partnership included collaborating to determine research questions and programming priorities. Other aspects of the partnership included applying for funding together and building consensus on study budget and aims. The academic partners were responsible for administrative details and the community partners led programming and were largely responsible for participant recruitment. The community and academic partners collaborated to design and implement Harvest of Hope, a church-based pilot garden project involving 44 youth and adults. Community and academic partners shared responsibility for study design, recruitment, programming, and reporting of results. The successful operation of the Harvest of Hope project gave rise to a larger National Institutes of Health (NIH)-funded study, Faith, Farming and the Future (F3) involving 4 churches and 60 youth. Both projects were CBPR efforts to improve healthy food access and reducing chronic disease. This partnership continues to expand as we develop additional CBPR projects targeting physical activity, healthy eating, and environmental justice, among others. Benefits of the partnership include increased community ownership and cultural appropriateness of interventions. Challenges include managing expectations of diverse parties and adequate communication. Lessons learned and strategies for building

  6. Psychology and Rural America: Current Status and Future Directions.

    Science.gov (United States)

    Murray, J. Dennis; Keller, Peter A.

    1991-01-01

    Rural people constitute about one-fourth of the U.S. population; their special mental health needs have largely been neglected. Psychologists are needed to practice in rural areas, to develop rural service models, and to support the development of state and federal policies that address rural needs. (DM)

  7. From rural Colombia to urban alienation

    Directory of Open Access Journals (Sweden)

    Alejandro Valencia Arias

    2012-08-01

    Full Text Available The relationships between poverty, inequality and conflict exacerbateyouth migration from rural areas. Policymakers need to consider anumber of areas where efforts are needed to address the impact onyoung people – both in the cities and in the rural areas.

  8. Portrait of Rural Virtual Schooling

    Science.gov (United States)

    Barbour, Michael K.

    2007-01-01

    Over the past two decades, distance education has become a reality of rural schooling in Newfoundland and Labrador. In this article, I provide historical background into the challenges facing rural schools in the province and how distance education was introduced to address that challenge. I also describe how that system of distance education…

  9. Point-of-sale tobacco marketing in rural and urban Ohio: Could the new landscape of Tobacco products widen inequalities?

    Science.gov (United States)

    Roberts, Megan E; Berman, Micah L; Slater, Michael D; Hinton, Alice; Ferketich, Amy K

    2015-12-01

    Considerable research has examined how cigarette point-of-sale advertising is closely related to smoking-related disparities across communities. Yet few studies have examined marketing of alternative tobacco products (e.g., e-cigarettes). The goal of the present study was to examine external point-of-sale marketing of various tobacco products and determine its association with community-level demographics (population density, economic-disadvantage, race/ethnicity) in urban and rural regions of Ohio. During the summer of 2014, fieldworkers collected comprehensive tobacco marketing data from 199 stores in Ohio (99 in Appalachia, 100 in Columbus), including information on external features. The address of each store was geocoded to its census tract, providing information about the community in which the store was located. Results indicated that promotions for e-cigarettes and advertising for menthol cigarettes, cigarillos, and cigars were more prevalent in communities with a higher percentage of African Americans. Cigarillos advertising was more likely in high-disadvantage and urban communities. A greater variety of products were also advertised outside retailers in urban, high-disadvantage, African American communities. Findings provide evidence of differential tobacco marketing at the external point-of-sale, which disproportionately targets urban, economically-disadvantaged, and African American communities. There is a need for tobacco control policies that will help improve equity and reduce health disparities. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Challenges for a Local Service Agency to Address Domestic Violence –A Case Study From Rural Indonesia

    Science.gov (United States)

    Hayati, Elli Nur; Emmelin, Maria; Eriksson, Malin

    2014-01-01

    Since the launch of a Zero Tolerance Policy in Indonesia, several policies to address domestic violence have been enacted. The obligation of local governments to establish service units for women survivors of domestic violence is one of them. Since domestic violence is a sensitive and complex issue in Indonesia it is important to understand how governmentally regulated services function in practice. This case study aimed to explore challenges faced by a local service agency in managing service provision for women survivors of domestic violence in rural Indonesia. Data from one focus group discussion (12 participants), four individual interviews, six short narratives, two days of participant observation, as well as archive reviews were collected. All data were analyzed using Grounded Theory Situational Analysis. The major challenge faced by the local agency was the low priority that was given them by the local authorities, mirrored also in low involvement by the assigned volunteers in the daily service. The study also identified a gap between the socio-cultural arena and the law & policy arena that needs to be bridged to avoid that the two arenas address domestic violence in a contradictory way. Budget allocation to support the sustainability of the daily routines of service agencies has to be given priority. There is also a need for careful considerations regarding the composition of personnel involved within daily management of service agencies addressing domestic violence. To bridge the gap between the legal systems and traditional cultural values, culturally adjusted alternative justice systems could be developed to increase women’s access to legal support. PMID:25363105

  11. Training for Rural Radiology and Imaging in Sub-Saharan Africa: Addressing the Mismatch Between Services and Population

    Directory of Open Access Journals (Sweden)

    Michael G Kawooya

    2012-01-01

    Full Text Available The objectives of this review are to outline the needs, challenges, and training interventions for rural radiology (RR training in Sub-Saharan Africa (SSA. Rural radiology may be defined as imaging requirements of the rural communities. In SSA, over 80% of the population is rural. The literature was reviewed to determine the need for imaging in rural Africa, the challenges, and training interventions. Up to 50% of the patients in the rural health facilities in Uganda may require imaging, largely ultrasound and plain radiography. In Uganda, imaging is performed, on an average, in 50% of the deserving patients in the urban areas, compared to 10-13 % in the rural areas. Imaging has been shown to increase the utilization of facility-based rural health services and to impact management decisions. The challenges in the rural areas are different from those in the urban areas. These are related to disease spectrum, human resource, and socio-economic, socio-cultural, infrastructural, and academic disparities. Countries in Sub-Saharan Africa, for which information on training intervention was available, included: Uganda, Kenya, Tanzania, Rwanda, Zambia, Ghana, Malawi, and Sudan. Favorable national policies had been instrumental in implementing these interventions. The interventions had been made by public, private-for-profit (PFP, private-not-for profit (PNFP, local, and international academic institutions, personal initiatives, and professional societies. Ultrasound and plain radiography were the main focus. Despite these efforts, there were still gross disparities in the RR services for SSA. In conclusion, there have been training interventions targeted toward RR in Africa. However, gross disparities in RR provision persist, requiring an effective policy, plus a more organized, focused, and sustainable approach, by the stakeholders.

  12. Rural women's health

    National Research Council Canada - National Science Library

    Thurston, Wilfreda E; Leach, Belinda; Leipert, Beverly

    2012-01-01

    ... about reduction of government funding and access to health care, and about the shortage of new volunteers to replace them when they burn out. These are a few of the stories told in the chapters of this book. This ground-breaking collection of essays identifies priority issues that must be addressed to ensure rural women's well-being, and offers innovative ideas for improvement and further research. Rural women play a critical role within their families and communities, and the health of these wome...

  13. Proposed criteria for the evaluation of an address assignment scheme in Botswana

    CSIR Research Space (South Africa)

    Ditsela, J

    2011-06-01

    Full Text Available propose criteria for an address assignment scheme in Botswana: a single set of place or area names; different addresses types for urban, rural and farm areas; principles for address numbering assignment; integration of different referencing systems; and a...

  14. Police and Community-partnered Delivery System to Address ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... Delivery System to Address Violence Against Women in the Punjab (India) ... Education, Scheduled Castes and Other Back Classes, and Land Rural Development. ... IWRA/IDRC webinar on climate change and adaptive water management.

  15. The Quest for Rural Sustainability in Russia

    Directory of Open Access Journals (Sweden)

    Stephen K. Wegren

    2016-06-01

    Full Text Available Rural depopulation and the disappearance of villages in rural Russia occurred as part of the historical process of urbanization and industrialization. Rural depopulation also occurred for structural reasons having to do with village location, and for behavioral reasons whereby villagers react to primitive living conditions and poor economic prospects. Three possible strategies for addressing the problem of sustainable villages are considered. The government is attempting to improve rural living conditions, but rural depopulation is likely to continue. Characteristics of sustainable villages are outlined. Agro-tourism is analyzed for its potential to support sustainable villages.

  16. Racism and Health in Rural America.

    Science.gov (United States)

    Kozhimannil, Katy B; Henning-Smith, Carrie

    2018-01-01

    This commentary responds to the recent article by Dr. James et al. on racial and ethnic health disparities in rural America, published in the November 16 issue of Morbidity and Mortality Weekly Report. We applaud Dr. James and colleagues for their important contribution uncovering intra-rural racial and ethnic disparities and build on their paper by discussing potential mechanisms, including structural racism. We also discuss several pragmatic steps that can be taken in research, policy, and practice to address racial and ethnic disparities in rural communities and to work toward health equity for all rural residents.

  17. Social Work Practice in a Rural Health Care Setting: Farm Families.

    Science.gov (United States)

    Durham, Judith A.; Miah, M. Mizanur Rahman

    1993-01-01

    Literature review addresses the status of farm families; farm stresses and their effects; dysfunctional family relationships; and the unique attitudes, behaviors, and perceptions of rural culture toward social service intervention. By implementing coordinated service programs and initiating new legislation that addresses rural health care issues,…

  18. Mental health academics in rural and remote Australia.

    Science.gov (United States)

    Pierce, David; Little, Fiona; Bennett-Levy, James; Isaacs, Anton N; Bridgman, Heather; Lutkin, Sarah J; Carey, Timothy A; Schlicht, Kate G; McCabe-Gusta, Zita P; Martin, Elizabeth; Martinez, Lee A

    2016-01-01

    The significant impact of mental ill health in rural and remote Australia has been well documented. Included among innovative approaches undertaken to address this issue has been the Mental Health Academic (MHA) project, established in 2007. Funded by the Australian Government (Department of Health), this project was established as a component of the University Departments of Rural Health (UDRH) program. All 11 UDRHs appointed an MHA. Although widely geographically dispersed, the MHAs have collaborated in various ways. The MHA project encompasses a range of activities addressing four key performance indicators. These activities, undertaken in rural and remote Australia, aimed to increase access to mental health services, promote awareness of mental health issues, support students undertaking mental health training and improve health professionals' capacity to recognise and address mental health issues. MHAs were strategically placed within the UDRHs across the country, ensuring an established academic base for the MHAs' work was available immediately. Close association with each local rural community was recognised as important. For most MHAs this was facilitated by having an established clinical role in their local community and actively engaging with the community in which they worked. In common with other rural health initiatives, some difficulties were experienced in the recruitment of suitable MHAs, especially in more remote locations. The genesis of this article was a national meeting of the MHAs in 2014, to identify and map the different types of activities MHAs had undertaken in their regions. These activities were analysed and categorised by the MHAs. These categories have been used as a guiding framework for this article. The challenge to increase community access to mental health services was addressed by (i) initiatives to address specific access barriers, (ii) supporting recruitment and retention of rural mental health staff, (iii) developing the

  19. Public health agendas addressing violence against rural women - an analysis of local level health services in the State of Rio Grande do Sul, Brazil.

    Science.gov (United States)

    da Costa, Marta Cocco; Lopes, Marta Julia Marques; Soares, Joannie dos Santos Fachinelli

    2015-05-01

    This study analyses health managers' perceptions of local public health agendas addressing violence against rural women in municipalities in the southern part of the State Rio Grande do Sul in Brazil. It consists of an exploratory descriptive study utilizing a qualitative approach. Municipal health managers responsible for planning actions directed at women's health and primary health care were interviewed. The analysis sought to explore elements of programmatic vulnerability related to violence in the interviewees' narratives based on the following dimensions of programmatic vulnerability: expression of commitment, transformation of commitment into action, and planning and coordination. It was found that local health agendas directed at violence against rural women do not exist. Health managers are therefore faced with the challenge of defining lines of action in accordance with the guidelines and principles of the SUS. The repercussions of this situation are expressed in fragile comprehensive services for these women and programmatic vulnerability.

  20. Rural development in the European Union: the concept and the policy

    Directory of Open Access Journals (Sweden)

    Rosa Gallardo-Cobos

    2010-12-01

    Full Text Available Rural areas are key elements that underpin the social and economic European territory and shape its landscape. The rural setting is a dynamic concept, able to distinguish three stages on how the European Union (EU understands “rural”: rural as image, rural as local, and rural as a social construction. The evolution of the concept is reflected in the need to adapt the approach used to address rural issues, and consequently the political design for rural development. Thus, under the term Rural Development, the EU has included and mixed very different issues, supporting measures and equally heterogeneous financial instruments. For the purpose of supporting the European rural world the two main EU policies have come together: the agricultural and the regional policies. So, Rural Development in the EU has been navigating between the sectorial policy and the territorial policy. At a time of redefinition of European priorities and policies for 2013, territorial cohesion, rural/urban articulation, social partnership, institutional cooperation, environmental sustainability, and governance (flexible and multilevel are the fundamental elements upon which a policy should rest that is addressed to ensure the existence of a living countryside, inhabitable and friendly environment.

  1. Design framework for developing ict products and services for rural development : A persuasive health information system for rural India

    NARCIS (Netherlands)

    Parmar, V.S.

    2009-01-01

    Information poverty cannot be addressed by simply giving away computers and installing internet connections in rural areas. What is really needed is to offer rural users relevant, personalized information that enables them to make positive changes in their daily lives, rather than give them the type

  2. Energy, environment and sustainable rural development

    Energy Technology Data Exchange (ETDEWEB)

    Best, G [Food and Agriculture Organization of the United Nations, Rome (Italy)

    1992-12-01

    This paper addresses the energy needs of the three quarters of the World's population living in the rural populations of many developing countries whose daily struggle to obtain the energy needed for survival is unaffected by international energy politics. It aims to identify energy-related actions in certain policy and technical areas which may contribute to ending rural poverty. The mutual benefits of a transition to modern technologies is stressed both for rural and urban groups, especially in terms of a more efficient use of fossil fuels and renewable energy sources such as biomass or solar power. Recommendations for sustainable rural and agricultural development are made. (UK)

  3. Theoretical Guidelines for a Psychology of Rural Development

    NARCIS (Netherlands)

    Landini, F.; Long, N.; Leeuwis, C.; Murtagh, S.

    2014-01-01

    Many processes related to rural development have a strong psychosocial component. Yet, there exists no specific psychosocial theoretical framework for addressing them. In this paper, then, we present a set of theoretical guidelines for analysing rural development processes and interventions from the

  4. Public health agendas addressing violence against rural women - an analysis of local level health services in the State of Rio Grande do Sul, Brazil

    Directory of Open Access Journals (Sweden)

    Marta Cocco da Costa

    2015-05-01

    Full Text Available This study analyses health managers' perceptions of local public health agendas addressing violence against rural women in municipalities in the southern part of the State Rio Grande do Sul in Brazil. It consists of an exploratory descriptive study utilizing a qualitative approach. Municipal health managers responsible for planning actions directed at women's health and primary health care were interviewed. The analysis sought to explore elements of programmatic vulnerability related to violence in the interviewees' narratives based on the following dimensions of programmatic vulnerability: expression of commitment, transformation of commitment into action, and planning and coordination. It was found that local health agendas directed at violence against rural women do not exist. Health managers are therefore faced with the challenge of defining lines of action in accordance with the guidelines and principles of the SUS. The repercussions of this situation are expressed in fragile comprehensive services for these women and programmatic vulnerability.

  5. Sustaining the Entrepreneurship in Rural Tourism Development

    Directory of Open Access Journals (Sweden)

    Norhafiza Md Sharif

    2017-12-01

    Full Text Available Entrepreneurs play an important role in sustaining rural tourism and formulation of sustainable strategies being the initiators of the tourism business and the engine of the local development. Therefore, it is necessary to stimulate the development of entrepreneurial activities for the recovery of rural tourism potential and regional traditions, maintaining local employment growth and increase living standards in line with identifies needs and priorities of regional human resources development. This article aims to discuss the involvement of local communities in development of rural tourism entrepreneurship as well as addressing the issue of entrepreneurship in rural tourism.

  6. Alaska Native Villages and Rural Communities Water Grant Program

    Science.gov (United States)

    Significant human health and water quality problems exist in Alaska Native Village and other rural communities in the state due to lack of sanitation. To address these issues, EPA created the Alaska Rural and Native Villages Grant Program.

  7. Environmental resources and poverty in rural communities

    DEFF Research Database (Denmark)

    Charlery, Lindy Callen

    , is to be sustainably realized. However, most datasets on rural livelihoods do not accurately account for environmental income and therefore cannot answer this question. The Poverty Environment Network (PEN) project was initiated specifically to address this issue in the assessment of rural livelihoods in developing......D study focuses on answering two main research questions: 1) What is the importance of environmental income in assessments of poverty and poverty dynamics in rural forest reliant communities? and 2) What are the impacts of infrastructural development, in the form of rural roads, on rural household income......Over the last two decades, the burgeoning empirical evidence on the importance of forests and environmental resources to rural livelihoods in developing countries has attracted the attention of policy makers aiming to develop and implement strategies for reducing poverty and improving livelihoods...

  8. Creating a new rural pharmacy workforce: Development and implementation of the Rural Pharmacy Health Initiative.

    Science.gov (United States)

    Scott, Mollie Ashe; Kiser, Stephanie; Park, Irene; Grandy, Rebecca; Joyner, Pamela U

    2017-12-01

    An innovative certificate program aimed at expanding the rural pharmacy workforce, increasing the number of pharmacists with expertise in rural practice, and improving healthcare outcomes in rural North Carolina is described. Predicted shortages of primary care physicians and closures of critical access hospitals are expected to worsen existing health disparities. Experiential education in schools and colleges of pharmacy primarily takes place in academic medical centers and, unlike experiential education in medical schools, rarely emphasizes the provision of patient care in rural U.S. communities, where chronic diseases are prevalent and many residents struggle with poverty and poor access to healthcare. To help address these issues, UNC Eshelman School of Pharmacy developed the 3-year Rural Pharmacy Health Certificate program. The program curriculum includes 4 seminar courses, interprofessional education and interaction with medical students, embedding of each pharmacy student into a specific rural community for the duration of training, longitudinal ambulatory care practice experiences, community engagement initiatives, leadership training, development and implementation of a population health project, and 5 pharmacy practice experiences in rural settings. The Rural Pharmacy Health Certificate program at UNC Eshelman School of Pharmacy seeks to transform rural pharmacy practice by creating a pipeline of rural pharmacy leaders and teaching a unique skillset that will be beneficial to healthcare systems, communities, and patients. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  9. Rural male suicide in Australia.

    Science.gov (United States)

    Alston, Margaret

    2012-02-01

    The rate of suicide amongst Australia's rural men is significantly higher than rural women, urban men or urban women. There are many explanations for this phenomenon including higher levels of social isolation, lower socio-economic circumstances and ready access to firearms. Another factor is the challenge of climate transformation for farmers. In recent times rural areas of Australia have been subject to intense climate change events including a significant drought that has lingered on for over a decade. Climate variability together with lower socio-economic conditions and reduced farm production has combined to produce insidious impacts on the health of rural men. This paper draws on research conducted over several years with rural men working on farms to argue that attention to the health and well-being of rural men requires an understanding not only of these factors but also of the cultural context, inequitable gender relations and a dominant form of masculine hegemony that lauds stoicism in the face of adversity. A failure to address these factors will limit the success of health and welfare programs for rural men. Copyright © 2010 Elsevier Ltd. All rights reserved.

  10. Building a Future without Gender Violence: Rural Teachers and Youth in Rural Kwazulu-Natal, South Africa, Leading Community Dialogue

    Science.gov (United States)

    de Lange, Naydene; Mitchell, Claudia

    2014-01-01

    This article advances the idea that rural youth and teachers are the key in leading community dialogue towards addressing gender-based violence (GBV) in their community through their film making. The youth voices on the realities of GBV in their school and community, in rural KwaZulu-Natal, South Africa, captured through the process of…

  11. Telegerontology as a Novel Approach to Address Health and Safety by Supporting Community-Based Rural Dementia Care Triads: Randomized Controlled Trial Protocol.

    Science.gov (United States)

    Wallack, Elizabeth M; Harris, Chelsea; Ploughman, Michelle; Butler, Roger

    2018-02-22

    Telegerontology is an approach using videoconferencing to connect an interdisciplinary team in a regional specialty center to patients in rural communities, which is becoming increasingly practical for addressing current limitations in rural community-based dementia care. Using the remotely-delivered expertise of the Telegerontology dementia care team, we aim to enhance the caregiver/patient/physician triad and thereby provide the necessary support for the person with dementia to "age in place." This is a cluster randomized feasibility trial with four rural regions in the province of Newfoundland and Labrador, Canada (2 regions randomly assigned to "intervention" and 2 to "control"). The study population includes 22 "dementia triads" that consist of a community-dwelling older Canadian with moderate to late dementia, their family caregivers, and their Primary Care Physician (PCP). Over the 6-month active study period, all participants will be provided an iPad. The intervention is intended as an adjunct to existing PCP care, consisting of weekly Skype-based videoconferencing calls with the Telegerontology physician, and other team members as needed (occupational therapist, physical therapist etc). Control participants receive usual community-based dementia care with their PCP. A baseline (pre-) assessment will be performed during a home visit with the study team. Post intervention, 6- and 12-month follow-up assessments will be collected remotely using specialized dementia monitoring applications and Skype calls. Primary outcomes include admission to long-term care, falls, emergency room visits, hospital stays, and caregiver burden. Results will be available in March of 2018. Results from this study will demonstrate a novel approach to dementia care that has the potential to impact both rural PCPs, family caregivers, and people with dementia, as well as provide evidence for the utility of Telegerontology in models of eHealth-based care. ©Elizabeth M. Wallack, Chelsea

  12. Impulsivity, Mental Disorder, and Suicide in Rural China.

    Science.gov (United States)

    Lin, Lin; Zhang, Jie

    2017-01-02

    The purpose of this study was to investigate the relationship among impulsivity, mental disorder, and suicide with a sample of rural young Chinese. Subjects were 392 consecutively recruited male and female suicides aged 15-34 years and 416 community male and female controls of the same age range sampled in rural China. The case-control data were obtained using psychological autopsy with structured and semi-structured instruments. Dysfunctional impulsivity was a significant risk factor regardless of mental disorder in rural China. Dysfunctional impulsivity is a potential area for further study of suicidal behavior. The suicide prevention efforts in rural China may address impulsivity.

  13. 43 CFR 404.3 - What is the Reclamation Rural Water Supply Program?

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false What is the Reclamation Rural Water Supply... RECLAMATION, DEPARTMENT OF THE INTERIOR RECLAMATION RURAL WATER SUPPLY PROGRAM Overview § 404.3 What is the Reclamation Rural Water Supply Program? This program addresses domestic, municipal, and industrial water...

  14. Problems Facing Rural Schools.

    Science.gov (United States)

    Stewart, C. E.; And Others

    Problems facing rural Scottish schools range from short term consideration of daily operation to long term consideration of organizational alternatives. Addressed specifically, such problems include consideration of: (1) liaison between a secondary school and its feeder primary schools; (2) preservice teacher training for work in small, isolated…

  15. Rural Trends in Diagnosis and Services for Autism Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Ligia Antezana

    2017-04-01

    Full Text Available Rural communities face significant challenges regarding the adequate availability of diagnostic-, treatment-, and support-services for individuals with autism spectrum disorder (ASD. Specifically, a variety of factors, including geographic distance between families and service providers, low reliance on health care professionals, and cultural characteristics, contribute to the diminished availability and utilization of services. Together, these factors lead to risks for delayed ASD screening and diagnosis, yielding lower educational and functional outcomes. The purpose of this review is to outline the specific diagnosis and treatment barriers that affect individuals with ASD and their families in rural settings. Telehealth feasibility and efficacy research is also reviewed, suggesting that telecommunication services may offer an inroad for addressing the specific service barriers faced by rural communities. Together, the current review identifies specific needs for both research and support services that address the specific access barriers characteristic of rural settings.

  16. Collaborative Rural Healthcare Network: A Conceptual Model

    Directory of Open Access Journals (Sweden)

    U. Raja

    2011-07-01

    Full Text Available Healthcare is a critical issue in rural communities throughout the world. Provision of timely and cost effective health care in these communities is a challenge since it is coupled with a lack of adequate infrastructure and manpower support. Twenty percent of the United States of America‘s population resides in rural communities, i.e., 59 million people; however, only nine percent of the nation’s physicians practice in rural communities. Shortage of health care personnel and the lack of equipment and facilities often force rural residents to travel long distances to receive needed medical treatment. Researchers and practitioners are in search of solutions to address these unique challenges. In this research, we present a proposed collaborative model of a health information system for rural communities and the challenges and opportunities of this global issue.

  17. Rural nurse job satisfaction.

    Science.gov (United States)

    Molinari, D L; Monserud, M A

    2008-01-01

    The lack of rural nursing studies makes it impossible to know whether rural and urban nurses perceive personal and organizational factors of job satisfaction similarly. Few reports of rural nurse job satisfaction are available. Since the unprecedented shortage of qualified rural nurses requires a greater understanding of what factors are important to retention, studies are needed. An analysis of the literature indicates job satisfaction is studied as both an independent and dependent variable. In this study, the concept is used to examine the intention to remain employed by measuring individual and organizational characteristics; thus, job satisfaction is used as a dependent variable. One hundred and three rural hospital nurses, from hospitals throughout the Northwest region of the United States were recruited for the study. Only nurses employed for more than one year were accepted. The sample completed surveys online. The McCloskey/Mueller Satisfaction Scale, the Gerber Control Over Practice Scale, and two open-ended job satisfaction questions were completed. The qualitative analysis of the open-ended questions identified themes which were then used to support the quantitative findings. Overall alphas were 0.89 for the McCloskey/Mueller Scale and 0.96 for the Gerber Control Over Practice Scale. Rural nurses indicate a preference for rural lifestyles and the incorporation of rural values in organizational practices. Nurses preferred the generalist role with its job variability, and patient variety. Most participants intended to remain employed. The majority of nurses planning to leave employment were unmarried, without children at home, and stated no preference for a rural lifestyle. The least overall satisfied nurses in the sample were employed from 1 to 3 years. Several new findings inform the literature while others support previous workforce studies. Data suggest some job satisfaction elements can be altered by addressing organizational characteristics and by

  18. Biotelemetry: could technological developments assist healthcare in rural India.

    Science.gov (United States)

    Singh, Kanika

    2005-01-01

    In India 60-70% of the population live in rural villages. The rural population suffers from a burden of disease and disorders due to the non-availability of appropriate healthcare personnel and facilities. Since 1950, the Indian Government has responded with a series of five-year plans but has been unable to address the lack of healthcare professionals prepared to work in isolated and rural areas. The use of biotelemetry is proposed as a solution, its advantages and disadvantages are discussed. The development of biotelemetry in India will improve healthcare for the rural and remote population and ease the effects of the shortage of rural healthcare professionals. However, a number of questions remain and require further consideration.

  19. Rural Roads and Local Market Development in Vietnam

    OpenAIRE

    Mu, Ren; van de Walle, Dominique

    2007-01-01

    The authors assess impacts of rural road rehabilitation on market development at the commune level in rural Vietnam and examine the variance of those impacts and the geographic, community, and household factors that explains it. Double difference and matching methods are used to address sources of selection bias in identifying impacts. The results point to significant average impacts on the ...

  20. Addressing service delivery in rural areas through deployment of information and communication technology platforms

    CSIR Research Space (South Africa)

    Foko, Thato E

    2017-05-01

    Full Text Available deployment of ICT Platforms in the rural areas. The contribution of ICT Platform adds to the important notion of access which enhances service delivery. This is seen through the Technology Acceptance Models used in this paper. The main research methodology...

  1. Access to emergency hospital care provided by the public sector in sub-Saharan Africa in 2015: a geocoded inventory and spatial analysis.

    Science.gov (United States)

    Ouma, Paul O; Maina, Joseph; Thuranira, Pamela N; Macharia, Peter M; Alegana, Victor A; English, Mike; Okiro, Emelda A; Snow, Robert W

    2018-03-01

    Timely access to emergency care can substantially reduce mortality. International benchmarks for access to emergency hospital care have been established to guide ambitions for universal health care by 2030. However, no Pan-African database of where hospitals are located exists; therefore, we aimed to complete a geocoded inventory of hospital services in Africa in relation to how populations might access these services in 2015, with focus on women of child bearing age. We assembled a geocoded inventory of public hospitals across 48 countries and islands of sub-Saharan Africa, including Zanzibar, using data from various sources. We only included public hospitals with emergency services that were managed by governments at national or local levels and faith-based or non-governmental organisations. For hospital listings without geographical coordinates, we geocoded each facility using Microsoft Encarta (version 2009), Google Earth (version 7.3), Geonames, Fallingrain, OpenStreetMap, and other national digital gazetteers. We obtained estimates for total population and women of child bearing age (15-49 years) at a 1 km 2 spatial resolution from the WorldPop database for 2015. Additionally, we assembled road network data from Google Map Maker Project and OpenStreetMap using ArcMap (version 10.5). We then combined the road network and the population locations to form a travel impedance surface. Subsequently, we formulated a cost distance algorithm based on the location of public hospitals and the travel impedance surface in AccessMod (version 5) to compute the proportion of populations living within a combined walking and motorised travel time of 2 h to emergency hospital services. We consulted 100 databases from 48 sub-Saharan countries and islands, including Zanzibar, and identified 4908 public hospitals. 2701 hospitals had either full or partial information about their geographical coordinates. We estimated that 287 282 013 (29·0%) people and 64 495 526 (28·2

  2. Access to emergency hospital care provided by the public sector in sub-Saharan Africa in 2015: a geocoded inventory and spatial analysis

    Directory of Open Access Journals (Sweden)

    Paul O Ouma, MSc

    2018-03-01

    Full Text Available Summary: Background: Timely access to emergency care can substantially reduce mortality. International benchmarks for access to emergency hospital care have been established to guide ambitions for universal health care by 2030. However, no Pan-African database of where hospitals are located exists; therefore, we aimed to complete a geocoded inventory of hospital services in Africa in relation to how populations might access these services in 2015, with focus on women of child bearing age. Methods: We assembled a geocoded inventory of public hospitals across 48 countries and islands of sub-Saharan Africa, including Zanzibar, using data from various sources. We only included public hospitals with emergency services that were managed by governments at national or local levels and faith-based or non-governmental organisations. For hospital listings without geographical coordinates, we geocoded each facility using Microsoft Encarta (version 2009, Google Earth (version 7.3, Geonames, Fallingrain, OpenStreetMap, and other national digital gazetteers. We obtained estimates for total population and women of child bearing age (15–49 years at a 1 km2 spatial resolution from the WorldPop database for 2015. Additionally, we assembled road network data from Google Map Maker Project and OpenStreetMap using ArcMap (version 10.5. We then combined the road network and the population locations to form a travel impedance surface. Subsequently, we formulated a cost distance algorithm based on the location of public hospitals and the travel impedance surface in AccessMod (version 5 to compute the proportion of populations living within a combined walking and motorised travel time of 2 h to emergency hospital services. Findings: We consulted 100 databases from 48 sub-Saharan countries and islands, including Zanzibar, and identified 4908 public hospitals. 2701 hospitals had either full or partial information about their geographical coordinates. We estimated that 287

  3. Libyan intuitive for rural electrification

    International Nuclear Information System (INIS)

    Ibrahim, I. M. Saleh; Kreama, N. M.; Khalat, M. A.

    2006-01-01

    One of the obstacles in rural electrification is choosing the type of the electric source which best fits rural areas technically, socially, and economically. Renewable sources can be used to electrify rural areas. Rural electrification in Libya by photovoltaic systems in a national program which is devoted to electrify isolated villages, as part of this program the installation of 300 systems was started at the beginning of the year 2003 with a total power of 400 K Wp, the sizes of stand alone systems are 1.8 K Wp, 1.2 K Wp, 0.75 K Wp, and 0.15 K Wp, beside a hybrid system of diesel and PV. The systems was designed to supply different family needs a total of 5000 inhabitants will benefit from this project. In this paper we will introduce the rural photovoltaic electrification in Libya program, company the performance of three different PV sizes through the first two years of working. The systems performing well and with performance ratio much more than the deigned, very little power failure was reported, and there are social and technical issues to be addressed before, and after the installation of the PV system.(Author)

  4. Strategies for gender-equitable HIV services in rural India

    Science.gov (United States)

    Sinha, Gita; Peters, David H; Bollinger, Robert C

    2009-01-01

    The emergence of HIV in rural India has the potential to heighten gender inequity in a context where women already suffer significant health disparities. Recent Indian health policies provide new opportunities to identify and implement gender-equitable rural HIV services. In this review, we adapt Mosley and Chen's conceptual framework of health to outline determinants for HIV health services utilization and outcomes. Examining the framework through a gender lens, we conduct a comprehensive literature review for gender-related gaps in HIV clinical services in rural India, focusing on patient access and outcomes, provider practices, and institutional partnerships. Contextualizing findings from rural India in the broader international literature, we describe potential strategies for gender-equitable HIV services in rural India, as responses to the following three questions: (1) What gender-specific patient needs should be addressed for gender-equitable HIV testing and care? (2) What do health care providers need to deliver HIV services with gender equity? (3) How should institutions enforce and sustain gender-equitable HIV services? Data at this early stage indicate substantial gender-related differences in HIV services in rural India, reflecting prevailing gender norms. Strategies including gender-specific HIV testing and care services would directly address current gender-specific patient needs. Rural care providers urgently need training in gender sensitivity and HIV-related communication and clinical skills. To enforce and sustain gender equity, multi-sectoral institutions must establish gender-equitable medical workplaces, interdisciplinary HIV services partnerships, and oversight methods, including analysis of gender-disaggregated data. A gender-equitable approach to rural India's rapidly evolving HIV services programmes could serve as a foundation for gender equity in the overall health care system. PMID:19244284

  5. Emerging potential for radical e-enabled improvements in rural collaboration and accessibility

    CSIR Research Space (South Africa)

    Naude, AH

    2007-05-01

    Full Text Available volumes, as well as problems associated with limited local human capacities and uncoordinated or misdirected rural development planning; and enhanced accessibility - addressing the typical problems of rural isolation such as inadequated or costly digital...

  6. The WAMI Rural Hospital Project. Part 3: Building health care leadership in rural communities.

    Science.gov (United States)

    Elder, W G; Amundson, B A

    1991-01-01

    The WAMI Rural Hospital Project (RHP) intervention combined aspects of community development, strategic planning and organizational development to address the leadership issues in six Northwest rural hospitals. Hospitals and physicians, other community health care providers and local townspeople were involved in this intervention, which was accomplished in three phases. In the first phase, extensive information about organizational effectiveness was collected at each site. Phase two consisted of 30 hours of education for the physician, board, and hospital administrator community representatives covering management, hospital board governance, and scope of service planning. In the third phase, each community worked with a facilitator to complete a strategic plan and to resolve conflicts addressed in the management analyses. The results of the evaluation demonstrated that the greatest change noted among RHP hospitals was improvement in the effectiveness of their governing boards. All boards adopted some or all of the project's model governance plan and had successfully completed considerable portions of their strategic plans by 1989. Teamwork among the management triad (hospital, board, and medical staff) was also substantially improved. Other improvements included the development of marketing plans for the three hospitals that did not initially have them and more effective use of outside consultants. The project had less impact on improving the functioning of the medical chief of staff, although this was not a primary target of the intervention. There was also relatively less community interest in joining regional health care associations. The authors conclude that an intervention program tailored to address specific community needs and clearly identified leadership deficiencies can have a positive effect on rural health care systems.

  7. AN ANALYSIS OF THE ROUMANIAN RURAL TOURISTIC PHENOMENON

    Directory of Open Access Journals (Sweden)

    Marius BOIŢĂ

    2014-04-01

    Full Text Available The paper addresses the main aspects and tendencies of the tourism in the context of sustainable development, of the place and importance of rural tourism, the usefulness of using an index system in touristy and rural tourism activity, of measuring the rural tourism activity on a country level and the need to develop it, considering its possible integration into the European touristic market. Furthermore, a new index system, to be applied in the rural tourism is set up, as well as an original structure concerning data processing and analyzing for the data acquired by sampling. These elements are only useful if applied by I.C.T (Touristy Research Institute, by other government- and non-government institutions, or even by companies interested in developing business in rural tourism, or make research work on certain aspects of the rural tourism activity, on the tourists’ behaviour in the context of this type of tourism.

  8. Rural Revitalization in New Mexico: A Grass Roots Initiative Involving School and Community

    Science.gov (United States)

    Pitzel, Gerald R.; Benavidez, Alicia C.; Bianchi, Barbara C.; Croom, Linda L.; de la Riva, Brandy R.; Grein, Donna L.; Holloway, James E.; Rendon, Andrew T.

    2007-01-01

    The Rural Education Bureau of the New Mexico Public Education Department has established a program to address the special needs of schools and communities in the extensive rural areas of the state. High poverty rates, depopulation and a general lack of viable economic opportunity have marked rural New Mexico for decades. The program underway aims…

  9. Generator Requirements For Rural Electrification From Renewable Energy

    Energy Technology Data Exchange (ETDEWEB)

    Dzune Mipoung, Olivare; Pragasen, Pillay

    2010-09-15

    This paper addresses the issue of rural electrification from renewable energy. A brief introduction on biomass and wind electrical systems is given. The aim of this research is to propose optimal electrification system design for rural areas. This requires suitable generators selection as a starting point. Some generator types for rural electrification systems are introduced, followed by a discussion on the selection criteria. Simulation results of a typical electrification system for remote areas are obtained to support the safety aspect related to the individual generator types, in the event of accidental rotor motion. All simulations are done in Matlab-Simulink.

  10. Is Western Australia's rural surgical workforce going to sustain the future? A quantitative and qualitative analysis.

    Science.gov (United States)

    Shanmugakumar, Sharanyaa; Playford, Denese; Burkitt, Tessa; Tennant, Marc; Bowles, Tom

    2017-03-01

    Objective Despite public interest in the rural workforce, there are few published data on the geographical distribution of Australia's rural surgeons, their practice skill set, career stage or work-life balance (on-call burden). Similarly, there has not been a peer-reviewed skills audit of rural training opportunities for surgical trainees. The present study undertook this baseline assessment for Western Australia (WA), which has some of the most remote practice areas in Australia. Methods Hospital staff from all WA Country Health Service hospitals with surgical service (20 of 89 rural health services) were contacted by telephone. A total of 18 of 20 provided complete data. The study questionnaire explored hospital and practice locations of practicing rural surgeons, on-call rosters, career stage, practice skill set and the availability of surgical training positions. Data were tabulated in excel and geographic information system geocoded. Descriptive statistics were calculated in Excel. Results Of the seven health regions for rural Western Australia, two (28.6%) were served by resident surgeons at a ratio consistent with Royal Australasian College of Surgeons (RACS) guidelines. General surgery was offered in 16 (89%) hospitals. In total, 16 (89%) hospitals were served by fly-in, fly-out (FIFO) surgical services. Two hospitals with resident surgeons did not use FIFO services, but all hospitals without resident surgeons were served by FIFO surgical specialists. The majority of resident surgeons (62.5%) and FIFO surgeons (43.2%) were perceived to be mid-career by hospital staff members. Three hospitals (16.7%) offered all eight of the identified surgical skill sets, but 16 (89%) offered general surgery. Conclusions Relatively few resident rural surgeons are servicing large areas of WA, assisted by the widespread provision of FIFO surgical services. The present audit demonstrates strength in general surgical skills throughout regional WA, and augers well for the

  11. Angolan reality from the social vulnerability: experiences in rural communes de Belas

    Directory of Open Access Journals (Sweden)

    João Francisco-Cardoso

    2016-09-01

    Full Text Available Rural education and vulnerable groups associated with disadvantages which are schools of secondary education in Angolan communities, constitute the main elements addressed in this article within a social context characterized by the government's willingness to mitigate impacts of underdevelopment in rural areas. The Angolan government promotes programs to address the problems of social reintegration and advocates rebuilding the social, economic and administrative fabric, where education emerges as one of its most relevant policies.

  12. The Internet & Regional Australia: How Rural Communities Can Address the Impact of the Internet.

    Science.gov (United States)

    Simpson, Rosie

    In the last decade, a technological revolution has touched all aspects of business and society in Australia, the Western world, and to a lesser extent, the developing world. This revolution has occurred against a backdrop of long-term fundamental changes in rural Australian communities. The decline in traditional agriculture's terms of trade and…

  13. Cognitive components of rural tourism destination images

    DEFF Research Database (Denmark)

    Kokkali, Panagiota; Koutsouris, Alex; Chrysochou, Polymeros

    This paper aims at exploring issues related to rural tourism destination image focusing on TDI cognitive components. By means of empirical research addressing tourists visiting the Lake Plastiras area, Central Greece, the cognitive components of the area's TDI were identified along with their eff......This paper aims at exploring issues related to rural tourism destination image focusing on TDI cognitive components. By means of empirical research addressing tourists visiting the Lake Plastiras area, Central Greece, the cognitive components of the area's TDI were identified along......; (3) visitors can be classified in four clusters according the cognitive factors; (4) tourists' clusters differ in terms of age, education and income as well as number of visits and perception of the area's attractiveness. Such findings point towards the need of both a new strategy for the area...

  14. A rural African American faith community's solutions to depression disparities.

    Science.gov (United States)

    Bryant, Keneshia; Haynes, Tiffany; Kim Yeary, Karen Hye-Cheon; Greer-Williams, Nancy; Hartwig, Mary

    2014-01-01

    The aim of this study was to explore how a rural African American faith community would address depression within their congregations and the community as a whole. A qualitative, interpretive descriptive methodology was used. The sample included 24 participants representing pastors, parishioners interested in health, and African American men who had experienced symptoms of depression in a community in the Arkansas Delta. The primary data sources for this qualitative research study were focus groups. Participants identified three key players in the rural African American faith community who can combat depression: the Church, the Pastor/Clergy, and the Layperson. The roles of each were identified and recommendations for each to address depression disparities in rural African Americans. The recommendations can be used to develop faith-based interventions for depression targeting the African American faith community. © 2013 Wiley Periodicals, Inc.

  15. Getting to know the island: Artistic experiments in rural community development

    OpenAIRE

    Crawshaw, Julie

    2016-01-01

    This paper makes an original contribution to our understandings of the relational role of artistic practice as part of rural community development. Art-led initiatives are now commonplace in rural development strategies. However, the effects of art in rural community, particularly beyond economic development, have received little attention. In this paper we seek to address this omission by exploring artistic ex- periments as part of community development processes. Theoretically, we draw on r...

  16. Research on Rural Ageing: Where Have We Got to and Where Are We Going in Europe?

    Science.gov (United States)

    Burholt, Vanessa; Dobbs, Christine

    2012-01-01

    This paper examines the extent to which rural studies conducted in Europe (compared to other countries in the Global North) have addressed the phenomenon of rural ageing. Through a review of the literature published on rural ageing research in the last decade, it compares the research goals identified by the International Rural Ageing Project…

  17. Rural electrification: utilities' chafe or challenge?

    NARCIS (Netherlands)

    Zomers, A.N.; Zomers, Adriaan N.

    2001-01-01

    The earlier research on electricity supply to rural areas has tended to address the technical and financial performance of both grid connected and decentralised power systems and the socio-economic impact of electrification. However, this study has chosen to examine the impact of the developments

  18. Potential of hybrid PV systems for rural South Africa: addressing income activities and water supply

    CSIR Research Space (South Africa)

    Ortiz, B

    2009-10-01

    Full Text Available " player to develop sustainable solutions and to scale-up hybrid PV systems for supplying energy and water to rural areas and to other African countries. The challenge to scale-up new renewable energy technologies in the next years is that they have...

  19. Science Learning in Rural Australia: Not Necessarily the Poor Cousin

    Science.gov (United States)

    Tytler, Russell; Symington, David

    2015-01-01

    There is considerable evidence suggesting that students in rural schools lag behind their city counterparts in measures of science literacy and attitude to science learning. If we are to address this situation we need to build as full a picture as we can of the key features of what is a complex and varied rural schooling context. In this article…

  20. ICTs for rural development: potential applications and barriers involved

    Directory of Open Access Journals (Sweden)

    Anastasia Stratigea

    2013-03-01

    Full Text Available Rural policy nowadays is at the heart of the policy discussion in many countries all over the world, in the effort to address and effectively support the specific needs and opportunities of rural places and their population in the new era. Along these lines, the focus of the present paper is twofold: on the one hand it attempts to shed light on the role of ICTs and their applications as enabling tools empowering rural development; while on the other hand it explores the barriers appearing towards the adoption and use of ICTs in rural regions. In such a context, it firstly places emphasis on the evolving new rural development paradigm. Then, the range and potential of ICTs applications is explored, that can serve the implementation of the new policy paradigm in rural regions. It follows a discussion on the steps that are needed in order to develop value-added ICTs applications in rural regions and the barriers appearing in the adoption and use of ICTs in these regions. Finally, are presented some issues of policy concern in respect to the adoption and use of ICTs in a rural development perspective.

  1. Developing rural palliative care: validating a conceptual model.

    Science.gov (United States)

    Kelley, Mary Lou; Williams, Allison; DeMiglio, Lily; Mettam, Hilary

    2011-01-01

    The purpose of this research was to validate a conceptual model for developing palliative care in rural communities. This model articulates how local rural healthcare providers develop palliative care services according to four sequential phases. The model has roots in concepts of community capacity development, evolves from collaborative, generalist rural practice, and utilizes existing health services infrastructure. It addresses how rural providers manage challenges, specifically those related to: lack of resources, minimal community understanding of palliative care, health professionals' resistance, the bureaucracy of the health system, and the obstacles of providing services in rural environments. Seven semi-structured focus groups were conducted with interdisciplinary health providers in 7 rural communities in two Canadian provinces. Using a constant comparative analysis approach, focus group data were analyzed by examining participants' statements in relation to the model and comparing emerging themes in the development of rural palliative care to the elements of the model. The data validated the conceptual model as the model was able to theoretically predict and explain the experiences of the 7 rural communities that participated in the study. New emerging themes from the data elaborated existing elements in the model and informed the requirement for minor revisions. The model was validated and slightly revised, as suggested by the data. The model was confirmed as being a useful theoretical tool for conceptualizing the development of rural palliative care that is applicable in diverse rural communities.

  2. Proximity to Pediatric Cardiac Surgical Care among Adolescents with Congenital Heart Defects in 11 New York Counties.

    Science.gov (United States)

    Sommerhalter, Kristin M; Insaf, Tabassum Z; Akkaya-Hocagil, Tugba; McGarry, Claire E; Farr, Sherry L; Downing, Karrie F; Lui, George K; Zaidi, Ali N; Van Zutphen, Alissa R

    2017-11-01

    Many individuals with congenital heart defects (CHDs) discontinue cardiac care in adolescence, putting them at risk of adverse health outcomes. Because geographic barriers may contribute to cessation of care, we sought to characterize geographic access to comprehensive cardiac care among adolescents with CHDs. Using a population-based, 11-county surveillance system of CHDs in New York, we characterized proximity to the nearest pediatric cardiac surgical care center among adolescents aged 11 to 19 years with CHDs. Residential addresses were extracted from surveillance records documenting 2008 to 2010 healthcare encounters. Addresses were geocoded using ArcGIS and the New York State Street and Address Maintenance Program, a statewide address point database. One-way drive and public transit time from residence to nearest center were calculated using R packages gmapsdistance and rgeos with the Google Maps Distance Matrix application programming interface. A marginal model was constructed to identify predictors associated with one-way travel time. We identified 2522 adolescents with 3058 corresponding residential addresses and 12 pediatric cardiac surgical care centers. The median drive time from residence to nearest center was 18.3 min, and drive time was 30 min or less for 2475 (80.9%) addresses. Predicted drive time was longest for rural western addresses in high poverty census tracts (68.7 min). Public transit was available for most residences in urban areas but for few in rural areas. We identified areas with geographic barriers to surgical care. Future research is needed to determine how these barriers influence continuity of care among adolescents with CHDs. Birth Defects Research 109:1494-1503, 2017.© 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  3. Rural model dedicated education unit: partnership between college and hospital.

    Science.gov (United States)

    Harmon, Lisa M

    2013-02-01

    This article describes the pilot project development of a rural model Dedicated Education Unit (DEU) by a rural college nursing program and a rural hospital to increase student nurses' confidence and proficiency and improve recruitment of prepared rural staff nurses. Traditionally, for economies of scale, most student clinical rotations occurred in urban settings with the number of students per clinical instructor allowed by the state board of nursing. College budget constraints negated the placement of fewer than this mandated maximum number of students in a rural hospital with a clinical instructor; moreover, rural hospitals could not accommodate 10 students at one time. Rural nursing students were anxious in the urban settings, and this anxiety precluded learning in many instances. Rural hospitals face higher registered nurse vacancies than urban centers. Of the nurses applying for open positions, many were not prepared for the demands of rural nursing, resulting in increased turnover and high orientation costs. The rural model DEU addressed issues of both the nursing program and the hospital. The design and development of the rural model DEU and the advantages of the partnership for the college nursing program and the hospital are discussed. Initial outcomes and serendipitous findings from the pilot project are also discussed. Copyright 2013, SLACK Incorporated.

  4. Rural areas of Eastern Germany: modern challenges

    Directory of Open Access Journals (Sweden)

    Klüter Helmut

    2012-03-01

    Full Text Available After the German reunification the agricultural development of eastern territories seemed to have picked up its pace. Yet the main problems those territories are facing today hatched already in the mid-1990s. In our study we address the problems and challenges that hinder sustainable development of East German rural areas. We analyse agricultural statistics and describe the structure of agricultural enterprises, land-use, and other critical dimensions of agriculture. We discuss pros and cons of modern rural areas spatial planning policy and take a critical look at the current status of rural areas. We also put forward a number of concrete proposals aimed at the development of the area and counteracting the negative trends it is now experiencing. Even taking into account all ‘positive’ development trends that are postulated to have occurred since the unification, we underline the crucial necessity of diversification of labour forces and of changing the spatial planning policies in the rural areas of East Germany.

  5. Strengthening rural Latinos' civic engagement for health: The Voceros de Salud project.

    Science.gov (United States)

    López-Cevallos, Daniel; Dierwechter, Tatiana; Volkmann, Kelly; Patton-López, Megan

    2013-11-01

    This article describes the Latino Health Ambassadors Network (Voceros de Salud ) project created to support and mobilize Latino community leaders to address health inequalities in a rural Oregon county. Voceros de Salud is discussed as a model that other rural communities may implement towards strengthening Latino civic engagement for health.

  6. Dynamic speed feedback signs for rural traffic calming.

    Science.gov (United States)

    2013-10-01

    Small rural communities often lack the expertise and resources necessary to address speeding and the persistent challenge of slowing high-speed through traffic. The entrances to communities are especially problematic given that drivers must transitio...

  7. Lo spazio rurale come risorsa strategica in Paesaggi coltivati, paesaggio da coltivare di Alessandra Cazzola

    Directory of Open Access Journals (Sweden)

    Elisabetta Maino

    2015-10-01

    Full Text Available A. Cazzola emphasizes on a new culture of open areas, where the rural space is understood as a strategic resources to landscape redevelopment. In the book ‘Paesaggi coltivati, paesaggio da coltivare. Lo spazio agricolo dell’area romana tra campagna, territorio urbanizzato e produzione’ are outlined methodological criteria and address for a lecture and a planning of rural landscape that can offer either sustainable food or non-commercial products, addressed to protection and environmental compensation, to social building, to safeguard of cultural identities and rural landscape revitalization. Everything through actions calibrated on local landscape specificity, either traditional identity signs or new elements, sometimes dissonant and lacerating.

  8. MIVIS image geocoding experience on merging position attitude system data and public domain GPS stream (ASI-GeoDAF

    Directory of Open Access Journals (Sweden)

    S. Pignatti

    2006-06-01

    Full Text Available The use of airborne scanners involves geo-referencing problems, which are difficult because of the need to know the exact platform position and attitude for each scan line. The errors of the onboard navigation system are normally corrected using ground control point on the image. This post-processing correction procedure is too long in case of multiple flight campaigns, and besides it implies the need to have available 1:10000 orthophotoimages or maps in digital format. To optimize the above procedure a new method to correct MIVIS navigational data in the post-processing phase has been implemented. The procedure takes into consideration the GPS stream in Rinex format of common knowledge and findable on the web, acquired at the ground stations of the Geodetic Data Archiving Facilities provided by ASI. The application of this correction entails the assumption that the environmental variables affecting both onboard and geodetic GPS equally affect the position measurements. The airborne data correction was carried out merging the two data sets (onboard and ground station GPS to achieve a more precise aircraft trajectory. The present study compares the geo-coded images obtained by means of the two post-processing methods.

  9. Sanitation challenges of the poor in urban and rural settings: Case studies of Bengaluru City and rural North Karnataka

    NARCIS (Netherlands)

    Seshaiah, Manasi; Nagesh, Latha; Ramesh, Hemalatha

    2017-01-01

    Bengaluru city faces severe challenges in providing sanitation infrastructure for the urban poor. Similarly, we have villages in North Karnataka that encounter problems of toilet access and related challenges. This paper addresses concerns both in city and rural contexts. We surveyed 400 respondents

  10. Rural Women's Perceptions About Cancer Disparities and Contributing Factors: a Call to Communication.

    Science.gov (United States)

    Molina, Yamile; Zimmermann, Kristine; Carnahan, Leslie R; Paulsey, Ellen; Bigman, Cabral A; Khare, Manorama M; Zahnd, Whitney; Jenkins, Wiley D

    2017-02-27

    Rural cancer disparities are increasingly documented in the USA. Research has identified and begun to address rural residents' cancer knowledge and behaviors, especially among women. Little, however, is known about rural female residents' awareness of cancer inequities and perceived contributing factors affecting them and their families. The purpose of this study was to address these gaps in the literature via a secondary analysis of qualitative needs assessment in Illinois' rural southernmost seven counties, a geographic region with relatively high rates of cancer incidence, morbidity, and mortality. A convenience sample of 202 rural adult female residents was recruited and participated in 26 focus groups, with 3-13 women per group. Inductive content analysis, guided by the principle of constant comparison, was used to analyze the qualitative data. Most respondents indicated their awareness of disproportionate cancer burden in their communities. Individual-level behaviors and environmental toxins were identified as contributing factors. Interestingly, however, environmental toxins were more often discussed as factors contributing to geographic differences, whereas individual-level behaviors were noted as important for overall cancer prevention and control. This study provides important insight into female rural residents' perspectives and offers novel venues for educational programs and research in the context of communication to eliminate disparities.

  11. Mobile bone densitometry service in rural South Australia

    International Nuclear Information System (INIS)

    Tucker, K.N.; Schultz, C.G.; Chatterton, B.E.

    1997-01-01

    Full text: Twenty per cent of South Australia's population live rurally, with limited access to modern medical services. The Mobile Bone Densitometry Unit was established to address this problem. The Unit began in 1994 with cooperation from private industry. In fostering the service, many issues were addressed, including choice of appropriate sites; selection of a liaison person at each site; towing of the Unit; transportation and accommodation of staff; education of local health professionals and community members; promotion of the service to the community: and timely reporting of results to referring doctors. The scanner is an Hologic ODR-1000+ densitometer, housed in a 5.9 1.8 metre, 2200 kg caravan. It is necessary to reduce vibration and motion during travel, control the internal environment, and have an electrically clean power supply. Addressing these parameters result in the critical value for quality control being 2500 patients, averaging 13 patients/working day. The mean age of the patients was 64 y (range 30-90 y), with 93 % of patients being >50 y. Results show a normally distributed Z score, suggesting that non-selected 'normal' population is being studied and the Hologic normal range matches that of the South Australian rural community. Local communities have utilised the service to full capacity resulting in future visits being extended. In conclusion, it is possible to provide a high quality, reliable bone densitometry service to rural communities

  12. Developing a research agenda for cardiovascular disease prevention in high-risk rural communities.

    Science.gov (United States)

    Melvin, Cathy L; Corbie-Smith, Giselle; Kumanyika, Shiriki K; Pratt, Charlotte A; Nelson, Cheryl; Walker, Evelyn R; Ammerman, Alice; Ayala, Guadalupe X; Best, Lyle G; Cherrington, Andrea L; Economos, Christina D; Green, Lawrence W; Harman, Jane; Hooker, Steven P; Murray, David M; Perri, Michael G; Ricketts, Thomas C

    2013-06-01

    The National Institutes of Health convened a workshop to engage researchers and practitioners in dialogue on research issues viewed as either unique or of particular relevance to rural areas, key content areas needed to inform policy and practice in rural settings, and ways rural contexts may influence study design, implementation, assessment of outcomes, and dissemination. Our purpose was to develop a research agenda to address the disproportionate burden of cardiovascular disease (CVD) and related risk factors among populations living in rural areas. Complementary presentations used theoretical and methodological principles to describe research and practice examples from rural settings. Participants created a comprehensive CVD research agenda that identified themes and challenges, and provided 21 recommendations to guide research, practice, and programs in rural areas.

  13. Community resiliency as a measure of collective health status: perspectives from rural communities.

    Science.gov (United States)

    Kulig, Judith C; Edge, Dana; Joyce, Brenda

    2008-12-01

    Community resiliency is a theoretical framework useful for describing the process used by communities to address adversity. A mixed-method 2-year case study was conducted to gather information about community resiliency in 2 rural communities. This article focuses on the themes generated from qualitative interviews with 55 members of these communities. The participants viewed community as a place of interdependence and interaction. The majority saw community resiliency as the ability to address challenges. Characteristics included physical and social infrastructure, population characteristics, conceptual characteristics, and problem-solving processes. Barriers included negative individual attitudes and lack of infrastructure in rural communities. Nurses could play a key role in enhancing the resiliency of rural communities by developing and implementing programs based on the Community Resiliency Model, which was supported in this study.

  14. Family Size and Rural Poverty -in the Kwahu South District in Ghana ...

    African Journals Online (AJOL)

    Rural Poverty is one of the greatest social problems confronting the world today. The problem is more pronounced in the developing countries. Ghana is no exception to this global problem of rural poverty. Ghana as a nation has adopted a lot of measures to address poverty. From the early 1980's to 2002, the country has ...

  15. Sustainable development of rural regions; Insights on land use and policy from the Shetlands Islands

    NARCIS (Netherlands)

    Horlings, L.G.; Kanemasu, Y.

    2015-01-01

    To address rural diversity, a place-based approach to sustainable development becomes more relevant. Place-based approaches to development are said to strengthen the resilience of rural areas against global pressures by decreasing state dependencies and increasing the economic competitiveness of

  16. Schools at the Rural-Urban Boundary - Blurring the Divide?

    Science.gov (United States)

    Burdick-Will, Julia; Logan, John R

    2017-07-01

    Schools mirror the communities in which they are located. Research on school inequality across the rural-urban spectrum tends to focus on the contrast between urban, suburban, and rural schools and glosses over the variation within these areas as well as the similarities between them. To address this gap and provide a richer description of the spatial distribution of educational inequality, we examine the school composition, achievement, and resources of all U.S. elementary schools in 2010-2011. We apply standard census definitions of what areas fall within central cities, the remainder of metropolitan regions, and in rural America. We then apply spatially explicit methods to reveal blurred boundaries and gradual gradients rather than sharp breaks at the edges of these zones. The results show high levels of variation within the suburbs and substantial commonality between rural and urban areas.

  17. A Response to the Commentary Entitled: “Addressing the Shortage of Health Professionals in Rural China: Issues and Progress”

    Directory of Open Access Journals (Sweden)

    Qian Yang

    2015-05-01

    Full Text Available The principal problems of healthcare services in China are “difficulty in seeing a doctor”and “high expense of getting medical service” (commonly known in Chinese as “kan bing nan, kan bing gui”. The central Chinese government has already launched the bottom-up cascading medical system and two-way referral system recently in order to solve these problems (1. Only when patients go to medical institutions in an orderly fashion, can we see the hope of breaking the kan bing nan, kan bing gui (2. However, we face a number of obstacles when implementing the referral policies. The biggest obstacle is the lack of Human Resource (HR for primary care both in capacity and volume (3. The central Chinese government has launched a series of policies to deal with the shortage of HRs in rural areas. Profound measurements involve postgraduate training for General Practitioner (GP (a three-year plan beginning in 2010 for producing health professionals for rural areas and improving rural retention, “3+2” medical education model (3-year diploma education and 2-year postgraduate GP training, and in-service training for physicians in rural areas (4. It is not the time to assess their effectiveness, however, these measurements are certain to improve the capacity of Community Health Service (CHS institutions.

  18. Low-level arsenic in drinking water and risk of incident myocardial infarction

    DEFF Research Database (Denmark)

    Monrad, Maria; Ersbøll, Annette Kjær; Sørensen, Mette

    2017-01-01

    to end of follow-up in February 2012. Cohort participants were enrolled in the Copenhagen and Aarhus areas. We geocoded residential addresses of the cohort members and used a geographic information system to link addresses with water supply areas. Arsenic in tap water at each cohort members address from...

  19. Determinants of Prelacteal Feeding in Rural Northern India

    Directory of Open Access Journals (Sweden)

    Manas Pratim Roy

    2014-01-01

    Conclusions: The problem of prelacteal feeding is still prevalent in rural India. Age, caste, and place of delivery were associated with the problem. For ensuring neonatal health, the problem should be addressed with due gravity, with emphasis on exclusive breast feeding.

  20. The hub-and-spoke organization design revisited: a lifeline for rural hospitals.

    Science.gov (United States)

    Elrod, James K; Fortenberry, John L

    2017-12-13

    Characterized by declining populations, high poverty, reduced employment opportunities, and high numbers of uninsured residents, rural communities pose significant challenges for healthcare providers desirous of addressing these medically underserved areas. Such difficult environments, in fact, have forced the closure of many rural hospitals across America, with scores facing the same threat, compelling intensive efforts to identify pathways which will yield an improved future. Collaborations with stronger urban or suburban healthcare institutions offer a prudent avenue for rural hospitals to continue serving their patients. Such relationships can be structured in many different ways, but Willis-Knighton Health System found that its use of the hub-and-spoke organization design set the stage for the institution to cast a vital lifeline to neighboring rural hospitals, affording the relatively seamless integration and assimilation of partner facilities into its network, ensuring continuity of services in remote regions. This article supplies an overview of the hub-and-spoke network and discusses Willis-Knighton Health System's use of it to facilitate the establishment of productive partnerships with rural hospitals. The delivery of healthcare services in rural environments is essential, but with small community hospitals increasingly being under threat, the outlook is not particularly attractive. Partnerships with better positioned healthcare entities offer significant hope, but care must be taken to structure these arrangements optimally. Willis-Knighton Health System found utility and value in its hub-and-spoke organization design, with the insights presented in this account potentially offering a pathway for others to follow as they go about addressing the healthcare needs of rural populations.

  1. Factors Affecting Development of Rural Areas in the Czech Republic: a Literature Review

    Directory of Open Access Journals (Sweden)

    Jakub Straka

    2016-01-01

    Full Text Available Rural development is a topic that is frequently discussed, but there is no consensus on how to measure it. Various criteria exist such as economic, social, cultural or environmental, which can be used to assess rural development. Therefore the main question addressed in this paper is to identify what factors and indicators are suitable for scrutinizing development of rural areas under the conditions of the Czech Republic. For this purpose, articles focused on Czech rural regions were analysed. Fourteen most frequently used indicators were identified based on the comprehensive analysis of the selected Czech studies.

  2. Homicide in post-Soviet Belarus: urban-rural trends.

    Science.gov (United States)

    Stickley, Andrew; Leinsalu, Mall; Razvodovsky, Yury E

    2009-01-01

    To investigate the occurrence of homicide in urban and rural regions of Belarus in the post-Soviet period. All-age male and female homicide mortality and population data were obtained for the years 1990, 1995, 2000 and 2005 for urban and rural regions of Belarus. These data were recalculated into three age categories and directly standardised. To assess relative changes in rural-urban homicide rates across time Poisson regression models were used to calculate rate ratios. Between 1990 and 1995 homicide rates rose sharply in urban and rural regions although the rise was greater in the former. Although there was little change in homicide rates in 2000, a notable divergence had occurred by 2005. While homicide rates rose slightly in rural areas, a large fall occurred in the rates of both men and women in urban areas. This resulted in significantly higher rural homicide rate ratios at the end of the study period. With some variations age-specific homicide rates followed this overall general pattern resulting in significantly higher homicide rate ratios in all rural groups aged 15 and above in 2005. It is probable that a combination of factors such as high levels of poverty, the effects of alcohol consumption, as well as the poor provision of emergency medical services underlie both the high levels of lethal violence and the growing rural-urban divergence in homicide rates in contemporary Belarus. Urgent action is now needed to address the deteriorating social and economic conditions underpinning violence, especially in rural regions.

  3. Determinants of under-five mortality in rural and urban Kenya.

    Science.gov (United States)

    Ettarh, R R; Kimani, J

    2012-01-01

    The disparity in under-five year-old mortality rates between rural and urban areas in Kenya (also reported in other in sub-Saharan African countries), is a critical national concern. The objective of this study was to investigate the influence of geographical location and maternal factors on the likelihood of mortality among under-five children in rural and urban areas in Kenya. Data from the 2008-2009 Kenya Demographic and Health Survey were used to determine mortality among under-five children (n=16,162) in rural and urban areas in the 5 years preceding the survey. Multivariate analysis was used to compare the influence of key risk factors in rural and urban areas. Overall, the likelihood of death among under-five children in the rural areas was significantly higher than that in the urban areas (ppoverty was a key predictor for mortality in the rural areas, but the influence of breastfeeding was similar in the two areas. The likelihood of under-five mortality was significantly higher in the rural areas of Coast, Nyanza and Western Provinces than in Central Province. The study shows that the determinants of under-five mortality differ in rural and urban areas in Kenya. Innovative and targeted strategies are required to address rural poverty and province-specific sociocultural factors in order to improve child survival in rural Kenya.

  4. An approach to rural distribution network design for sub-Saharan Africa

    International Nuclear Information System (INIS)

    Sebitosi, A.B.; Pillay, P.; Khan, M.A.

    2006-01-01

    The bulk of rural populations in sub-Saharan Africa have no access to electricity and are under-served by any other form of modern infrastructure. The cost of infrastructure to mainly scattered communities has been perennially cited as largely to blame. Quite often rural networks are overdesigned, resulting in under utilization and, therefore, costly overheads. One reason often cited for the overspecification is anticipation of load growth. In most sub-Sahara African rural areas, however, economic growth rates are low, and a designer has no justification in specifying an infrastructure capacity exceeding more than a few percent of existing consumer requirements. This paper proposes methods that critically look at the geometry of small grid network designs to address the construction challenges in rural sub-Saharan Africa

  5. Infection prevention needs assessment in Colorado hospitals: rural and urban settings.

    Science.gov (United States)

    Reese, Sara M; Gilmartin, Heather; Rich, Karen L; Price, Connie S

    2014-06-01

    The purpose of our study was to conduct a needs assessment for infection prevention programs in both rural and urban hospitals in Colorado. Infection control professionals (ICPs) from Colorado hospitals participated in an online survey on training, personnel, and experience; ICP time allocation; and types of surveillance. Responses were evaluated and compared based on hospital status (rural or urban). Additionally, rural ICPs participated in an interview about resources and training. Surveys were received from 62 hospitals (77.5% response); 33 rural (75.0% response) and 29 urban (80.6% response). Fifty-two percent of rural ICPs reported multiple job responsibilities compared with 17.2% of urban ICPs. Median length of experience for rural ICPs was 4.0 years compared with 11.5 years for urban ICPs (P = .008). Fifty-one percent of rural ICPs reported no access to infectious disease physicians (0.0% urban) and 81.8% of rural hospitals reported no antimicrobial stewardship programs (31.0% urban). Through the interviews it was revealed that priorities for rural ICPs were training and communication. Our study revealed numerous differences between infection prevention programs in rural versus urban hospitals. An infection prevention outreach program established in Colorado could potentially address the challenges faced by rural hospital infection prevention departments. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  6. Current State of Child Health in Rural America: How Context Shapes Children's Health.

    Science.gov (United States)

    Probst, Janice C; Barker, Judith C; Enders, Alexandra; Gardiner, Paula

    2018-02-01

    Children's health is influenced by the context in which they live. We provide a descriptive essay on the status of children in rural America to highlight features of the rural environment that may affect health. We compiled information concerning components of the rural environment that may contribute to health outcomes. Areas addressed include the economic characteristics, provider availability, uniquely rural health risks, health services use, and health outcomes among rural children. Nearly 12 million children live in the rural United States. Rural counties are economically disadvantaged, leading to higher rates of poverty among rural versus urban children. Rural and urban children are approximately equally likely to be insured, but Medicaid insures a higher proportion of children in rural areas. While generally similar in health, rural children are more likely to be overweight or obese than urban children. Rural parents are less likely to report that their children received preventive medical or oral health visits than urban parents. Rural children are more likely to die than their urban peers, largely due to unintentional injury. Improving rural children's health will require both increased public health surveillance and research that creates solutions appropriate for rural environments, where health care professionals may be in short supply. Most importantly, solutions must be multisectoral, engaging education, economic development, and other community perspectives as well as health care. © 2016 National Rural Health Association.

  7. Responding to rural health disparities in the United States

    Directory of Open Access Journals (Sweden)

    Ian Jones

    2013-04-01

    Full Text Available The paper focuses on the need to address territorial inequalities in American healthcare services. It shows how much the situation has become critical in the United States. It discusses to what extent telemedicine is a sustainable option to reduce the negative consequences of the economic, professional and physical barriers to care in rural areas. As far as healthcare is concerned, rural and urban environments in the United States do not have to face the same barriers and challenges. The article first details what specific health issues have to be dealt with in rural areas. The case of emergency care in Vermont is then developed to illustrate what could be the benefits of using ICTs to improve access to care.

  8. Health-Related Quality of Life of Rural Clients Seeking Telepsychology Services

    Directory of Open Access Journals (Sweden)

    Kevin R. Tarlow

    2014-01-01

    Full Text Available Sixty million US residents live in rural areas, but health policies and interventions developed from an urban mindset often fail to address the significant barriers to health experienced by these local communities. Telepsychology, or psychological services delivered by distance via technology, is an emerging treatment modality with special implications for underserved rural areas. This study found that a sample of rural residents seeking telepsychology services (n=94 had low health-related quality of life (HRQOL, often due to cooccurring physical and mental health diagnoses including high rates of depression. However, a brief telepsychology treatment delivered to rural clients (n=40 was associated with an improvement in mental health-related quality of life (d = 0.70,  P<.001. These results indicate that despite the complex health needs of these underserved communities, telepsychology interventions may help offset the disparities in health service access in rural areas.

  9. Supporting nurses' transition to rural healthcare environments through mentorship.

    Science.gov (United States)

    Rohatinsky, Noelle K; Jahner, Sharleen

    2016-01-01

    education. The rural community context clearly presents challenges for the transition of nurses. Participants described mentorship as a vital component to personal and professional success of new employees in rural areas. The findings of this qualitative exploratory study inform the development of creative and supportive ways to establish mentorships to address the challenges specifically associated with integration of nurses into rural practice.

  10. Schools at the Rural-Urban Boundary – Blurring the Divide?

    Science.gov (United States)

    Burdick-Will, Julia; Logan, John R.

    2018-01-01

    Schools mirror the communities in which they are located. Research on school inequality across the rural-urban spectrum tends to focus on the contrast between urban, suburban, and rural schools and glosses over the variation within these areas as well as the similarities between them. To address this gap and provide a richer description of the spatial distribution of educational inequality, we examine the school composition, achievement, and resources of all U.S. elementary schools in 2010–2011. We apply standard census definitions of what areas fall within central cities, the remainder of metropolitan regions, and in rural America. We then apply spatially explicit methods to reveal blurred boundaries and gradual gradients rather than sharp breaks at the edges of these zones. The results show high levels of variation within the suburbs and substantial commonality between rural and urban areas. PMID:29430017

  11. Nutritional Status of Adolescent Girls from Rural Communities of ...

    African Journals Online (AJOL)

    Background: Addressing the nutritional needs of adolescents could be an important step towards breaking the vicious cycle of intergenerational malnutrition. Objective: Assess nutritional status of rural adolescent girls. Design: Cross-sectional. Methods: Anthropometric and socio-demographic information from 211 ...

  12. Working in rural areas – the experiences of Umthombo Youth Development Foundation graduates

    Directory of Open Access Journals (Sweden)

    Andrew J. Ross

    2014-12-01

    Full Text Available Background: Recruiting and retaining healthcare professionals (HCPs for rural areas is challenging throughout the world. Although rural origin HCPs have been identified as being the most likely to work in rural areas, only a small number of rural-origin South African scholars are trained as HCPs each year and many do not return to work in rural areas. Aim: The aim of this article was to present the experiences of rural-origin HCPs who returned to work in a rural area after graduation. Setting: Umthombo Youth Development Foundation has been running an innovating rurally-based scholarship scheme since 1999. By December 2013, 184 students supported by the scheme had graduated and all had returned to work in a rural area for a period of time. Methods: This was a qualitative study using a life history methodology to explore the educational experience of six rural-origin HCPs working in rural areas. Results: The four themes that emerged from the data were: (1 contribution to service delivery; (2 professional development (3 the challenges and frustrations of working in rural hospitals; and (4 the impact of working as an HCP. Conclusion: Rural-origin HCPs are willing to return and work in rural areas. However, context and content factors need to be addressed if a work-back scholarship scheme is to be along-term strategy for the recruitment and retention of HCPs.

  13. Impact of a Rural Domestic Violence Prevention Campaign.

    Science.gov (United States)

    Gadomski, Anne M.; Tripp, Maria; Wolff, Debra A.; Lewis, Carol; Jenkins, Paul

    2001-01-01

    A 7-month public health information campaign used radio advertising, mass media articles, mailings, and posters to address attitudes and behavioral intentions toward domestic violence in a rural county. The campaign raised public awareness, particularly among men; increased stated intentions to intervene in a neighbor's domestic violence; and…

  14. Fertility and Life Satisfaction in Rural Ethiopia.

    Science.gov (United States)

    Conzo, Pierluigi; Fuochi, Giulia; Mencarini, Letizia

    2017-08-01

    Despite recent strong interest in the link between fertility and subjective well-being, the focus has centered on developed countries. For poorer countries, in contrast, the relationship remains rather elusive. Using a well-established panel survey-the Ethiopian Rural Household Survey (ERHS)-we investigate the empirical relationship between fertility and life satisfaction in rural Ethiopia, the largest landlocked country in Africa. Consistent with the fertility theories for developing countries and with the sociodemographic characteristics of rural Ethiopia, we hypothesize that this relationship varies by gender and across life stages, being more positive for men and for parents in old age. Indeed, our results suggest that older men benefit the most in terms of life satisfaction from having a large number of children, while the recent birth of a child is detrimental for the subjective well-being of women at reproductive ages. We address endogeneity issues by using lagged life satisfaction in ordinary least squares regressions, through fixed-effects estimation and the use of instrumental variables.

  15. Exploring the Attractiveness of a Norwegian Rural Higher Education Institution Using Importance-Performance Analysis

    Science.gov (United States)

    Hanssen, Thor-Erik Sandberg; Mathisen, Terje Andreas

    2018-01-01

    High school graduates in rural counties often move to urban areas to study at higher education institutions (HEIs). Because graduates from HEIs often settle in regions in which they graduate, the result is a permanent out-migration of young talent from rural areas. This study adds to the body of literature on student choice by addressing measures…

  16. Rural Medicine Realities: The Impact of Immersion on Urban-Based Medical Students.

    Science.gov (United States)

    Crump, Allison M; Jeter, Karie; Mullins, Samantha; Shadoan, Amber; Ziegler, Craig; Crump, William J

    2017-05-02

    The purpose of our study was to determine what effect a rural-based 8-week surgical clerkship during the third year of medical school in a rural setting has on students' opinions about rural living and practice. Thirty-three third-year medical students completed a rural health opinion survey at the beginning and end of their 8-week rural rotation and a survey measuring their interest in rural practice after the rotation. The setting was a rural hospital with an average acute care census of 100 that is a regional referral center for 5 rural counties. Urban campus-based students had a statistically significant positive change in opinions about rural comfortable living, availability of quality services, community support, and medical resources. The urban campus-based students also showed a significantly increased interest in small town practice after the rotation. Our hypothesis that urban-based students would report an increased level of rural community support at the end of the rotation was confirmed. These urban-based students also reported positive opinions about rural living and practice. The students primarily based at the urban campus also showed a statistically significant more positive attitude toward pursuing a career in a small town after the 8-week experience. This suggests that brief rural immersion experiences may make the larger student pool at an urban campus available to address rural workforce challenges. Future studies at multiple rural sites with a larger sample size are needed to confirm this possibility. © 2017 National Rural Health Association.

  17. Factors affecting rural volunteering in palliative care - an integrated review.

    Science.gov (United States)

    Whittall, Dawn; Lee, Susan; O'Connor, Margaret

    2016-12-01

    To review factors shaping volunteering in palliative care in Australian rural communities using Australian and International literature. Identify gaps in the palliative care literature and make recommendations for future research. A comprehensive literature search was conducted using Proquest, Scopus, Sage Premier, Wiley online, Ovid, Cochran, Google Scholar, CINAHL and Informit Health Collection. The literature was synthesised and presented in an integrated thematic narrative. Australian Rural communities. While Australia, Canada, the United States (US) and the United Kingdom (UK) are leaders in palliative care volunteer research, limited research specifically focuses on volunteers in rural communities with the least occurring in Australia. Several interrelated factors influence rural palliative care provision, in particular an increasingly ageing population which includes an ageing volunteer and health professional workforce. Also current and models of palliative care practice fail to recognise the innumerable variables between and within rural communities such as distance, isolation, lack of privacy, limited health care services and infrastructure, and workforce shortages. These issues impact palliative care provision and are significant for health professionals, volunteers, patients and caregivers. The three key themes of this integrated review include: (i) Geography, ageing rural populations in palliative care practice, (ii) Psychosocial impact of end-end-of life care in rural communities and (iii) Palliative care models of practice and volunteering in rural communities. The invisibility of volunteers in rural palliative care research is a concern in understanding the issues affecting the sustainability of quality palliative care provision in rural communities. Recommendations for future Australian research includes examination of the suitability of current models of palliative care practice in addressing the needs of rural communities; the recruitment

  18. Examining Rural-Urban Obesity Trends among Youth in the U.S.: Testing the Socioeconomic Gradient Hypothesis

    Directory of Open Access Journals (Sweden)

    Jeremy Reed Porter

    2014-12-01

    Full Text Available Adolescent obesity has increased three-fold in the U.S. during the last three decades. While this trend is well-known, relatively little is known about differences in obesity across the rural-urban continuum. This research addresses that gap by testing for such a relationship across time while accounting for variations in familial socioeconomic status.  Using 1986-2004 Monitoring the Future (MTF survey data, we estimate recent trends in rural-urban body weight, also testing for potential differences among the rural, small town, and urban high school seniors along socioeconomic gradients. Statistically significant differences disfavoring rural high school seniors in their BMI, their risk for the onset of obesity, and obesity itself over the past decade are identified, with significant interactions between demographics and parental education levels driving the largest disparities. These findings are rich and speak directly to the allocation of public health resources aimed at addressing issues associated with the adolescent obesity epidemic.

  19. Identifying Factors for Worker Motivation in Zambia's Rural Health Facilities.

    Science.gov (United States)

    Cross, Samuel S; Baernholdt, Dr Marianne

    2017-01-01

    Within Zambia there is a shortage of health workers in rural areas. This study aims to identify motivating factors for retaining rural health workers. Sixty rural health workers completed surveys and 46 were interviewed. They rated the importance of six motivating factors and discussed these and other factors in interviews. An interview was conducted with a Government Human Resources Manager (HR Manager) to elicit contextual information. All six factors were identified as being very important motivators, as were two additional factors. Additional career training was identified by many as the most important factor. Comparison of results and the HR Manager interview revealed that workers lacked knowledge about opportunities and that the HR manager was aware of barriers to career development. The Zambian government might better motivate and retain rural health workers by offering them any combination of identified factors, and by addressing the barriers to career development.

  20. Rural school in the Tenza Valley, rural education and agroecology reflections on rural “development”

    Directory of Open Access Journals (Sweden)

    Mejia Alfonso Miguel Fernando

    2011-08-01

    Full Text Available

    The municipality of Sutatenza (Boyaca, constitutes an important reference for rural education in Colombia due to “Radio Sutatenza” (Educational Radio and the People’s Cultural Action in the mid-twentieth century. Currently, in the same town, a process called the Campesina Community School del Valle de Tenza has been brewing, under an agroecological approach, guided in its work to the cultural and productive Andean farmers, their families and their young people to cultivate in them a return the field. This article addresses this educational experience for contrasting approaches of “development” with the perceptions and visions that emerge from the rural world, without being radically different, it raises important questions for the call for and controversy of development, from the local.

  1. Child Marriage, Agency, and Schooling in Rural Honduras

    Science.gov (United States)

    Murphy-Graham, Erin; Leal, Graciela

    2015-01-01

    This article examines the relationships between child marriage, agency, and schooling in rural Honduras. Through an in-depth qualitative case study, we address the following questions: (1) In what ways, if any, do girls exercise agency in their decision to marry? (2) How might education enhance girls' agency, expanding their choice sets and…

  2. Built environment interventions aimed at improving physical activity levels in rural Ontario health units: a descriptive qualitative study.

    Science.gov (United States)

    Coghill, Cara-Lee; Valaitis, Ruta K; Eyles, John D

    2015-05-03

    Few studies to date have explored the relationship between the built environment and physical activity specifically in rural settings. The Ontario Public Health Standards policies mandate that health units in Ontario address the built environment; however, it is unclear how public health practitioners are integrating the built environment into public health interventions aimed at improving physical activity in chronic disease prevention programs. This descriptive qualitative study explored interventions that have or are being implemented which address the built environment specifically related to physical activity in rural Ontario health units, and the impact of these interventions. Data were collected through twelve in-depth semi-structured interviews with rural public health practitioners and managers representing 12 of 13 health units serving rural communities. Key themes were identified using qualitative content analysis. Themes that emerged regarding the types of interventions that health units are employing included: Engagement with policy work at a municipal level; building and working with community partners, committees and coalitions; gathering and providing evidence; developing and implementing programs; and social marketing and awareness raising. Evaluation of interventions to date has been limited. Public health interventions, and their evaluations, are complex. Health units who serve large rural populations in Ontario are engaging in numerous activities to address physical activity levels. There is a need to further evaluate the impact of these interventions on population health.

  3. Users' perspectives on decentralized rural water services in Tanzania

    NARCIS (Netherlands)

    Masanyiwa, Z.S.; Niehof, A.; Termeer, C.J.A.M.

    2015-01-01

    This article examines the impact of decentralization reforms on improving access to domestic water supply in the rural districts of Kondoa and Kongwa, Tanzania, using a users' and a gender perspective. The article addresses the question whether and to what extent the delivery of gender-sensitive

  4. Making basic health care accessible to rural communities: a case study of Kiang West district in rural Gambia.

    Science.gov (United States)

    Sanneh, Edward Saja; Hu, Allen H; Njai, Modou; Ceesay, Omar Malleh; Manjang, Buba

    2014-01-01

    This study focuses on lack of access to basic health care, which is one of the hindrances to the development of the poor, and subjects them to the poverty penalty. It also focuses on contributing to the Bottom of the Pyramid in a general sense, in addition to meeting the health needs of communities where people live on less than $1 a day. Strengthened multistakeholder responses and better-targeted, low-cost prevention, and care strategies within health systems are suggested to address the health burdens of poverty-stricken communities. In this study, a multistakeholder model which includes the government, World Health Organization, United Nations Children Emergency Fund, and the Medical Research Council was created to highlight the collaborative approach in rural Gambia. The result shows infant immunization and antenatal care coverage were greatly improved which contributes to the reduction in mortality. This case study also finds that strategies addressing health problems in rural communities are required to achieve 'Millennium Development Goals'. In particular, actual community visits to satellite villages within a district (area of study) are extremely vital to making health care accessible. © 2013 Wiley Periodicals, Inc.

  5. Georreferenciamento e cartogrametria dos mapas da Capitania de Minas Gerais elaborados por José Joaquim da Rocha em 1778 e 1793 / Geocoding and cartometric maps in the province of Minas Gerais, drawn by José Joaquim da Rocha in 1778 and 1793

    Directory of Open Access Journals (Sweden)

    José Flávio Morais Castro

    2013-12-01

    Full Text Available The accuracy of historical maps is being evaluated in research Historical Cartography through the use of geospatial technologies. This research aims to apply general techniques geocoding and cartometric maps in the province of Minas Gerais, drawn by José Joaquim da Rocha in 1778 and 1793, especially the overlay layer, the displacement vector and distortions of the grid over the map current.

  6. Rural Veterans' dental utilization, Behavioral Risk Factor Surveillance Survey, 2014.

    Science.gov (United States)

    Wiener, R Constance; Shen, Chan; Sambamoorthi, Usha; Findley, Patricia A

    2017-09-01

    Rural residents are overrepresented in the military; however, access to Veteran services is limited in rural areas. There is a need to identify rural Veteran healthcare utilization. This study addresses that need and has two purposes: a) to determine if there is an association between rural dwelling and Veteran utilization of dental services; and b) to determine if there is an association between rural dwelling and the oral health outcome of missing teeth. Data from the 2014 Behavioral Risk Factor Surveillance Survey were used in this study. Chi square and logistic regression analyses were conducted. Rural Veterans were less likely to have a dental visit during the previous year as compared with metropolitan Veterans in unadjusted analysis (Odds ratio = 0.71, 95% Confidence Interval, 0.64, 0.77) and in adjusted analysis [0.87 (95% Confidence Interval, 0.78, 0.96)]. In cases in which all teeth were missing, rural Veterans had an unadjusted odds ratio of 1.79 [95% Confidence Interval, 1.55, 2.08] and an adjusted odds ratio of 1.37 [95% Confidence Interval, 1.17, 1.62] as compared with metropolitan Veterans. The Veterans Health Administration develops policies for establishing centers for care for Veterans. The policy development should take into consideration that rural Veterans have not been as likely as urban Veterans to utilize dental services and have poorer oral health outcomes. © 2017 American Association of Public Health Dentistry.

  7. Proposal for the creation of an autonomous recurrent fund for the development of decentralized rural electrification

    International Nuclear Information System (INIS)

    Masse, R.

    1998-01-01

    The socio-economic implications regarding the establishment of a recurrent fund for the rural electrification of developing countries are discussed in conjunction with an evaluation of the current status of rural electrification. The technological developments in off-grid power production has made rural electrification feasible but several important issues need to be addressed. This paper emphasizes the need for consideration of the scale of the problem. Results of the assessment show that the involvement of the private sector in rural electrification is still minimal. Moreover, in many countries off-grid power production is either impossible or illegal

  8. Task-Sharing Approaches to Improve Mental Health Care in Rural and Other Low-Resource Settings: A Systematic Review.

    Science.gov (United States)

    Hoeft, Theresa J; Fortney, John C; Patel, Vikram; Unützer, Jürgen

    2018-12-01

    Rural areas persistently face a shortage of mental health specialists. Task shifting, or task sharing, is an approach in global mental health that may help address unmet mental health needs in rural and other low-resource areas. This review focuses on task-shifting approaches and highlights future directions for research in this area. Systematic review on task sharing of mental health care in rural areas of high-income countries included: (1) PubMed, (2) gray literature for innovations not yet published in peer-reviewed journals, and (3) outreach to experts for additional articles. We included English language articles published before August 31, 2013, on interventions sharing mental health care tasks across a team in rural settings. We excluded literature: (1) from low- and middle-income countries, (2) involving direct transfer of care to another provider, and (3) describing clinical guidelines and shared decision-making tools. The review identified approaches to task sharing focused mainly on community health workers and primary care providers. Technology was identified as a way to leverage mental health specialists to support care across settings both within primary care and out in the community. The review also highlighted how provider education, supervision, and partnerships with local communities can support task sharing. Challenges, such as confidentiality, are often not addressed in the literature. Approaches to task sharing may improve reach and effectiveness of mental health care in rural and other low-resource settings, though important questions remain. We recommend promising research directions to address these questions. © 2017 National Rural Health Association.

  9. Livelihood strategies and dynamics in rural Cambodia

    DEFF Research Database (Denmark)

    Jiao, Xi; Pouliot, Mariéve; Walelign, Solomon Zena

    2017-01-01

    This paper addresses one of the major challenges in rural livelihood analysis to quantitatively examine the dynamics of household livelihood strategies. It investigates the interactions between livelihood assets, activities, and outcomes, and captures the dynamics of long-term changes......, for latent class cluster analysis and regression estimation. In this paper, livelihood strategies are quantified based on allocation of available resources, which overcomes the limitations of income-based analysis. Our study identifies five household livelihood strategies pursued in the study areas...... and their underlying factors. The study aims to identify the classification of rural livelihood strategies, their transitions and factors influencing these processes and changes. We employ the dynamic livelihood strategy framework, and use panel data for 2008 and 2012 covering 464 households in 15 villages in Cambodia...

  10. Farm Studies and Post-Medieval Rural Archaeology in Denmark: Comments on the Past, the Present and the Future

    DEFF Research Database (Denmark)

    Kristiansen, Mette Svart

    2012-01-01

    legislation and administrative practice, has left the post-medieval cultural heritage in a rather peculiar and to some extent neglected position. This paper will address research on post-medieval rural buildings and farms in particular and discuss the current challenges within post-medieval rural archaeology...

  11. Addressing Obstetrical Challenges at 12 Rural Ugandan Health Facilities: Findings from an International Ultrasound and Skills Development Training for Midwives in Uganda.

    Science.gov (United States)

    Kinnevey, Christina; Kawooya, Michael; Tumwesigye, Tonny; Douglas, David; Sams, Sarah

    2016-01-01

    Like much of Sub-Saharan Africa, Uganda is facing significant maternal and fetal health challenges. Despite the fact that the majority of the Uganda population is rural and the major obstetrical care provider is the midwife, there is a lack of data in the literature regarding rural health facilities' and midwives' knowledge of ultrasound technology and perspectives on important maternal health issues such as deficiencies in prenatal services. A survey of the current antenatal diagnostic and management capabilities of midwives at 12 rural Ugandan health facilities was performed as part of an international program initiated to provide ultrasound machines and formal training in their use to midwives at antenatal care clinics. The survey revealed that the majority of pregnant women attend less than the recommended minimum of four antenatal care visits. There were significant knowledge deficits in many prenatal conditions that require ultrasound for early diagnosis, such as placenta previa and macrosomia. The cost of providing ultrasound machines and formal training to 12 midwives was $6,888 per powered rural health facility and $8,288 for non-powered rural health facilities in which solar power was required to maintain ultrasound. In order to more successfully meet Millennium Development Goal 4 (reduce child mortality), 5 (improve maternal health) and 6 (combat HIV) through decreasing maternal to child transmission of HIV, the primary healthcare provider, which is the midwife in Uganda, must be competent at the diagnosis and management of a wide spectrum of obstetrical challenges. A trained ultrasound-based approach to obstetrical care is a cost effective method to take on these goals.

  12. Exploring example models of cross-sector, sessional employment of pharmacists to improve medication management and pharmacy support in rural hospitals.

    Science.gov (United States)

    Tan, Amy Cw; Emmerton, Lynne M; Hattingh, Laetitia; La Caze, Adam

    2015-01-01

    Many rural hospitals in Australia are not large enough to sustain employment of a full-time pharmacist, or are unable to recruit or retain a full-time pharmacist. The absence of a pharmacist may result in hospital nurses undertaking medication-related roles outside their scope of practice. A potential solution to address rural hospitals' medication management needs is contracted part-time ('sessional') employment of a local pharmacist external to the hospital ('cross-sector'). The aim of this study was to explore the roles and experiences of pharmacists in their provision of sessional services to rural hospitals with no on-site pharmacist and explore how these roles could potentially address shortfalls in medication management in rural hospitals. A qualitative study was conducted to explore models with pharmacists who had provided sessional services to a rural hospital. A semi-structured interview guide was informed by a literature review, preliminary research and stakeholder consultation. Participants were recruited via advertisement and personal contacts. Consenting pharmacists were interviewed between August 2012 and January 2013 via telephone or Skype for 40-55 minutes. Thirteen pharmacists with previous or ongoing hospital sessional contracts in rural communities across Australia and New Zealand participated. Most commonly, the pharmacists provided weekly services to rural hospitals. All believed the sessional model was a practical solution to increase hospital access to pharmacist-mediated support and to address medication management gaps. Roles perceived to promote quality use of medicines were inpatient consultation services, medicines information/education to hospital staff, assistance with accreditation matters and system reviews, and input into pharmaceutical distribution activities. This study is the first to explore the concept of sessional rural hospital employment undertaken by pharmacists in Australia and New Zealand. Insights from participants

  13. Determinants of apparent rural-urban differentials in measles vaccination uptake in Indonesia.

    Science.gov (United States)

    Fernandez, Renae C; Awofeso, Niyi; Rammohan, Anu

    2011-01-01

    Regional differences in vaccination uptake are common in both developed and developing countries, and are often linked to the availability of healthcare services and socioeconomic factors. In 2007, 0.9 million eligible Indonesian children missed measles vaccination, and 19 456 cases of measles were documented among Indonesian children. The authors investigated rural-urban differentials in measles vaccination coverage among young Indonesian children, and sought to identify key factors influencing the probability of a child receiving the first dose of measles vaccination in Indonesia. Data used in the analyses were sourced from the nationally representative Indonesia Demographic and Health Survey 2007. The influence of location of residence, household wealth, maternal and paternal education, total children ever born and use of skilled birth attendants on measles vaccination coverage was investigated using bivariate analysis and chi-square tests. The independent effects of these variables were established using binomial logistic regression analysis. Indonesia's 2007 first-dose measles national vaccination coverage was, at 72.8%, lower than the 2008 global first-dose measles vaccination average coverage of 82%. Bivariate analysis revealed that the first-dose measles vaccination coverage in rural areas of Indonesia was 68.5%, compared with 80.1% in urban regions (p rural residence in impairing vaccination coverage was marginal after controlling for the sex of the child, maternal age, maternal and paternal education, wealth, and access to skilled health workers. Apart from sustainable initiatives to increase measles vaccination coverage globally, it is important to close the rural-urban gap in Indonesia's measles vaccination uptake. Addressing critical determinants of inferior measles vaccination coverage in Indonesia's rural regions will facilitate major improvements in Indonesia's child health trends. This article suggests initiatives for addressing three of such

  14. Community management and sustainability of rural water facilities in Tanzania

    NARCIS (Netherlands)

    Mandara, C.G.; Butijn, C.A.A.; Niehof, Anke

    2013-01-01

    This paper addresses the question of whether community management in water service delivery affects the sustainability of rural water facilities (RWFs) at village level, in terms of their technical and managerial aspects, and what role capacity building of users and providers plays in this process.

  15. Globalisation, rural restructuring and health service delivery in Australia: policy failure and the role of social work?

    Science.gov (United States)

    Alston, Margaret

    2007-05-01

    The impacts of globalisation and rural restructuring on health service delivery in rural Australia have been significant. In the present paper, it is argued that declining health service access represents a failure of policy. Rural communities across the world are in a state of flux, and Australia is no different: rural communities are ageing at faster rates than urban communities and young people are out-migrating in large numbers. During the past 5 years, rural Australia has also experienced a severe and widespread drought that has exacerbated rural poverty, and impacted on the health and well-being of rural Australians. Australian governments have responded to globalising forces by introducing neoliberal policy initiatives favouring market solutions and championing the need for self-reliance among citizens. The result for rural Australia has been a withdrawal of services at a time of increased need. This paper addresses the social work response to these changes.

  16. School Proximity and Child Labor: Evidence from Rural Tanzania

    Science.gov (United States)

    Kondylis, Florence; Manacorda, Marco

    2012-01-01

    Is improved school accessibility an effective policy tool for reducing child labor in developing countries? We address this question using microdata from rural Tanzania and a regression strategy that attempts to control for nonrandom location of households around schools as well as classical and nonclassical measurement error in self-reported…

  17. An ecosystem approach to climate policy : the role of rural renewable energy design

    International Nuclear Information System (INIS)

    Venema, H.D.

    2004-01-01

    Climate change provides renewed importance to the issues of rural energy and the task of providing modern, sustainable energy services to the 2 billion people around the world who rely on biomass energy. Impoverished countries are most vulnerable to the adverse affects of climate change. The author argues that energy deprivation must be addressed in order to alleviate poverty, and that increased energy provision to the world's poor is not a development option, rather a basic necessity. The choices made in how that energy is delivered can either intensify climate change or mitigate it. There are many changes that are transforming the power sector. Deregulation is providing new business opportunities for independent power producers and contributing to the break up of vertically integrated power utilities. Ecosystem and community-based methods to rural development are contributing to the application of decentralized renewable energy source development. In countries such as India, policy-makers have legislated decentralized renewable energy systems. This study addresses the fact that there are no appropriate design tools for ecosystem-oriented rural energy planning. The author therefore presents a newly developed ecosystem-based approach to rural energy systems design whose main components include the use of a complex adaptive system theory to establish rural energy system design principles; a human energetics model for studying the influence of bioenergy resource accessibility; and spatial optimization methods for rural biomass energy planning. The approach was refined to include landscape structure optimization for biodiversity objectives using landscape ecology concepts in subregions of India. It was then generalized for regional-scale distributed renewable energy system designs with integrated bioenergy, wind and solar resource assessment

  18. Sustaining the rural workforce: nursing perspectives on worklife challenges.

    Science.gov (United States)

    Hunsberger, Mabel; Baumann, Andrea; Blythe, Jennifer; Crea, Mary

    2009-01-01

    Concerns have been raised about the sustainability of health care workforces in rural settings. According to the literature, rural nurses' work satisfaction varies with the resources and supports available to respond to specific challenges. Given the probable effects of stressors on retention, it is essential to understand the unique requirements of nurses in rural practice environments. To investigate whether nurses receive the resources and supports necessary to meet the challenges of rural practice. Semi-structured interviews were conducted with 21 managers and 44 staff nurses in 19 selected rural hospitals in Ontario, Canada. The interviews were taped and transcripts interpreted through a thematic analysis. Major worklife themes were identified and analyzed within a healthy work environment model based on the work of Kristensen. Three interrelated dimensions of the model were relevant to workforce sustainability: the balance between demands and the resources of the person, the level of social support, and the degree of influence. The availability of resources and supports affected whether the nurses perceived challenges as stimulating or overwhelming. Deficits interfered with practice and the well-being of the nurses and patients. The nurses felt frustrated and powerless when they lacked resources, support, and influence to manage negative situations. Strategies to achieve workforce sustainability include resources to reduce stress in the workplace, education to meet the needs of new and experienced nurses, and offering of employment preferences to the workforce. Addressing resources, support, and influence of rural nurses is essential to alleviate workplace challenges and sustain the rural nursing workforce.

  19. Restrictions and Countermeasures of Rural Vocational Education in Urban-rural Integration

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    Developing rural vocational education is of great significance to urban-rural integration: developing rural vocational education is helpful to cultivating new farmers for construction of new socialist countryside,favorable to improving farmers’ ability of finding jobs and starting undertaking, and beneficial to transfer of rural surplus labor and acceleration of urbanization. Restrictions on development rural vocational education mainly include: low value cognition of society and social assessment of rural vocational education; out of balance of cost and expected return of rural vocational education; the quality of supply of rural vocational education failure to satisfy demand of socio-economic development; imperfect rural vocational education system. In view of these,following countermeasures and suggestions are put forward: strengthen propaganda and guidance to build environment of public opinion for rural vocational education; push forward rural vocational compulsory education system to lay social foundation for rural vocational education; reinforce policy support to assist in building rural vocational education system; improve education system to build overall framework of rural vocational education; perfect laws and regulations to establish system and norm for development of rural vocational education.

  20. Managerial Strategies for the Conservation of Rurality in Rural Tourism

    Directory of Open Access Journals (Sweden)

    Cornelia Petroman

    2010-10-01

    Full Text Available If we admit that rurality designates small densities, open areas, small settlements below 1,000 inhabitants, and land reserved mainly to agricultural and forestry practices, and as natural area, if we admit that society tends to be traditional and that government al policies tend to conserve rather than to make rapid or radical changes, then we should admit that rural tourism should be an activity generating new incomes in the area. Rurality also means preserving a continuum in the approach of different types of areas with different characteristics, a concept that can also be of use in the identification of activities specific to rural tourism. Be they activities specific to the rural environment or activities common to the rural area, they need to aim at the conservation of rurality as a main tourism resource. Managerial strategies in rural tourism contribute effectively to rural development, provided they are sustainable and that rural tourism be not the only solution for rural development.

  1. Food access and perceptions of the community and household food environment as correlates of fruit and vegetable intake among rural seniors.

    Science.gov (United States)

    Sharkey, Joseph R; Johnson, Cassandra M; Dean, Wesley R

    2010-06-02

    Although the importance of fruit and vegetable consumption to health has been well established, few studies have focused on access to fruits and vegetables in rural areas; even fewer examined the relationship between food access and fruit and vegetable consumption among seniors. To examine the spatial challenges to good nutrition faced by seniors who reside in rural areas and how spatial access influences fruit and vegetable intake. A cross-sectional analysis using data from the 2006 Brazos Valley Health Assessment (mailsurvey) for 582 rural seniors (60-90 years), who were recruited by random digit dialing; food store data from the 2006-2007 Brazos Valley Food Environment Project that used ground-truthed methods to identify, geocode, and inventory fruit and vegetables in all food stores. Few of the BVHA seniors consumed the recommended intakes of fruits or vegetables; women consumed more servings of fruit (1.49 +/- 0.05 vs. 1.29 +/- 0.07, p = 0.02), similar servings of vegetables (2.18 +/- 0.04 vs. 2.09 +/- 0.07, p = 0.28), and more combined fruit and vegetables (3.67 +/- 0.08 vs. 3.38 +/- 0.12, p = 0.04) than men. The median distances to fresh fruit and vegetables were 5.5 miles and 6.4 miles, respectively. When canned and frozen fruit and vegetables were included in the measurement of overall fruit or vegetables, the median distance for a good selection of fruit or vegetables decreased to 3.4 miles for overall fruit and 3.2 miles for overall vegetables. Almost 14% reported that food supplies did not last and there was not enough money to buy more. Our analyses revealed that objective and perceived measures of food store access--increased distance to the nearest supermarket, food store with a good variety of fresh and processed fruit, or food store with a good variety of fresh and processed vegetables--were associated with decreased daily consumption of fruit, vegetables, and combined fruit and vegetables, after controlling for the influence of individual

  2. The Current State of Rural Neurosurgical Practice: An International Perspective.

    Science.gov (United States)

    Upadhyayula, Pavan S; Yue, John K; Yang, Jason; Birk, Harjus S; Ciacci, Joseph D

    2018-01-01

    Rural and low-resource areas have diminished capacity to care for neurosurgical patients due to lack of infrastructure, healthcare investment, and training programs. This review summarizes the range of rural neurosurgical procedures, novel mechanisms for delivering care, rapid training programs, and outcome differences across international rural neurosurgical practice. A comprehensive literature search was performed for English language manuscripts with keywords "rural" and "neurosurgery" using the National Library of Medicine PubMed database (01/1971-06/2017). Twenty-four articles focusing on rural non-neurosurgical practice were included. Time to care and/or surgery and shortage of trained personnel remain the strongest risk factors for mortality and poor outcome. Telemedicine consults to regional centers with neurosurgery housestaff have potential for increased timeliness of diagnosis/triage, improved time to surgery, and reductions in unnecessary transfers in remote areas. Mobile neurosurgery teams have been deployed with success in nations with large transport distances precluding initial transfers. Common neurosurgical procedures involve trauma mechanisms; accordingly, training programs for nonneurosurgery medical personnel on basic assessment and operative techniques have been successful in resource-deficient settings where neurosurgeons are unavailable. Protracted transport times, lack of resources/training, and difficulty retaining specialists are barriers to successful outcomes. Advances in telemedicine, mobile neurosurgery, and training programs for urgent operative techniques have been implemented efficaciously. Development of guidelines for paired partnerships between rural centers and academic hospitals, supplying surplus technology to rural areas, and rapid training of qualified local surgical personnel can create sustainable feed-forward programs for trainees and infrastructural solutions to address challenges in rural neurosurgery.

  3. National Rural Employment Guarantee Scheme, poverty and prices in rural India.

    Science.gov (United States)

    Gaiha, Raghav; Kulkarni, Vani S; Pandey, Manoj K; Imai, Katsushi S

    2010-01-01

    The objective of this analysis is mainly to construct an intuitive measure of the performance of the National Rural Employment Guarantee Scheme (NREGS) in India. The focus is on divergence between demand and supply at the district level. Some related issues addressed are: (i) whether the gap between demand and supply responds to poverty; and (ii) whether recent hikes in NREGS wages are inflationary. Our analysis confirms responsiveness of the positive gap between demand and supply to poverty. Also, apprehensions expressed about the inflationary potential of recent hikes in NREGS wages have been confirmed. More importantly, higher NREGS wages are likely to undermine self-selection of the poor in it.

  4. Dimensional evaluation of a rural mobile learning teacher professional development curriculum

    CSIR Research Space (South Africa)

    Botha, Adele

    2017-10-01

    Full Text Available Education Development (ICT4RED) TPD Curriculum was designed and validated as a standalone intervention in a single district, for rural teachers, but did it carry Higher Education Institution accreditation. This implementation gap is addressed in its adaption...

  5. Creation of a mobile rural workforce following undergraduate longitudinal rural immersion.

    Science.gov (United States)

    Playford, Denese E; Ng, Wen Qi; Burkitt, Tessa

    2016-05-01

    This study followed the workforce choices of 10-years of graduates from a longitudinal rural immersion programme, which involved living for one academic year in a rural location as a medical student. The Rural Clinical School of Western Australia is a whole-of-state Rural Clinical School partnership involving two medical schools and fourteen rural/remote towns. For this longitudinal cohort study, all consenting graduates were contacted annually after graduation, with the outcome measure being rural work location (defined by the Australian Standard Geographical Classification -Remoteness Area) of any duration. There were 417 consenting graduates. Between 16 and 50% of contacted alumni worked rurally for a period of each post-graduate year. Aggregated over time, the majority took up to 30% of their postgraduate training rurally. There was considerable movement in and out of rural work. About 17% of contacted and practicing graduates were working full time rurally at the 2013 contact point. The majority remained in their state of training. The majority identified with GP and other rural-related colleges, and College-affiliation predicted amount of rural training time. Entry into rural work was equivalent for urban-origin and rural origin alumni, suggesting one year of RCS is sufficient to convert commitment to rural work. Undergraduate rural immersion is sufficient to create a graduate rural workforce that is far more mobile that was previously appreciated.

  6. Comparative Study on Rural Electrification Policies in Emerging Economies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

    Brazil, China, India and South Africa have each worked to improve access to electricity services. While many of the challenges faced by these countries are similar, the means of addressing them varied in their application and effectiveness. This report analyses the four country profiles, determining the pre-requisites to successful rural electrification policies.

  7. Nutritional Status of Adolescent Girls from Rural Communities of Tigray, Northern Ethiopia

    NARCIS (Netherlands)

    Mulugeta, A.; Hagos, F.; Stroecker, B.; Kruseman, G.; Linderhof, V.G.M.; Zenebe, A.; Mekonen, Y.; Girmay, G.

    2009-01-01

    Background: Addressing the nutritional needs of adolescents could be an important step towards breaking the vicious cycle of intergenerational malnutrition. Objective: Assess nutritional status of rural adolescent girls. Design: Cross-sectional. Methods: Anthropometric and socio-demographic

  8. Dental Care Utilization among North Carolina Rural Older Adults

    Science.gov (United States)

    Arcury, Thomas A.; Savoca, Margaret R.; Anderson, Andrea M.; Chen, Haiying; Gilbert, Gregg H.; Bell, Ronny A.; Leng, Xiaoyan; Reynolds, Teresa; Quandt, Sara A.

    2012-01-01

    Objectives This analysis delineates the predisposing, need, and enabling factors that are significantly associated with regular and recent dental care in a multi-ethnic sample of rural older adults. Methods A cross-sectional comprehensive oral health survey conducted with a random, multi-ethnic (African American, American Indian, white) sample of 635 community-dwelling adults aged 60 years and older was completed in two rural southern counties. Results Almost no edentulous rural older adults received dental care. Slightly more than one-quarter (27.1%) of dentate rural older adults received regular dental care and slightly more than one-third (36.7%) received recent dental care. Predisposing (education) and enabling (regular place for dental care) factors associated with receiving regular and recent dental care among dentate participants point to greater resources being the driving force in receiving dental care. Contrary to expectations of the Behavioral Model of Health Services, those with the least need (e.g., better self-rated oral health) received regular dental care; this has been referred to as the Paradox of Dental Need. Conclusions Regular and recent dental care are infrequent among rural older adults. Those not receiving dental care are those who most need care. Community access to dental care and the ability of older adults to pay for dental care must be addressed by public health policy to improve the health and quality of life of older adults in rural communities. PMID:22536828

  9. Ice and the outback: Patterns and prevalence of methamphetamine use in rural Australia.

    Science.gov (United States)

    Roche, Ann; McEntee, Alice

    2017-08-01

    This study investigated whether lifetime and recent methamphetamine use (including crystal methamphetamine) differed among city, regional and rural residents and whether particular subpopulations were more at-risk. Secondary analyses of the last three National Drug Strategy Household Surveys and corresponding Alcohol and Other Drug Treatment Services National Minimum Data Sets (AODTS NMDS). Australian general population. Australians who completed the 2007 (n = 22 519), 2010 (n = 25 786) and 2013 (n = 23 512) NDSHS (aged 14 + ); and treatment episodes where the principal drug of concern was recorded in the 2006/2007 (n = 139 808), 2009/2010 (n = 139 608) and 2012/2013 (n = 154 489) AODTS NMDS. To determine whether rural Australians were more likely to use methamphetamine than non-rural counterparts. Lifetime and recent methamphetamine and recent crystal methamphetamine use were significantly higher among rural than other Australians. Significantly more rural men and employed rural Australians used methamphetamine than their city, regional or Australian counterparts. Rural Australians aged 18-24 and 25-29 years were significantly more likely to have used methamphetamine in their lifetime than city or Australian residents. Rural Australians aged 18-24 years were significantly more likely to have recently used crystal methamphetamine. Interventions tailored to address the specific and unique circumstances of rural settings are required to reduce and prevent methamphetamine use, particularly crystal methamphetamine. Scope exists to focus prevention efforts on rural workplaces and primary care settings. Greater understanding of the higher prevalence of methamphetamine use in rural areas is required, plus implementation of comprehensive strategies and optimised treatment utilisation. © 2016 National Rural Health Alliance Inc.

  10. Adolescent Experience of Menstruation in Rural Kenya.

    Science.gov (United States)

    Secor-Turner, Molly; Schmitz, Kaitlin; Benson, Kristen

    2016-01-01

    Although menstruation is a universal experience, girls in resource-poor areas face unique challenges related to menstruation management. In Kenya, girls miss nearly 3.5 million learning days per month because of limited access to sanitary products and lack of adequate sanitation. Global priorities to address gender inequality-especially related to education-often do not consider the impact of poverty on gendered experiences, such as menstruation. The aim of the study was to describe the experiences of menstruation from the perspective of adolescent girls living in rural Kenya. Data for this qualitative study were collected through 29 individual interviews with adolescent girls and separate field observations. Descriptive content analysis was used to identify themes reflective of the data from the individual interviews and field notes. Four themes were developed to summarize the data: (a) receiving information about menstruation, (b) experiences of menstruation, (c) menstrual hygiene practices, and (d) social norms and the meaning of menstruation. Findings from this study describe the impact of menstruation on the lives of adolescent girls in rural Kenya. Menstrual hygiene management and its associated challenges may impact girls' academic continuity. Experiences of menstruation also reinforce gender inequality and further marginalize girls in low-income, rural areas of Kenya. Consideration of menstruation is critical to promote health and academic continuity for girls in rural Kenya.

  11. Neighborhood deprivation, vehicle ownership, and potential spatial access to a variety of fruits and vegetables in a large rural area in Texas

    Directory of Open Access Journals (Sweden)

    Horel Scott

    2010-05-01

    Full Text Available Abstract Objective There has been limited study of all types of food stores, such as traditional (supercenters, supermarkets, and grocery stores, convenience stores, and non-traditional (dollar stores, mass merchandisers, and pharmacies as potential opportunities for purchase of fresh and processed (canned and frozen fruits and vegetables, especially in small-town or rural areas. Methods Data from the Brazos Valley Food Environment Project (BVFEP are combined with 2000 U.S. Census data for 101 Census block groups (CBG to examine neighborhood access to fruits and vegetables. BVFEP data included identification and geocoding of all food stores (n = 185 in six rural counties in Texas, using ground-truthed methods and on-site assessment of the availability and variety of fresh and processed fruits and vegetables in all food stores. Access from the population-weighted centroid of each CBG was measured using proximity (minimum network distance and coverage (number of shopping opportunities for a good selection of fresh and processed fruits and vegetables. Neighborhood inequalities (deprivation and vehicle ownership and spatial access for fruits and vegetables were examined using Wilcoxon matched-pairs signed-rank test and multivariate regression models. Results The variety of fruits or vegetables was greater at supermarkets compared with grocery stores. Among non-traditional and convenience food stores, the largest variety was found at dollar stores. On average, rural neighborhoods were 9.9 miles to the nearest supermarket, 6.7 miles and 7.4 miles to the nearest food store with a good variety of fresh fruits and vegetables, respectively, and 4.7 miles and 4.5 miles to a good variety of fresh and processed fruits or vegetables. High deprivation or low vehicle ownership neighborhoods had better spatial access to a good variety of fruits and vegetables, both in the distance to the nearest source and in the number of shopping opportunities. Conclusion

  12. Community Strategic Visioning as a Method to Define and Address Poverty: An Analysis from Select Rural Montana Communities

    Science.gov (United States)

    Lachapelle, Paul; Austin, Eric; Clark, Daniel

    2010-01-01

    Community strategic visioning is a citizen-based planning process in which diverse sectors of a community collectively determine a future state and coordinate a plan of action. Twenty-one communities in rural Montana participated in a multi-phase poverty reduction program that culminated in a community strategic vision process. Research on this…

  13. Does the Medicare Part D Decision-Making Experience Differ by Rural/Urban Location?

    Science.gov (United States)

    Henning-Smith, Carrie; Casey, Michelle; Moscovice, Ira

    2017-01-01

    Although much has been written about Medicare Part D enrollment, much less is known about beneficiaries' personal experiences with choosing a Part D plan, especially among rural residents. This study sought to address this gap by examining geographic differences in Part D enrollees' perceptions of the plan decision-making process, including their confidence in their choice, their knowledge about the program, and their satisfaction with available information. We used data from the 2012 Medicare Current Beneficiary Survey and included adults ages 65 and older who were enrolled in Part D at the time of the survey (n = 3,706). We used ordered logistic regression to model 4 outcomes based on beneficiaries' perceptions of the Part D decision-making and enrollment process, first accounting only for differences by rurality, then adjusting for sociodemographic, health, and coverage characteristics. Overall, half of all beneficiaries were not very confident in their Part D knowledge. Rural beneficiaries had lower odds of being confident in the plan they chose and in being satisfied with the amount of information available to them during the decision-making process. After adjusting for all covariates, micropolitan residents continued to have lower odds of being confident in the plan that they chose. Policy-makers should pay particular attention to making information about Part D easily accessible for all beneficiaries and to addressing unique barriers that rural residents have in accessing information while making decisions, such as reduced Internet availability. Furthermore, confidence in the decision-making process may be improved by simplifying the Part D program. © 2016 National Rural Health Association.

  14. Comparative approaches to gentrification: Lessons from the rural.

    Science.gov (United States)

    Phillips, Martin; Smith, Darren P

    2018-03-01

    The epistemologies and politics of comparative research are prominently debated within urban studies, with 'comparative urbanism' emerging as a contemporary lexicon of urban studies. The study of urban gentrification has, after some delay, come to engage with these debates, which can be seen to pose a major challenge to the very concept of gentrification. To date, similar debates or developments have not unfolded within the study of rural gentrification. This article seeks to address some of the challenges posed to gentrification studies through an examination of strategies of comparison and how they might be employed within a comparative study of rural gentrification. Drawing on Tilly ( Big structures Large Processes Huge Comparisons . New York: Russell Sage), examples of four 'strategies of comparison' are identified within studies of urban and rural gentrification, before the paper explores how 'geographies of the concept' and 'geographies of the phenomenon' of rural gentrification in the United Kingdom, United States and France may be investigated using Latour's ( Pandora's Hope . London: Harvard University Press) notion of 'circulatory sociologies of translation'. The aim of our comparative discussion is to open up dialogues on the challenges of comparative studies that employ conceptions of gentrification and also to promote reflections of the metrocentricity of recent discussions of comparative research.

  15. Non-Economic Determinants of Energy Use in Rural Areas of South Africa

    Energy Technology Data Exchange (ETDEWEB)

    Annecke, W. (Energy and Development Research Center, University of Cape Town, South Africa)

    1999-03-29

    This project will begin to determine the forces and dimensions in rural energy-use patterns and begin to address policy and implementation needs for the future. This entails: Forecasting the social and economic benefits that electrification is assumed to deliver regarding education and women's lives; Assessing negative perceptions of users, which have been established through the slow uptake of electricity; Making recommendations as to how these perceptions could be addressed in policy development and in the continuing electrification program; Making recommendations to policy makers on how to support and make optimal use of current energy-use practices where these are socio-economically sound; Identifying misinformation and wasteful practices; and Other recommendations, which will significantly improve the success of the rural electrification program in a socio-economically sound manner, as identified in the course of the work.

  16. Too Few Skills for Some, Too Many Skills for Others: Are Future Rural Employment Opportunities a Poor Match for the Rural Labor Supply?

    Science.gov (United States)

    Eades, Daniel C.; Hughes, David W.

    2018-01-01

    Researchers and practitioners are aware of the importance of the skills of the local workforce in attracting and developing businesses in a regional economy. There has been, however, relatively little applied research concerning the identification of labor skill gaps in rural areas. We seek to address this issue through a case study of the Upper…

  17. 2014 Rural Clinical School Training and Support Program Snapshot survey.

    Science.gov (United States)

    Mendis, Kumara; Greenhill, Jennene; Walker, Judi; Bailey, Jannine; Croft, Amanda; Doyle, Zelda; McCrossin, Timothy; Stevens, Wendy

    2015-01-01

    The Rural Clinical Training and Support (RCTS) program is an Australian Government initiative to address the shortage of medical practitioners within rural and remote Australia. There is a large amount of published information about the RCTS program and rural medical student cohorts who have undertaken short- and long-term rotations. However, very little is known about the academic and professional staff involved in the program, a knowledge gap that may impact workforce and succession planning. To address this, the Federation of Rural Australian Medical Educators (FRAME) initiated the pilot 2014 RCTS Snapshot survey to obtain data on the current RCTS workforce. All professional, academic and clinical academic staff (fixed-term and continuing, regardless of fraction) employed through the RCTS program were invited to complete a short, web-based survey. The survey was conducted from March to June 2014. The quantitative variables in the survey included demographics (age and gender), rural background and exposure, employment history in rural/regional areas and at rural clinical schools (RCS), experience and expertise, reasons for working at RCS, and future employment intentions. The last three questions also were of a qualitative open-ended format to allow respondents to provide additional details regarding their reasons for working at RCSs and their future intentions. The estimated total RCTS workforce was 970. A total of 413 responses were received and 316 (40.9%) complete responses analysed. The majority of respondents were female (71%), the 40-60-year age group was predominant (28%), and professional staff constituted the majority (62%). The below 40-year age group had more professionals than academics (21% vs 12%) and more than 62% of academics were aged above 50 years. Notably, there were no academics aged less than 30 years. The percentage of professional staff with a rural background was higher (62%) than that of academics with a rural background (42%). However

  18. Gender, cooperative organisation and participatory intervention in rural Tanzania : a case study of different types of cooperatives and Moshi University College’s support to rural women

    NARCIS (Netherlands)

    Msonganzila, M.

    2013-01-01

    The thesis examines cooperation and participation as modes of institutional action to address women’ social and economic problems and needs in the context of rural Tanzania. It does so against the background of the history of cooperatives in Tanzania and development cooperation. The thesis takes

  19. Why doctors choose small towns: a developmental model of rural physician recruitment and retention.

    Science.gov (United States)

    Hancock, Christine; Steinbach, Alan; Nesbitt, Thomas S; Adler, Shelley R; Auerswald, Colette L

    2009-11-01

    workforce must address these complexities in order to support the variety of physicians who choose and remain in rural practice.

  20. Feasibility of a rural palliative supportive service.

    Science.gov (United States)

    Pesut, B; Hooper, B P; Robinson, C A; Bottorff, J L; Sawatzky, R; Dalhuisen, M

    2015-01-01

    January 2013 and May 2014. Scheduled in-person visit duration showed a mean of 67 minutes. During this same time period only 19 scheduled visits were declined, and there was no study attrition except through death, indicating a high degree of acceptability of the intervention. The primary needs that were addressed during these visits have been related to chronic disease management, and the attending physical symptoms were addressed through teaching and support. The use of structured quality of life and family caregiver needs assessments has been useful in facilitating communication, although some participants experienced the nature of the questions as too personal in the early stages of the relationship with the nurse coordinator. Findings from this study illustrate the feasibility of providing home-based services for rural older adults living with life-limiting chronic illness. The RPaSS model has the potential to smooth transitions and enhance quality of life along the disease trajectory and across locations of care by providing a consistent source of support and education. This type of continuity has the potential to foster the patient- and family-centered approach to care that is the ideal of a palliative approach. Further, the use of a rural community capacity-building approach may contribute to sustainability, which is a particularly important part of rural health service delivery.

  1. Developing Leaders: The Role of Competencies in Rural Community Colleges

    Science.gov (United States)

    Eddy, Pamela L.

    2013-01-01

    Pending retirements underscore the need to develop community college campus leaders. Rural community colleges will be particularly hard-hit by changes in leadership as they represent the majority of 2-year colleges and face unique challenges given their location. To help address the anticipated leadership transition, the American Association of…

  2. Community participation in rural Ecuador’s school feeding programme

    DEFF Research Database (Denmark)

    Torres, Irene; Simovska, Venka

    2017-01-01

    participation can include the possibility of the community challenging the social order at school, and the educational policies and practices. When addressing community participation, counter-participating and non-participating can be also considered as legitimate forms of participating. Originality/value......Purpose - The aim of this paper is to contribute to the debate concerning health education and health promotion at schools, particularly with regard to food and nutrition. Design/methodology/approach - Based on empirical data generated over the course of one year of fieldwork in three rural...... – The study contributes to an understanding of policy implementation and the implications of a HPS approach to health education and health promotion in small rural schools....

  3. Rural Family Physicians Are Twice as Likely to Use Telehealth as Urban Family Physicians.

    Science.gov (United States)

    Jetty, Anuradha; Moore, Miranda A; Coffman, Megan; Petterson, Stephen; Bazemore, Andrew

    2018-04-01

    Telehealth has the potential to reduce health inequities and improve health outcomes among rural populations through increased access to physicians, specialists, and reduced travel time for patients. Although rural telehealth services have expanded in several specialized areas, little is known about the attitudes, beliefs, and uptake of telehealth use in rural American primary care. This study characterizes the differences between rural and urban family physicians (FPs), their perceptions of telehealth use, and barriers to further adoption. Nationally representative randomly sampled survey of 5,000 FPs. Among the 31.3% of survey recipients who completed the survey, 83% practiced in urban areas and 17% in rural locations. Rural FPs were twice as likely to use telehealth as urban FPs (22% vs. 10%). Logistic regressions showed rural FPs had greater odds of reporting telehealth use to connect their patients to specialists and to care for their patients. Rural FPs were less likely to identify liability concerns as a barrier to using telehealth. Telemedicine allows rural patients to see specialists without leaving their communities and permits rural FPs to take advantage of specialist expertise, expand their scope of practice, and reduce the feeling of isolation experienced by rural physicians. Efforts to raise awareness of current payment policies for telehealth services, addressing the limitations of current reimbursement policies and state regulations, and creating new avenues for telehealth reimbursement and technological investments are critical to increasing primary care physician use of telehealth services.

  4. Assessing the Sustainability of the Built Environment in Mountainous Rural Villages in Southwest China

    Directory of Open Access Journals (Sweden)

    Li Wan

    2016-02-01

    Full Text Available Mountainous rural areas such as those in southwest China are developing rapidly. This requires scientific understanding and a framework for assessing the sustainability of the built environment that is suitable to such areas. At present, no such framework exists. This lack of assessment options has contributed to the unsustainable development of these areas, which has caused a series of environmental, social, and economic problems. This article analyzes existing assessment frameworks, reviews the theory on sustainable rural development as it applies to rural southwest China, and proposes a new assessment framework that is more suitable to this region and others like it. This framework is based on a sustainable development model for rural areas that emphasizes endogenous development; addresses the environmental, social, and economic dimensions of sustainability; and takes the natural and social conditions of mountainous rural areas into account. Our study tested its applicability to rural southwest China and its sensitivity to local conditions and found them to be better than those of existing assessment frameworks.

  5. A rural Appalachian faith-placed smoking cessation intervention.

    Science.gov (United States)

    Schoenberg, Nancy E; Bundy, Henry E; Baeker Bispo, Jordan A; Studts, Christina R; Shelton, Brent J; Fields, Nell

    2015-04-01

    Although health promotion programming in faith institutions is promising, most faith-based or placed health projects focus on diet, exercise, or cancer screening and many have been located in urban environments. This article addresses the notable absence of faith programming for smoking cessation among underserved rural US residents who experience tobacco-related health inequities. In this article, we describe our faith-oriented smoking cessation program in rural Appalachia, involving 590 smokers in 26 rural churches randomized to early and delayed intervention groups. We present three main themes that account for participants' positive evaluation of the program; the program's ability to leverage social connections; the program's convenience orientation; and the program's financial support for smoking cessation. We also present themes on the roles of faith and church in smoking cessation programming, including some mixed perceptions on smoking stigma and comfort in church settings; challenges in faith-placed smoking cessation recruitment; and the positive perception of such programming by church leaders. We conclude that faith-placed smoking cessation programs offer great potential, although they must be administered with great sensitivity to individual and community norms.

  6. A cross-sectional ecological analysis of international and sub-national health inequalities in commercial geospatial resource availability.

    Science.gov (United States)

    Dotse-Gborgbortsi, Winfred; Wardrop, Nicola; Adewole, Ademola; Thomas, Mair L H; Wright, Jim

    2018-05-23

    Commercial geospatial data resources are frequently used to understand healthcare utilisation. Although there is widespread evidence of a digital divide for other digital resources and infra-structure, it is unclear how commercial geospatial data resources are distributed relative to health need. To examine the distribution of commercial geospatial data resources relative to health needs, we assembled coverage and quality metrics for commercial geocoding, neighbourhood characterisation, and travel time calculation resources for 183 countries. We developed a country-level, composite index of commercial geospatial data quality/availability and examined its distribution relative to age-standardised all-cause and cause specific (for three main causes of death) mortality using two inequality metrics, the slope index of inequality and relative concentration index. In two sub-national case studies, we also examined geocoding success rates versus area deprivation by district in Eastern Region, Ghana and Lagos State, Nigeria. Internationally, commercial geospatial data resources were inversely related to all-cause mortality. This relationship was more pronounced when examining mortality due to communicable diseases. Commercial geospatial data resources for calculating patient travel times were more equitably distributed relative to health need than resources for characterising neighbourhoods or geocoding patient addresses. Countries such as South Africa have comparatively high commercial geospatial data availability despite high mortality, whilst countries such as South Korea have comparatively low data availability and low mortality. Sub-nationally, evidence was mixed as to whether geocoding success was lowest in more deprived districts. To our knowledge, this is the first global analysis of commercial geospatial data resources in relation to health outcomes. In countries such as South Africa where there is high mortality but also comparatively rich commercial geospatial

  7. Towards Strengths-Based Planning Strategies for Rural Localities in Finland

    Directory of Open Access Journals (Sweden)

    Rönkkö Emilia

    2017-09-01

    Full Text Available In this article, we will introduce the topic of strengths-based planning strategies for rural localities in Finland. The strengths-based approach focuses on capacity building and competence enhancement with the local people, encouraging communities to valorise, identify and mobilise existing but often unrecognised assets. Setting focus only on the deficiencies and problems easily inflicts a ‘surrender mentality‘ in places outside of the urbanisation impact, creating a narrative that both decision-makers and community members start to believe. Hence, the role and potential of smaller rural localities is easily forgotten by planners, politicians and the public at large. Addressing the scale of rural localities in spatial planning, we will first reflect upon the main findings from our earlier research project “Finnish rural localities in the 2010`s” conducted by Lahti University of Applied Sciences, the University of Oulu and Aalto University in 2013-2015. Findings from the research project affirmed the unfortunate consequences of rapid urbanisation, rational blueprint planning and overoptimistic expectations of growth in the 1960s and 70s, which have resulted in the state of permanent incompleteness in rural localities today. However, these localities possess many under-utilised strengths, and we consider it essential for the future development of rural localities to make the most of this potential, and not only tackle the downwards spiral. This requires the ability to engage local stakeholders around a common vision for the future, and strategic approach based on endogenous strengths. We will discuss these possibilities via two theoretically informed case studies. The first one, Vieremä, is situated in the region of Northern Savo, and the other one, Vääksy, is the main centre in the municipality of Asikkala, situated in the region of Päijät-Häme in Southern Finland. Our study design can be characterised as qualitative research

  8. Rural interdisciplinary mental health team building via satellite: a demonstration project.

    Science.gov (United States)

    Cornish, Peter A; Church, Elizabeth; Callanan, Terrence; Bethune, Cheri; Robbins, Carl; Miller, Robert

    2003-01-01

    This paper reports on the results of a demonstration project that examined the role of telehealth/telemedicine (hereafter referred to as telehealth) in providing interdisciplinary mental health training and support to health professionals in a rural region of Atlantic Canada. Special emphasis was placed on addressing the question of how training might affect interdisciplinary collaboration among the rural health professionals. Five urban mental health professionals from three disciplines provided training and support via video-satellite and internet, print and video resources to 34 rural health and community professionals. In order to assess the rural community's needs and the impact of the interventions, questionnaires were administered and on-site interviews were conducted before and after the project. Throughout the project, field notes were recorded and satisfaction ratings were obtained. Satisfaction with the video-satellite presentations was high and stable, with the exception of one session when signal quality was very poor. Rural participants were most satisfied with opportunities for interaction and least satisfied with the variable quality of the video transmission signal. High staff turnover among rural professionals resulted in insufficient power to permit statistical analysis. Positive reports of the project impact included expanded knowledge and heightened sensitivity to mental health issues, increased cross-disciplinary connections, and greater cohesion among professionals. The results suggest that, with some refinements, telehealth technology can be used to facilitate mental health training and promote interdisciplinary collaboration among professionals in a rural setting.

  9. A Survey of Rural Hospitals’ Perspectives on Health Information Technology Outsourcing

    Science.gov (United States)

    Johnson, Nicholas; Murphy, Alison; McNeese, Nathan; Reddy, Madhu; Purao, Sandeep

    2013-01-01

    A survey of rural hospitals was conducted in the spring of 2012 to better understand their perspectives on health information technology (HIT) outsourcing and the role that hospital-to-hospital HIT partnerships (HHPs) can play as an outsourcing mechanism. The survey sought to understand how HHPs might be leveraged for HIT implementation, as well as the challenges with forming them. The results suggest that HHPs have the potential to address rural hospitals’ slow rate of HIT adoption, but there are also challenges to creating these partnerships. These issues, as well as avenues for further research, are then discussed. PMID:24551373

  10. A survey of rural hospitals' perspectives on health information technology outsourcing.

    Science.gov (United States)

    Johnson, Nicholas; Murphy, Alison; McNeese, Nathan; Reddy, Madhu; Purao, Sandeep

    2013-01-01

    A survey of rural hospitals was conducted in the spring of 2012 to better understand their perspectives on health information technology (HIT) outsourcing and the role that hospital-to-hospital HIT partnerships (HHPs) can play as an outsourcing mechanism. The survey sought to understand how HHPs might be leveraged for HIT implementation, as well as the challenges with forming them. The results suggest that HHPs have the potential to address rural hospitals' slow rate of HIT adoption, but there are also challenges to creating these partnerships. These issues, as well as avenues for further research, are then discussed.

  11. Needs of cancer patients treated in rural and urban cancer departments

    International Nuclear Information System (INIS)

    Mercurit, Angelina; Kallady, Susannah

    2005-01-01

    Literature indicates that cancer patients experience high levels of unmet needs, particularly in relation to health information, psychological requirements and physical and daily living needs. It suggests that the needs of patients living in rural areas are likely to be higher than those of urban patients due to geographical factors and health service accessibility issues. This paper will explore the needs of cancer patients with particular focus on the impact of location (rural vs. urban), present the basis of these needs and identify strategies that address the needs expressed, by reviewing current literature. Copyright (2005) Australian Institute of Radiography

  12. Factors influencing students' choices in considering rural radiography careers at Makerere University, Uganda

    International Nuclear Information System (INIS)

    Gonzaga, Mubuuke Aloysius; Kiguli-Malwadde, E.; Francis, Businge; Rosemary, Byanyima K.

    2010-01-01

    Introduction: The Faculty of Medicine, Makerere University is the oldest health professions training institution in East Africa having started in 1924. The radiography degree course started in 2001 and Makerere remains the only institution in the East African region offering this degree course. The faculty adopted a Problem based Learning/Community based education curriculum in order to stimulate students' interests to consider working in rural areas. Attracting and retaining radiographers and other health professionals in rural areas is a recognized problem in Uganda and overseas and strategic actions to enhance the rural health workforce and its ability to deliver the required services are paramount. A range of factors in different domains can be associated with recruitment and retention. By consulting students, some of these factors can be identified and addressed. Methodology: It was a descriptive exploratory study involving 31 students. Data was collected through a questionnaire and focus group discussions. Results: 58% of the students reported that they would consider rural radiography practice while 42% would not. Key motivational factors cited to work in rural areas were; attractive salaries/incentives, community based training curricular, opportunities for further training and well equipped rural health facilities. Conclusion: This study has shown that students would consider working in rural areas provided the working conditions are improved upon.

  13. Rural and remote health research: Does the investment match the need?

    Science.gov (United States)

    Barclay, Lesley; Phillips, Andrew; Lyle, David

    2018-04-01

    To determine the percentage of research projects funded by the National Health and Medical Research Council in the period 2000-2014 that aimed specifically to deliver health benefits to Australians living in rural and remote areas and to estimate the proportion of total funding this represented in 2005-2014. This is a retrospective analysis of publicly available datasets. National Health and Medical Research Council Rural and Remote Health Research 2000-2014. 'Australian Rural Health Research' was defined as: research that focussed on rural or remote Australia; that related to the National Health and Medical Research Council's research categories other than Basic Science; and aimed specifically to improve the health of Australians living in rural and remote areas. Grants meeting the inclusion criteria were grouped according to the National Health and Medical Research Council's categories and potential benefit. Funding totals were aggregated and compared to the total funding and Indigenous funding for the period 2005-2014. Of the 16 651 National Health and Medical Research Council-funded projects, 185 (1.1%) that commenced funding during the period 2000-2014 were defined as 'Australian Rural Health Research'. The funding for Australian Rural Health Research increased from 1.0% of the total in 2005 to 2.4% in 2014. A summary of the funding according to the National Health and Medical Research Council's research categories and potential benefit is presented. Addressing the health inequality experienced by rural and remote Australians is a stated aim of the Australian Government. While National Health and Medical Research Council funding for rural health research has increased over the past decade, at 2.4% by value, it appears very low given the extent of the health status and health service deficits faced by the 30% who live in rural Australia. © 2018 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National

  14. An innovative program to address learning barriers in small schools: Washington State School Nurse Corps.

    Science.gov (United States)

    Fast, Gail Ann; Gray, Lorali; Miles-Koehler, Mona

    2013-01-01

    While all schools in Washington State have had to deal with shrinking financial resources, small, rural school districts, with fewer than 2,000 students, face unique circumstances that further challenge their ability to meet rising student health needs. This article will explore how small districts utilize the services of the Washington State School Nurse Corps (SNC), an innovative program that supports student health and safety while reducing barriers to learning. Through direct registered nursing services and regional nurse administrative consultation and technical assistance, the SNC strengthens rural school districts' capacity to provide a safe and healthy learning environment. In addition, we will examine current research that links health and learning to discover how the SNC model is successful in addressing health risks as barriers to learning. Lastly, as resources continue to dwindle, partnerships between schools, the SNC, and state and local health and education organizations will be critical in maintaining health services and learning support to small, rural schools.

  15. Megacities and Large Urban Complexes - WMO Role in Addressing Challenges and Opportunities

    Science.gov (United States)

    Terblanche, Deon; Jalkanen, Liisa

    2013-04-01

    Megacities and Large Urban Complexes - WMO Role in Addressing Challenges and Opportunities Deon E. Terblanche and Liisa Jalkanen dterblanche@wmo.int ljalkanen@wmo.int World Meteorological Organization, Geneva, Switzerland The 21st Century could amongst others, become known as the century in which our species has evolved from Homo sapiens to Homo urbanus. By now the urban population has surpassed the rural population and the rate of urbanization will continue at such a pace that by 2050 urban dwellers could outnumber their rural counterpart by more than two to one. Most of this growth in urban population will occur in developing countries and along coastal areas. Urbanization is to a large extent the outcome of humans seeking a better life through improved opportunities presented by high-density communities. Megacities and large urban complexes provide more job opportunities and social structures, better transport and communication links and a relative abundance of physical goods and services when compared to most rural areas. Unfortunately these urban complexes also present numerous social and environmental challenges. Urban areas differ from their surroundings by morphology, population density, and with high concentration of industrial activities, energy consumption and transport. They also pose unique challenges to atmospheric modelling and monitoring and create a multi-disciplinary spectrum of potential threats, including air pollution, which need to be addressed in an integrated way. These areas are also vulnerable to the changing climate and its implications to sea-level and extreme events, air quality and related health impacts. Many urban activities are significantly impacted by weather events that would not be considered to be of high impact in less densely populated areas. For instance, moderate precipitation events can cause flooding and landslides as modified urban catchments generally have higher run-off to rainfall ratios than their more pristine rural

  16. Making rural and remote communities more age-friendly: experts' perspectives on issues, challenges, and priorities.

    Science.gov (United States)

    Menec, Verena; Bell, Sheri; Novek, Sheila; Minnigaleeva, Gulnara A; Morales, Ernesto; Ouma, Titus; Parodi, Jose F; Winterton, Rachel

    2015-01-01

    With the growing interest worldwide in making communities more age-friendly, it is becoming increasingly important to understand the factors that help or hinder communities in attaining this goal. In this article, we focus on rural and remote communities and present perspectives of 42 experts in the areas of aging, rural and remote issues, and policy who participated in a consensus conference on age-friendly rural and remote communities. Discussions highlighted that strengths in rural and remote communities, such as easy access to local leaders and existing partnerships, can help to further age-friendly goals; however, addressing major challenges, such as lack of infrastructure and limited availability of social and health services, requires regional or national government buy-in and funding opportunities. Age-friendly work in rural and remote communities is, therefore, ideally embedded in larger age-friendly initiatives and supported by regional or national policies, programs, and funding sources.

  17. Has Rural Banking Developed Rural Nigeria? | Amadasu | African ...

    African Journals Online (AJOL)

    There is problem of rural development in Nigeria because of increasing poverty in the rural areas where about 70% of the people live. Reducing poverty means increasing income. Increasing income means increasing bank loans and advances for efficient application to agricultural and industrial activities in the rural Nigeria ...

  18. Rural and remote speech-language pathology service inequities: An Australian human rights dilemma.

    Science.gov (United States)

    Jones, Debra M; McAllister, Lindy; Lyle, David M

    2018-02-01

    Access to healthcare is a fundamental human right for all Australians. Article 19 of the Universal Declaration of Human Rights acknowledges the right to freedom of opinion and to seek, receive and impart information and ideas. Capacities for self-expression and effective communication underpin the realisation of these fundamental human rights. For rural and remote Australian children this realisation is compromised by complex disadvantages and inequities that contribute to communication delays, inequity of access to essential speech-language pathology services and poorer later life outcomes. Localised solutions to the provision of civically engaged, accessible, acceptable and sustainable speech-language pathology services within rural and remote Australian contexts are required if we are to make substantive human rights gains. However, civically engaged and sustained healthcare can significantly challenge traditional professionalised perspectives on how best to design and implement speech-language pathology services that seek to address rural and remote communication needs and access inequities. A failure to engage these communities in the identification of childhood communication delays and solutions to address these delays, ultimately denies children, families and communities of their human rights for healthcare access, self-expression, self-dignity and meaningful inclusion within Australian society.

  19. Energy and spectrum efficiency in rural areas based on cognitive radio technology

    CSIR Research Space (South Africa)

    Masonta, MT

    2009-09-01

    Full Text Available spectrum scarcity in the most energy efficient manner. In this paper, researchers present the proposed work to be carried out as part of a doctoral thesis to address the spectrum scarcity and transmission power in energy constrained rural areas....

  20. Opinions of South African optometry students about working in rural areas after graduation

    Directory of Open Access Journals (Sweden)

    Khathutshelo P. Mashige

    2015-07-01

    Full Text Available Background: Eye and vision problems have been reported to be more prevalent in rural than urban areas; and a large proportion of South Africans live in the rural areas. Aim: To investigate the opinions of South African optometry students about working in rural areas after completion of their training and to identify factors that may influence theirdecisions. Method: This was a cross-sectional quantitative study using a survey instrument containing both closed and open-ended, semi-structured questions. Results: Four hundred and thirty-eight students responded to the questionnaire (85.4% response rate. Overall, many of the respondents did not want to open their first (66% or second practices (64.6% in the rural areas. However, most respondents from rural backgrounds reported that they would open their first (77.2% or second (79.4% practice in the rural areas. The main reasons cited by the respondents for their unwillingness to work in the rural areaswere financial concerns (81.2%, personal safety (80.1% and poor living conditions (75.3%, with a significantly higher number (p < 0.05 being from urban respondents for the latter twoissues only. Conclusion: Many students were not in favour of opening practices in rural areas, but were willing to work for the government or a non-governmental organisation after graduation. Efforts should be made to address financial incentives, safety and living conditions in the rural areas. The results of this study have implications for the future of availability and accessibility of eye care services to those living in the rural and remoteareas of the country.

  1. Opinions of South African optometry students about working in rural areas after graduation.

    Science.gov (United States)

    Mashige, Khathutshelo P; Oduntan, Olalekan A; Hansraj, Rekha

    2015-07-31

    Eye and vision problems have been reported to be more prevalent in rural than urban areas; and a large proportion of South Africans live in the rural areas. To investigate the opinions of South African optometry students about working in rural areas after completion of their training and to identify factors that may influence their decisions. This was a cross-sectional quantitative study using a survey instrument containing both closed and open-ended, semi-structured questions. Four hundred and thirty-eight students responded to the questionnaire (85.4% response rate). Overall, many of the respondents did not want to open their first (66%) or second practices (64.6%) in the rural areas. However, most respondents from rural backgrounds reported that they would open their first (77.2%) or second (79.4%) practice in the rural areas. The main reasons cited by the respondents for their unwillingness to work in the rural areas were financial concerns (81.2%), personal safety (80.1%) and poor living conditions (75.3%), with a significantly higher number (p < 0.05) being from urban respondents for the latter two issues only. Many students were not in favour of opening practices in rural areas, but were willing to work for the government or a non-governmental organisation after graduation. Efforts should be made to address financial incentives, safety and living conditions in the rural areas. The results of this study have implications for the future of availability and accessibility of eye care services to those living in the rural and remote areas of the country.

  2. Screening and Follow-Up Monitoring for Substance Use in Primary Care: An Exploration of Rural-Urban Variations.

    Science.gov (United States)

    Chan, Ya-Fen; Lu, Shou-En; Howe, Bill; Tieben, Hendrik; Hoeft, Theresa; Unützer, Jürgen

    2016-02-01

    Rates of substance use in rural areas are close to those of urban areas. While recent efforts have emphasized integrated care as a promising model for addressing workforce shortages in providing behavioral health services to those living in medically underserved regions, little is known on how substance use problems are addressed in rural primary care settings. To examine rural-urban variations in screening and monitoring primary care- based patients for substance use problems in a state-wide mental health integration program. This was an observational study using patient registry. The study included adult enrollees (n = 15,843) with a mental disorder from 133 participating community health clinics. We measured whether a standardized substance use instrument was used to screen patients at treatment entry and to monitor symptoms at follow-up visits. While on average 73.6 % of patients were screened for substance use, follow-up on substance use problems after initial screening was low (41.4 %); clinics in small/isolated rural settings appeared to be the lowest (13.6 %). Patients who were treated for a mental disorder or substance abuse in the past and who showed greater psychiatric complexities were more likely to receive a screening, whereas patients of small, isolated rural clinics and those traveling longer distances to the care facility were least likely to receive follow-up monitoring for their substance use problems. Despite the prevalent substance misuse among patients with mental disorders, opportunities to screen this high-risk population for substance use and provide a timely follow-up for those identified as at risk remained overlooked in both rural and urban areas. Rural residents continue to bear a disproportionate burden of substance use problems, with rural-urban disparities found to be most salient in providing the continuum of services for patients with substance use problems in primary care.

  3. Rural Asthma: Current Understanding of Prevalence, Patterns, and Interventions for Children and Adolescents.

    Science.gov (United States)

    Estrada, Robin Dawson; Ownby, Dennis R

    2017-06-01

    Asthma is the most common chronic illness of children and adolescents in the USA. While asthma has been understood to disproportionately affect urban dwellers, recent investigations have revealed rural pediatric asthma prevalence to be very similar to urban and to be more closely correlated with socioeconomic and environmental factors than geographic location or population density. Rural children experience factors unique to location that impact asthma development and outcomes, including housing quality, cigarette smoke exposure, and small/large-scale farming. Additionally, there are challenging barriers to appropriate asthma care that frequently are more severe for those living in rural areas, including insurance status, lack of primary care providers and pulmonary specialists, knowledge deficits (both patient and provider), and a lack of culturally tailored asthma interventions. Interventions designed to address rural pediatric asthma disparities are more likely to be successful when targeted to specific challenges, such as the use of school-based services or telemedicine to mitigate asthma care access issues. Continued research on understanding the complex interaction of specific rural environmental factors with host factors can inform future interventions designed to mitigate asthma disparities.

  4. Personalized Health Monitoring System for Managing Well-Being in Rural Areas.

    Science.gov (United States)

    Nedungadi, Prema; Jayakumar, Akshay; Raman, Raghu

    2017-12-14

    Rural India lacks easy access to health practitioners and medical centers, depending instead on community health workers. In these areas, common ailments that are easy to manage with medicines, often lead to medical escalations and even fatalities due to lack of awareness and delayed diagnosis. The introduction of wearable health devices has made it easier to monitor health conditions and to connect doctors and patients in urban areas. However, existing initiatives have not succeeded in providing adequate health monitoring to rural and low-literate patients, as current methods are expensive, require consistent connectivity and expect literate users. Our design considerations address these concerns by providing low-cost medical devices connected to a low-cost health platform, along with personalized guidance based on patient physiological parameters in local languages, and alerts to medical practitioners in case of emergencies. This patient-centric integrated healthcare system is designed to manage the overall health of villagers with real-time health monitoring of patients, to offer guidance on preventive care, and to increase health awareness and self-monitoring at an affordable price. This personalized health monitoring system addresses the health-related needs in remote and rural areas by (1) empowering health workers in monitoring of basic health conditions for rural patients in order to prevent escalations, (2) personalized feedback regarding nutrition, exercise, diet, preventive Ayurveda care and yoga postures based on vital parameters and (3) reporting of patient data to the patient's health center with emergency alerts to doctor and patient. The system supports community health workers in the diagnostic procedure, management, and reporting of rural patients, and functions well even with only intermittent access to Internet.

  5. A qualitative examination of the role of small, rural worksites in obesity prevention.

    Science.gov (United States)

    Escoffery, Cam; Kegler, Michelle C; Alcantara, Iris; Wilson, Mark; Glanz, Karen

    2011-07-01

    The prevalence of overweight and obesity in the United States is highest in rural counties. We explored social support, policies, and programmatic resources that encourage more healthful diets and participation in physical activity among employees of small, rural worksites. We conducted in-depth interviews with 33 employed adults aged 50 years or older in rural Georgia about access to healthful foods and opportunities for physical activity at work; conversations about exercise, weight loss, and eating healthfully in general; and worksite nutrition and physical activity programs; and we asked for suggestions for making the worksite more healthful. The research team developed a codebook, and 2 coders coded each transcript. Data were analyzed and reports were generated for thematic analyses. Participants from rural worksites, most with fewer than 50 employees, cited lack of vending machines and cafeterias, health promotion programs to address healthful eating and exercise, and facilities for physical activity as barriers to eating healthfully and engaging in physical activity at work. Many participants reported conversations with coworkers about how to eat more healthfully by making more nutritious choices or preparing food more healthfully. Participants also discussed the importance of engaging in physical activity on their own and gave suggestions on ways to incorporate exercise into their routines. Participants' access to healthful foods at work varied, but barriers such as being too busy, worksite location, and no worksite cafeteria were noted. Some workers reported engaging in physical activity at work, and others reported a heavy workload and lack of time as barriers. Building on the social environment and implementing policies for healthful eating and participation in physical activity may help address obesity prevention in rural workplaces.

  6. Admission Factors Predicting Family Medicine Specialty Choice: A Literature Review and Exploratory Study among Students in the Rural Medical Scholars Program

    Science.gov (United States)

    Avery, Daniel M., Jr.; Wheat, John R.; Leeper, James D.; McKnight, Jerry T.; Ballard, Brent G.; Chen, Jia

    2012-01-01

    Purpose: The Rural Medical Scholars Program (RMSP) was created to increase production of rural family physicians in Alabama. Literature review reveals reasons medical students choose careers in family medicine, and these reasons can be categorized into domains that medical schools can address through admission, curriculum, and structural…

  7. Keeping It Safe: Aging in Place among Rural Older Adults

    Science.gov (United States)

    Peek, Gina G.; Bishop, Alex J.

    2016-01-01

    The purpose of the study addressed in this article was to identify ways to reduce risk and improve safe aging in place among rural older adults. Resident and Extension faculty and county educators visited study participants at home to assess functional capacity and the home environment. Extension professionals may be uniquely positioned to provide…

  8. Addressing rural health disparities through policy change in the stroke belt.

    Science.gov (United States)

    Jilcott Pitts, Stephanie B; Smith, Tosha W; Thayer, Linden Maya; Drobka, Sarah; Miller, Cassandra; Keyserling, Thomas C; Ammerman, Alice S

    2013-01-01

    Obesity-prevention policies are needed, particularly in low-income rural areas of the southern United States, where obesity and chronic disease prevalence are high. In 2009, the Centers for Disease Control and Prevention issued the "Common Community Measures for Obesity Prevention" (COCOMO), a set of 24 recommended community-level obesity-prevention strategies. A variety of stakeholders in Lenoir County, North Carolina, were surveyed and interviewed, ranking the winnability, defined as feasibility and acceptability, of each of the 24 COCOMO-recommended strategies based on local culture, infrastructure, funding, and community support. Mixed-methods. This study was part of the Heart Healthy Lenoir project, a community-based project to reduce cardiovascular disease risk and disparities in risk in Lenoir County, North Carolina. COCOMO assessments were conducted with 19 Community Advisory Council members and in-depth interviews were conducted with 11 community stakeholders. Heart Healthy Lenoir lifestyle intervention participants (n = 366) completed surveys wherein they ranked their support for 7 obesity-prevention strategies (based on the COCOMO strategies). Ranking of obesity-prevention strategies. Policies to improve physical activity opportunities were deemed the most winnable, whereas policies that would limit advertisement of unhealthy food and beverages were deemed the least winnable. The most winnable food-related strategy was improving mechanisms to procure food from local farms. Stakeholders perceived the public as unfavorably disposed toward government mandates, taxes, and incentives. Among Heart Healthy Lenoir participants, males indicated lower levels of support for COCOMO-related strategies than females, and African Americans indicated higher levels of support than white participants. The formative work presented here provides insight into the winnability of proposed obesity-prevention policy change strategies in Lenoir County, North Carolina.

  9. Rural exposure during medical education and student preference for future practice location - a case of Botswana.

    Science.gov (United States)

    Arscott-Mills, Tonya; Kebaabetswe, Poloko; Tawana, Gothusang; Mbuka, Deogratias O; Makgabana-Dintwa, Orabile; Sebina, Kagiso; Kebaetse, Masego; Mokgatlhe, Lucky; Nkomazana, Oathokwa

    2016-06-10

    Botswana's medical school graduated its first class in 2014. Given the importance of attracting doctors to rural areas the school incorporated rural exposure throughout its curriculum. This study explored the impact of rural training on students' attitudes towards rural practice. The University of Botswana family medicine rural training sites, Maun and Mahalapye. The study used a mixed-methods design. After rural family medicine rotations, third- and fifth-year students were invited to complete a questionnaire and semi-structured interview. Data were analysed using descriptive statistics and thematic analysis. The thirty-six participants' age averaged 23 years and 48.6% were male. Thirtythree desired urban practice in a public institution or university. Rural training did not influence preferred future practice location. Most desired specialty training outside Botswana but planned to practice in Botswana. Professional stagnation, isolation, poorly functioning health facilities, dysfunctional referral systems, and perceived lack of learning opportunities were barriers to rural practice. Lack of recreation and poor infrastructure were personal barriers. Many appreciated the diversity of practice and supportive staff seen in rural practice. Several considered monetary compensation as an enticement for rural practice. Only those with a rural background perceived proximity to family as an incentive to rural practice. The majority of those interviewed plan to practice in urban Botswana, however, they did identify factors that, if addressed, may increase rural practice in the future. Establishing systems to facilitate professional development, strengthening specialists support, and deploying doctors near their home towns are strategies that may improve retention of doctors in rural areas.Keyords: rural health, student perceptions.

  10. The current state of rural neurosurgical practice: An international perspective

    Directory of Open Access Journals (Sweden)

    Pavan S Upadhyayula

    2018-01-01

    infrastructural solutions to address challenges in rural neurosurgery.

  11. The Current State of Rural Neurosurgical Practice: An International Perspective

    Science.gov (United States)

    Upadhyayula, Pavan S.; Yue, John K.; Yang, Jason; Birk, Harjus S.; Ciacci, Joseph D.

    2018-01-01

    address challenges in rural neurosurgery. PMID:29456356

  12. Community participation to design rural primary healthcare services.

    Science.gov (United States)

    Farmer, Jane; Nimegeer, Amy

    2014-03-21

    This paper explores how community participation can be used in designing rural primary healthcare services by describing a study of Scottish communities. Community participation is extolled in healthcare policy as useful in planning services and is understood as particularly relevant in rural settings, partly due to high social capital. Literature describes many community participation methods, but lacks discussion of outcomes relevant to health system reconfiguration. There is a spectrum of ideas in the literature on how to design services, from top-down standard models to contextual plans arising from population health planning that incorporates community participation. This paper addresses an evidence gap about the outcomes of using community participation in (re)designing rural community health services. Community-based participatory action research was applied in four Scottish case study communities in 2008-10. Data were collected from four workshops held in each community (total 16) and attended by community members. Workshops were intended to produce hypothetical designs for future service provision. Themes, rankings and selections from workshops are presented. Community members identified consistent health priorities, including local practitioners, emergency triage, anticipatory care, wellbeing improvement and health volunteering. Communities designed different service models to address health priorities. One community did not design a service model and another replicated the current model despite initial enthusiasm for innovation. Communities differ in their receptiveness to engaging in innovative service design, but some will create new models that fit in a given budget. Design diversity indicates that context influences local healthcare planning, suggesting community participation impacts on design outcomes, but standard service models maybe useful as part of the evidence in community participation discussions.

  13. Rural-urban disparities in child nutrition in Bangladesh and Nepal.

    Science.gov (United States)

    Srinivasan, Chittur S; Zanello, Giacomo; Shankar, Bhavani

    2013-06-14

    The persistence of rural-urban disparities in child nutrition outcomes in developing countries alongside rapid urbanisation and increasing incidence of child malnutrition in urban areas raises an important health policy question - whether fundamentally different nutrition policies and interventions are required in rural and urban areas. Addressing this question requires an enhanced understanding of the main drivers of rural-urban disparities in child nutrition outcomes especially for the vulnerable segments of the population. This study applies recently developed statistical methods to quantify the contribution of different socio-economic determinants to rural-urban differences in child nutrition outcomes in two South Asian countries - Bangladesh and Nepal. Using DHS data sets for Bangladesh and Nepal, we apply quantile regression-based counterfactual decomposition methods to quantify the contribution of (1) the differences in levels of socio-economic determinants (covariate effects) and (2) the differences in the strength of association between socio-economic determinants and child nutrition outcomes (co-efficient effects) to the observed rural-urban disparities in child HAZ scores. The methodology employed in the study allows the covariate and coefficient effects to vary across entire distribution of child nutrition outcomes. This is particularly useful in providing specific insights into factors influencing rural-urban disparities at the lower tails of child HAZ score distributions. It also helps assess the importance of individual determinants and how they vary across the distribution of HAZ scores. There are no fundamental differences in the characteristics that determine child nutrition outcomes in urban and rural areas. Differences in the levels of a limited number of socio-economic characteristics - maternal education, spouse's education and the wealth index (incorporating household asset ownership and access to drinking water and sanitation) contribute a

  14. The construction of professional identity: symbolic power in rural partnerships in The Netherlands

    NARCIS (Netherlands)

    Derkzen, P.H.M.; Bock, B.B.

    2007-01-01

    This article addresses the construction of professionalism in rural partnerships in Achterhoek, a region in the east of The Netherlands, where public, private and community representatives are involved in the spatial reorganisation of agriculture. In contrast to the dichotomy between `professional'

  15. Does availability of physical activity and food outlets differ by race and income? Findings from an enumeration study in a health disparate region.

    Science.gov (United States)

    Hill, Jennie L; Chau, Clarice; Luebbering, Candice R; Kolivras, Korine K; Zoellner, Jamie

    2012-09-06

    Low-income, ethnic/racial minorities and rural populations are at increased risk for obesity and related chronic health conditions when compared to white, urban and higher-socio-economic status (SES) peers. Recent systematic reviews highlight the influence of the built environment on obesity, yet very few of these studies consider rural areas or populations. Utilizing a CBPR process, this study advances community-driven causal models to address obesity by exploring the difference in resources for physical activity and food outlets by block group race and income in a small regional city that anchors a rural health disparate region. To guide this inquiry we hypothesized that lower income and racially diverse block groups would have fewer food outlets, including fewer grocery stores and fewer physical activity outlets. We further hypothesized that walkability, as defined by a computed walkability index, would be lower in the lower income block groups. Using census data and GIS, base maps of the region were created and block groups categorized by income and race. All food outlets and physical activity resources were enumerated and geocoded and a walkability index computed. Analyses included one-way MANOVA and spatial autocorrelation. In total, 49 stores, 160 restaurants and 79 physical activity outlets were enumerated. There were no differences in the number of outlets by block group income or race. Further, spatial analyses suggest that the distribution of outlets is dispersed across all block groups. Under the larger CPBR process, this enumeration study advances the causal models set forth by the community members to address obesity by providing an overview of the food and physical activity environment in this region. This data reflects the food and physical activity resources available to residents in the region and will aid many of the community-academic partners as they pursue intervention strategies targeting obesity.

  16. Does availability of physical activity and food outlets differ by race and income? Findings from an enumeration study in a health disparate region

    Directory of Open Access Journals (Sweden)

    Hill Jennie L

    2012-09-01

    Full Text Available Abstract Background Low-income, ethnic/racial minorities and rural populations are at increased risk for obesity and related chronic health conditions when compared to white, urban and higher-socio-economic status (SES peers. Recent systematic reviews highlight the influence of the built environment on obesity, yet very few of these studies consider rural areas or populations. Utilizing a CBPR process, this study advances community-driven causal models to address obesity by exploring the difference in resources for physical activity and food outlets by block group race and income in a small regional city that anchors a rural health disparate region. To guide this inquiry we hypothesized that lower income and racially diverse block groups would have fewer food outlets, including fewer grocery stores and fewer physical activity outlets. We further hypothesized that walkability, as defined by a computed walkability index, would be lower in the lower income block groups. Methods Using census data and GIS, base maps of the region were created and block groups categorized by income and race. All food outlets and physical activity resources were enumerated and geocoded and a walkability index computed. Analyses included one-way MANOVA and spatial autocorrelation. Results In total, 49 stores, 160 restaurants and 79 physical activity outlets were enumerated. There were no differences in the number of outlets by block group income or race. Further, spatial analyses suggest that the distribution of outlets is dispersed across all block groups. Conclusions Under the larger CPBR process, this enumeration study advances the causal models set forth by the community members to address obesity by providing an overview of the food and physical activity environment in this region. This data reflects the food and physical activity resources available to residents in the region and will aid many of the community-academic partners as they pursue intervention

  17. Modern energy access to all in rural India: An integrated implementation strategy

    International Nuclear Information System (INIS)

    Balachandra, P.

    2011-01-01

    Expanding energy access to the rural population of India presents a critical challenge for its government. The presence of 364 million people without access to electricity and 726 million who rely on biomass for cooking indicate both the failure of past policies and programs, and the need for a radical redesign of the current system. We propose an integrated implementation framework with recommendations for adopting business principles with innovative institutional, regulatory, financing and delivery mechanisms. The framework entails establishment of rural energy access authorities and energy access funds, both at the national and regional levels, to be empowered with enabling regulatory policies, capital resources and the support of multi-stakeholder partnership. These institutions are expected to design, lead, manage and monitor the rural energy interventions. At the other end, trained entrepreneurs would be expected to establish bioenergy-based micro-enterprises that will produce and distribute energy carriers to rural households at an affordable cost. The ESCOs will function as intermediaries between these enterprises and the international carbon market both in aggregating carbon credits and in trading them under CDM. If implemented, such a program could address the challenges of rural energy empowerment by creating access to modern energy carriers and climate change mitigation. - Highlights: ► Expanding rural energy access in India is critical with majority lacking access to modern energy. ► Innovative and integrated implementation strategy for achieving universal rural energy access. ► Design of an integrated rural energy policy and proposal for new institutional mechanism. ► Establishing rural energy access authorities and energy access funds as supporting mechanisms. ► Bioenergy-based micro-enterprises for delivering energy services at an affordable cost.

  18. Rural-Urban Differences in Cancer Incidence and Trends in the United States.

    Science.gov (United States)

    Zahnd, Whitney E; James, Aimee S; Jenkins, Wiley D; Izadi, Sonya R; Fogleman, Amanda J; Steward, David E; Colditz, Graham A; Brard, Laurent

    2017-07-27

    Cancer incidence and mortality rates in the US are declining, but this decrease may not be observed in rural areas where residents are more likely to live in poverty, smoke, and forego cancer screening. However, there is limited research exploring national rural-urban differences in cancer incidence and trends. We analyzed data from the North American Association of Central Cancer Registries' public use dataset, which includes population-based cancer incidence data from 46 states. We calculated age-adjusted incidence rates, rate ratios, and annual percentage change (APC) for: all cancers combined; selected individual cancers; and cancers associated with tobacco use and human papillomavirus (HPV). Rural-urban comparisons were made by demographic, geographic, and socioeconomic characteristics for 2009 to 2013. Trends were analyzed for 1995 to 2013. Combined cancers incidence rates were generally higher in urban populations, except for the South, though the urban decline in incidence rate was greater than in rural populations (10.2% vs. 4.8%, respectively). Rural cancer disparities included higher rates of tobacco associated, HPV associated, lung and bronchus, cervical , and colorectal cancers across most population groups. Further, HPV-associated cancer incidence rates increased in rural areas (APC=0.724, purban areas. Cancer rates associated with modifiable risks - tobacco, HPV, and some preventive screening modalities (e.g. colorectal and cervical cancers) - were higher in rural compared to urban populations. Population-based, clinical, and/or policy strategies and interventions that address these modifiable risk factors could help reduce cancer disparities experienced in rural populations. Copyright ©2017, American Association for Cancer Research.

  19. Factors influencing students' choices in considering rural radiography careers at Makerere University, Uganda

    Energy Technology Data Exchange (ETDEWEB)

    Gonzaga, Mubuuke Aloysius [Makerere University, Faculty of Medicine, Department of Radiology, Kampala (Uganda)], E-mail: mubuukeroy@yahoo.co.uk; Kiguli-Malwadde, E.; Francis, Businge [Makerere University, Faculty of Medicine, Department of Radiology, Kampala (Uganda); Rosemary, Byanyima K. [Mulago Hospital, Department of Radiology, Kampala (Uganda)

    2010-02-15

    Introduction: The Faculty of Medicine, Makerere University is the oldest health professions training institution in East Africa having started in 1924. The radiography degree course started in 2001 and Makerere remains the only institution in the East African region offering this degree course. The faculty adopted a Problem based Learning/Community based education curriculum in order to stimulate students' interests to consider working in rural areas. Attracting and retaining radiographers and other health professionals in rural areas is a recognized problem in Uganda and overseas and strategic actions to enhance the rural health workforce and its ability to deliver the required services are paramount. A range of factors in different domains can be associated with recruitment and retention. By consulting students, some of these factors can be identified and addressed. Methodology: It was a descriptive exploratory study involving 31 students. Data was collected through a questionnaire and focus group discussions. Results: 58% of the students reported that they would consider rural radiography practice while 42% would not. Key motivational factors cited to work in rural areas were; attractive salaries/incentives, community based training curricular, opportunities for further training and well equipped rural health facilities. Conclusion: This study has shown that students would consider working in rural areas provided the working conditions are improved upon.

  20. Joys and challenges of relationships in Scotland and New Zealand rural midwifery: A multicentre study.

    Science.gov (United States)

    Crowther, Susan; Deery, Ruth; Daellenbach, Rea; Davies, Lorna; Gilkison, Andrea; Kensington, Mary; Rankin, Jean

    2018-04-21

    Globally there are challenges meeting the recruitment and retention needs for rural midwifery. Rural practice is not usually recognised as important and feelings of marginalisation amongst this workforce are apparent. Relationships are interwoven throughout midwifery and are particularly evident in rural settings. However, how these relationships are developed and sustained in rural areas is unclear. To study the significance of relationships in rural midwifery and provide insights to inform midwifery education. Multi-centre study using online surveys and discussion groups across New Zealand and Scotland. Descriptive and template analysis were used to organise, examine and analyse the qualitative data. Rural midwives highlighted how relationships with health organisations, each other and women and their families were both a joy and a challenge. Social capital was a principal theme. Subthemes were (a) working relationships, (b) respectful communication, (c) partnerships, (d) interface tensions, (e) gift of time facilitates relationships. To meet the challenges of rural practice the importance of relationship needs acknowledging. Relationships are created, built and sustained at a distance with others who have little appreciation of the rural context. Social capital for rural midwives is thus characterised by social trust, community solidarity, shared values and working together for mutual benefit. Rural communities generally exhibit high levels of social capital and this is key to sustainable rural midwifery practice. Midwives, educationalists and researchers need to address the skills required for building social capital in rural midwifery practice. These skills are important in midwifery pre- and post-registration curricula. Copyright © 2018 Australian College of Midwives. All rights reserved.

  1. The role and importance of diversified farming enterprises in socio-economic development of rural areas

    OpenAIRE

    Askarov N.

    2018-01-01

    In this article considered the necessity of the organization and development of diversified farming enterprises, their role and importance in the practical solution of socio-economic problems of rural areas. The issues of the development of farms are important in increasing the employment and income of the rural population, as well as in addressing the social problems associated with them. For the period 2013-2016. 352,015 new jobs were created. Today one of the most effective factors...

  2. Rural recruitment and retention of health workers across cadres and types of contract in north-east India: A qualitative study.

    Science.gov (United States)

    Rajbangshi, Preety R; Nambiar, Devaki; Choudhury, Nandini; Rao, Krishna D

    2017-09-01

    Background Like many other low- and middle-income countries, India faces challenges of recruiting and retaining health workers in rural areas. Efforts have been made to address this through contractual appointment of health workers in rural areas. While this has helped to temporarily bridge the gaps in human resources, the overall impact on the experience of rural services across cadres has yet to be understood. This study sought to identify motivations for, and the challenges of, rural recruitment and retention of nurses, doctors and specialists across types of contract in rural and remote areas in India's largely rural north-eastern states of Meghalaya and Nagaland. Methods A qualitative study was undertaken, in which 71 semi-structured interviews were carried out with doctors (n = 32), nurses (n = 28) and specialists (n = 11). In addition, unstructured key informant interviews (n = 11) were undertaken, along with observations at health facilities and review of state policies. Data were analysed using Ritchie and Spencer's framework method and the World Health Organization's 2010 framework of factors affecting decisions to relocate to, stay in or leave rural areas. Results It was found that rural background and community attachment were strongly associated with health workers' decision to join rural service, regardless of cadre or contract. However, this aspiration was challenged by health-systems factors of poor working and living conditions; low salary and incentives; and lack of professional growth and recognition. Contractual health workers faced unique challenges (lack of pay parity, job insecurity), as did those with permanent positions (irrational postings and political interference). Conclusion This study establishes that the crisis in recruiting and retaining health workers in rural areas will persist until and unless health systems address the core basic requirements of health workers in rural areas, which are related to health-sector policies

  3. Implementing an anti-smoking program in rural-remote communities: challenges and strategies.

    Science.gov (United States)

    Tall, Julie A; Brew, Bronwyn K; Saurman, Emily; Jones, Therese C

    2015-01-01

    Rural-remote communities report higher smoking rates and poorer health outcomes than that of metropolitan areas. While anti-smoking programs are an important measure for addressing smoking and improving health, little is known of the challenges faced by primary healthcare staff implementing those programs in the rural-remote setting. The aim of this study was to explore the challenges and strategies of implementing an anti-smoking program by primary healthcare staff in rural-remote Australia. Guided by a phenomenological approach, semi-structured interviews and focus groups were conducted with health service managers, case managers and general practitioners involved in program implementation in Australian rural-remote communities between 2008 and 2010. Program implementation was reported to be challenged by limited primary and mental healthcare resources and client access to services; limited collaboration between health services; the difficulty of accessing staff training; high levels of community distress and disadvantage; the normalisation of smoking and its deleterious impact on smoking abstinence among program clients; and low morale among health staff. Strategies identified to overcome challenges included appointing tobacco-dedicated staff; improving health service collaboration, access and flexibility; providing subsidised pharmacotherapies and boosting staff morale. Findings may assist health services to better tailor anti-smoking programs for the rural-remote setting, where smoking rates are particularly high. Catering for the unique challenges of the rural-remote setting is necessary if anti-smoking programs are to be efficacious, cost-effective and capable of improving rural-remote health outcomes.

  4. Defining and Describing Rural: Implications for Rural Special Education Research and Policy

    Science.gov (United States)

    Hawley, Leslie R.; Koziol, Natalie A.; Bovaird, James A.; McCormick, Carina M.; Welch, Greg W.; Arthur, Ann M.; Bash, Kirstie

    2016-01-01

    A critical aspect of rural research is carefully defining and describing the rural context. This is particularly important in rural special education research because different definitions of rural may influence resource allocation, grant funding eligibility, and/or research findings. In order to highlight the importance of operationalizing rural,…

  5. Rural Entrepreneurship or Entrepreneurship in the Rural

    DEFF Research Database (Denmark)

    Korsgaard, Steffen; Müller, Sabine; Tanvig, Hanne Wittorff

    2015-01-01

    Purpose: This article investigates how rural entrepreneurship engages with place and space. It explores the concept of “rural” in rural enterprise, and illustrates the importance of distinguishing between types of rural entrepreneurship. Design/methodology/approach: The constructs of “place” and ...... these processes are enabled and constrained by the immediate context or “place”. The paper weaves space and place in order to show the importance of context for entrepreneurship, which responds to the recent calls for contextualizing entrepreneurship research and theories....

  6. Regionalisation of general practice training--are we meeting the needs of rural Australia?

    Science.gov (United States)

    Campbell, David G; Greacen, Jane H; Giddings, Patrick H; Skinner, Lesley P

    2011-06-06

    The concept of "social accountability" has underpinned the development of many medical education programs over the past decade. Success of the regionalisation of the general practice training program in Australia will ultimately be measured by the ability of the program to deliver a sufficient rural general practice workforce to meet the health needs of rural communities. Regionalisation of general practice training in Australia arose from the 1998 recommendations of the Ministerial Review of General Practice Training. The resultant competitive structure adopted by government was not the preferred option of the Review Committee, and may be a negative influence on rural workforce, as the competitive corporate structure of regional training providers has created barriers to meaningful vertical integration. Available data suggest that the regionalised training program is not yet providing a sustainable general practice workforce to rural Australia. The current increase in medical student and general practice training places provides an opportunity to address some of these issues. In particular, it is recommended that changes be made to registrar selection processes, the rural pipeline and vertical integration of training, and training for procedural rural practice. To achieve these goals, perhaps it is time for another comprehensive ministerial review of general practice training in Australia.

  7. Rural origin plus a rural clinical school placement is a significant predictor of medical students' intentions to practice rurally: a multi-university study.

    Science.gov (United States)

    Walker, Judith H; Dewitt, Dawn E; Pallant, Julie F; Cunningham, Christine E

    2012-01-01

    Health workforce shortages are a major problem in rural areas. Australian medical schools have implemented a number of rural education and training interventions aimed at increasing medical graduates' willingness to work in rural areas. These initiatives include recruiting students from rural backgrounds, delivering training in rural areas, and providing all students with some rural exposure during their medical training. However there is little evidence regarding the impact of rural exposure versus rural origin on workforce outcomes. The aim of this study is to identify and assess factors affecting preference for future rural practice among medical students participating in the Australian Rural Clinical Schools (RCS) Program. Questionnaires were distributed to 166 medical students who had completed their RCS term in 2006; 125 (75%) responded. Medical students were asked about their preferred location and specialty for future practice, their beliefs about rural work and life, and the impact of the RCS experience on their future rural training and practice preferences. Almost half the students (47%; n=58) self-reported a 'rural background'. Significantly, students from rural backgrounds were 10 times more likely to prefer to work in rural areas when compared with other students (ppreferring general practice, 80% (n=24) wished to do so rurally. Eighty-five per cent (n=105) of students agreed that their RCS experience increased their interest in rural training and practice with 62% (n=75) of students indicating a preference for rural internship/basic training after their RCS experience. A substantial percentage (86%; n=108) agreed they would consider rural practice after their RCS experience. This baseline study provides significant evidence to support rural medical recruitment and retention through education and training, with important insights into the factors affecting preference for future rural practice. By far the most significant predictor of rural practice

  8. Mapping the interprofessional education landscape for students on rural clinical placements: an integrative literature review.

    Science.gov (United States)

    Walker, Lorraine; Cross, Merylin; Barnett, Tony

    2018-05-01

    Interprofessional collaboration and effective teamwork are core to optimising rural health outcomes; however, little is known about the opportunities available for interprofessional education (IPE) in rural clinical learning environments. This integrative literature review addresses this deficit by identifying, analysing and synthesising the research available about the nature of and potential for IPE provided to undergraduate students undertaking rural placements, the settings and disciplines involved and the outcomes achieved. An integrative review method was adopted to capture the breadth of evidence available about IPE in the rural context. This integrative review is based on a search of nine electronic databases: CINAHL, Cochrane Library, EMBASE, MEDLINE, ProQuest, PubMed, SCOPUS, Web of Science and Google Scholar. Search terms were adapted to suit those used by different disciplines and each database and included key words related to IPE, rurality, undergraduate students and clinical placement. The inclusion criteria included primary research and reports of IPE in rural settings, peer reviewed, and published in English between 2000 and mid-2016. This review integrates the results of 27 primary research studies undertaken in seven countries: Australia, Canada, USA, New Zealand, the Philippines, South Africa and Tanzania. Despite geographical, cultural and health system differences, all of the studies reviewed were concerned with developing collaborative, interprofessional practice-ready graduates and adopted a similar mix of research methods. Overall, the 27 studies involved more than 3800 students (range 3-1360) from 36 disciplinary areas, including some not commonly associated with interprofessional education, such as theology. Interprofessional education was provided in a combination of university and rural placement settings including hospitals, community health services and other rural venues. The education activities most frequently utilised were

  9. Doctors' perspectives on the viability of rural practice.

    Science.gov (United States)

    Jones, J A; Humphreys, J S; Adena, M A

    2004-01-01

    characteristics' (all approximately 23%), 'GP activities and workload' (16%) and 'Professional support' (12%). Eight main factors were identified by practitioners as threats to viability. 'Workforce' was nominated by 57% of respondents, followed by 'Financial' (44%), 'Medico-legal' (33%), 'Administration-political' (16%), 'Community characteristics' (15%), 'GP-practice characteristics' and 'Personal circumstances' (10%) and 'Family circumstances' (3%). Across RRMA 3 to 5 the order of the percentage of respondents identifying each factor was generally consistent, with significant differences in the magnitude of the percentages for three contributing factors and four risk factors. While respondent numbers in RRMA 6 and 7 communities were low, significance testing did reveal differences between them and the rural communities on two contributing and one risk factor. Practice viability is a major factor affecting the attractiveness of rural and remote practice for intending and existing GPs. Initiatives designed to contribute to viability will not be successful unless measures are also adopted to address perceived threats. This study highlights the systemic nature of the factors which contribute to and threaten practice viability. Although a primary component of practice viability is economic, with income from consultations being critical, the importance of the interrelationships between the main viability factors should not be underestimated. Clearly a multifaceted systemic response is required to overcome problems associated with rural workforce recruitment of future and burnout of current rural GPs.

  10. Qualitative exploration of the career aspirations of rural origin health science students in South Africa.

    Science.gov (United States)

    Diab, Paula N; Flack, Penny S; Mabuza, Langalibalele H; Reid, Stephen J Y

    2012-01-01

    There is evidence in the literature that rural background significantly encourages eventual rural practice. Given the shortage of healthcare providers in rural areas, we need to explore ways of ensuring throughput and success of rural-origin students in health sciences. It is therefore important to understand who these students are, what motivates them and the factors involved in the formation of their career choices. The aim of this study is to understand the aspirations of undergraduate health science students of rural origin with regard to their future career plans. The objectives of the study include to explore and identify the key issues facing rural-origin students with regard to their future career plans. Individual interviews were conducted with 15 health science students from two South African universities. Transcriptions were analyzed with the aid of Nvivo v8 (www.qsrinternational.com). The findings suggest health science students of rural origin studying at universities in the South African context face specific challenges related to the nature of the contrast between rural and urban life, in addition to the more generic adaptations that confront all students on entering tertiary education. In order to support rural students in their studies, academic, financial, emotional and social stressors need to be addressed. Universities should strengthen existing support structures as well as aid the development of further support that may be required.Key words: career plan, health science, rural background, South Africa.

  11. The rural pipeline to longer-term rural practice: General practitioners and specialists.

    Directory of Open Access Journals (Sweden)

    Marcella M S Kwan

    Full Text Available Rural medical workforce shortage contributes to health disadvantage experienced by rural communities worldwide. This study aimed to determine the regional results of an Australian Government sponsored national program to enhance the Australian rural medical workforce by recruiting rural background students and establishing rural clinical schools (RCS. In particular, we wished to determine predictors of graduates' longer-term rural practice and whether the predictors differ between general practitioners (GPs and specialists.A cross-sectional cohort study, conducted in 2012, of 729 medical graduates of The University of Queensland 2002-2011. The outcome of interest was primary place of graduates' practice categorised as rural for at least 50% of time since graduation ('Longer-term Rural Practice', LTRP among GPs and medical specialists. The main exposures were rural background (RB or metropolitan background (MB, and attendance at a metropolitan clinical school (MCS or the Rural Clinical School for one year (RCS-1 or two years (RCS-2.Independent predictors of LTRP (odds ratio [95% confidence interval] were RB (2.10 [1.37-3.20], RCS-1 (2.85 [1.77-4.58], RCS-2 (5.38 [3.15-9.20], GP (3.40 [2.13-5.43], and bonded scholarship (2.11 [1.19-3.76]. Compared to being single, having a metropolitan background partner was a negative predictor (0.34 [0.21-0.57]. The effects of RB and RCS were additive-compared to MB and MCS (Reference group: RB and RCS-1 (6.58[3.32-13.04], RB and RCS-2 (10.36[4.89-21.93]. Although specialists were less likely than GPs to be in LTRP, the pattern of the effects of rural exposures was similar, although some significant differences in the effects of the duration of RCS attendance, bonded scholarships and partner's background were apparent.Among both specialists and GPs, rural background and rural clinical school attendance are independent, duration-dependent, and additive, predictors of longer-term rural practice. Metropolitan

  12. Rural transformations in the context of changing rural-urban connections

    DEFF Research Database (Denmark)

    Birch-Thomsen, Torben; Ørtenblad, Sinne Borby; Msese, Lukelo

    , the infrastructure, including road systems and means of communication, has in general increased and improved. This development has among a number of other things caused changing patterns of mobility. These changes are highly interrelated and connected to changing rural-urban linkages, which include flows of people......, capital, resources, agricultural commodities, goods, services, technology and information, between rural and urban locations. We emphasize that the rural-urban connections go beyond the spatial dichotomy and that the linkages often occur in a dynamic rural-urban continuum. Influenced by these changes......, this paper sets out to elucidate patterns and dynamics of rural transformation in Tanzania in the context of changing rural-urban linkages by presenting data from a particularly dynamic region; namely Njombe Region in the Southern Highlands of Tanzania. Based on fieldwork conducted during 2014 and 2015...

  13. Rural electrification: benefits in different spheres; Eletrificacao rural: beneficios em diferentes esferas

    Energy Technology Data Exchange (ETDEWEB)

    Cruz, Cassiano N.P. [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Eletrovento Ltda, Incubadora de Empresas de Base Tecnologica], e-mail: cassiano@eletrovento.com.br; Mourad, Anna L. [Instituto de Tecnologia de Alimentos (ITAL) Campinas, SP (Brazil). Centro de Tecnologia de Embalagem], e-mail: anna@ital.sp.gov.br; Morinigo, Marcos A. [Comissao de Servicos Publicos de Energia do Estado de Sao Paulo (CSPE), SP (Brazil)], e-mail: mmorinigo@sp.gov.br; Sanga, Godfrey [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Fac. de Engenharia Mecanica], e-mail: godfrey@fem.unicamp.br

    2004-07-01

    In the last few decades, there has been a constant migration of rural population to urban areas looking for employment and better quality of life. During the same period, industrial sector grew significantly and became economically more important than the rural sector. Consequently, the industrial sector became government's first development priority. In addition, the energy system was focused on large power plants energy production and high potentials long distance transmissions to large energy consumers, urban centers and industries. Limited efforts were done to provide energy to small and dispersed rural consumers as it seemed to be economically less attractive. This article, therefore, shows the importance of rural electrification over human, economical and social development including its impact across the rural communities' boundaries. While regarded as an important factor for development, rural electrification is, however, a function of many input factors in a mutual dependence relationships, reinforcement and feedback loops. Besides of the evident benefits of increased comfort and satisfaction levels to the rural population, other benefits of rural electrification includes improved access to information and communication media, agricultural mechanization and consequent improvement of the agricultural productivity. Agricultural sector is an important part of the industrial production chain: each R$ 1,00 invested in rural electrification generates R$ 3,00 along the production chain and increases the consumption of durable goods, Word Bank, Gazeta Mercantil (1999). For the population and urbanization control, rural electrification creates favorable conditions to maintain people in the rural areas as such reducing government expenditures for urban infrastructure which is more expensive than the rural one. Moreover, this reduces incidences of unemployment in big cities as it generates jobs in the rural sector. Implementation of a combined rural

  14. Food Access and Perceptions of the Community and Household Food Environment as Correlates of Fruit and Vegetable Intake among Rural Seniors

    Directory of Open Access Journals (Sweden)

    Johnson Cassandra M

    2010-06-01

    Full Text Available Abstract Background Although the importance of fruit and vegetable consumption to health has been well established, few studies have focused on access to fruits and vegetables in rural areas; even fewer examined the relationship between food access and fruit and vegetable consumption among seniors. Methods To examine the spatial challenges to good nutrition faced by seniors who reside in rural areas and how spatial access influences fruit and vegetable intake. A cross-sectional analysis using data from the 2006 Brazos Valley Health Assessment (mailsurvey for 582 rural seniors (60-90 years, who were recruited by random digit dialing; food store data from the 2006-2007 Brazos Valley Food Environment Project that used ground-truthed methods to identify, geocode, and inventory fruit and vegetables in all food stores. Results Few of the BVHA seniors consumed the recommended intakes of fruits or vegetables; women consumed more servings of fruit (1.49 ± 0.05 vs. 1.29 ± 0.07, p = 0.02, similar servings of vegetables (2.18 ± 0.04 vs. 2.09 ± 0.07, p = 0.28, and more combined fruit and vegetables (3.67 ± 0.08 vs. 3.38 ± 0.12, p = 0.04 than men. The median distances to fresh fruit and vegetables were 5.5 miles and 6.4 miles, respectively. When canned and frozen fruit and vegetables were included in the measurement of overall fruit or vegetables, the median distance for a good selection of fruit or vegetables decreased to 3.4 miles for overall fruit and 3.2 miles for overall vegetables. Almost 14% reported that food supplies did not last and there was not enough money to buy more. Our analyses revealed that objective and perceived measures of food store access - increased distance to the nearest supermarket, food store with a good variety of fresh and processed fruit, or food store with a good variety of fresh and processed vegetables - were associated with decreased daily consumption of fruit, vegetables, and combined fruit and vegetables, after

  15. Perceived barriers, resources, and training needs of rural primary care providers relevant to the management of childhood obesity.

    Science.gov (United States)

    Findholt, Nancy E; Davis, Melinda M; Michael, Yvonne L

    2013-08-01

    To explore the perceived barriers, resources, and training needs of rural primary care providers in relation to implementing the American Medical Association Expert Committee recommendations for assessment, treatment, and prevention of childhood obesity. In-depth interviews were conducted with 13 rural primary care providers in Oregon. Transcribed interviews were thematically coded. Barriers to addressing childhood obesity fell into 5 categories: barriers related to the practice (time constraints, lack of reimbursement, few opportunities to detect obesity), the clinician (limited knowledge), the family/patient (family lifestyle and lack of parent motivation to change, low family income and lack of health insurance, sensitivity of the issue), the community (lack of pediatric subspecialists and multidisciplinary/tertiary care services, few community resources), and the broader sociocultural environment (sociocultural influences, high prevalence of childhood obesity). There were very few clinic and community resources to assist clinicians in addressing weight issues. Clinicians had received little previous training relevant to childhood obesity, and they expressed an interest in several topics. Rural primary care providers face extensive barriers in relation to implementing recommended practices for assessment, treatment, and prevention of childhood obesity. Particularly problematic is the lack of local and regional resources. Employing nurses to provide case management and behavior counseling, group visits, and telehealth and other technological communications are strategies that could improve the management of childhood obesity in rural primary care settings. © 2013 National Rural Health Association.

  16. The End of Rural Society and the Future of Rural Sociology.

    Science.gov (United States)

    Friedland, William H.

    Rural sociology confronts a continuing crisis of identity because of its failure to develop a sociology of agriculture. Historically, despite an initial focus on agriculture, rural sociology became deflected to the analysis of rurality. Recent emphasis of rural sociologists on the turnaround phenomenon is symptomatic, but fails to deal with the…

  17. A rural/urban comparison of privacy and confidentiality concerns associated with providing sensitive location information in epidemiologic research involving persons who use drugs.

    Science.gov (United States)

    Rudolph, Abby E; Young, April M; Havens, Jennifer R

    2017-11-01

    Analyses that link contextual factors with individual-level data can improve our understanding of the "risk environment"; however, the accuracy of information provided by participants about locations where illegal/stigmatized behaviors occur may be influenced by privacy/confidentiality concerns that may vary by setting and/or data collection approach. We recruited thirty-five persons who use drugs from a rural Appalachian town and a Mid-Atlantic city to participate in in-depth interviews. Through thematic analyses, we identified and compared privacy/confidentiality concerns associated with two survey methods that (1) collect self-reported addresses/cross-streets and (2) use an interactive web-based map to find/confirm locations in rural and urban settings. Concerns differed more by setting than between methods. For example, (1) rural participants valued interviewer rapport and protections provided by the Certificate of Confidentiality more; (2) locations considered to be sensitive differed in rural (i.e., others' homes) and urban (i.e., where drugs were used) settings; and (3) urban participants were more likely to view providing cross-streets as an acceptable alternative to providing exact addresses for sensitive locations and to prefer the web-based map approach. Rural-urban differences in privacy/confidentiality concerns reflect contextual differences (i.e., where drugs are used/purchased, population density, and prior drug-related arrests). Strategies to alleviate concerns include: (1) obtain a Certificate of Confidentiality, (2) collect geographic data at the scale necessary for proposed analyses, and (3) permit participants to provide intersections/landmarks in close proximity to actual locations rather than exact addresses or to skip questions where providing an intersection/landmark would not obfuscate the actual address. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. The role of rural libraries in the attainment of rural development ...

    African Journals Online (AJOL)

    The paper examines the role that rural libraries could play in the attainment of rural development with a view to accelerate growth in all areas of human endeavors in rural areas of Nigeria. The study took cognizance of inherent problems that undermine the establishment of rural libraries such as funding, illiteracy, clientele ...

  19. Building-level analyses to prospectively detect influenza outbreaks in long-term care facilities: New York City, 2013-2014.

    Science.gov (United States)

    Levin-Rector, Alison; Nivin, Beth; Yeung, Alice; Fine, Annie D; Greene, Sharon K

    2015-08-01

    Timely outbreak detection is necessary to successfully control influenza in long-term care facilities (LTCFs) and other institutions. To supplement nosocomial outbreak reports, calls from infection control staff, and active laboratory surveillance, the New York City (NYC) Department of Health and Mental Hygiene implemented an automated building-level analysis to proactively identify LTCFs with laboratory-confirmed influenza activity. Geocoded addresses of LTCFs in NYC were compared with geocoded residential addresses for all case-patients with laboratory-confirmed influenza reported through passive surveillance. An automated daily analysis used the geocoded building identification number, approximate text matching, and key-word searches to identify influenza in residents of LTCFs for review and follow-up by surveillance coordinators. Our aim was to determine whether the building analysis improved prospective outbreak detection during the 2013-2014 influenza season. Of 119 outbreaks identified in LTCFs, 109 (92%) were ever detected by the building analysis, and 55 (46%) were first detected by the building analysis. Of the 5,953 LTCF staff and residents who received antiviral prophylaxis during the 2013-2014 season, 929 (16%) were at LTCFs where outbreaks were initially detected by the building analysis. A novel building-level analysis improved influenza outbreak identification in LTCFs in NYC, prompting timely infection control measures. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  20. Unpacking Global Service-Learning in Developing Contexts: A Case Study from Rural Tanzania

    Science.gov (United States)

    Oberhauser, Ann M.; Daniels, Rita

    2017-01-01

    This article examines intercultural aspects of global service learning (GSL) focused on gender and sustainable development in rural Tanzania. The discussion draws from critical development and postcolonial feminist approaches to examine how GSL addresses globalization, social histories, and political economies of development. The empirical…

  1. Rural residents' perspectives on the rural 'good death': a scoping review.

    Science.gov (United States)

    Rainsford, Suzanne; MacLeod, Roderick D; Glasgow, Nicholas J; Wilson, Donna M; Phillips, Christine B; Wiles, Robert B

    2018-05-01

    The 'good death' is one objective of palliative care, with many 'good death' viewpoints and research findings reflecting the urban voice. Rural areas are distinct and need special consideration. This scoping review identified and charted current research knowledge on the 'good' rural death through the perspectives of rural residents, including rural patients with a life-limiting illness, to identify evidence and gaps in the literature for future studies. A comprehensive literature search of English language articles (no date filter applied) was conducted in 2016 (2 January to 14 February) using five library databases. Reference lists of included articles, recent issues of eight relevant journals and three grey literature databases were also hand-searched. Twenty articles (for 17 studies and one systematic review) were identified after a two-phase screening process by two reviewers, using pre-determined inclusion criteria. Data from each study were extracted and charted, analysed using a thematic analysis of the included articles' content, and with a quantitative analysis of the scoping review. These papers revealed data collected from rural patients with a life-limiting illness and family caregivers, rural healthcare providers, the wider rural community, rural community leaders and rural health administrators and policy makers. Rural locations were heterogeneous. Residents from developed and developing countries believe a 'good death' is one that is peaceful, free of pain and without suffering; however, this is subjective and priorities are based on personal, cultural, social and religious perspectives. Currently, there is insufficient data to generalise rural residents' perspectives and what it means for them to die well. Given the extreme importance of a 'good death', there is a need for further studies to elicit rural patient and family caregiver perspectives. © 2016 John Wiley & Sons Ltd.

  2. Supermarket and fast-food outlet exposure in Copenhagen

    DEFF Research Database (Denmark)

    Svastisalee, Chalida Mae; Jensen, Helene Nordahl; Glumer, Charlotte

    2011-01-01

    and neighbourhood-level socio-economic indicators. Food business addresses were obtained from commercial and public business locators and geocoded using a geographic information system for all neighbourhoods in the city of Copenhagen (n 400). The regression of counts of fast-food outlets and supermarkets v...

  3. Food Insecurity and Rural Adolescent Personal Health, Home, and Academic Environments.

    Science.gov (United States)

    Shanafelt, Amy; Hearst, Mary O; Wang, Qi; Nanney, Marilyn S

    2016-06-01

    Food-insecure (FIS) adolescents struggle in school and with health and mental health more often than food-secure (FS) adolescents. Rural communities experience important disparities in health, but little is known about rural FIS adolescents. This study aims to describe select characteristics of rural adolescents by food-security status. Baseline analysis using data from a randomized trial to increase school breakfast participation (SBP) in rural Minnesota high schools. Students completed a survey regarding food security, characteristics, and home and school environments. Schools provided academic data and staff measured height and weight. Food security was dichotomized as FS vs FIS. Bivariate analysis, multivariate linear/logistic regression, and testing for interaction of food security and sex were performed. Food-insecure adolescents reported poorer health, less exercise, had lower grades, and higher SBP (p breakfast (p = .05). All associations except reported benefits remained significant after adjustment. Interactions were identified with girls' grade point average and with boys' caloric and added sugar intake. Negative associations among food insecurity and positive youth development are identified in our sample. Policy and environmental strategies should address the complexities of these associations, including exploration of the role of school meals. © 2016, American School Health Association.

  4. LO RURAL. UN CAMPO INACABADO THE RURAL AREA: AN UNFINISHED “FIELD”

    Directory of Open Access Journals (Sweden)

    Nelly del Carmen Suárez Restrepo

    2008-12-01

    Full Text Available El surgimiento de nuevas lecturas de la realidad social rural latinoamericana, e incluso europea, y los efectos de las políticas internacionales sobre qué producir, cuánto, cómo y dónde, han puesto en la agenda académica el debate entorno al significado y contenido de lo rural y del desarrollo rural. En el centro de esta controversia está la superación o ruptura entre lo rural y lo agrario, dos términos otrora considerados como sinónimos. Trascender esta dicotomía reduccionista abre la posibilidad de repensar los caminos y las estrategias mediante las cuales las sociedades en general, en sus esfuerzos por autoproducirse crean condiciones de vida, proveen recursos necesarios y pertinentes y movilizan las capacidades y las libertades de los pobladores rurales. Este documento recoge los elementos más sobresalientes de la investigación “Repensando lo rural y el desarrollo rural” en la que se hizo una revisión de literatura sobre el tema y se buscó, mediante entrevistas semiestructuradas³, la participación de funcionarios institucionales, representantes gremiales y académicos. En términos generales se pretendía identificar los significados y los contenidos que se atribuyen a lo rural y al desarrollo rural. El texto se organiza en tres partes: En la primera parte, Reiteración o resignificación, se analizan los posibles avances y permanencias en los significados y contenidos de lo rural y del desarrollo rural. En la segunda, denominada Elementos constitutivos del desarrollo rural, se hace referencia a las dimensiones, los indicadores y los actores identificados mediante la información obtenida. En la tercera parte, se establece una relación entre el discurso y las prácticas de desarrollo en Colombia y sus implicaciones en el diseño de políticas públicas. Finalmente se concluye que el desarrollo rural ha tenido como trasfondo una orientación modernizadora de la sociedad rural en general y del sector agrario en particular

  5. Non-Emergency Medical Transportation Needs of Middle-Aged and Older Adults: A Rural-Urban Comparison in Delaware, USA.

    Science.gov (United States)

    Smith, Matthew Lee; Prohaska, Thomas R; MacLeod, Kara E; Ory, Marcia G; Eisenstein, Amy R; Ragland, David R; Irmiter, Cheryl; Towne, Samuel D; Satariano, William A

    2017-02-10

    Background : Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas. Methods : Data were analyzed from 39,194 NEMT users of LogistiCare-brokered services in Delaware residing in rural (68.3%) and urban (30.9%) areas. Multivariable logistic analyses compared trip characteristics by rurality designation. Results : Rural (37.2%) and urban (41.2%) participants used services more frequently for dialysis than for any other medical concern. Older age and personal accompaniment were more common and wheel chair use was less common for rural trips. The mean cost per trip was greater for rural users (difference of $2910 per trip), which was attributed to the greater distance per trip in rural areas. Conclusions : Among a sample who were eligible for subsidized NEMT and who utilized this service, rural trips tended to be longer and, therefore, higher in cost. Over 50% of trips were made for dialysis highlighting the need to address prevention and, potentially, health service improvements for rural dialysis patients.

  6. Non-Emergency Medical Transportation Needs of Middle-Aged and Older Adults: A Rural-Urban Comparison in Delaware, USA

    Directory of Open Access Journals (Sweden)

    Matthew Lee Smith

    2017-02-01

    Full Text Available Background: Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas. Methods: Data were analyzed from 39,194 NEMT users of LogistiCare-brokered services in Delaware residing in rural (68.3% and urban (30.9% areas. Multivariable logistic analyses compared trip characteristics by rurality designation. Results: Rural (37.2% and urban (41.2% participants used services more frequently for dialysis than for any other medical concern. Older age and personal accompaniment were more common and wheel chair use was less common for rural trips. The mean cost per trip was greater for rural users (difference of $2910 per trip, which was attributed to the greater distance per trip in rural areas. Conclusions: Among a sample who were eligible for subsidized NEMT and who utilized this service, rural trips tended to be longer and, therefore, higher in cost. Over 50% of trips were made for dialysis highlighting the need to address prevention and, potentially, health service improvements for rural dialysis patients.

  7. Men's Educational Group Appointments in Rural Nicaragua.

    Science.gov (United States)

    Campbell, Bruce B; Gonzalez, Hugo; Campbell, McKenzie; Campbell, Kent

    2017-03-01

    Men's preventive health and wellness is largely neglected in rural Nicaragua, where a machismo culture prevents men from seeking health care. To address this issue, a men's educational group appointment model was initiated at a rural health post to increase awareness about hypertension, and to train community health leaders to measure blood pressure. Men's hypertension workshops were conducted with patient knowledge pretesting, didactic teaching, and posttesting. Pretesting and posttesting performances were recorded, blood pressures were screened, and community leaders were trained to perform sphygmomanometry. An increase in hypertension-related knowledge was observed after every workshop and community health leaders demonstrated proficiency in sphygmomanometry. In addition, several at-risk patients were identified and follow-up care arranged. Men's educational group appointments, shown to be effective in the United States in increasing patient knowledge and satisfaction, appear to function similarly in a resource-constrained environment and may be an effective mechanism for reaching underserved men in Nicaragua.

  8. Pedagogy of the Rural: Implications of Size on Conceptualisations of Rural

    Science.gov (United States)

    Walker-Gibbs, Bernadette; Ludecke, Michelle; Kline, Jodie

    2015-01-01

    This paper proposes a concept of Pedagogy of the Rural that draws together current rural education theory and practice to illustrate the complexities of rural space and place often overlooked in teacher education more broadly. We firstly examine notions of size, and then we explore how this impacts on the ways in which teachers in rural locations…

  9. Estimating the accuracy of geographical imputation

    Directory of Open Access Journals (Sweden)

    Boscoe Francis P

    2008-01-01

    Full Text Available Abstract Background To reduce the number of non-geocoded cases researchers and organizations sometimes include cases geocoded to postal code centroids along with cases geocoded with the greater precision of a full street address. Some analysts then use the postal code to assign information to the cases from finer-level geographies such as a census tract. Assignment is commonly completed using either a postal centroid or by a geographical imputation method which assigns a location by using both the demographic characteristics of the case and the population characteristics of the postal delivery area. To date no systematic evaluation of geographical imputation methods ("geo-imputation" has been completed. The objective of this study was to determine the accuracy of census tract assignment using geo-imputation. Methods Using a large dataset of breast, prostate and colorectal cancer cases reported to the New Jersey Cancer Registry, we determined how often cases were assigned to the correct census tract using alternate strategies of demographic based geo-imputation, and using assignments obtained from postal code centroids. Assignment accuracy was measured by comparing the tract assigned with the tract originally identified from the full street address. Results Assigning cases to census tracts using the race/ethnicity population distribution within a postal code resulted in more correctly assigned cases than when using postal code centroids. The addition of age characteristics increased the match rates even further. Match rates were highly dependent on both the geographic distribution of race/ethnicity groups and population density. Conclusion Geo-imputation appears to offer some advantages and no serious drawbacks as compared with the alternative of assigning cases to census tracts based on postal code centroids. For a specific analysis, researchers will still need to consider the potential impact of geocoding quality on their results and evaluate

  10. Application of Greenhouse Gas Inventory to Urban Rural Planning in China

    Institute of Scientific and Technical Information of China (English)

    Stanley; C.; T.; YIP

    2013-01-01

    Greenhouse Gas (GHG) inventory analysis provides crucial scientific basis to support the preparation of urban-rural planning policies on managing climate change. This article reviews current studies on GHG inventory in China and points out the short fall in translating these inventory data into specific local policies. It examines the issue of setting up the GHG inventory based on the statutory urban-rural planning systems in China. It enables the local government to set up a platform coordinating various city policies and to serve well as the platform for local emission mitigation and removal policies. The urban-rural planning GHG inventory system needs to address the issue of spatial boundary in accounting for local emission sources and origins with respect to the boundaries of planning area, and it must directly relate to the various statutory master plan policy contents and the local municipal government functional structure. Finally it presents a case study of applying the proposed inventory as a planning tool for Jiangyin at the Jiangsu Province.

  11. Adolescent health: a rural community's approach.

    Science.gov (United States)

    Groft, Jean N; Hagen, Brad; Miller, Nancy K; Cooper, Natalie; Brown, Sharon

    2005-01-01

    drugs. Participants indicated awareness of other health-compromising behaviours, including unsafe driving habits and high stress levels, and acknowledged several steps they wanted to take to improve their health, as well as the barriers to taking those steps. Students identified improved nutrition, stress reduction, and increased levels of physical activity as particular important health goals. Students also recommended ways in which information and support could be provided within the school environment to enable them to achieve their health-related goals. Several activities developed in collaboration with students have incorporated the recommendations, and have spawned other activities in response to the ongoing identification of new concerns. The process of including the rural community in the identification of health assets and needs from the perspective of students -- as well as the planning and implementation of appropriate strategies to address those needs -- demonstrates the strengths inherent within a small rural population. Community members' awareness of the need to create a healthy environment for youth is reflected in their willingness to participate in activities leading to improved health. Greater awareness of the health needs of rural adolescents, and of the influence of gender in some aspects of health behaviors, will help researchers to explore ways in which the unique culture of rural communities can be harnessed to help shape health-focused interventions.

  12. Teaching undergraduate students in rural general practice: an evaluation of a new rural campus in England.

    Science.gov (United States)

    Bartlett, Maggie; Pritchard, Katie; Lewis, Leo; Hays, Richard B; Mckinley, Robert K

    2016-01-01

    structured clinical examination performance and that of their peers in other locations. Some students had difficulty with the isolation from peers and academic activities, and travel was a problem despite their accommodation close to the practices. Students valued the learning opportunities offered by the rural practice placements. The general practice tutors, patients and community hospital staff found teaching to be a positive experience overall and perceived a value to the health system and broader community in students learning locally for substantial periods of time. The evaluation has identified some student concerns about transport times and costs, social isolation, and access to resources and administrative tasks, and these are being addressed.

  13. How infrastructure and financial institutions affect rural income and poverty: evidence from Bangladesh.

    Science.gov (United States)

    Khandker, Shahidur R; Koolwal, Gayatri B

    2010-01-01

    The mechanisms by which the poor benefit from economic growth remain a topic of debate in development literature. We address this issue in the context of rural Bangladesh, using a pooled dataset of three household panels between 1991-2001. Expansion of irrigation, paved roads, electricity, and access to formal and informal credit have (through different veins) led to higher rural farm and non-farm incomes, accounting for exogenous local agroclimatic endowments that explain a large part of the variation in the growth of infrastructure and credit programmes. However, this has not translated into substantial reductions in poverty for the poorest households.

  14. LEVERAGING RURAL LIVELIHOODS WITH FOREST CONSERVATION IN NIGERIA: THE ROLE OF NON-TIMBER FOREST PRODUCTS

    Directory of Open Access Journals (Sweden)

    Egbe BASSEY ETOWA

    2015-03-01

    Full Text Available In recent times some economists view Non-Timber Forest Products (NTFPs extraction and marketing as a better alternative to timber exploitation as a rural livelihood strategy. Harvesting and sale of NTFPs have the potential for accomplishing the dual goals of natural forest conservation and income generation for the rural inhabitants. Meanwhile, realization of these dual goals in Nigeria, require an understanding of how NTFPs functions in the face of marketing, ecological, geographic and institutional constraints. Following a conceptualization of NTFPs, this paper provides a vivid overview of the simultaneous roles of NTFPs in rural livelihood enhancement and forest conservation in Nigeria. It highlights governmental initiatives with respect to conservation, the challenges and prospects of NTFPs as a conservation strategy. Conclusively, the paper suggests that appropriate NTFPs development policies are required to simultaneously address forest depletion and poverty in rural areas of Nigeria.

  15. A Comparison of the J-1 Visa Waiver and Loan Repayment Programs in the Recruitment and Retention of Physicians in Rural Nebraska.

    Science.gov (United States)

    Opoku, Samuel T; Apenteng, Bettye A; Lin, Ge; Chen, Li-Wu; Palm, David; Rauner, Thomas

    2015-01-01

    There is a dearth of literature evaluating the effectiveness of programs aimed at recruiting and retaining physicians in rural Nebraska. Taking advantage of the Nebraska Health Professional Tracking System, this study attempts to comparatively assess the effectiveness of the J-1 visa waiver and state loan repayment programs in the recruitment and retention of physicians in rural Nebraska. A mixed methods approach was used. We tracked 240 physicians who enrolled in the J-1 visa waiver and state loan repayment programs between 1996 and 2012 until 2013. In addition, key informant interviews were conducted to obtain perspectives on the recruitment and retention of physicians in rural Nebraska through the 2 programs. Results from multilevel survival regression analysis indicated that physicians enrolled in the J-1 visa waiver program were more likely to leave rural Nebraska when compared with those enrolled in the state loan repayment program. Participants in the qualitative study, however, cautioned against declaring one program as superior over the other, given that the 2 programs addressed different needs for different communities. In addition, results suggested that fostering the integration of physicians and their families into rural communities might be a way of enhancing retention, regardless of program. The findings from this study highlight the complexity of recruitment and retention issues in rural Nebraska and suggest the need for more holistic and family-centered approaches to addressing these issues. © 2015 National Rural Health Association.

  16. Agriculture, Food Production, and Rural Land Use in Advanced Placement® Human Geography

    Science.gov (United States)

    Moseley, William G.; Watson, Nancy H.

    2016-01-01

    ''Agriculture, Food, and Rural Land Use" constitutes a major part of the AP Human Geography course outline. This article explores challenging topics to teach, emerging research trends in agricultural geography, and sample teaching approaches for concretizing abstract topics. It addresses content identified as "essential knowledge"…

  17. A framework for widespread replication of a highly spatially resolved childhood lead exposure risk model.

    Science.gov (United States)

    Kim, Dohyeong; Galeano, M Alicia Overstreet; Hull, Andrew; Miranda, Marie Lynn

    2008-12-01

    Preventive approaches to childhood lead poisoning are critical for addressing this longstanding environmental health concern. Moreover, increasing evidence of cognitive effects of blood lead levels system-based childhood lead exposure risk models, especially if executed at highly resolved spatial scales, can help identify children most at risk of lead exposure, as well as prioritize and direct housing and health-protective intervention programs. However, developing highly resolved spatial data requires labor-and time-intensive geocoding and analytical processes. In this study we evaluated the benefit of increased effort spent geocoding in terms of improved performance of lead exposure risk models. We constructed three childhood lead exposure risk models based on established methods but using different levels of geocoded data from blood lead surveillance, county tax assessors, and the 2000 U.S. Census for 18 counties in North Carolina. We used the results to predict lead exposure risk levels mapped at the individual tax parcel unit. The models performed well enough to identify high-risk areas for targeted intervention, even with a relatively low level of effort on geocoding. This study demonstrates the feasibility of widespread replication of highly spatially resolved childhood lead exposure risk models. The models guide resource-constrained local health and housing departments and community-based organizations on how best to expend their efforts in preventing and mitigating lead exposure risk in their communities.

  18. Red Rural, Blue Rural: The Geography of Presidential Voting in Rural America

    Science.gov (United States)

    Scala, Dante J.; Johnson, Kenneth M.

    2016-01-01

    Political commentators routinely treat rural America as an undifferentiated bastion of strength for Republicans. In fact, rural America is a deceptively simple term describing a remarkably diverse collection of places encompassing nearly 75 percent of the U.S. land area and 50 million people. Voting trends in this vast area are far from…

  19. The only gay in the village? Everyday life of gays and lesbians in rural Slovenia.

    Science.gov (United States)

    Kuhar, Roman; Svab, Alenka

    2014-01-01

    The article deals with the comparison of the characteristics, experiences, and perceptions of everyday life of gays and lesbians living in rural and urban areas of Slovenia. We focus on the following thematic aspects: (1) coming out; (2) intimate partnerships; (3) the access and the use of gay infrastructure; and (4) violence against gays and lesbians. The article also addresses and discusses the urban/rural divide as a Western construct that might not be completely applicable to other social and cultural contexts. Taking Slovenia as an example, this article questions the self-evidence of rural/urban divide as an analytical concept. On the basis of our research, we conclude that this concept requires continuous revisions and reinterpretations in a concrete social and cultural context(s). The characteristics of gay and lesbian everyday life either in rural or in urban context in Slovenia lead to the conclusion that even within a specific social and cultural context, the concept of urban/rural divide should be used carefully, taking into account complexities of everyday lives and various factors that influence them.

  20. Addressing challenges in scaling up TB and HIV treatment integration in rural primary healthcare clinics in South Africa (SUTHI): a cluster randomized controlled trial protocol.

    Science.gov (United States)

    Naidoo, Kogieleum; Gengiah, Santhanalakshmi; Yende-Zuma, Nonhlanhla; Padayatchi, Nesri; Barker, Pierre; Nunn, Andrew; Subrayen, Priashni; Abdool Karim, Salim S

    2017-11-13

    A large and compelling clinical evidence base has shown that integrated TB and HIV services leads to reduction in human immunodeficiency virus (HIV)- and tuberculosis (TB)-associated mortality and morbidity. Despite official policies and guidelines recommending TB and HIV care integration, its poor implementation has resulted in TB and HIV remaining the commonest causes of death in several countries in sub-Saharan Africa, including South Africa. This study aims to reduce mortality due to TB-HIV co-infection through a quality improvement strategy for scaling up of TB and HIV treatment integration in rural primary healthcare clinics in South Africa. The study is designed as an open-label cluster randomized controlled trial. Sixteen clinic supervisors who oversee 40 primary health care (PHC) clinics in two rural districts of KwaZulu-Natal, South Africa will be randomized to either the control group (provision of standard government guidance for TB-HIV integration) or the intervention group (provision of standard government guidance with active enhancement of TB-HIV care integration through a quality improvement approach). The primary outcome is all-cause mortality among TB-HIV patients. Secondary outcomes include time to antiretroviral therapy (ART) initiation among TB-HIV co-infected patients, as well as TB and HIV treatment outcomes at 12 months. In addition, factors that may affect the intervention, such as conditions in the clinic and staff availability, will be closely monitored and documented. This study has the potential to address the gap between the establishment of TB-HIV care integration policies and guidelines and their implementation in the provision of integrated care in PHC clinics. If successful, an evidence-based intervention comprising change ideas, tools, and approaches for quality improvement could inform the future rapid scale up, implementation, and sustainability of improved TB-HIV integration across sub-Sahara Africa and other resource

  1. Empowering village doctors and enhancing rural healthcare using cloud computing in a rural area of mainland China.

    Science.gov (United States)

    Lin, Che-Wei; Abdul, Shabbir Syed; Clinciu, Daniel L; Scholl, Jeremiah; Jin, Xiangdong; Lu, Haifei; Chen, Steve S; Iqbal, Usman; Heineck, Maxwell J; Li, Yu-Chuan

    2014-02-01

    China's healthcare system often struggles to meet the needs of its 900 million people living in rural areas due to major challenges in preventive medicine and management of chronic diseases. Here we address some of these challenges by equipping village doctors (ViDs) with Health Information Technology and developing an electronic health record (EHR) system which collects individual patient information electronically to aid with implementation of chronic disease management programs. An EHR system based on a cloud-computing architecture was developed and deployed in Xilingol county of Inner Mongolia using various computing resources (hardware and software) to deliver services over the health network using Internet when available. The system supports the work at all levels of the healthcare system, including the work of ViDs in rural areas. An analysis done on 291,087 EHRs created from November 2008 to June 2011 evaluated the impact the EHR system has on preventive medicine and chronic disease management programs in rural China. From 2008 to 2011 health records were created for 291,087 (26.25%) from 1,108,951 total Xilingol residents with 10,240 cases of hypertension and 1152 cases of diabetes diagnosed and registered. Furthermore, 2945 hypertensive and 305 diabetic patients enrolled in follow-up. Implementing the EHR system revealed a high rate of cholecystectomies leading to investigations and findings of drinking water contaminated with metals. Measures were taken to inform the population and clean drinking water was supplied. The cloud-based EHR approach improved the care provision for ViDs in rural China and increased the efficiency of the healthcare system to monitor the health status of the population and to manage preventive care efforts. It also helped discover contaminated water in one of the project areas revealing further benefits if the system is expanded and improved. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Connecting College Learners with Rural Entrepreneurship Opportunities: The Rural Entrepreneurship Teaching Unit

    Science.gov (United States)

    Frazier, Barbara J.; Niehm, Linda S.; Stoel, Leslie

    2012-01-01

    The Rural Entrepreneurship Teaching Unit (RETU) is designed to acquaint university retailing and hospitality majors with rural entrepreneurship opportunities. The unit is an outcome of a federal grant focused on the contribution of the local retail sector to rural community resilience. The RETU integrates knowledge regarding rural development,…

  3. Voluntary, Randomized, Student Drug-Testing: Impact in a Rural, Low-Income, Community

    Science.gov (United States)

    Barrington, Kyle D.

    2008-01-01

    Illegal drug use and abuse by the nation's secondary school students is a continuing public health issue and this is especially true for students living in rural, low-income areas where access to intervention and treatment services is often limited. To address this issue, some school districts have implemented voluntary, randomized, student …

  4. Rural Non-Farm Sector and Labor Market in Rural Vietnam: Trends and Determinants

    OpenAIRE

    Nguyen , Trung Hung

    2016-01-01

    This dissertation aims to investigate the Trends and Determinants of the Rural Non-Farm Sector and Labor Market in Rural Vietnam since the global economic crisis occurred in 2007 with the focus on the household's diversification; the involvement of rural individuals in Rural Non-Farm Employment; Rural Labor Market development; and assessment of a specific labor market policy.

  5. Cervical cancer screening in rural South Africa among HIV-infected migrant farm workers and sex workers

    Directory of Open Access Journals (Sweden)

    Omara Afzal

    2017-05-01

    We demonstrate successful integration of cervical cancer screening using VIA for HIV+ farm workers and sex workers into an existing HIV treatment and prevention clinic in rural South Africa, addressing and treating abnormal results promptly.

  6. Collaborative innovations with rural and regional secondary teachers: enhancing student learning in mathematics

    Science.gov (United States)

    Pegg, John; Panizzon, Debra

    2011-06-01

    When questioned, secondary mathematics teachers in rural and regional schools in Australia refer to their limited opportunities to engage and share experiences with peers in other schools as an under-utilised and cost-effective mechanism to support their professional learning and enhance their students' learning. The paper reports on the creation and evaluation of a network of learning communities of rural secondary mathematics teachers around a common purpose—enhancement and increased engagement of student learning in mathematics. To achieve this goal, teams of teachers from six rural schools identified an issue hindering improved student learning of mathematics in their school. Working collaboratively with support from university personnel with expertise in curriculum, assessment and quality pedagogy, teachers developed and implemented strategies to address an identified issue in ways that were relevant to their teaching contexts. The research study identifies issues in mathematics of major concern to rural teachers of mathematics, the successes and challenges the teachers faced in working in learning communities on the issue they identified, and the efficacy of the professional learning model.

  7. Parenting Education: An Exemplary Program for Rural/Migrant Youth and Adults. Final Report.

    Science.gov (United States)

    Baum, Rosemere; And Others

    Designed for use in a parenting education course for rural/migrant youth and adults, this parenting education learning kit consists of a coordinator's manual and bilingual instructional materials for seven course sessions. Issues addressed in the coordinator's manual include program content, program format, orientation for experienced parents,…

  8. Rural maternity care.

    Science.gov (United States)

    Miller, Katherine J; Couchie, Carol; Ehman, William; Graves, Lisa; Grzybowski, Stefan; Medves, Jennifer

    2012-10-01

    To provide an overview of current information on issues in maternity care relevant to rural populations. Medline was searched for articles published in English from 1995 to 2012 about rural maternity care. Relevant publications and position papers from appropriate organizations were also reviewed. This information will help obstetrical care providers in rural areas to continue providing quality care for women in their communities. Recommendations 1. Women who reside in rural and remote communities in Canada should receive high-quality maternity care as close to home as possible. 2. The provision of rural maternity care must be collaborative, woman- and family-centred, culturally sensitive, and respectful. 3. Rural maternity care services should be supported through active policies aligned with these recommendations. 4. While local access to surgical and anaesthetic services is desirable, there is evidence that good outcomes can be sustained within an integrated perinatal care system without local access to operative delivery. There is evidence that the outcomes are better when women do not have to travel far from their communities. Access to an integrated perinatal care system should be provided for all women. 5. The social and emotional needs of rural women must be considered in service planning. Women who are required to leave their communities to give birth should be supported both financially and emotionally. 6. Innovative interprofessional models should be implemented as part of the solution for high-quality, collaborative, and integrated care for rural and remote women. 7. Registered nurses are essential to the provision of high-quality rural maternity care throughout pregnancy, birth, and the postpartum period. Maternity nursing skills should be recognized as a fundamental part of generalist rural nursing skills. 8. Remuneration for maternity care providers should reflect the unique challenges and increased professional responsibility faced by providers in

  9. ROLE OF RURAL TOURISM FOR DEVELOPMENT OF RURAL AREAS

    Directory of Open Access Journals (Sweden)

    Andrej Udovč

    2001-09-01

    Full Text Available The paper analyse the role of rural tourism for the development of rural areas, on the comparison of two regions with different types of rural tourism. One area is of highly diversifi ed rural tourism with wide range of tourist products (rafting, hiking, cycling, farm tourism, skiing …. The tourism offer in the second area is much more uniform (mainly farm tourism and some spa. The study analysed how the two different types of tourist product diversifi cations influence the development possibilities of studied rural areas. We analysed how different systems are able to maintain its functions in the context of identifi ed perturbations (socio-economic and geophysical. We analysed the infl uence of different factors on systems stability, its resilience, robustness and integrity. The gained results show that only the higher level of diversifi cation is not a guarantee for systems higher stability, resilience, robustness and integrity, but there also other

  10. Implications of rural tourism and agritourism in sustainable rural development

    Directory of Open Access Journals (Sweden)

    Flavia-Lorena Cut-Lupulescu

    2014-10-01

    Full Text Available Romania shows: a variety of historical cultural values ​​- folk art, ethnography, folklore, traditions, historical artifacts - a natural harmoniously combined with a varied and picturesque landscape background. All these are facets of Romanian rural tourism in particular. Occurred and developed by the various forms of relief since the time of the Thracian-Dacian, Romanian rural settlements kept and still keeps in good measure ancient customs and traditions, a rich and varied folklore, ethnography and folk original elements that can be travel exploited in a strategy for the organization and development of rural tourism. Rural tourism in our country always practical, but spontaneous, sporadic, random, and mostly unorganized form of manifestation is the beginning of the '20s and '30s, the casual visitor accommodation citizens of rural settlements.

  11. Prevalence of diabetic complications in rural Goa, India

    Directory of Open Access Journals (Sweden)

    Nafisa C Vaz

    2011-01-01

    Full Text Available Objective : To determine the prevalence of diabetes mellitus (DM and its associated diabetic complications in rural Goa, India. Materials and Methods: A community-based study was carried out in a rural setting in Goa, India. About 1,266 participants were selected by systematic random sampling. The participants were interviewed using a semi-structured questionnaire and were subjected to anthropometric, clinical evaluation and biochemical investigations. American Diabetes Association criteria were used to determine the prevalence of diabetes and standard operational definitions were used to define the diabetic complications. Data was analyzed using SPSS version 14.0 while chi-square and chi-square for trend were the tests used. Results: Among the total 1,266 study participants about 130 (10.3% were diabetics. The prevalence of the associated diabetic complications were as follows viz. neuropathy (60%, CHD (32.3% and cataract (20%, retinopathy (15.4%, peripheral vascular disease (11.5% and cerebrovascular accidents (CVAs (6.9%. A significant rising trend in the prevalence of all diabetic complications was observed with advancing duration of diabetes. Conclusion: The prevalence of DM and its associated complications was higher among the diabetic individuals in the rural setting of Goa, India. All the associated diabetic complications observed need to be addressed with appropriate prevention and control strategies.

  12. Violence in Rural, Suburban, and Urban Schools in Pennsylvania.

    Science.gov (United States)

    Flynn, Kalen; McDonald, Catherine C; D'Alonzo, Bernadette A; Tam, Vicky; Wiebe, Douglas J

    2018-01-01

    School violence is a public health issue with direct and collateral consequences that has academic and social impacts for youth. School violence is often considered a uniquely urban problem, yet more research is needed to understand how violence in rural and suburban schools may be similar or different from urban counterparts. Using school violence data from a state with urban, suburban, and rural counties, we explored the landscape of school violence in Pennsylvania (PA) through mapping, descriptive statistics, and factor analysis. Results show school violence is not solely an urban problem. Schools in all county types and across grade levels deal with violence to varying degrees, and the majority of schools across county types experience low levels of violence. Types of violence experienced by PA schools loaded onto three factors, suggesting that targeted interventions may be better suited to addressing school violence.

  13. Integrated farm sustainability assessment for the environmental management of rural activities

    International Nuclear Information System (INIS)

    Stachetii Rodrigues, Geraldo; Aparecida Rodrigues, Izilda; Almeida Buschinelli, Claudio Cesar de; Barros, Inacio de

    2010-01-01

    Farmers have been increasingly called upon to respond to an ongoing redefinition in consumers' demands, having as a converging theme the search for sustainable production practices. In order to satisfy this objective, instruments for the environmental management of agricultural activities have been sought out. Environmental impact assessment methods are appropriate tools to address the choice of technologies and management practices to minimize negative effects of agricultural development, while maximizing productive efficiency, sound usage of natural resources, conservation of ecological assets and equitable access to wealth generation means. The 'system for weighted environmental impact assessment of rural activities' (APOIA-NovoRural) presented in this paper is organized to provide integrated farm sustainability assessment according to quantitative environmental standards and defined socio-economic benchmarks. The system integrates sixty-two objective indicators in five sustainability dimensions - (i) Landscape ecology, (ii) Environmental quality (atmosphere, water and soil), (iii) Sociocultural values, (iv) Economic values, and (v) Management and administration. Impact indices are expressed in three integration levels: (i) specific indicators, that offer a diagnostic and managerial tool for farmers and rural administrators, by pointing out particular attributes of the rural activities that may be failing to comply with defined environmental performance objectives; (ii) integrated sustainability dimensions, that show decision-makers the major contributions of the rural activities toward local sustainable development, facilitating the definition of control actions and promotion measures; and (iii) aggregated sustainability index, that can be considered a yardstick for eco-certification purposes. Nine fully documented case studies carried out with the APOIA-NovoRural system, focusing on different scales, diverse rural activities/farming systems, and contrasting

  14. Problemy razvitija sel'skoj mestnosti Severo-Vostochnoj Germanii [Rural areas of Eastern Germany: modern challenges

    Directory of Open Access Journals (Sweden)

    Levchenkov Andrei

    2012-01-01

    Full Text Available After the German reunification the agricultural development of eastern territories seemed to have picked up its pace. Yet the main problems those territories are facing today hatched already in the mid-1990s. In our study we address the problems and challenges that hinder sustainable development of East German rural areas. We analyse agricultural statistics and describe the structure of agricultural enterprises, land-use, and other critical dimensions of agriculture. We discuss pros and cons of modern rural areas spatial planning policy and take a critical look at the current status of rural areas. We also put forward a number of concrete proposals aimed at the development of the area and counteracting the negative trends it is now experiencing. Even taking into account all ‘positive’ development trends that are postulated to have occurred since the unification, we underline the crucial necessity of diversification of labour forces and of changing the spatial planning policies in the rural areas of East Germany.

  15. Rural women caregivers in Canada.

    Science.gov (United States)

    Crosato, Kay E; Leipert, Beverly

    2006-01-01

    Informal caregiving within rural contexts in Canada is increasing. This is due in part to a number of factors related to the restructuring of the Canadian health care system, the regionalization of services to urban locations, the increased population of people 65 years and older, and the desire of this population to age within their rural homes. Most often, the informal caregiving role is assumed by rural women. Women tend to fall into the role of informal caregiver to elders because of the many societal and gender expectations and values that are present within the rural culture. The purpose of this literature review is to identify the context in which women provide care for an elder in rural Canada. Illustrating these issues will help to uncover challenges and barriers rural women face when providing care and highlight recommendations and implications for rural women caregivers and nurses employed within rural settings. Many rural women share similar caregiving experiences as urban informal caregivers, but rural women are faced with additional challenges in providing quality care for an elder. Rural women caregivers are faced with such issues as limited access to adequate and appropriate healthcare services, culturally incongruent health care, geographical distance from regionalized centers and health services, transportation challenges, and social/geographical isolation. In addition to these issues, many rural women are faced with the multiple role demands that attend being a wife, mother, caregiver and employee. The pile up of these factors leaves rural women caregivers susceptible to additional stresses and burn out, with limited resources on which to depend. Through reviewing pertinent literature, appropriate implications and recommendations can be made that may assist rural women caregivers and rural nurses. Nurses working within rural communities are in ideal settings to work collaboratively in building supportive relationships with rural women in order to

  16. Southern Nevada residents' views about the Yucca Mountain high-level nuclear waste repository and related issues: A comparative analysis of urban and rural survey data

    International Nuclear Information System (INIS)

    Krannich, R.S.; Little, R.L.; Mushkatel, A.; Pijawka, K.D.; Jones, P.

    1991-10-01

    Two separate surveys were undertaken in 1988 to ascertain southern Nevadans' views about the Yucca Mountain repository and related issues. The first of these studies focused on the attitudes and perceptions of residents in the Las Vegas metropolitan area. The second study addressed similar issues, but focused on the views of residents in six rural communities in three counties adjacent to the Yucca Mountain site. However, parallel findings from the two data sets have not been jointly analyzed in order to identify ways in which the views and orientations of residents in the rural and urban study areas may be similar or different. The purpose of this report is to develop and present a comparative assessment of selected issues addressed in the rural and urban surveys. Because both urban and rural populations would potentially be impacted by the Yucca Mountain repository, such an analysis will provide important insights into possible repository impacts on the well-being of residents throughout southern Nevada

  17. RURAL TOURISM AS AN IMPORTANT SOURCE OF INCOME FOR RURAL PLACES

    Directory of Open Access Journals (Sweden)

    Mariana IATAGAN

    2009-06-01

    Full Text Available Tourism is the most important economic branch, worldwide, owning 12% of all areas of activity and revenue of approximately 530 billion dollars per year. In the past 10 years we could see an increasing demand for rural tourism and ecotourism, many of the international travel agencies offering ecotourism packages. Our country is attractive from the perspective of international travel agencies, because of unpolluted nature, the authenticity of traditions, the Danube Delta, old forests and not least, because the Romanian hospitality.Rural tourism had been practiced for a long time in Romania but for the past 15-20 years, it was casual and without any form of organization. Tourism activities in rural areas are carried out when agricultural activities takeplace and contribute to the welfare of rural communities that practice it.The development of tourism activities requires attention to the quality of the environment by preserving and developing the quality in the areas that have entered the tourist circuit, controlling the activity quality for a rational use of tourism resources.Our country benefits from EU funding through several programs including SAPARD, taking one of the measures, Measure 3.4, which is called the development and diversification of economic activities that generate multiple activities and alternative incomes.A deciding role in the development of rural tourism is held by the general infrastructure, requiring subsidies from the budget for tourism attraction areas for sustaining, by public administrations, programs to support tourism in rural areas.Rural tourism contributes to the sustainable development of the Romanian rural environment by proper use of local resources, establishing youth in rural areas, reducing the number of unemployed, women's involvement in economic and social life of rural settlements, raising living standards, growth in household rural areas, increasing the industry's contribution to the formation of gross

  18. Factors Associated with Contraceptive Use among Women of Reproductive Age in Rural Districts of Burkina Faso.

    Science.gov (United States)

    Wulifan, Joseph K; Mazalale, Jacob; Jahn, Albrecht; Hien, Hervé; Ilboudo, Patrick Christian; Meda, Nicolas; Robyn, Paul Jacob; Hamadou, Saidou; Haidara, Ousmane; De Allegri, Manuela

    2017-01-01

    Given the current low contraceptive use and corresponding high levels of unwanted pregnancies leading to induced abortions and poor maternal health outcomes among rural populations, a detailed understanding of the factors that limit contraceptive use is essential. Our study investigated household and health facility factors that influence contraceptive use decisions among rural women in rural Burkina Faso. We collected data on fertile non-pregnant women in 24 rural districts in 2014. Of 8,657 women, 1,098 used a modern contraceptive. Women having a living son, a child younger than one year, and household wealth were more likely to use modern contraceptives. Women in polygamous marriages and women living at least 5 kilometers from a health facility were less likely to use contraception. We conclude that modern contraceptive use remains weak, hence, programs aiming to encourage contraceptive use must address barriers at both the health facility and the household level.

  19. A Systematic Review of Services to DHH Children in Rural and Remote Regions

    Science.gov (United States)

    Barr, Megan; Duncan, Jill; Dally, Kerry

    2018-01-01

    Children in regional, rural and remote areas have less access to services than those living in urban areas. Practitioners serving children with a hearing loss have attempted to address this gap, however there are few studies investigating service access and experiences of non-metropolitan families and professionals. This systematic review…

  20. The Potential of Computer-Based Expert Systems for Special Educators in Rural Settings.

    Science.gov (United States)

    Parry, James D.; Ferrara, Joseph M.

    Knowledge-based expert computer systems are addressing issues relevant to all special educators, but are particularly relevant in rural settings where human experts are less available because of distance and cost. An expert system is an application of artificial intelligence (AI) that typically engages the user in a dialogue resembling the…

  1. Efficacy Study of a Pre-Algebra Supplemental Program in Rural Mississippi: Preliminary Findings

    Science.gov (United States)

    Clark, Tedra F.; Arens, Sheila A.; Stewart, Joshua

    2015-01-01

    Mastering mathematics is important for all students, not only because such success increases college and career options and prospects for future income, but also because mathematics literacy helps citizens and policy leaders to make sound judgments (NMAP, 2008). Research suggests that the rural achievement gap can be addressed with modifiable…

  2. Self-reported morbidity and health service utilization in rural Tamil Nadu, India.

    Science.gov (United States)

    Dodd, Warren; King, Nia; Humphries, Sally; Little, Matthew; Dewey, Cate

    2016-07-01

    In Tamil Nadu, India, improvements have been made toward developing a high-quality, universally accessible healthcare system. However, some rural residents continue to confront significant barriers to obtaining healthcare. The primary objective of this study was to investigate self-reported morbidity, health literacy, and healthcare preferences, utilization, and experiences in order to identify priority areas for government health policies and programs. Drawing on 66 semi-structured interviews and 300 household surveys (including 1693 individuals), administered in 26 rural villages in Tamil Nadu's Krishnagiri district, we found that the prevalence of self-reported major health conditions was 22.3%. There was a large burden of non-communicable and chronic diseases, and the most common major morbidities were: connective tissue problems (7.6%), nervous system and sense organ diseases (5.0%), and circulatory and respiratory diseases (2.5%). Increased age and decreased education level were associated with higher odds of reporting most diseases. Low health literacy levels resulted in individuals seeking care only once pain interfered with daily activities. As such, individuals' health-seeking behaviour depended on which strategy was believed to result in the fastest return to work using the fewest resources. Although government facilities were the most common healthcare access point, they were mistrusted; 48.8% and 19.2% of respondents perceived inappropriate treatment protocols and corruption, respectively, at public facilities. Conversely, 93.3% of respondents reported high treatment cost as the main barrier to accessing private facilities. Our results highlight that addressing the chronic and non-communicable disease burdens amongst rural populations in this context will require health policies and village-level programs that address the low health literacy and the issues of rural healthcare accessibility and acceptability. Copyright © 2016 Elsevier Ltd. All rights

  3. Rural Airports

    Data.gov (United States)

    Department of Transportation — The Rural Airports database is the list of rural airports compiled annually by BTS for the Treasury Department/IRS. It is used by airlines to assist in establishing...

  4. Rural Cultural Houses (A New Approach to Rural Youth Work in Iran).

    Science.gov (United States)

    Salmanzadeh, Cyrus

    Based on field work in rural areas of Khuzestan Province in southwestern Iran in 1973-74, an examination of the nature of rural cultural houses in Iran was undertaken. Set up by royal decree in 1968, the rural cultural houses have had as their objective to assist peasantry in general and rural youth in particular to achieve a socially enriched…

  5. CORRELACIONES ENTRE LA SELECCIÓN PRONOMINAL, EL ORIGEN URBANO/RURAL Y LA EDAD: EL CASO DE JÓVENES UNIVERSITARIOS DE MEDELLÍN (COLOMBIA CORRELATIONS BETWEEN THE PRONOMINAL ADDRESS FORMS, ORIGIN (URBAN/RURAL AND AGE: THE CASE OF COLLEGE STUDENTS IN MEDELLIN (COLOMBIA

    Directory of Open Access Journals (Sweden)

    Ji son Jang

    2012-08-01

    ; 3 Non-parametric Kruskal-Wallis test (Kruskal & Wallis, 1952; and 4 Analysis of variance (ANOVA. Statistics show that : 1 students from rural areas with parents of the same origin tend to use more usted than tú/ vos in most interpersonal relationships, and more vos than tú almost exclusively when they are addressing their boy/girlfriend; 2 the average age for the selection of usted is higher than for the selection of tú/vos in most cases, and just in certain cases the average age is higher using tú than the average age using vos.

  6. Home Water Treatment Habits and Effectiveness in a Rural Arizona Community.

    Science.gov (United States)

    Lothrop, Nathan; Wilkinson, Sarah T; Verhougstraete, Marc; Sugeng, Anastasia; Loh, Miranda M; Klimecki, Walter; Beamer, Paloma I

    Drinking water quality in the United States (US) is among the safest in the world. However, many residents, often in rural areas, rely on unregulated private wells or small municipal utilities for water needs. These utilities may violate the Safe Drinking Water Act contaminant guidelines, often because they lack the required financial resources. Residents may use alternative water sources or install a home water treatment system. Despite increased home water treatment adoption, few studies have examined their use and effectiveness in the US. Our study addresses this knowledge gap by examining home water treatment in a rural Arizona community. Water samples were analyzed for metal(loid)s, and home treatment and demographic data were recorded in 31 homes. Approximately 42% of homes treated their water. Independent of source water quality, residents with higher income (OR = 1.25; 95%CI (1.00 - 1.64)) and education levels (OR = 1.49; 95%CI (1.12 - 2.12)) were more likely to treat their water. Some contaminant concentrations were effectively reduced with treatment, while some were not. We conclude that increased educational outreach on contaminant testing and treatment, especially to rural areas with endemic water contamination, would result in a greater public health impact while reducing rural health disparities.

  7. Rural-to-urban migration and its implications for poverty alleviation.

    Science.gov (United States)

    Skeldon, R

    1997-03-01

    This article examines rural-urban migration, its role in poverty alleviation in Thailand, and policy implications. The empirical research literature suggests that the poorest tend be left behind by wealthier migrants moving to urban areas. The youngest tend to migrate. The impact of remittances tends to appear more positive in international migration, but the impact of remittances among rural internal migrant families can also be substantial and be responsible for wealth differences within rural communities. Return migrants contribute to communities by bringing back new ideas and new attitudes toward family size. Migration can also produce negative impacts for sending communities, but the total analysis appears to favor positive impacts. The urban sector becomes another resource base for rural populations that can sustain rural populations during rapid change processes. The migrant population tends to be wealthier and better educated than rural populations, but poorer and less educated than urban populations. Informal sectors in urban areas may offer migrants flexible working hours, no taxes or deductions, less bureaucratic structures, and only 9% less income than the formal sector. Social networks reinforce migrant work in the informal sector and segmentation of the labor force. Social networks may be formalized into associations and help in securing migrant's housing and living. Migrants are integrated in a variety of ways into city life. Migrant communities are a source of energy, organizational skills, and talent. The incidence of poverty appears to be the greatest among women. Women migrants and women left behind by migrants must adjust to new conditions. Migration policies tend to focus on regulating the volume of migration. The author concludes that migration alleviates poverty and that policies should address city management, migrant adjustment processes, and training programs for nonmigrants.

  8. Multiple Relationships : Maintaining Professional Identity in Rural Social Work Practice

    Directory of Open Access Journals (Sweden)

    Keith Brownlee

    2015-03-01

    Full Text Available Working in a rural community locates the professional in a wider social network as community members often expect more from their professionals; not only as service providers, but also as engaged members of the community. This can result in the rural social worker being highly visible both personally and professionally and it can also lead to overlapping relationships. These higher expectations can place stress on the worker in terms of maintaining accepted professional roles and a sense of professional identity. This qualitative study explores the first-hand experiences of a cross-section of service providers in more than a dozen communities within northwestern Ontario and northern Manitoba, Canada. The responses of the participants provide some insight into how rural practitioners maintain their professional identity when working within the unique demands of the rural and remote context. Recurring themes from the interviews suggest that these professionals craft their own informal decision-making processes to address intersecting roles, community gossip, and personal isolation, even while, in some cases, practicing in their home community. The findings provide greater understanding of the pressures and realities of working in small remote towns and the challenges of responding to the expectations and realities of relationships including the expectation of working with friends and family members of friends or colleagues: issues that have not been adequately studied in the literature to date.

  9. Surgical specialty procedures in rural surgery practices: implications for rural surgery training.

    Science.gov (United States)

    Sticca, Robert P; Mullin, Brady C; Harris, Joel D; Hosford, Clint C

    2012-12-01

    Specialty procedures constitute one eighth of rural surgery practice. Currently, general surgeons intending to practice in rural hospitals may not get adequate training for specialty procedures, which they will be expected to perform. Better definition of these procedures will help guide rural surgery training. Current Procedural Terminology codes for all surgical procedures for 81% of North Dakota and South Dakota rural surgeons were entered into the Dakota Database for Rural Surgery. Specialty procedures were analyzed and compared with the Surgical Council on Resident Education curriculum to determine whether general surgery training is adequate preparation for rural surgery practice. The Dakota Database for Rural Surgery included 46,052 procedures, of which 5,666 (12.3%) were specialty procedures. Highest volume specialty categories included vascular, obstetrics and gynecology, orthopedics, cardiothoracic, urology, and otolaryngology. Common procedures in cardiothoracic and vascular surgery are taught in general surgical residency, while common procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology are usually not taught in general surgery training. Optimal training for rural surgery practice should include experience in specialty procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Building consensus on key priorities for rural health care in South Africa using the Delphi technique.

    Science.gov (United States)

    Versteeg, Marije; du Toit, Lilo; Couper, Ian

    2013-01-24

    South Africa is currently undergoing major health system restructuring in an attempt to improve health outcomes and reduce inequities in access. Such inequities exist between private and public health care and within the public health system itself. Experience shows that rural health care can be disadvantaged in policy formulation despite good intentions. The objective of this study was to identify the major challenges and priority interventions for rural health care provision in South Africa thereby contributing to pro-rural health policy dialogue. The Delphi technique was used to develop consensus on a list of statements that was generated through interviews and literature review. A panel of rural health practitioners and other stakeholders was asked to indicate their level of agreement with these statements and to rank the top challenges in and interventions required for rural health care. Response rates ranged from 83% in the first round (n=44) to 64% in the final round (n=34). The top five priorities were aligned to three of the WHO health system building blocks: human resources for health (HRH), governance, and finance. Specifically, the panel identified a need to focus on recruitment and support of rural health professionals, the employment of managers with sufficient and appropriate skills, a rural-friendly national HRH plan, and equitable funding formulae. Specific policies and strategies are required to address the greatest rural health care challenges and to ensure improved access to quality health care in rural South Africa. In addition, a change in organisational climate and a concerted effort to make a career in rural health appealing to health care workers and adequate funding for rural health care provision are essential.

  11. Coroners' records of rural and non-rural cases of youth suicide in New South Wales.

    Science.gov (United States)

    Dudley, M; Kelk, N; Florio, T; Waters, B; Howard, J; Taylor, D

    1998-04-01

    The aim of this study is to compare the frequency of certain putative risk factors for youth suicide in New South Wales (especially use of alcohol, social class, unemployment, and internal migration) in metropolitan and rural settings. A review of 137 files for 10-19-year-old subjects judged by the Coroner to have committed suicide in 1988-1990 was carried out. One hundred and fifteen males and 21 females were identified (one subjects sex was unavailable). The male-female ratio was higher in rural (13.0) areas than non-rural (4.9 chi 2 = 12.14, p Australia, most migrated in a rural direction, and most to rural shires. Unemployment was somewhat more common among rural (38.5%) than non-rural (28.9%) subjects (chi 2 = 0.75, p = 0.39). Eleven of 50 non-rural parents of the deceased, but none of the 11 rural parents, were ranked as being in social classes 2 or 3. Alcohol consumption appeared more common in rural shires (44%) than metropolitan areas (32.9%), but this was not statistically significant. Medical services were less utilised prior to death in rural (15%) than non-rural (25%) areas (chi 2 = 1.69, p = 0.19), and a psychiatric diagnosis was recorded more commonly in non-rural areas. Incomplete coronial file data and relatively small numbers limit this study's conclusions. Male suicides, principally by firearms, predominated in rural areas. Youth firearm access remains highly relevant to rural communities. Possible trends among rural subjects toward rural migration, higher unemployment, lower social class and lower medical attendance may point to resource deprivation among this group; these matters require further investigation.

  12. Youth retention in rural areas, a prerequisite for sustainable rural entrepreneurship and employment

    Directory of Open Access Journals (Sweden)

    Ali Ghasemi Ardahaee

    2017-07-01

    Full Text Available Entrepreneurship and sustainable rural employment are the main concerns of rural planners. One of the most basic requirements for this is that young people remain in the rural areas. Accordingly, the aim of this paper is to identify individual and structural factors that are effective in keeping young people in rural areas. Statistical results of the bivariate and multilevel modeling (HLM shows that rural youth are not willing to stay in rural regions. One may cite the following individual factors contributing to this lack of interest in staying in rural areas: age, marital status, education, communication with relatives in the city, as well as employment status and job skills. People with higher human capital who have technical skills and building related non-agricultural skills are not interested in staying in rural areas. Moreover, the increased population in the villages and lack of social welfare facilities in village are highly effective in reducing the tendency of young people to stay in the villages.

  13. Men’s Educational Group Appointments in Rural Nicaragua

    Science.gov (United States)

    Campbell, Bruce B.; Gonzalez, Hugo; Campbell, McKenzie; Campbell, Kent

    2016-01-01

    Men’s preventive health and wellness is largely neglected in rural Nicaragua, where a machismo culture prevents men from seeking health care. To address this issue, a men’s educational group appointment model was initiated at a rural health post to increase awareness about hypertension, and to train community health leaders to measure blood pressure. Men’s hypertension workshops were conducted with patient knowledge pretesting, didactic teaching, and posttesting. Pretesting and posttesting performances were recorded, blood pressures were screened, and community leaders were trained to perform sphygmomanometry. An increase in hypertension-related knowledge was observed after every workshop and community health leaders demonstrated proficiency in sphygmomanometry. In addition, several at-risk patients were identified and follow-up care arranged. Men’s educational group appointments, shown to be effective in the United States in increasing patient knowledge and satisfaction, appear to function similarly in a resource-constrained environment and may be an effective mechanism for reaching underserved men in Nicaragua. PMID:27885146

  14. Habilidades sociales en contextos urbanos y rurales. Un estudio comparativo con adolescentes

    Directory of Open Access Journals (Sweden)

    Evangelina Norma Contini de González

    2013-01-01

    Full Text Available Abstract The purpose of this research paper is to compare the social skills of adolescents from Tucumán (Argentina in a rural/urban context using their socio-economical levels (NES. The study was comparative and transversal with a non probabilistic sample. The battery of socialization (BAS-3 and a survey to 11 and 12 year-old urban and rural adolescents (NES is applied. The results show that the urban adolescents with high socio-economical level have more consideration for others than urban and rural adolescents with low socio-economical levels. The rural adolescents have more leadership qualities than the urban adolescents. Women show more social anxiety when compared with urban and rural women and men. The results supply important local information in order to supply information to address programs that require assertive social skills. Resumen El objetivo del trabajo que dio como resultado este artículo de investigación consistió en comparar las habilidades sociales de adolescentes escolarizados de Tucumán (Argentina, según su contexto (urbano-rural y su nivel socioeconómico (NES. El estudio fue de tipo comparativo, transversal con muestreo no probabilístico intencional. Se aplicó la batería de socialización (BAS-3 y una encuesta sociodemográfica a 372 adolescentes de 11 y 12 años. Los adolescentes urbanos de NES alto refirieron más consideración hacia los demás que los adolescentes urbanos y rurales de NES bajo. Además, los adolescentes rurales se percibieron con más liderazgo que sus pares urbanos, en tanto que las mujeres presentaron mayor ansiedad social respecto a sus pares mujeres y varones rurales y urbanos. En definitiva, los resultados proveen información valiosa a nivel local para encarar programas de promoción de habilidades sociales asertivas.

  15. Voices from the Gila: health care issues for rural elders in south-western New Mexico.

    Science.gov (United States)

    Averill, Jennifer B

    2002-12-01

    A goal of the Healthy People 2010 initiative is to reduce or eliminate health disparities in vulnerable populations, including populations from rural and minority ethnic backgrounds. Rural communities, including elderly populations, experience lower rates of personal income, educational attainment, health-insurance coverage, access to emergency and specialty care services, and reported health status than do urban communities. A need exists to address identified research priorities, such as the perceptions of rural elders, their family members, and health care providers. The purposes of this study were to explore the health care perceptions, needs, and definitions of health for multicultural rural elders in one county of south-western New Mexico, and to consider practice implications. Informed consent procedures followed the University of New Mexico Health Sciences Center Human Research Review Committee guidelines. Research methods. This critical ethnography incorporated ethnographic interviews, ethnographic participant observation, photography, review of pertinent documents, and analysis of contextual factors. The sample consisted of 22 participants. Definitions of health varied with socioeconomic status, encompassing avoidance of contact with the health care system, obtaining needed medications, remaining independent, a sense of spiritual belonging, eating wisely, and exercising moderately. Three major concerns emerged from the analysis: the escalating cost of prescription drugs, access-to-care issues, and social isolation. The primary limitation was the small sample size. Although the researcher's position as an outsider to local communities may also have affected the outcome, it provided fresh insight to regional problems. The study addressed national research priorities for a vulnerable group of rural elders. Nursing implications include the need for expanded knowledge and educational preparation regarding elder issues and community-level services, inclusion of

  16. Oral Health in Rural Communities

    Science.gov (United States)

    ... people with partial edentulism when compared to urban (Urban, 38.4%, High Poverty Rural 51.3%, Other Rural, 45%). Counties with high rates of full edentulism are also rural (Urban, 4.3%, High-Poverty Rural 10.5%, Other Rural, 8.2%). ( Mitchell, ...

  17. Previdência social rural e gênero Rural Social Welfare and gender

    Directory of Open Access Journals (Sweden)

    Anita Brumer

    2002-06-01

    Full Text Available O trabalho apresenta uma análise das principais transformações da previdência social rural no Brasil, que culminaram com a inclusão das mulheres trabalhadoras rurais como beneficiárias (direito à aposentadoria por idade e salário-maternidade na legislação aprovada pelo Congresso Nacional em 1988. Paralelamente, faz-se um exame do papel do Estado e da sociedade civil na evolução da legislação relativa à previdência social rural, procurando-se evidenciar seu caráter de "doação" por parte do Estado ou da "conquista" polos próprios trabalhadores(as. Finalmente, são examinados alguns impactos da implantação da previdência social rural no Sul do Brasil, ressaltando-se seu papel na diminuição da pobreza rural e da desigualdade na distribuição da renda, assim como sua importância material e simbólica na mudança de relações de gênero no meio rural.The work analyzes the main transformations in the rural Social Welfare in Brazil. The outcome of these transformations has been the inclusion of rural hard-working women in the welfare system as of the legislation approved by the National Congress in 1988. Rural-work women in Brazil have become entitled to the benefits of paid maternity leave and retirement accordant to a legal age limit. Concurrently, the article examines the role played by the State and the civil society in the unfolding of the legislation related to rural Social Welfare, in an attempt of exposing its character of either a "donation" given by the State or the workers' own "conquest". Finally, the author queries the impact of rural Social Welfare implementation in the South of Brazil, emphasizing its achievements in the decrease of rural poverty and unequal income distribution, as well as its material and symbolic importance in the gender relationship shift in rural areas.

  18. Accessibility of public libraries by rural dwellers in rural areas of ...

    African Journals Online (AJOL)

    In conclusion, public libraries are essential to rural dwellers; therefore it is recommended that all types of information be made available to public libraries. Sensitization programmes should be encouraged. This will in turn bring about positive impact on the rural dwellers. Key words: Accessibility, Public, Library, rural, ...

  19. The Effects of Violence and Internal Displacement on Rural-Agrarian Change in Turkey

    Science.gov (United States)

    Sonmez, Abdulkerim

    2008-01-01

    This paper addresses two interrelated issues that have assumed major political significance in the handling of the Kurdish question in Turkey. The first is the impact of violence and resulting internal displacement in Eastern and Southeastern Turkey on rural-agrarian change. The second concerns the implications of the structural change and social…

  20. Governance in agribusiness organizations: challenges in the management of rural family firms

    Directory of Open Access Journals (Sweden)

    Cláudio Pinheiro Machado Filho

    Full Text Available Abstract The rural production in Brazil has experienced a significant competitive impact with the stabilization of the economy promoted by the Real Plan in 1994. Indeed, the Brazilian agriculture has achieved efficiency gains in terms of technology, economies of scale and general modernization of the activity in the field. In this context, the professional management of rural production evolved. However, the governance process does not evolve in the same dimension, and the “governance risk” is still poorly addressed in the rural environment, which often limits the potential of operations. In this study, we sought to deepen the understanding of the factors that impact the implementation of governance practices in rural properties in Brazil. Based on a convenience and non-probability sample, this study seeks to understand the evolution of the governance process on farms and its correlation with the management practices. This study found a correlation between the existence of some formal management processes (for example, strategic planning and more robust accounting systems and advances in the governance mechanisms and processes, such as the establishment of a board of directors, clearer rules regarding the separation between corporate and family assets and more transparency in income statements. This study also found a lack of clarity in the separation of return on capital (dividend and compensation for work (compensation for services provided for partners, heirs and other family members. In summary, we concluded that there is the adoption of some governance mechanisms in the rural sector, but they are still poorly developed among rural producers, hence the need to stimulate them.

  1. Barriers to Rural Induced Abortion Services in Canada: Findings of the British Columbia Abortion Providers Survey (BCAPS)

    Science.gov (United States)

    Norman, Wendy V.; Soon, Judith A.; Maughn, Nanamma; Dressler, Jennifer

    2013-01-01

    Background Rural induced abortion service has declined in Canada. Factors influencing abortion provision by rural physicians are unknown. This study assessed distribution, practice, and experiences among rural compared to urban abortion providers in the Canadian province of British Columbia (BC). Methods We used mixed methods to assess physicians on the BC registry of abortion providers. In 2011 we distributed a previously-published questionnaire and conducted semi-structured interviews. Results Surveys were returned by 39/46 (85%) of BC abortion providers. Half were family physicians, within both rural and urban cohorts. One-quarter (17/67) of rural hospitals offer abortion service. Medical abortions comprised 14.7% of total reported abortions. The three largest urban areas reported 90% of all abortions, although only 57% of reproductive age women reside in the associated health authority regions. Each rural physician provided on average 76 (SD 52) abortions annually, including 35 (SD 30) medical abortions. Rural physicians provided surgical abortions in operating rooms, often using general anaesthesia, while urban physicians provided the same services primarily in ambulatory settings using local anaesthesia. Rural providers reported health system barriers, particularly relating to operating room logistics. Urban providers reported occasional anonymous harassment and violence. Conclusions Medical abortions represented 15% of all BC abortions, a larger proportion than previously reported (under 4%) for Canada. Rural physicians describe addressable barriers to service provision that may explain the declining accessibility of rural abortion services. Moving rural surgical abortions out of operating rooms and into local ambulatory care settings has the potential to improve care and costs, while reducing logistical challenges facing rural physicians. PMID:23840578

  2. Changes in Veterinary Students' Attitudes Toward the Rural Environment and Rural Veterinary Practice: A Longitudinal Cohort Study.

    Science.gov (United States)

    Hashizume, Cary T; Woloschuk, Wayne; Hecker, Kent G

    2015-01-01

    There is a paucity of research regarding veterinary students' attitudes toward the rural environment and rural veterinary practice and how these attitudes might change over the course of a veterinary medicine program that includes rural clinical experience. Using a 23-item questionnaire, attitudes toward rural lifestyle, rural work-life balance, opportunities for career and skill development in rural veterinary practice, and inter-professional teamwork in the rural environment were assessed at the beginning and completion of a four-year veterinary medicine program. Eighty-six students (74.4% female) were included in this Canadian study over a six-year period. Thirty-one participants (36.1%) were rural students. Overall, students' attitudes toward the rural lifestyle, rural work-life balance, and inter-professional teamwork in rural veterinary practice all significantly decreased (pstudents, rural students had significantly higher rural lifestyle scores at both the beginning (pworking in a rural environment could influence students to exclude rural veterinary practice as a career choice. Rural clinical experiences designed to sustain or increase veterinary student interest in rural practice may not be sufficient to support positive rural attitudes. Given the demand for rural veterinary services in developed countries, the implications of this study may extend beyond Canada.

  3. Reaching Rural Handicapped Children: The Transportation Situation in Rural Service Delivery. Making It Work in Rural Communities. A Rural Network Monograph.

    Science.gov (United States)

    Tucker, Jamie; And Others

    Almost everyone who responded to three transportation surveys of rural Handicapped Children's Early Education Program (HCEEP) projects identified transportation as a critical problem in the delivery of services to handicapped children in rural areas. Transportation problems encountered were attributed to environmental/geographic factors,…

  4. What do beginning students, in a rurally focused medical course, think about rural practice?

    Science.gov (United States)

    Young, Louise; Lindsay, Daniel B; Ray, Robin A

    2016-12-07

    Medical schools may select students for their attitudes towards rural medical practice, yet the rural-urban disparity in availability of medical practitioners and services has not diminished in recent times despite government initiatives and increasing numbers being trained for a career in medicine. One medical school, with a focus on rural and remote medicine, aims to select students with positive perceptions for rural medical practice. A research project collected data on the perceptions of these medical students in the first week of their medical studies. Students completed a low stakes essay on the life and work of a rural doctor. Initially, this formed part of a literacy assessment to determine any students requiring remediation. All students were asked if they would consent to their essay being reviewed for a research project. Data was obtained from those students who consented and handed their essays in for review. The 103 student essays underwent thematic analysis and sentences were coded into three main themes of rural lifestyle, doctor role and rural practice. Second level themes were further elicited and results were quantified according to whether they were positive or negative. Positive themes included rural lifestyle, doctor role, views of doctor, impact on community, broader work and skills knowledge, and better relationships with community and patients. Negative themes included doctor's health, pressure on doctor, family problems, greater workload, privacy and confidentiality issues, cultural issues, isolation, limited resources and financial impacts. Quantitisation of this data was used to transform essay sentences into a numerical form which allowed statistical analysis and comparison of perceptions using Z tests. No significant differences on the number of positive and negative responses for rural lifestyle and rural practice were found. The rural doctor role had a significantly more positive than negative views. Significant differences were

  5. What Is Rural? Revised

    Science.gov (United States)

    US Department of Agriculture, 2016

    2016-01-01

    Many people have definitions for the term rural, but seldom are these rural definitions in agreement. For some, rural is a subjective state of mind. For others, rural is an objective quantitative measure. In this brief report the United States Department of Agriculture presents the following information along with helpful links for the reader: (1)…

  6. Substance Use in Rural Central Appalachia: Current Status and Treatment Considerations.

    Science.gov (United States)

    Moody, Lara; Satterwhite, Emily; Bickel, Warren K

    2017-04-01

    The burden of substance use and especially the unmatched rates of overdoses in rural Central Appalachia highlight the need for innovative approaches to curb the initiation to drug misuse and to address current substance use disorders. Effective substance use interventions involve a thorough understanding of the region. In Central Appalachia, many of the barriers to treatment are shared with other rural and impoverished areas, including a lack of access to health care and lack of health care providers with specialized training. Parts of Appalachia also present their own considerations, including the challenges of fostering trust and encouraging treatment-seeking in communities with dense, long-term, place-based social and family networks. Current policies and interventions for substance use have been largely inadequate in the region, as evidenced by continued increases in substance use and substance-related deaths, especially related to nonmedical prescription drug use and increasing heroin use. The authors discuss ways in which rural life, poverty, identity, and values in Appalachia have influenced substance use and treatment and propose strategies and interventions to improve outcomes.

  7. From expert generalists to ambiguity masters: using ambiguity tolerance theory to redefine the practice of rural nurses.

    Science.gov (United States)

    Knight, Kaye; Kenny, Amanda; Endacott, Ruth

    2016-06-01

    To redefine the practice of rural nurses and describe a model that conceptualises the capabilities and characteristics required in the rural environment. The way in which the practice of rural nurses has been conceptualised is problematic. Definitions of rural nursing have been identified primarily through the functional context of rural health service delivery. The expert generalist term has provided a foundation theory for rural nurses with understandings informed by the scope of practice needed to meet service delivery requirements. However, authors exploring intrinsic characteristics of rural nurses have challenged this definition, as it does not adequately address the deeper, intangible complexities of practice required in the rural context. Despite this discourse, an alternative way to articulate the distinctive nature of rural nursing practice has eluded authors in Australia and internationally. A theoretical paper based on primary research. The development of the model was informed by the findings of a study that explored the nursing practice of managing telephone presentations in rural health services in Victoria, Australia. The study involved policy review from State and Federal governments, nursing and medical professional bodies, and five rural health services; semi-structured interviews with eight Directors of Nursing, seven registered nurses and focus group interviews with eight registered nurses. An ambiguity tolerance model drawn from corporate global entrepreneurship theory was adapted to explain the findings of the study. The adapted model presents capabilities and characteristics used by nurses to successfully manage the ambiguity of providing care in the rural context. Redefining the practice of rural nurses, through an adapted theory of ambiguity tolerance, highlights nursing characteristics and capabilities required in the rural context. This perspective offers new ways of thinking about the work of rural nurses, rural nurse policy, education

  8. Stable financial inclusion: Recovering the Salvadoran Rurality

    Directory of Open Access Journals (Sweden)

    Héctor David Córdova

    2013-06-01

    Full Text Available This article approaches a topic of great significance for the Salvadorian financial sector, as well as for the whole population, especially that in the rural areas of this country.  This article refers, in terms of their institutional evolution, the stages the Federation of Cooperative Associations of Savings and Credit of El Salvador FEDECACES DE R.L has lived through in its development.  In this work an analysis of the process of financial inclusion that has been undertaken by FEDECACES is shown, as well as the impact achieved in the country, specially in the rural areas, which lacked financial entities able to offer this type of service with the stability and guarantee that the cooperatives affiliated to the Federation bring today.  The work carried out is sustained on an analysis of the main financial variables of base cooperatives as well as of the sustained membership increase in these entities. This demonstrates the quality of the services they offer, shown by the level of satisfaction of the population, to whom they are addressed.

  9. Rural and Urban Youth Programs.

    Science.gov (United States)

    Backman, Kenneth; And Others

    This publication provides a variety of information on prevention and intervention programs for rural and urban children and adolescents. Drawing from a rural sociological perspective, the introductory paper defines "rural," discusses rural-urban economic and social differences, and lists indicators of risk for rural youth. It discusses the extent…

  10. Duration and setting of rural immersion during the medical degree relates to rural work outcomes.

    Science.gov (United States)

    O'Sullivan, Belinda; McGrail, Matthew; Russell, Deborah; Walker, Judi; Chambers, Helen; Major, Laura; Langham, Robyn

    2018-04-19

    Providing year-long rural immersion as part of the medical degree is commonly used to increase the number of doctors with an interest in rural practice. However, the optimal duration and setting of immersion has not been fully established. This paper explores associations between various durations and settings of rural immersion during the medical degree and whether doctors work in rural areas after graduation. Eligible participants were medical graduates of Monash University between 2008 and 2016 in postgraduate years 1-9, whose characteristics, rural immersion information and work location had been prospectively collected. Separate multiple logistic regression and multinomial logit regression models tested associations between the duration and setting of any rural immersion they did during the medical degree and (i) working in a rural area and (ii) working in large or smaller rural towns, in 2017. The adjusted odds of working in a rural area were significantly increased if students were immersed for one full year (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.15-2.79), for between 1 and 2 years (OR, 2.26; 95% CI, 1.54-3.32) and for 2 or more years (OR, 4.43; 95% CI, 3.03-6.47) relative to no rural immersion. The strongest association was for immersion in a mix of both regional hospitals and rural general practice (OR, 3.26; 95% CI, 2.31-4.61), followed by immersion in regional hospitals only (OR, 1.94; 95% CI, 1.39-2.70) and rural general practice only (OR, 1.91; 95% CI, 1.06-3.45). More than 1 year's immersion in a mix of regional hospitals and rural general practices was associated with working in smaller regional or rural towns (immersion programmes. Longer rural immersion and immersion in both regional hospitals and rural general practices are likely to increase rural work and rural distribution of early career doctors. © 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  11. Access to and use of research by rural nurses.

    Science.gov (United States)

    Winters, C A; Lee, H J; Besel, J; Strand, A; Echeverri, R; Jorgensen, K P; Dea, J E

    2007-01-01

    The use of relevant research findings to inform clinical practice is important for nurses, regardless of setting. Although there have been studies addressing the use of research among various practitioners, little is known about how nurses in rural areas access health information (specifically research findings), nor how such findings are incorporated into daily practice. The purpose of this study was to explore rural nurses' access, use and perceived usefulness of research for rural practice. The study was conducted in a sparsely populated state located in the western part of the USA. An ethnographic method was chosen to answer the research questions for this descriptive study. Semi-structured interviews were conducted with 29 rural nurses from nine communities by graduate nursing students enrolled in a rural nursing course following in-class instruction and practice. Field notes taken by the students supplemented the interview data. The students' notes included a windshield survey or description of the context and location within which the participants lived and/or practiced as well as the interviewers' observations, thoughts and impressions about the research project. Interviews were audiotaped and transcribed verbatim. Once transcribed, the interview narratives, windshield data and field notes were analyzed by the students for common themes; the students then wrote and submitted papers to the faculty addressing the themes that emerged from their interviews. The analysis conducted by the faculty members included four sources of data: transcriptions of interviews; field notes; windshield data; and students' papers. The process of identifying themes was facilitated by using the software program NUD*IST (QSR International; Melbourne, VIC, Australia). Demographic information was entered into the Statistical Package for Social Scientists (SPSS Inc; Chicago, IL, USA) to compile descriptive information about the sample. Twenty-seven female and two male nurses

  12. Implementation factors and their effect on e-Health service adoption in rural communities: a systematic literature review

    Directory of Open Access Journals (Sweden)

    Hage Eveline

    2013-01-01

    Full Text Available Abstract Background An ageing population is seen as a threat to the quality of life and health in rural communities, and it is often assumed that e-Health services can address this issue. As successful e-Health implementation in organizations has proven difficult, this systematic literature review considers whether this is so for rural communities. This review identifies the critical implementation factors and, following the change model of Pettigrew and Whipp, classifies them in terms of “context”, “process”, and “content”. Through this lens, we analyze the empirical findings found in the literature to address the question: How do context, process, and content factors of e-Health implementation influence its adoption in rural communities? Methods We conducted a systematic literature review. This review included papers that met six inclusion and exclusion criteria and had sufficient methodological quality. Findings were categorized in a classification matrix to identify promoting and restraining implementation factors and to explore whether any interactions between context, process, and content affect adoption. Results Of the 5,896 abstracts initially identified, only 51 papers met all our criteria and were included in the review. We distinguished five different perspectives on rural e-Health implementation in these papers. Further, we list the context, process, and content implementation factors found to either promote or restrain rural e-Health adoption. Many implementation factors appear repeatedly, but there are also some contradictory results. Based on a further analysis of the papers’ findings, we argue that interaction effects between context, process, and content elements of change may explain these contradictory results. More specifically, three themes that appear crucial in e-Health implementation in rural communities surfaced: the dual effects of geographical isolation, the targeting of underprivileged groups, and the

  13. Rural Policy and the New Regional Economics: Implications for Rural America.

    Science.gov (United States)

    Quigley, John M.

    This paper discusses gross economic and demographic trends in rural and urban America during the past 30 years, the kinds of competitive advantages enjoyed by urban and rural regions, and insights offered by the new regional economics concerning exploitation of those advantages. The importance of agriculture has declined in rural areas, while that…

  14. Lay discourses of the rural and stated and revealed preferences for rural living; some evidence of the existence of a rural idyll in the Netherlands

    NARCIS (Netherlands)

    Dam, van F.; Heins, S.; Elbersen, B.S.

    2002-01-01

    Dutch rural areas have changed into a post-modern countryside and have become marketable commodities. The demand for rural space and rural amenities has increased, with concomitant tensions on the rural housing market, tensions which are enhanced by the restrictive spatial policy in Dutch rural

  15. Rural roadway safety perceptions among rural teen drivers living in and outside of towns.

    Science.gov (United States)

    Ramirez, Marizen; Roth, Lisa; Young, Tracy; Peek-Asa, Corinne

    2013-01-01

    To compare perceptions about rural road and general driving behaviors between teens who live in- and out-of-town from rural communities in Iowa. A cross-sectional survey was conducted with 160 teens anticipating their Intermediate License within 3 months upon enrollment into this study. Self-administered surveys were used to collect demographics and driving exposures (eg, frequency of driving, age when first drove unsupervised). Two Likert scales were included to measure agreement with safe driving behaviors on rural roads and general safe driving behaviors (eg, speeding, seat belt use). T-tests were calculated comparing mean composite scores between in- and out-of-town teens, and between mean rural road and general driving safety attitude scores. A linear regression multivariable model was constructed to identify predictors of the rural road score. While the majority of teens endorsed rural road and general safe driving behaviors, up to 40% did not. Thirty-two percent did not believe the dangers of animals on rural roads, and 40% disagreed that exceeding the speed limit is dangerous. In-town teens were less safety conscious about rural road hazards with a significantly lower mean composite score (4.4) than out-of-town teens (4.6); mean scores for general driving behaviors were similar. Living out-of-town and owning one's own car were significant predictors of increased rural road safety scores. Rural, in-town teens have poorer safety attitudes about rural roadway hazards compared with out-of-town teens. Interventions that involve education, parental supervision, and practice on rural roads are critical for preventing teen crashes on rural roads. No claim to original US government works.

  16. An application of the edge effect in measuring accessibility to multiple food retailer types in Southwestern Ontario, Canada

    Science.gov (United States)

    2011-01-01

    Background Trends in food retailing associated with the consolidation of smaller-format retailers into fewer, larger-format supercentres have left some rural areas with fewer sources of nutritious, affordable food. Access to nutritious, affordable food is essential for good dietary habits and combating health issues such as type-2 diabetes, obesity, and cardiovascular disease. Many studies on food environments use inaccurate or incomplete methods for locating food retailers, which may be responsible for mischaracterising food deserts. This study uses databases of every residence in and every food retailer in and around Middlesex County, Ontario, Canada. Residences were geocoded to their precise address, and network analysis techniques were performed in a geographic information system (GIS) to determine distances between every residence and different types of food retailers (grocery stores, fast food, fruit and vegetable sources, grocery stores plus fruit and vegetable sources, variety stores), both when considering and neglecting facilities outside the area of study, to account for a deficiency in analysis termed the 'edge effect'. Results Analysis of household accessibility to food outlets by neighbourhood socioeconomic distress level indicated that residents in the most distressed neighbourhoods tended to have better accessibility to all types of food retailers. In the most distressed neighbourhoods, 79 percent of residences were within walking distance of a grocery store, compared to only 10 percent in the least distressed neighbourhoods. When the edge effect was neglected, 37 percent of distance estimates proved inaccurate. Average accessibility to all food retailer types improved dramatically when food outlets adjacent to the study area were considered, thereby controlling for the edge effect. Conclusion By neglecting to consider food retailers just outside study area boundaries, previous studies may significantly over-report the actual distance necessary to

  17. An application of the edge effect in measuring accessibility to multiple food retailer types in southwestern Ontario, Canada.

    Science.gov (United States)

    Sadler, Richard C; Gilliland, Jason A; Arku, Godwin

    2011-05-15

    Trends in food retailing associated with the consolidation of smaller-format retailers into fewer, larger-format supercentres have left some rural areas with fewer sources of nutritious, affordable food. Access to nutritious, affordable food is essential for good dietary habits and combating health issues such as type-2 diabetes, obesity, and cardiovascular disease. Many studies on food environments use inaccurate or incomplete methods for locating food retailers, which may be responsible for mischaracterising food deserts. This study uses databases of every residence in and every food retailer in and around Middlesex County, Ontario, Canada. Residences were geocoded to their precise address, and network analysis techniques were performed in a geographic information system (GIS) to determine distances between every residence and different types of food retailers (grocery stores, fast food, fruit and vegetable sources, grocery stores plus fruit and vegetable sources, variety stores), both when considering and neglecting facilities outside the area of study, to account for a deficiency in analysis termed the 'edge effect'. Analysis of household accessibility to food outlets by neighbourhood socioeconomic distress level indicated that residents in the most distressed neighbourhoods tended to have better accessibility to all types of food retailers. In the most distressed neighbourhoods, 79 percent of residences were within walking distance of a grocery store, compared to only 10 percent in the least distressed neighbourhoods. When the edge effect was neglected, 37 percent of distance estimates proved inaccurate. Average accessibility to all food retailer types improved dramatically when food outlets adjacent to the study area were considered, thereby controlling for the edge effect. By neglecting to consider food retailers just outside study area boundaries, previous studies may significantly over-report the actual distance necessary to travel for food. Research on

  18. An application of the edge effect in measuring accessibility to multiple food retailer types in Southwestern Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Arku Godwin

    2011-05-01

    Full Text Available Abstract Background Trends in food retailing associated with the consolidation of smaller-format retailers into fewer, larger-format supercentres have left some rural areas with fewer sources of nutritious, affordable food. Access to nutritious, affordable food is essential for good dietary habits and combating health issues such as type-2 diabetes, obesity, and cardiovascular disease. Many studies on food environments use inaccurate or incomplete methods for locating food retailers, which may be responsible for mischaracterising food deserts. This study uses databases of every residence in and every food retailer in and around Middlesex County, Ontario, Canada. Residences were geocoded to their precise address, and network analysis techniques were performed in a geographic information system (GIS to determine distances between every residence and different types of food retailers (grocery stores, fast food, fruit and vegetable sources, grocery stores plus fruit and vegetable sources, variety stores, both when considering and neglecting facilities outside the area of study, to account for a deficiency in analysis termed the 'edge effect'. Results Analysis of household accessibility to food outlets by neighbourhood socioeconomic distress level indicated that residents in the most distressed neighbourhoods tended to have better accessibility to all types of food retailers. In the most distressed neighbourhoods, 79 percent of residences were within walking distance of a grocery store, compared to only 10 percent in the least distressed neighbourhoods. When the edge effect was neglected, 37 percent of distance estimates proved inaccurate. Average accessibility to all food retailer types improved dramatically when food outlets adjacent to the study area were considered, thereby controlling for the edge effect. Conclusion By neglecting to consider food retailers just outside study area boundaries, previous studies may significantly over-report the

  19. Is Peru Prepared for Large-Scale Sustainable Rural Electrification?

    Directory of Open Access Journals (Sweden)

    Sarah Feron

    2018-05-01

    Full Text Available Peru has historically been among the Latin-American countries with a low rural electrification rate. Aiming to improve this situation, the country conducted several electrification efforts in the last few decades that included off-grid photovoltaic (PV solutions for remote areas (where the grid expansion was unviable. More recently, the government has also sponsored a ‘massive program’ that aims to deploy a minimum of 150,000 off-grid PV solutions in the upcoming years. In this paper, we assess the sustainability of rural electrification programs in Peru, paying special attention to the ongoing “massive program”. Our assessment considers four dimensions of sustainability (institutional, economic, environmental, and socio-cultural and is based on an exhaustive qualitative document analysis complemented by semi-structured expert interviews. We found that the lack of strong formal institutions with a flexible and decentralized structure seriously compromises the sustainability of rural electrification efforts in Peru. Staff rotation and overlapping competences have caused disturbing changes and inhibited following a strategic line, while widespread outsourcing combined with weak controls have often affected the reliability of the deployed systems. Although cross subsidies have made off-grid PV systems affordable for users, systems often fell short of energy demand. Notably, we found that Peruvian officials appear to be unaware of the importance of local participation, and there is a significant mistrust between the government and the rural population (especially in areas where mining is extensive. As a consequence, most of the projects are still designed without the participation and engagement of the communities, which has frequently led to project failures, payment defaults, and inhibited seizing opportunities regarding productive uses of off-grid PV systems. We expect that our findings may help Peruvian institutions to address the most

  20. Evaluation plan : national advanced rural transportation systems : field operational tests of traveler information services in tourism areas : executive summary

    Science.gov (United States)

    1998-07-01

    This evaluation addresses technical challenges of developing advanced traveler information systems (ATIS) in rural environments, institutional benefits and issues, usefulness of the information to the traveling public, effectiveness of various media ...

  1. A double whammy! New baccalaureate registered nurses' transitions into rural acute care.

    Science.gov (United States)

    Smith, Jean; Vandall-Walker, Virginia

    2017-12-01

    and rural acute care hospitals, which currently do not accurately address rural population growth and the services provided at rural acute care hospitals. Populations of some communities identified as rural by Alberta Health Services exceeded the upper limit of 10 000, the level long used to distinguish between rural and urban in the Canadian literature. As well, two different types of rural hospitals exist in Alberta: generalist types and urban types. The transition experience into these two different types of hospitals varied significantly. Whiledouble whammyoffers only one description of new RNs\\' transition experiences into rural acute care, it may present readers with recognizable similarities about transition that resonate with their own learning and responsibilities. Transition supports and challenges learned from this study can assist rural healthcare providers, policymakers, and educators in developing strategies to support and retain new RNs in rural acute care environments. Additionally, researchers must consider a priori whether or not different types of rural acute care hospitals exist in their study locale and if rural population growth is a factor when conducting future investigations related to rural acute care.

  2. Hearing loss and social support in urban and rural communities.

    Science.gov (United States)

    Hay-McCutcheon, Marcia J; Hyams, Adriana; Yang, Xin; Parton, Jason

    2018-04-19

    Perceived social support and hearing handicap were assessed in adults with and without hearing loss who lived in different geographical regions of Alabama. The Hearing Handicap Inventory for Adults (HHIA) assessed emotional and social consequences of hearing loss. The Medical Outcomes Study (MOS) Social Support Survey and the Social Functioning, Role Emotional and Mental Health scales of the SF-36 were administered. Data were collected from 71 study participants with hearing loss and from 45 adults without hearing loss. Degree of hearing loss and outcomes from the HHIA did not differ between adults who lived in rural or urban settings. Tangible support was poorer for adults with hearing loss who lived in rural settings compared to those who lived in urban settings. For adults without hearing loss, residency was not associated with tangible support. For these adults, income was associated with other types of social support (i.e. informational support, affection, positive social interaction). Adults with hearing loss living in rural areas had poor perceived tangible support. The provision of support to address a hearing loss could be worse for these adults compared to adults who lived in urban settings.

  3. The Rural Obstetric Workforce in US Hospitals: Challenges and Opportunities

    Science.gov (United States)

    Kozhimannil, Katy B.; Casey, Michelle M.; Hung, Peiyin; Han, Xinxin; Prasad, Shailendra; Moscovice, Ira S.

    2015-01-01

    Purpose The purpose of this study was to describe the types and combinations of clinicians who are delivering babies in rural hospitals, their employment status, the relationship between hospital birth volume and staffing models, and the staffing challenges faced by rural hospitals. Methods We conducted a telephone survey of 306 rural hospitals in 9 states: Colorado, Iowa, Kentucky, New York, North Carolina, Oregon, Vermont, Washington, and Wisconsin, from November 2013-March 2014 to assess their obstetric workforce. Bivariate associations between hospitals’ annual birth volume and obstetric workforce characteristics were examined, as well as qualitative analysis of workforce changes and staffing challenges. Findings Hospitals with lower birth volume (< 240 births per year) are more likely to have family physicians and general surgeons attending deliveries, while those with a higher birth volume more frequently have obstetricians and midwives attending deliveries. Reported staffing challenges include scheduling, training, census fluctuation, recruitment and retention, and intra-hospital relationships. Conclusions Individual hospitals working in isolation may struggle to address staffing challenges. Federal and state policy makers, regional collaboratives, and health care delivery systems can facilitate solutions through programs such as telehealth, simulation training, and interprofessional education. PMID:25808202

  4. Financial Performance of Rural Medicare ACOs.

    Science.gov (United States)

    Nattinger, Matthew C; Mueller, Keith; Ullrich, Fred; Zhu, Xi

    2018-12-01

    The Centers for Medicare & Medicaid Services (CMS) has facilitated the development of Medicare accountable care organizations (ACOs), mostly through the Medicare Shared Savings Program (MSSP). To inform the operation of the Center for Medicare & Medicaid Innovation's (CMMI) ACO programs, we assess the financial performance of rural ACOs based on different levels of rural presence. We used the 2014 performance data for Medicare ACOs to examine the financial performance of rural ACOs with different levels of rural presence: exclusively rural, mostly rural, and mixed rural/metropolitan. Of the ACOs reporting performance data, we identified 97 ACOs with a measurable rural presence. We found that successful rural ACO financial performance is associated with the ACO's organizational type (eg, physician-based) and that 8 of the 11 rural ACOs participating in the Advanced Payment Program (APP) garnered savings for Medicare. Unlike previous work, we did not find an association between ACO size or experience and rural ACO financial performance. Our findings suggest that rural ACO financial success is likely associated with factors unique to rural environments. Given the emphasis CMS has placed on rural ACO development, further research to identify these factors is warranted. © 2016 National Rural Health Association.

  5. The Role of READ (Rural Education and Development) Foundation in Quality Education of Pakistan

    Science.gov (United States)

    Farooq, Muhammad Sabil; Kai, Yuan Tong

    2016-01-01

    Education means all round development, this all round development means intellectual, social and emotional development. It is only education that can mould the behavior of an individual. READ (Rural Education and Development) Foundation is not-for-profit organization established in 1994 to address the dire need for education and literacy in…

  6. Trends in Rural Water Supply: Towards a Service Delivery Approach

    Directory of Open Access Journals (Sweden)

    Patrick Moriarty

    2013-10-01

    The papers in this special issue argue that tackling these challenges requires a shift in emphasis in rural water supply in developing countries: away from a de-facto focus on the provision of hardware for first-time access towards the proper use of installed hardware as the basis for universal access to rural water services. The outline of the main actions required to achieve this shift are becoming clearer. Chief amongst these are the professionalisation of community management and/or provision of direct support to community service providers; adoption of a wider range of service delivery models than community management alone; and addressing the sustainable financing of all costs with a particular focus on financing capital maintenance (asset management and direct support costs. This introductory paper provides an overview of these issues and a guide to the other articles, which demonstrate these points.

  7. Building consensus on key priorities for rural health care in South Africa using the Delphi technique

    Directory of Open Access Journals (Sweden)

    Marije Versteeg

    2013-01-01

    Full Text Available Background: South Africa is currently undergoing major health system restructuring in an attempt to improve health outcomes and reduce inequities in access. Such inequities exist between private and public health care and within the public health system itself. Experience shows that rural health care can be disadvantaged in policy formulation despite good intentions. The objective of this study was to identify the major challenges and priority interventions for rural health care provision in South Africa thereby contributing to pro-rural health policy dialogue. Methods: The Delphi technique was used to develop consensus on a list of statements that was generated through interviews and literature review. A panel of rural health practitioners and other stakeholders was asked to indicate their level of agreement with these statements and to rank the top challenges in and interventions required for rural health care. Results: Response rates ranged from 83% in the first round (n=44 to 64% in the final round (n=34. The top five priorities were aligned to three of the WHO health system building blocks: human resources for health (HRH, governance, and finance. Specifically, the panel identified a need to focus on recruitment and support of rural health professionals, the employment of managers with sufficient and appropriate skills, a rural-friendly national HRH plan, and equitable funding formulae. Conclusion: Specific policies and strategies are required to address the greatest rural health care challenges and to ensure improved access to quality health care in rural South Africa. In addition, a change in organisational climate and a concerted effort to make a career in rural health appealing to health care workers and adequate funding for rural health care provision are essential.

  8. Migration intentions of rural youth in the Westhoek, Flanders, Belgium and the Veenkolonien, The Netherlands

    NARCIS (Netherlands)

    Thissen, Frans; Fortuijn, Joos Droogleever; Strijker, Dirk; Haartsen, Tialda

    2010-01-01

    'Should I stay or should I leave my home region?' is one of the key life course questions that many young people must address as they grow to maturity. Social mobility increasingly presupposes geographical mobility, especially in rural areas. The consequences of the selective out-migration of

  9. Medicaid and Rural Health

    Science.gov (United States)

    ... State Guides Rural Data Visualizations Rural Data Explorer Chart Gallery Maps Case Studies & Conversations Rural Health Models & ... services provided by state Medicaid programs might include dental care, physical therapy, home and community-based services, ...

  10. Satisfaction and sustainability: a realist review of decentralized models of perinatal surgery for rural women.

    Science.gov (United States)

    Kornelsen, Jude; McCartney, Kevin; Williams, Kim

    2016-01-01

    This article was developed as part of a larger realist review investigating the viability and efficacy of decentralized models of perinatal surgical services for rural women in the context of recent and ongoing service centralization witnessed in many developed nations. The larger realist review was commissioned by the British Columbia Ministry of Health and Perinatal Services of British Columbia, Canada. Findings from that review are addressed in this article specific to the sustainability of rural perinatal surgical sites and the satisfaction of providers that underpins their recruitment to and retention at such sites. A realist method was used in the selection and analysis of literature with the intention to iteratively develop a sophisticated understanding of how perinatal surgical services can best meet the needs of women who live in rural and remote environments. The goal of a realist review is to examine what works for whom under what circumstances and why. The high sensitivity search used language (English) and year (since 1990) limiters in keeping with both a realist and rapid review tradition of using reasoned contextual boundaries. No exclusions were made based on methodology or methodological approach in keeping with a realist review. Databases searched included MEDLINE, PubMed, EBSCO, CINAHL, EBM Reviews, NHS Economic Evaluation Database and PAIS International for literature in December 2013. Database searching produced 103 included academic articles. A further 59 resources were added through pearling and 13 grey literature reports were added on recommendation from the commissioner. A total of 42 of these 175 articles were included in this article as specific to provider satisfaction and service sustainability. Operative perinatal practice was found to be a lynchpin of sustainable primary and surgical services in rural communities. Rural shortages of providers, including challenges with recruitment and retention, were found to be a complex issue, with

  11. Using i2b2 to Bootstrap Rural Health Analytics and Learning Networks.

    Science.gov (United States)

    Harris, Daniel R; Baus, Adam D; Harper, Tamela J; Jarrett, Traci D; Pollard, Cecil R; Talbert, Jeffery C

    2016-08-01

    We demonstrate that the open-source i2b2 (Informatics for Integrating Biology and the Bedside) data model can be used to bootstrap rural health analytics and learning networks. These networks promote communication and research initiatives by providing the infrastructure necessary for sharing data and insights across a group of healthcare and research partners. Data integration remains a crucial challenge in connecting rural healthcare sites with a common data sharing and learning network due to the lack of interoperability and standards within electronic health records. The i2b2 data model acts as a point of convergence for disparate data from multiple healthcare sites. A consistent and natural data model for healthcare data is essential for overcoming integration issues, but challenges such as those caused by weak data standardization must still be addressed. We describe our experience in the context of building the West Virginia/Kentucky Health Analytics and Learning Network, a collaborative, multi-state effort connecting rural healthcare sites.

  12. Paediatric case mix in a rural clinical school is relevant to future practice.

    Science.gov (United States)

    Wright, Helen M; Maley, Moira A L; Playford, Denese E; Nicol, Pam; Evans, Sharon F

    2017-11-29

    in clinical settings. Logged cases met the curriculum learning outcomes of graduates. Minor variations were readily addressed via recommendations about logging. This paper provides evidence of the legitimacy of student logs as useful tools in affirming appropriate paediatric case mix. It validates the rural clinical school context as appropriate for medical students to prepare for future clinical paediatric practice.

  13. Rural Education as Rural Development: Understanding the Rural School-Community Well-Being Linkage in a 21st-Century Policy Context

    Science.gov (United States)

    Schafft, Kai A.

    2016-01-01

    Despite the significant proportions of rural Americans, schools, and public school students situated in the geographic peripheries of an increasingly urbanizing country, rural education in the United States has consistently occupied both scholarly and policy peripheries. This is to the detriment of rural America, especially to the extent that…

  14. A qualitative study of medical students in a rural track: views on eventual rural practice.

    Science.gov (United States)

    Roseamelia, Carrie; Greenwald, James L; Bush, Tiffany; Pratte, Morgan; Wilcox, Jessica; Morley, Christopher P

    2014-04-01

    Rural tracks (RTs) exist within medical schools across the United States. These programs often target those students from rural areas and those with primary care career interests, given that these factors are robust predictors of eventual rural practice. However, only 26% to 64% of graduates from RTs enter eventual rural practice. We conducted a qualitative, exploratory study of medical students enrolled in one school's RT, examining their interests in rural training, specialization, and eventual rural practice, via open coding of transcripts from focus groups and in-depth individual interviews, leading to identification of emerging themes. A total of 16 out of 54 eligible first- and second-year preclinical medical students participated in focus group sessions, and a total of seven out of 17 eligible third- and fourth-year medical students participated in individual interviews. Analyses revealed the recognition of a "Rural Identity," typical characteristics, and the importance of "Program Fit" and "Intentions for Practice" that trended toward family medicine specialization and rural practice. However, nuances within the comments reveal incomplete commitment to rural practice. In many cases, student preference for rural practice was driven largely by a disinterest in urban practice. Students with rural and primary care practice interests are often not perfectly committed to rural practice. However, RTs may provide a haven for such students within medical school.

  15. Ruralization of students' horizons: insights into Australian health professional students' rural and remote placements.

    Science.gov (United States)

    Smith, Tony; Cross, Merylin; Waller, Susan; Chambers, Helen; Farthing, Annie; Barraclough, Frances; Pit, Sabrina W; Sutton, Keith; Muyambi, Kuda; King, Stephanie; Anderson, Jessie

    2018-01-01

    Health workforce shortages have driven the Australian and other Western governments to invest in engaging more health professional students in rural and remote placements. The aim of this qualitative study was to provide an understanding of the lived experiences of students undertaking placements in various nonmetropolitan locations across Australia. In addition to providing their suggestions to improve rural placements, the study provides insight into factors contributing to positive and negative experiences that influence students' future rural practice intentions. Responses to open-ended survey questions from 3,204 students from multiple health professions and universities were analyzed using two independent methods applied concurrently: manual thematic analysis and computerized content analysis using Leximancer software. The core concept identified from the thematic analysis was "ruralization of students' horizons," a construct representing the importance of preparing health professional students for practice in nonmetropolitan locations. Ruralization embodies three interrelated themes, "preparation and support," "rural or remote health experience," and "rural lifestyle and socialization," each of which includes multiple subthemes. From the content analysis, factors that promoted students' rural practice intentions were having a "positive" practice experience, interactions with "supportive staff," and interactions with the "community" in general. It was apparent that "difficulties," eg, with "accommodation," "Internet" access, "transport," and "financial" support, negatively impacted students' placement experience and rural practice intentions. The study findings have policy and practice implications for continuing to support students undertaking regional, rural, and remote placements and preparing them for future practice in nonmetropolitan locations. This study may, therefore, further inform ongoing strategies for improving rural placement experiences and

  16. Is There A Rural-Urban Technology Gap? Results of the ERS Rural Manufacturing Survey

    OpenAIRE

    Gale, H. Frederick, Jr.

    1997-01-01

    Advanced technology use is less prevalent in rural than in urban manufacturing plants, but plants of comparable size in the same industry use about the same level of technology, regardless of urban/rural location. The rural gap comes about because the mix of rural industries is more heavily weighted with "low-technology" industries. Both rural and urban businesses rate inadequate worker skills as the most important barrier to use of new production technologies and management practices, while ...

  17. Some Enlightenments of "Beautiful Rural Construction" on Rural Energy Policy in Beijing—Applying Informatization Means

    Science.gov (United States)

    Zhi, Wang; Kongan, Wu

    2018-06-01

    "Beautiful rural construction" is a systematic project, rural energy is one of the important contents of its construction. In accordance with the concept of eco-friendly construction, Beijing carried out a thorough "structural adjustment of rural energy optimization," "Earthquake energy-saving projects of rural housing" and other measures. By conventional heating technology research in Beijing 13 counties and 142 villages, we predict the future of rural energy will further the implementation of solar heating, electric heating and other new green energy technologies. It is suggested to establish the "Beijing Rural Information Service Platform" and "Beautiful Rural Information Resource Bank" through the means of informatization, which will greatly strengthen the regulation and control of rural people-land relationship and realize the systematic optimization, making the cities and villages have. Space for human survival and sustainable development.

  18. Do Head Start Impacts Vary by Neighborhood Context?

    Science.gov (United States)

    Morris, Pamela A.; Connors, Maia C.; McCoy, Dana Charles; Gomez, Celia J.; Yoshikawa, Hiro; Aber, J. Lawrence

    2014-01-01

    This paper capitalizes on the addition of geocodes for Head Start centers in which children were randomly assigned to address questions about the role of neighborhood characteristics in moderating impacts of assignment to the Head Start program. Researchers explore the extent to which impacts of assignment to Head Start on outcomes for children…

  19. Promoting the Positive Development of Boys in High-Poverty Neighborhoods: Evidence from Four Anti-Poverty Experiments

    Science.gov (United States)

    Snell, Emily K.; Castells, Nina; Duncan, Greg; Gennetian, Lisa; Magnuson, Katherine; Morris, Pamela

    2013-01-01

    This study uses geocoded address data and information about parents' economic behavior and children's development from four random-assignment welfare and anti-poverty experiments conducted during the 1990s. We find that the impacts of these welfare and anti-poverty programs on boys' and girls' developmental outcomes during the transition to early…

  20. Neighborhood Disadvantage and Variations in Blood Pressure

    Science.gov (United States)

    Cathorall, Michelle L.; Xin, Huaibo; Peachey, Andrew; Bibeau, Daniel L.; Schulz, Mark; Aronson, Robert

    2015-01-01

    Purpose: To examine the extent to which neighborhood disadvantage accounts for variation in blood pressure. Methods: Demographic, biometric, and self-reported data from 19,261 health screenings were used. Addresses of participants were geocoded and located within census block groups (n = 14,510, 75.3%). Three hierarchical linear models were…

  1. Australia's rural medical workforce: Supply from its medical schools against career stage, gender and rural-origin.

    Science.gov (United States)

    McGrail, Matthew R; Russell, Deborah J

    2017-10-01

    The aim of this study was to explore the association between career stage and rural medical workforce supply among Australian-trained medical graduates. Descriptive analysis using the national Medicine in Australia: Balancing Employment and Life (MABEL) longitudinal study. Australian-trained GPs and other specialists who participated in the MABEL study, 2008-2013. Proportions of GPs and specialists working in rural locations, according to career stage (establishing, early, mid and late), gender and childhood-origin type (rural versus metropolitan). Logistic regression models revealed that establishing- and early-career GPs had significantly higher likelihood (OR 1.67 and 1.38, respectively) of working rurally, but establishing and early-career doctors were significantly less likely (OR 0.34 and 0.43, respectively) to choose general practice, contributing proportionally fewer rural GPs overall (OR 0.77 and 0.75, respectively) compared to late-career doctors. For specialists, there were no significant associations between career cohorts and rural practice. Overall, there was a significantly lower likelihood (OR 0.83) of establishing-career doctors practising rurally. Women were similarly likely to be rural GPs but less likely to be rural specialists, while rural-origin was consistently associated with higher odds of rural practice. The supply of Australia's rural medical workforce from its medical schools continues to be challenging, with these data highlighting both their source and associations with doctors at different career stages. Despite large investments through rural medical training and rural workforce recruitment and retention policies, these data confirm continued reliance on internationally trained medical graduates for large proportions of rural supply is likely. © 2016 National Rural Health Alliance Inc.

  2. Realist review and synthesis of retention studies for health workers in rural and remote areas

    NARCIS (Netherlands)

    Dieleman, M.A.; Kane, Sumit; Zwanikken, Prisca A C; Gerretsen, Barend

    2011-01-01

    This report uses a realist review, which is a theory-based method, to address the questions of “why” and “how” certain rural retention interventions work better in some contexts and fail in others. Through applying a realist perspective to the review of these retention studies, a greater

  3. Rural entrepreneurship: Between place and space

    DEFF Research Database (Denmark)

    Korsgaard, Steffen; Müller, Sabine; Tanvig, Hanne Wittorff

    for a better use of rural resource-bases as well as for sustainable economic development. On the basis of an exploration of the spatial dynamics of rural entrepreneurship we develop propositions concerning rural entrepreneurship as a distinct form of entrepreneurial activity, emphasising bricolage, mixed......This paper proposes a distinction between rural entrepreneurship and entrepreneurship in the rural. While the latter is incidentally located in a rural area, the former engages with the localised resources of the rural area. We argue that rural entrepreneurship in this form holds promise...

  4. The Consortium for Evidence Based Research in Rural Educational Settings (CEBRRES): Applying Collaborative Action Research as a Means of Enhancing the Development of Rural Middle School Science Teachers

    Science.gov (United States)

    Wulff, A. H.

    2006-05-01

    Kentucky ranks third in the U.S. in need of rural education attention. Rural schools in Kentucky serve nearly 40% of the total student population, and graduation rates and NAEP scores are low. A two-year pilot study is being completed addressing psychological, social, and content knowledge based constructs, as they apply to science and mathematics achievement in rural environments. The goals are to identify the key aspects of rural teachers knowledge and skills, use a framework to describe how knowledge and skills develop in the rural classroom, apply a useful model of intervention to promote teacher development and increased student learning. If proven successful the knowledge can be incorporated into the practice of current teaching and preservice pedagogical methods. The problem that was identified and addressed by CEBRRES is the high level of student disengagement and the shortage of rigorous stimulating curriculum models. The action taken was the development and implementation of model eliciting activities. Teachers at the target school were expected to utilize action research methodology to execute model-eliciting activities in the classroom, and then communicate results in forms that are useful for other teachers. Benefits to teachers included stipends, increased science content depth and breadth, support to achieve "highly qualified teacher status", extensive professional development, and technology, equipment, and supplies for their school. Survey instruments were devised to address school perceptions (61% worry that they are not doing well enough in school), future plans (80% expect to attend college vs. the current 47.5%), various self concepts, academic self concepts (23% feel that learning is difficult for them), and family self concepts. Science was identified by the students as the subject that interests them the most, followed by math, yet Kentucky ranks near the bottom of the U.S. in math and science training in the workplace. Geology

  5. Ruralization of students’ horizons: insights into Australian health professional students’ rural and remote placements

    Science.gov (United States)

    Cross, Merylin; Waller, Susan; Chambers, Helen; Farthing, Annie; Barraclough, Frances; Pit, Sabrina W; Sutton, Keith; Muyambi, Kuda; King, Stephanie; Anderson, Jessie

    2018-01-01

    Introduction Health workforce shortages have driven the Australian and other Western governments to invest in engaging more health professional students in rural and remote placements. The aim of this qualitative study was to provide an understanding of the lived experiences of students undertaking placements in various nonmetropolitan locations across Australia. In addition to providing their suggestions to improve rural placements, the study provides insight into factors contributing to positive and negative experiences that influence students’ future rural practice intentions. Methods Responses to open-ended survey questions from 3,204 students from multiple health professions and universities were analyzed using two independent methods applied concurrently: manual thematic analysis and computerized content analysis using Leximancer software. Results The core concept identified from the thematic analysis was “ruralization of students’ horizons,” a construct representing the importance of preparing health professional students for practice in nonmetropolitan locations. Ruralization embodies three interrelated themes, “preparation and support,” “rural or remote health experience,” and “rural lifestyle and socialization,” each of which includes multiple subthemes. From the content analysis, factors that promoted students’ rural practice intentions were having a “positive” practice experience, interactions with “supportive staff,” and interactions with the “community” in general. It was apparent that “difficulties,” eg, with “accommodation,” “Internet” access, “transport,” and “financial” support, negatively impacted students’ placement experience and rural practice intentions. Conclusions The study findings have policy and practice implications for continuing to support students undertaking regional, rural, and remote placements and preparing them for future practice in nonmetropolitan locations. This study

  6. a Discussion about Effective Ways of Basic Resident Register on GIS

    Science.gov (United States)

    Oku, Naoya; Nonaka, Yasuaki; Ito, Yutaka

    2016-06-01

    In Japan, each municipality keeps a database of every resident's name, address, gender and date of birth called the Basic Resident Register. If the address information in the register is converted into coordinates by geocoding, it can be plotted as point data on a map. This would enable prompt evacuation from disaster, analysis of distribution of residents, integrating statistics and so on. Further, it can be used for not only analysis of the current situation but also future planning. However, the geographic information system (GIS) incorporating the Basic Resident Register is not widely used in Japan because of the following problems: - Geocoding In order to plot address point data, it is necessary to match the Basic Resident Register and the address dictionary by using the address as a key. The information in the Basic Resident Register does not always match the actual addresses. As the register is based on applications made by residents, the information is prone to errors, such as incorrect Kanji characters. - Security policy on personal information In the register, the address of a resident is linked with his/her name and date of birth. If the information in the Basic Resident Register were to be leaked, it could be used for malicious purposes. This paper proposes solutions to the above problems. The suitable solutions for the problems depend on the purpose of use, thus it is important that the purpose should be defined and a suitable way of the application for each purpose should be chosen. In this paper, we mainly focus on the specific purpose of use: to analyse the distribution of the residents. We provide two solutions to improve the matching rate in geocoding. First, regarding errors in Kanji characters, a correction list of possible errors should be compiled in advance. Second, some sort of analyses such as distribution of residents may not require exactly correct position for the address point. Therefore we set the matching level in order: prefecture

  7. Rural-Urban Differences in Late-Stage Breast Cancer: Do Associations Differ by Rural-Urban Classification System?

    Science.gov (United States)

    Pruitt, Sandi L; Eberth, Jan M; Morris, E Scott; Grinsfelder, David B; Cuate, Erica L

    2016-01-01

    Introduction Rural residence is associated with later stage of breast cancer diagnosis in some but not all prior studies. The lack of a standardized definition of rural residence may contribute to these mixed findings. We characterize and compare multiple definitions of rural vs. non-rural residence to provide guidance regarding choice of measures and to further elucidate rural disparities in breast cancer stage at diagnosis. Methods We used Texas Cancer Registry data of 120,738 female breast cancer patients ≥50 years old diagnosed between 1995–2009. We defined rural vs. non-rural residence using 7 different measures and examined their agreement using Kappa statistics. Measures were defined at various geographic levels: county, ZIP code, census tract, and census block group. Late-stage was defined as regional or distant disease. For each measure, we tested the association of rural residence and late-stage cancer with unadjusted and adjusted logistic regression. Covariates included: age; patient race/ethnicity; diagnosis year; census block group-level mammography capacity; and census tract-level percent poverty, percent Hispanic, and percent Black. Results We found moderate to high levels of agreement between measures of rural vs. non-rural residence. For 72.9% of all patients, all 7 definitions agreed as to rural vs. non-rural residence. Overall, 6 of 7 definitions demonstrated an adverse association between rural residence and late-stage disease in unadjusted and adjusted models (Adjusted OR Range = 1.09–1.14). Discussion Our results document a clear rural disadvantage in late-stage breast cancer. We contribute to the heterogeneous literature by comparing varied measures of rural residence. We recommend use of the census tract-level Rural Urban Commuting Area Codes in future cancer outcomes research where small area data are available. PMID:27158685

  8. Prevalence of and Differences in Salad Bar Implementation in Rural Versus Urban Arizona Schools.

    Science.gov (United States)

    Blumenschine, Michelle; Adams, Marc; Bruening, Meg

    2018-03-01

    Rural children consume more calories per day on average than urban children, and they are less likely to consume fruit. Self-service salad bars have been proposed as an effective approach to better meet the National School Lunch Program's fruit and vegetable recommendations. No studies have examined how rural and urban schools differ in the implementation of school salad bars. To compare the prevalence of school-lunch salad bars and differences in implementation between urban and rural Arizona schools. Secondary analysis of a cross-sectional web-based survey. School nutrition managers (N=596) in the state of Arizona. National Center for Education Statistics locale codes defined rural and urban classifications. Barriers to salad bar implementation were examined among schools that have never had, once had, and currently have a school salad bar. Promotional practices were examined among schools that once had and currently have a school salad bar. Generalized estimating equation models were used to compare urban and rural differences in presence and implementation of salad bars, adjusting for school-level demographics and the clustering of schools within districts. After adjustment, the prevalence of salad bars did not differ between urban and rural schools (46.9%±4.3% vs 46.8%±8.5%, respectively). Rural schools without salad bars more often reported perceived food waste and cost of produce as barriers to implementing salad bars, and funding was a necessary resource for offering a salad bar in the future, as compared with urban schools (Pbar promotion, challenges, or resources among schools that currently have or once had a salad bar. After adjustment, salad bar prevalence, implementation practices, and concerns are similar across geographic settings. Future research is needed to investigate methods to address cost and food waste concerns in rural areas. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  9. Urban dogs in rural areas: Human-mediated movement defines dog populations in southern Chile.

    Science.gov (United States)

    Villatoro, Federico J; Sepúlveda, Maximiliano A; Stowhas, Paulina; Silva-Rodríguez, Eduardo A

    2016-12-01

    Management strategies for dog populations and their diseases include reproductive control, euthanasia and vaccination, among others. However, the effectiveness of these strategies can be severely affected by human-mediated dog movement. If immigration is important, then the location of origin of dogs imported by humans will be fundamental to define the spatial scales over which population management and research should apply. In this context, the main objective of our study was to determine the spatial extent of dog demographic processes in rural areas and the proportion of dogs that could be labeled as immigrants at multiple spatial scales. To address our objective we conducted surveys in households located in a rural landscape in southern Chile. Interviews allowed us to obtain information on the demographic characteristics of dogs in these rural settings, human influence on dog mortality and births, the localities of origin of dogs living in rural areas, and the spatial extent of human-mediated dog movement. We found that most rural dogs (64.1%) were either urban dogs that had been brought to rural areas (40.0%), or adopted dogs that had been previously abandoned in rural roads (24.1%). Some dogs were brought from areas located as far as ∼700km away from the study area. Human-mediated movement of dogs, especially from urban areas, seems to play a fundamental role in the population dynamics of dogs in rural areas. Consequently, local scale efforts to manage dog populations or their diseases are unlikely to succeed if implemented in isolation, simply because dogs can be brought from surrounding urban areas or even distant locations. We suggest that efforts to manage or study dog populations and related diseases should be implemented using a multi-scale approach. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. A qualitative study of recruitment barriers, motivators, and community-based strategies for increasing clinical trials participation among rural and urban populations.

    Science.gov (United States)

    Friedman, Daniela B; Foster, Caroline; Bergeron, Caroline D; Tanner, Andrea; Kim, Sei-Hill

    2015-01-01

    Participation in clinical trials (CTs) is low among rural communities. Investigators report difficulty recruiting rural individuals for CTs. The study purpose was to identify recruitment barriers, motivators, and strategies to help increase access to and participation in CTs in rural and urban communities. Qualitative focus groups/interviews. Rural and urban counties in one southeastern state. Two hundred twelve African-American and white men and women ages 21+. Nineteen focus groups and nine interviews were conducted. Audio files were transcribed and organized into NVivo10. Recurring themes were examined by geographic location. Although similar barriers, motivators, and strategies were reported by urban and rural groups, perceptions regarding their importance varied. Recruitment barriers mentioned in both rural and urban groups included fear, side effects, limited understanding, limited time, and mistrust. Rural groups were more mindful of time commitment involved. Both rural and urban participants reported financial incentives as the top motivator to CT participation, followed by personal illness (urban groups) and benefits to family (rural groups). Recruitment strategies suggested by rural participants involved working with schools/churches and using word of mouth, whereas partnering with schools, word of mouth, and media were recommended most by urban groups. Perceived recruitment barriers, motivators, and strategies did not differ considerably between rural and urban groups. Major barriers identified by participants should be addressed in future CT recruitment and education efforts. Findings can inform recruitment and communication strategies for reaching both urban and rural communities.

  11. Development of Rural Communities by Diversification of Rural Economy in the Context of Sustainable Development

    Directory of Open Access Journals (Sweden)

    Manuela Dora Orboi

    2012-05-01

    Full Text Available The sustainable development is a process taking place at the same time with the complex and sustainable agricultural development; agriculture and the rural area being interdependent sides specific to rural communities. When analysing economic activity in the rural area we should pay a particular attention to the identification of such alternative activities that have a real chance for development and create new jobs that compensate the diminution of labour occupancy degree in agriculture. Opportunities of rural economy represent a source of having alternative income for the population from rural communities in order to escape from poverty and in order to accelerate the social progress in the rural area. Alternative activities with economic, social and cultural impact, providers of jobs and incomes are: the development of agro tourism and rural tourism, processing and promoting foodstuff, local traditional drinks, ecological foodstuff, handicraft and silviculture. Improving the conditions for business in the rural area is a main condition for the generation of economic activities generating jobs in the rural area.

  12. Rural Entrepreneurship: Challenges and Opportunities

    OpenAIRE

    Imedashvili, Sopiko; Kekua, Ani; Ivchenko, Polina

    2013-01-01

    According to World Bank Report published in 2012, the rural population in Sweden is 15.3 %. Rural population is calculated as difference between total populations minus urban population. 15.3 % clearly shows how important rural areas are for Sweden’s future development. Entrepreneurship plays the integral role in rural area development. However, earlier research has shown only economic perspective of rural development. On the other hand, the new ways to discover the challenges and opportuniti...

  13. Rural Pennsylvanians--A Troubled People.

    Science.gov (United States)

    Hillman, Arnold

    This report presents the problems of rural Pennsylvania and proposes solutions to those problems. Because the news media does not systematically report on rural situations, the public lacks awareness concerning the problems in rural Pennsylvania. Rural problems include high unemployment rates, high welfare expenditures, out migration, low…

  14. Development of Sustainable Rural Tourism

    Directory of Open Access Journals (Sweden)

    Sandra Kantar

    2017-06-01

    Full Text Available This paper presents a sociological view of possibilities for the development of sustainable rural tourism in Koprivnica-Krizevci county, which is located in the north-western part of Croatia. The possibilities for developing rural tourism within the concept of sustainable development have been researched through qualitative empirical research interview method. Research subjects were the owners of tourist farms, decision makers, experts and other stakeholders in the tourism development. Rural tourism represents an alternative to maritime tourism and is relatively undeveloped but important in terms of development of rural areas and family farms. This paper enables an insight into an integrated sustainability of rural tourism which consists of four dimensions: biologicalecological, economic, socio-cultural and political sustainability. In conclusion, integral sustainability in rural tourism is not achieved in all dimensions. Therefore, rural tourism could be a strategy for sustainable development for rural areas and also could be a tool for product differentiation for area that are at stagnation stage.

  15. Women’s decision-making autonomy and children’s schooling in rural Mozambique

    OpenAIRE

    Luciana Luz; Victor Agadjanian

    2015-01-01

    Background: Women's decision-making autonomy in developing settings has been shown to improve child survival and health outcomes. However, little research has addressed possible connections between women's autonomy and children's schooling. Objective: To examine the relationship between rural women's decision-making autonomy and enrollment status of primary school-age children living in their households and how this relationship differs by child's gender. Methods: The analysis uses data...

  16. Medical abortion: understanding perspectives of rural and marginalized women from rural South India.

    Science.gov (United States)

    Sri, B Subha; Ravindran, T K Sundari

    2012-09-01

    To understand how rural and other groups of marginalized women define safe abortion; their perspectives and concerns regarding medical abortion (MA); and what factors affect their access to safe abortion. Focus group discussions were held with various groups of rural and marginalized women in Tamil Nadu to understand their perspectives and concerns on abortion, especially MA. Nearly a decade after mifepristone was approved for abortion in India, most study participants had never heard of MA. When they learned of the method, most preferred it over other methods of abortion. The women also had questions and concerns about the method and recommendations on how services should be provided. Their definition of a "safe abortion" included criteria beyond medical safety. They placed a high priority on "social safety," including confidentiality and privacy. In their view, factors affecting access to safe abortion and choice of provider included cost, assurance of secrecy, promptness of service provision, and absence of provider gatekeeping and provider-imposed conditions for receiving services. Women's preference for MA shows the potential of this technology to address the problem of unsafe abortion in India. Women need better access to information and services to realize this potential, however. Women's preferences regarding information dissemination and service provision need to be taken into account if policies and programs are to be truly responsive to the needs of marginalized women. Copyright © 2012. Published by Elsevier Ireland Ltd.

  17. The Possibility of Deduction of Environmental Liabilities in Expropriation for Each Breach of Environmental Rural Property

    Directory of Open Access Journals (Sweden)

    Ricardo Nasser Sefer

    2016-10-01

    Full Text Available This study aims to address the deductibility of environmental liability indemnification of quantum measured in the expropriation of rural property that failed to fulfill its environmental function. The Federal Constitution of 1988, provided for the possibility to expropriate rural property that failed to comply with its social and environmental role. On the subject, the Federal Regional Court of the 1st Region does not signed a single position on this opportunity to deduct the environmental liability, generating as a result, legal uncertainty for landowners and the community itself, being the Institute of Colonization and Agrarian Reform - INCRA the correct deduction.

  18. A study protocol to evaluate the relationship between outdoor air pollution and pregnancy outcomes.

    Science.gov (United States)

    Ribeiro, Manuel C; Pereira, Maria J; Soares, Amílcar; Branquinho, Cristina; Augusto, Sofia; Llop, Esteve; Fonseca, Susana; Nave, Joaquim G; Tavares, António B; Dias, Carlos M; Silva, Ana; Selemane, Ismael; de Toro, Joaquin; Santos, Mário J; Santos, Fernanda

    2010-10-15

    The present study protocol is designed to assess the relationship between outdoor air pollution and low birth weight and preterm births outcomes performing a semi-ecological analysis. Semi-ecological design studies are widely used to assess effects of air pollution in humans. In this type of analysis, health outcomes and covariates are measured in individuals and exposure assignments are usually based on air quality monitor stations. Therefore, estimating individual exposures are one of the major challenges when investigating these relationships with a semi-ecologic design. Semi-ecologic study consisting of a retrospective cohort study with ecologic assignment of exposure is applied. Health outcomes and covariates are collected at Primary Health Care Center. Data from pregnant registry, clinical record and specific questionnaire administered orally to the mothers of children born in period 2007-2010 in Portuguese Alentejo Litoral region, are collected by the research team. Outdoor air pollution data are collected with a lichen diversity biomonitoring program, and individual pregnancy exposures are assessed with spatial geostatistical simulation, which provides the basis for uncertainty analysis of individual exposures. Awareness of outdoor air pollution uncertainty will improve validity of individual exposures assignments for further statistical analysis with multivariate regression models. Exposure misclassification is an issue of concern in semi-ecological design. In this study, personal exposures are assigned to each pregnant using geocoded addresses data. A stochastic simulation method is applied to lichen diversity values index measured at biomonitoring survey locations, in order to assess spatial uncertainty of lichen diversity value index at each geocoded address. These methods assume a model for spatial autocorrelation of exposure and provide a distribution of exposures in each study location. We believe that variability of simulated exposure values at

  19. A study protocol to evaluate the relationship between outdoor air pollution and pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Selemane Ismael

    2010-10-01

    Full Text Available Abstract Background The present study protocol is designed to assess the relationship between outdoor air pollution and low birth weight and preterm births outcomes performing a semi-ecological analysis. Semi-ecological design studies are widely used to assess effects of air pollution in humans. In this type of analysis, health outcomes and covariates are measured in individuals and exposure assignments are usually based on air quality monitor stations. Therefore, estimating individual exposures are one of the major challenges when investigating these relationships with a semi-ecologic design. Methods/Design Semi-ecologic study consisting of a retrospective cohort study with ecologic assignment of exposure is applied. Health outcomes and covariates are collected at Primary Health Care Center. Data from pregnant registry, clinical record and specific questionnaire administered orally to the mothers of children born in period 2007-2010 in Portuguese Alentejo Litoral region, are collected by the research team. Outdoor air pollution data are collected with a lichen diversity biomonitoring program, and individual pregnancy exposures are assessed with spatial geostatistical simulation, which provides the basis for uncertainty analysis of individual exposures. Awareness of outdoor air pollution uncertainty will improve validity of individual exposures assignments for further statistical analysis with multivariate regression models. Discussion Exposure misclassification is an issue of concern in semi-ecological design. In this study, personal exposures are assigned to each pregnant using geocoded addresses data. A stochastic simulation method is applied to lichen diversity values index measured at biomonitoring survey locations, in order to assess spatial uncertainty of lichen diversity value index at each geocoded address. These methods assume a model for spatial autocorrelation of exposure and provide a distribution of exposures in each study location

  20. Rural Vocational and Transition Assessment Practices for Students with Intellectual Disabilities: What Do Educators Really Know?

    Science.gov (United States)

    Brendle, Janna; Tucker, Kathryn J.; Lock, Robin H.

    2018-01-01

    Transition planning requires quality vocational and transition assessment tailored to the student's needs, strengths, preferences and interests. Limited research is currently available that addresses assessment types and use of results that rural practitioners utilize to aid in transition planning for students with intellectual disabilities (ID).…

  1. Health concerns associated with unconventional gas mining in rural Australia.

    Science.gov (United States)

    Haswell, Melissa R; Bethmont, Anna

    2016-01-01

    Many governments globally are investigating the benefits and risks associated with unconventional gas mining for shale, tight and coal seam gas (coalbed methane) to determine whether the industry should proceed in their jurisdiction. Most locations likely to be developed are in rural areas, with potential impact on farmers and small communities. Despite significant health concerns, public health knowledge and growing evidence are often overlooked in decision-making. It is difficult to gain a broad but accurate understanding of the health concerns for rural communities because the evidence has grown very recently and rapidly, is complex and largely based in the USA, where the industry is advanced. In 2016, a concerned South Australian beef and lamb farmer in an area targeted for potential unconventional gas development organised visits to homes in developed unconventional gas areas of Pennsylvania and forums with leading researchers and lawyers in Pennsylvania and New York. Guided by priorities identified during this trip, this communication concisely distils the research evidence on these key concerns, highlighting the Australian situation where evidence exists. It summarises key information of particular concern to rural regions, using Australia as an example, to assist rural health professionals to be better prepared to engage in decision-making and address the challenges associated with this new industry. Discussions with communities and experts, supported by the expanding research from the USA and Australia, revealed increasing health concerns in six key areas. These are absence of a safe solution to the toxic wastewater management problems, air pollution, land and water competition, mental health and psychosocial wellbeing risks, fugitive methane emissions and lack of proven regulatory regimes. Emerging epidemiological studies suggesting interference with foetal development and birth outcomes, and exacerbation of asthma conditions, are particularly concerning

  2. Keynote address

    International Nuclear Information System (INIS)

    Davis, J.M.

    1991-01-01

    DOE biomass R ampersand D programs have the potential to provide America with both plentiful, clean-burning domestic transportation fuels and cost-competitive industrial and utility fuels, benefiting energy security in the United States. Biofuels developed under our programs will also help improve air quality, reduce greenhouse gases, reduce the large daily quantities of waste we produce, and revitalize rural America. These research motivations have been documented in the National Energy Strategy. DOE looks forward to expanding its biofuels research program and to forging a partnership with private sector for cost-shared commercialization of new fuels and vehicle technologies. Many alternative fuels (e.g., ethanol, methanol, compressed natural gas, propane, or electricity) are candidates for gaining market share. Indeed, there may be significant regional variation in the future fuel mix. Alcohol fuels from biomass, particularly ethanol, have the potential to make a major contribution. Currently, ethanol in the United States is almost entirely made from corn; and the limitations of that process are well known (e.g., costly feedstock, end product requiring subsidy to be competitive, use of fossil fuels in renewable feedstock production and processing, and potential adverse impact of corn ethanol production on the price of food). To address these concerns, the DOE biofuels program is pursuing an ambitious research program to develop the technologies needed to convert these crops into alternative transportation fuels, primarily cellulose-based ethanol and methanol. Program R ampersand D has reduced the estimated cost per gallon of cellulose-based ethanol from $3.60 in 1980 to the current $1.35, with a program goal of $0.60 by the year 2000. DOE is also investigating the thermochemical conversion of biomass to methanol. The program goal is to achieve commercial production of methanol (like ethanol) at the gasoline equivalent of $0.90 per gallon by the year 2000. 4 figs

  3. A dengue outbreak on a floating village at Cat Ba Island in Vietnam.

    Science.gov (United States)

    Le Viet, Thanh; Choisy, Marc; Bryant, Juliet E; Vu Trong, Duoc; Pham Quang, Thai; Horby, Peter; Nguyen Tran, Hien; Tran Thi Kieu, Huong; Nguyen Vu, Trung; Nguyen Van, Kinh; Le Quynh, Mai; Wertheim, Heiman F L

    2015-09-22

    A dengue outbreak in an ecotourism destination spot in Vietnam, from September to November 2013, impacted a floating village of fishermen on the coastal island of Cat Ba. The outbreak raises questions about how tourism may impact disease spread in rural areas. Epidemiological data were obtained from the Hai Phong Preventive Medical Center (PMC), including case histories and residential location from all notified dengue cases from this outbreak. All household addresses were geo-located. Knox test, a spatio-temporal analysis that enables inference dengue clustering constrained by space and time, was performed on the geocoded locations. From the plasma available from two patients, positive for Dengue serotype 3 virus (DENV3), the Envelope (E) gene was sequenced, and their genetic relationships compared to other E sequences in the region. Of 192 dengue cases, the odds ratio of contracting dengue infections for people living in the floating villages compared to those living on the island was 4.9 (95 % CI: 3.6-6.7). The space-time analyses on 111 geocoded dengue residences found the risk of dengue infection to be the highest within 4 days and a radius of 20 m of a given case. Of the total of ten detected clusters with an excess risk greater than 2, the cluster with the highest number of cases was in the floating village area (24 patients for a total duration of 31 days). Phylogenetic analysis revealed a high homology of the two DENV3 strains (genotype III) from Cat Ba with DENV3 viruses circulating in Hanoi in the same year (99.1 %). Our study showed that dengue transmission is unlikely to be sustained on Cat Ba Island and that the 2013 epidemic likely originated through introduction of viruses from the mainland, potentially Hanoi. These findings suggest that prevention efforts should be focused on mainland rather than on the island.

  4. Agritourism Rural Development Public Administration

    Directory of Open Access Journals (Sweden)

    Maria MORTAN

    2006-02-01

    Full Text Available For Romania agritourism development represents the opportunity to differentiate between the rural and urban environment, as well as the best way for the preservation of traditions and customs in the rural areas, supplying a sustainable rural development. This work portrays agritourism as an element of rural development and critically analyzes the way in which the public administration should become involved in sustaining rural development in general and in sustaining agritourism development in particular.

  5. Successes, challenges and needs regarding rural health medical education in continental Central America: a literature review and narrative synthesis.

    Science.gov (United States)

    Colon-Gonzalez, Maria C; El Rayess, Fadya; Guevara, Sara; Anandarajah, Gowri

    2015-01-01

    Central American countries, like many others, face a shortage of rural health physicians. Most medical schools in this region are located in urban areas and focus on tertiary care training rather than on community health or primary care, which are better suited for rural practice. However, many countries require young physicians to do community service in rural communities to address healthcare provider shortages. This study aimed to: (a) synthesize what is known about the current state of medical education preparing physicians for rural practice in this region, and (b) identify common needs, challenges and opportunities for improving medical education in this area. A comprehensive literature review was conducted between December 2013 and May 2014. The stepwise, reproducible search process included English and Spanish language resources from both data-based web search engines (PubMed, Web of Science/Web of Knowledge, ERIC and Google Scholar) and the grey literature. Search criteria included MeSH terms: 'medical education', 'rural health', 'primary care', 'community medicine', 'social service', in conjunction with 'Central America', 'Latin America', 'Mexico', 'Guatemala', 'Belize', 'El Salvador', 'Nicaragua', 'Honduras', 'Costa Rica' and 'Panama'. Articles were included in the review if they (1) were published after 1984; (2) focused on medical education for rural health, primary care, community health; and (3) involved the countries of interest. A narrative synthesis of the content of resources meeting inclusion criteria was done using qualitative research methods to identify common themes pertaining to the study goals. The search revealed 20 resources that met inclusion criteria. Only four of the 20 were research articles; therefore, information about this subject was primarily derived from expert opinion. Thematic analysis revealed the historical existence of several innovative programs that directly address rural medicine training needs, suggesting that

  6. Reducing Food Poverty and Vulnerability among the Rural Elderly with Chronic Diseases: The Role of the New Rural Pension Scheme in China.

    Science.gov (United States)

    Zhang, Zhaohua; Luo, Yuxi; Robinson, Derrick

    2018-06-13

    Vulnerability to food poverty is the probability of an individual falling below the food poverty line in the near future, which provides a forward-looking welfare analysis. Applying a nationally representative survey dataset, this study investigates the role of the New Rural Pension Scheme (NRPS) in reducing food poverty and vulnerability among the rural elderly with chronic diseases. By designing province-specific food poverty lines to account for variations in the elderly’s needs, as well as the prices across provinces using a least-cost linear programming approach, the food poverty incidences among the elderly with chronic diseases are calculated. Applying a three-stage feasible generalized least squares (FGLS) procedure, the vulnerability to food poverty is estimated. Our results show that food poverty incidence and vulnerability of the elderly with chronic diseases in rural China is 41.9% and 35% respectively, which is 8% and 6% higher, respectively, than the elderly that are in good health. To address the potential endogeneity of pension payment, a fuzzy regression discontinuity (RD) regression is employed to investigate the effects of pension income on food poverty and vulnerability for different population groups. We found that pension income decreases the probability of being food poor and the vulnerability to food poverty among the elderly with chronic diseases by 12.9% and 16.8% respectively, while it has no significant effect on the elderly in good health.

  7. Pharmacy and primary care perspectives on e-prescribing in a rural community: A focused ethnography.

    Science.gov (United States)

    Kooienga, Sarah; Singh, Reshmi L

    , technological and communication dimensions are essential in understanding e-prescribing across settings and addressing digital divides in our health care system. Implications for interprofessional pharmacy education were addressed. Understanding the rural context and the need for role adaptability has implications for health care policy. Additional research is needed on the role of the rural pharmacist and how best to interact with primary care providers and patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Work of female rural doctors.

    Science.gov (United States)

    Wainer, Jo

    2004-04-01

    To identify the impact of family life on the ways women practice rural medicine and the changes needed to attract women to rural practice. Census of women rural doctors in Victoria in 2000, using a self-completed postal survey. General and specialist practice. Two hundred and seventy-one female general practitioners and 31 female specialists practising in Rural, Remote and Metropolitan Area Classifications 3-7. General practitioners are those doctors with a primary medical degree and without additional specialist qualifications. Interaction of hours and type of work with family responsibilities. Generalist and specialist women rural doctors carry the main responsibility for family care. This is reflected in the number of hours they work in clinical and non-clinical professional practice, availability for on-call and hospital work, and preference for the responsibilities of practice partnership or the flexibility of salaried positions. Most of the doctors had established a satisfactory balance between work and family responsibilities, although a substantial number were overworked in order to provide an income for their families or meet the needs of their communities. Thirty-six percent of female rural general practitioners and 56% of female rural specialists preferred to work fewer hours. Female general practitioners with responsibility for children were more than twice as likely as female general practitioners without children to be in a salaried position and less likely to be a practice partner. The changes needed to attract and retain women in rural practice include a place for everyone in the doctor's family, flexible practice structures, mentoring by women doctors and financial and personal recognition. Women make up less than a quarter of the rural general practice workforce and an even smaller percentage of the specialist rural medical workforce. As a result their experiences are not well articulated in research on rural medical practice and their needs are

  9. Rural health service managers' perspectives on preparing rural health services for climate change.

    Science.gov (United States)

    Purcell, Rachael; McGirr, Joe

    2018-02-01

    To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.

  10. Rural versus Urban

    DEFF Research Database (Denmark)

    Schøning, Signe Wedel

    and take position within larger social structures of unequal power structures through such employment. The adolescents did not explicitly discuss power relations between urban and rural Denmark in their everyday social encounters, but when they employ Stylised vestjysk and Stylised københavnsk......This ethnographic project discerns how rural adolescents living in West Jutland, Denmark, carry out their daily lives under globalised conditions. The project shows how the young speakers (re)activate, align with and discard ideological perceptions of rural and urban Denmark. By investigating......, they continuously ascribe low social status to the former and high social status to the latter. Thus, the overall picture is one reproducing urban Denmark as a powerful and prestigious centre, whereas rural Denmark is disempowered....

  11. Availability and Primary Health Care Orientation of Dementia-Related Services in Rural Saskatchewan, Canada.

    Science.gov (United States)

    Morgan, Debra G; Kosteniuk, Julie G; Stewart, Norma J; O'Connell, Megan E; Kirk, Andrew; Crossley, Margaret; Dal Bello-Haas, Vanina; Forbes, Dorothy; Innes, Anthea

    2015-01-01

    Community-based services are important for improving outcomes for individuals with dementia and their caregivers. This study examined: (a) availability of rural dementia-related services in the Canadian province of Saskatchewan, and (b) orientation of services toward six key attributes of primary health care (i.e., information/education, accessibility, population orientation, coordinated care, comprehensiveness, quality of care). Data were collected from 71 rural Home Care Assessors via cross-sectional survey. Basic health services were available in most communities (e.g., pharmacists, family physicians, palliative care, adult day programs, home care, long-term care facilities). Dementia-specific services typically were unavailable (e.g., health promotion, counseling, caregiver support groups, transportation, week-end/night respite). Mean scores on the primary health care orientation scales were low (range 12.4 to 17.5/25). Specific services to address needs of rural individuals with dementia and their caregivers are limited in availability and fit with primary health care attributes.

  12. Counting addressing method: Command addressable element and extinguishing module

    Directory of Open Access Journals (Sweden)

    Ristić Jovan D.

    2009-01-01

    Full Text Available The specific requirements that appear in addressable fire detection and alarm systems and the shortcomings of the existing addressing methods were discussed. A new method of addressing of detectors was proposed. The basic principles of addressing and responding of a called element are stated. Extinguishing module is specific subsystem in classic fire detection and alarm systems. Appearing of addressable fire detection and alarm systems didn't caused essential change in the concept of extinguishing module because of long calling period of such systems. Addressable fire security system based on counting addressing method reaches high calling rates and enables integrating of the extinguishing module in addressable system. Solutions for command addressable element and integrated extinguishing module are given in this paper. The counting addressing method was developed for specific requirements in fire detection and alarm systems, yet its speed and reliability justifies its use in the acquisition of data on slowly variable parameters under industrial conditions. .

  13. Methodology for agricultural and rural NPS pollution in a typical county of the North China Plain

    International Nuclear Information System (INIS)

    Yang Yong; Chen Ying; Zhang Xiaolan; Ongley, Edwin; Zhao Lei

    2012-01-01

    Agricultural non-point source (NPS) pollution has been recently identified by the Chinese government as a major source of aquatic pollution. Methodologies commonly used to make basin-wide or area-wide assessments are problematic and regional distinctions have not been made relative to rainfall and runoff. Using a typical agricultural county in the Hai River basin of the North China Plan we developed methodology to estimate potential load and delivered load for crops (field crops + rice), animal production, rural living and from atmospheric N input. We use scenarios to allow for uncertainty in delivery to estimate the relative roles of different rural forms of pollution. Livestock raising is the major source of NPS pollution. Despite a 75% rural population, rural living contributes almost nothing to surface water pollution. While over-fertilization is typical, nutrient runoff from crops is low. Our results have implications for policies now under development for NPS control in China. - Highlights: ► Provides specific methods guidance for agricultural NPS assessment in China. ► Crops do not contribute significant N and P to watercourses in North China Plain. ► Rural living contributes almost no N and P to watercourses. ► Livestock is the only significant agricultural source of COD, N and P. - We address the methodology for agricultural NPS pollution assessment. We show that livestock, not rural living or crops, is the significant pollutant source.

  14. RURAL DEVELOPMENT: MORE THAN SINGLE AGRICULTURAL DEVELOPMENT DESARROLLO RURAL: MÁS QUE DESARROLLO AGRÍCOLA

    Directory of Open Access Journals (Sweden)

    Pachón Ariza Fabio Alberto

    2007-11-01

    Full Text Available Rural development as the notion of development has been strongly influenced by the idea of economic growth. Conversely, the rural development road has been focus on agricultural modernization of production systems, intensive use of chemical inputs to increase levels and technology transfer. The actual rural reality has conducted to a revaluation of what rural means and therefore its development. In these sense has grown the importance of rural related activities linked to the diversification and generating of extra revenues for rural families. This could be one of the cases behind this change in perceptions on previous rural development, giving more importance to other aspects such as cultural diversity, community participation, decision taking, decentralization processes, cultural values, and in consequence hot associate rural development with agricultural development.El desarrollo rural al igual que el sólo desarrollo, ha estado fuertemente influenciado por la idea que lo liga con el crecimiento económico. Concebido de esta forma, la manera como se ha intentado alcanzar desarrollo rural ha sido por medio de la modernización de los sistemas de producción agropecuaria, del uso indiscriminado de insumos químicos para aumentar los niveles productivos y de transferencia de tecnología. La realidad que se vive en el sector rural ha hecho que se evolucione hacia una revaloración de lo que significa lo rural y, de esta manera, también su desarrollo. Por este camino han tomado más importancia actividades conexas a lo productivo agropecuario y también la diversificación de las formas de generación de ingresos para las familias rurales. Ésta podría ser una de las causas para que también cambie la percepción que existía sobre el desarrollo rural y se brinde más importancia a otros aspectos como la aceptación de la diversidad, la participación de la comunidad en la toma de decisiones, la descentralización de la administración, el

  15. Nonnative invasive plants: Maintaining biotic and soceioeconomic integrity along the urban-rural-natural gradient

    Science.gov (United States)

    Cynthia D. Huebner; David J. Nowak; Richard V. Pouyat; Allison R. Bodine

    2012-01-01

    In this chapter, we evaluate nonnative invasive plant species of the urban-rural-natural area gradient in order to reduce negative impacts of invasive plants on native species and ecosystems. This evaluation includes addressing (i) the concept of urban areas as the primary source of invasive plant species and characteristics of urban nonnative plants, including their...

  16. The Rural School Leadership Dilemma

    Science.gov (United States)

    Surface, Jeanne L.; Theobald, Paul

    2014-01-01

    The idea that rural schools and communities, indeed, even rural people, are somehow substandard or second-class has deep historical roots. The goal of this essay is to reveal that history so as to render stereotypical conceptions all things rural less powerful and more easily dismissed by rural school professionals. Consequently the focus is on…

  17. Characteristics of HIV-infected adults in the Deep South and their utilization of mental health services: A rural vs. urban comparison.

    Science.gov (United States)

    Reif, Susan; Whetten, Kathryn; Ostermann, Jan; Raper, James L

    2006-01-01

    Insufficient utilization of mental health services has been described among HIV-infected individuals in urban areas; however, little is known about utilization of mental health services among rural-living HIV-infected individuals. This article examines use of mental health services by HIV-infected adults in the Southern U.S., where approximately two-thirds of rural HIV cases reside, and compares mental health services use between those in rural and urban areas. Data were obtained from surveys of HIV-infected individuals receiving care at tertiary Infectious Diseases clinics in the Southern U.S. (n = 474). Study findings indicated that participants living in areas with a higher proportion of rural-living individuals were less likely to report seeing a mental health provider (p mental health visits in the previous month (p = .025). Furthermore, rural living was significantly associated with being African-American, heterosexual, less educated, and having minor children in the home. Due to differences in characteristics and mental health services use by degree of rurality, efforts are needed to assess and address the specific mental health and other needs of HIV-infected individuals in rural areas.

  18. The "Total Worker Health" Concept: A Case Study in a Rural Workplace.

    Science.gov (United States)

    Watkins, Cecilia; Macy, Gretchen; Golla, Vijay; Lartey, Grace; Basham, Jacqueline

    2018-05-01

    This case study was conducted to identify barriers of integration of health protection and health promotion in rural workplaces with tailored interventions that address the identified barriers. Data on a workplace's ability to integrate wellness programs and health protection programs were collected through a questionnaire along with a seven-question interview. Descriptive statistics were used to analyze the quantitative data. Qualitative measures were assessed using thematic analysis. Based off the results of the assessments, the company received tailored training sessions. The largest hindrance to organizational support was time. However, improved knowledge about the need and importance of integration helped the participants to conceptualize and plan for more collaboration between departments. New ways to increase integration at workplaces, especially rural workplaces are needed. More comprehensive interventions that include management are also needed.

  19. Connecting rural-urban economies?

    DEFF Research Database (Denmark)

    Larsen, Marianne Nylandsted; Birch-Thomsen, Torben; Lazaro, Evelyn

    The interlinked relationships between urban settlements and their rural hinterlands in Sub-Saharan Africa are perceived crucial in enhancing possibilities for livelihood diversification and poverty reduction. Urban settlements provide opportunities for investment in more remunerative economic...... activities, job/employment opportunities that retain potential migrants in the area, and access to services for the rural hinterlands. This paper examines the role of emerging urban centres (EUCs) as ‘drivers’ of rural development based on a study of two EUCs and their rural hinterlands in Tanzania. Findings...... and poverty reduction....

  20. Migration Intentions of Rural Youth in the Westhoek, Flanders, Belgium and the Veenkolonien, The Netherlands

    Science.gov (United States)

    Thissen, Frans; Fortuijn, Joos Droogleever; Strijker, Dirk; Haartsen, Tialda

    2010-01-01

    "Should I stay or should I leave my home region?" is one of the key life course questions that many young people must address as they grow to maturity. Social mobility increasingly presupposes geographical mobility, especially in rural areas. The consequences of the selective out-migration of socially mobile young people ("brain…

  1. Barriers to modern contraceptive use in rural areas in DRC.

    Science.gov (United States)

    Muanda, Mbadu Fidèle; Ndongo, Gahungu Parfait; Messina, Lauren J; Bertrand, Jane T

    2017-09-01

    Recent research in the Democratic Republic of Congo (DRC) has shown that over a quarter of women have an unmet need for family planning and that modern contraceptive use is three times higher among urban than rural women. This study focuses on the reasons behind the choices of married men and women to use contraception or not. What are the barriers that have led to low levels of modern contraceptive use among women and men in DRC rural areas? The research team conducted 24 focus groups among women (non-users of any method, users of traditional methods and users of modern methods) and husbands (of non-users or users of traditional methods) in six health zones of three geographically dispersed provinces. The key barriers that emerged were poor spousal communication, sociocultural norms (especially the husband's role as primary decision-maker and the desire for a large family), fear of side-effects and a lack of knowledge. Despite these barriers, many women in the study indicated that they were open to adopting a modern family planning method in the future. These findings imply that programming must address mutual comprehension and decision-making among rural men and women alike in order to trigger positive changes in behaviour and perceptions relating to contraceptive use.

  2. Fostering resilience: Empowering rural communities in the face of hardship

    Directory of Open Access Journals (Sweden)

    Darryl Maybery

    2010-11-01

    Full Text Available Australian rural communities are experiencing some of the worst climactic and economic conditions in decades. Unfortunately, the multiple government and non-government agency responses have reportedly been uncoordinated, sometimes losing sight of their consumers. This article describes a program designed to strengthen and empower resilience in small rural communities and summarises the outcomes, including needs and action planning undertaken. The 97 participants were from eight outer regional or remote towns and communities in the northern Riverina region of New South Wales, Australia. As groups representing their communities, they attended meetings and responded to a series of questions regarding issues arising from the drought, community needs, and actions their community could take to address these issues and needs. The study findings highlight the stress and strain of the climatic conditions and the insecurity of rural incomes, as well as problems with the high cost of transport. The communities recognised a degree of social disintegration but also expressed considerable hope that, by working together and better utilising social agencies, they could develop a social connectedness that would make their communities more resilient. Approaches that empower and facilitate community resilience are suggested as an effective model that governments and non-government agencies can use to encourage social groups that are struggling to build resilience.

  3. Performing rurality. But who?

    Directory of Open Access Journals (Sweden)

    Dymitrow Mirek

    2017-12-01

    Full Text Available Reflective inquiries to better understand ‘the rural’ have tried to embed rural research within the notion of performativity. Performativity assumes that the capacity of language is not simply to communicate but also to consummate action, whereupon citational uses of concepts produce a series of material effects. Of late, this philosophical shift has also implicated geographers as active agents in producing, reproducing and performing rurality. This paper provides a critical evaluation of what this new insistence really means for the production of geographical knowledge. Using framework analysis as a method, the paper scrutinizes several reportedly influential papers on the topic of rural performativity. Our findings reveal that, while indeed reflexive on issues of academic integrity, methodology and ethics, performances of rurality are continuedly placed ‘out there’ amongst ‘rural people’, i.e. in a priori defined and often stereotypically understood contexts, either by way of ‘spatial delimitation’ or ‘activity delimitation’. Effectively, such testimonies provide a truncated state of fidelity, where performance- oriented reflexivity is seconded by contradictory empirics of uneven value and with few commonalities. We conclude that by turning towards performativity as an allegedly more helpful way of obtaining rural coherence, we at the same time overlook our own role in keeping ‘rural theory’ alive.

  4. CHANGING SCHOOL NEEDS IN RURAL AREAS.

    Science.gov (United States)

    RHODES, ALVIN E.

    AS THE RURAL ECONOMY HAS BECOME MORE AFFECTED BY AUTOMATION, RURAL SOCIETY HAS BECOME MORE INDUSTRIAL. FARM POPULATION AND THE NUMBER OF FARMS HAVE DECREASED, WHILE NON-FARM RURAL POPULATION HAS INCREASED. THE CHANGING RURAL SCENE IS REFLECTED IN CHANGES IN RURAL EDUCATION. EDUCATIONAL OPPORTUNITIES HAVE GREATLY INCREASED DUE TO SCHOOL…

  5. A review of water quality policies in relation to public good benefits and community engagement in rural Ireland

    Directory of Open Access Journals (Sweden)

    Daly Karen

    2017-03-01

    Full Text Available This paper examines current recreational water use in the rural landscape in Ireland and reviews current EU policies and national regulations aimed at protecting water quality and the wider environment under agri-environmental schemes. Specifically, we review policy instruments that protect water for recreational use, their impacts and the challenges they pose for rural development against current requirements to increase public awareness and participation. In Ireland, there is limited experience in public participation in water quality protection and restoration and we highlight how this can be addressed by focussing on the specific contribution of water quality in rural areas in relation to the provision of recreational ecosystem services. These services provide the infrastructure for much of Ireland’s rural tourism sector. In this context, emerging participatory approaches to policy implementation are also assessed as national and local government prioritise community engagement for the second cycle under the EU Water Framework Directive.

  6. Association of hypothyroidism with low-level arsenic exposure in rural West Texas

    International Nuclear Information System (INIS)

    Gong, Gordon; Basom, Janet; Mattevada, Sravan; Onger, Frederick

    2015-01-01

    It has been reported recently that a higher airborne arsenic level was correlated with higher urinary arsenic concentration and lower serum thyroxin level among urban policemen and rural highway workmen in Italy. The current study was to determine whether exposure to low-level arsenic groundwater (2–22 µg/L) is associated with hypothyroidism among 723 participants (118 male and 267 female Hispanics; 108 male and 230 female non-Hispanic whites, NHW) living in rural West Texas counties. Arsenic and iodine levels in their groundwater used for drinking and or cooking were estimated by the inverse distance weighted (IDW) interpolation technique. Groundwater arsenic was ≥8 µg/L in 36% of the subjects' wells while iodine concentration was <1 µg/L in 91% of their wells. Logistic regression analysis showed that arsenic in groundwater ≥8 µg/L and cumulative arsenic exposure (groundwater arsenic concentration multiplied by the number of years living in the current address) but not groundwater iodine concentration were significant predictors for hypothyroidism among Hispanics (p<0.05) but not NHW after adjusting for covariates such as age, gender, annual household income and health insurance coverage. The ethnic difference may be due to a marginally higher percentage of Hispanics (p=0.0622) who lived in areas with groundwater arsenic ≥8 µg/L compared with NHW. The prevalence of hypothyroidism was significantly higher in Hispanics or NHW of this rural cohort than the national prevalence. Measures should be taken to reduce arsenic in drinking water in order to prevent hypothyroidism in rural areas. - Highlights: • We determined if arsenic exposure is associated with hypothyroidism in rural Texas. • Groundwater arsenic level is associated with hypothyroidism among Hispanics only. • The rate of hypothyroidism in rural Texas was higher than the US general population

  7. Association of hypothyroidism with low-level arsenic exposure in rural West Texas

    Energy Technology Data Exchange (ETDEWEB)

    Gong, Gordon, E-mail: gordon.gong@ttuhsc.edu [F. Marie Hall Institute for Rural and Community Health, Texas Tech University Health Sciences Center, Lubbock, TX (United States); Basom, Janet [F. Marie Hall Institute for Rural and Community Health, Texas Tech University Health Sciences Center, Lubbock, TX (United States); Department of Family and Community Medicine, Texas Tech University Health Sciences Center, Lubbock, TX (United States); Mattevada, Sravan [Department of Internal Medicine, University of North Texas Health Science Center, Fort Worth, TX (United States); Onger, Frederick [Department of Family and Community Medicine, Texas Tech University Health Sciences Center, Lubbock, TX (United States)

    2015-04-15

    It has been reported recently that a higher airborne arsenic level was correlated with higher urinary arsenic concentration and lower serum thyroxin level among urban policemen and rural highway workmen in Italy. The current study was to determine whether exposure to low-level arsenic groundwater (2–22 µg/L) is associated with hypothyroidism among 723 participants (118 male and 267 female Hispanics; 108 male and 230 female non-Hispanic whites, NHW) living in rural West Texas counties. Arsenic and iodine levels in their groundwater used for drinking and or cooking were estimated by the inverse distance weighted (IDW) interpolation technique. Groundwater arsenic was ≥8 µg/L in 36% of the subjects' wells while iodine concentration was <1 µg/L in 91% of their wells. Logistic regression analysis showed that arsenic in groundwater ≥8 µg/L and cumulative arsenic exposure (groundwater arsenic concentration multiplied by the number of years living in the current address) but not groundwater iodine concentration were significant predictors for hypothyroidism among Hispanics (p<0.05) but not NHW after adjusting for covariates such as age, gender, annual household income and health insurance coverage. The ethnic difference may be due to a marginally higher percentage of Hispanics (p=0.0622) who lived in areas with groundwater arsenic ≥8 µg/L compared with NHW. The prevalence of hypothyroidism was significantly higher in Hispanics or NHW of this rural cohort than the national prevalence. Measures should be taken to reduce arsenic in drinking water in order to prevent hypothyroidism in rural areas. - Highlights: • We determined if arsenic exposure is associated with hypothyroidism in rural Texas. • Groundwater arsenic level is associated with hypothyroidism among Hispanics only. • The rate of hypothyroidism in rural Texas was higher than the US general population.

  8. Innovating for Rural Development

    DEFF Research Database (Denmark)

    Christensen, Dorthe

    is that policies, agricultural research and extension should pay attention to these financial structural aspects, since they regulate the extent of ‘public good extension services’ like rural development services and ‘innovation intermediation’ in Danish agricultural extension agencies. The capacity differs among...... the individual agencies and among individual agents. There are agencies that financially invest in rural development service, including in innovation intermediation. On the other hand, there are agencies where the presence of rural development service is merely as a formal structure, possibly to signal...... as an analytical strategy. Paper 1 reports on, and critically examines, the entrance of consultants with rural development functions in Danish agricultural extension agencies. Paper 2 seeks to understand how multiple rural actor projects driven by Danish agricultural extension serve to generate new social...

  9. Application of the Rural Development Index to Analysis of Rural Regions in Poland and Slovakia

    Science.gov (United States)

    Michalek, Jerzy; Zarnekow, Nana

    2012-01-01

    The main purpose of this research was to construct a multi-dimensional (composite) index measuring the overall level of rural development and quality of life in individual rural regions of a given EU country. In the Rural Development Index (RDI) the rural development domains are represented by hundreds of partial socio-economic, environmental,…

  10. Rural Tourism - Alternative to the Development of Rural Areas

    Directory of Open Access Journals (Sweden)

    Maria Cristina PAIU

    2017-06-01

    Full Text Available Rural tourism through its content and its features is a distinct component in the economy of a region, and the sustainable, efficient use of local tourism resources can be an extremely important activity by: adding added value, boosting productivity, employment and increasing the living standard of the population. Rural tourism is considered a lever to mitigate local imbalances and besides attracting touristic areas in the circuit, it also has consequences on territorial development: housing construction, road development, development of public services and the development of small and medium-sized enterprises. Consequently, rural tourism has an impact on a country's economic and social development strategy, but also on a branch level.

  11. Gender, cooperative organisation and participatory intervention in rural Tanzania : a case study of different types of cooperatives and Moshi University College’s support to rural women

    OpenAIRE

    Msonganzila, M.

    2013-01-01

    The thesis examines cooperation and participation as modes of institutional action to address women’ social and economic problems and needs in the context of rural Tanzania. It does so against the background of the history of cooperatives in Tanzania and development cooperation. The thesis takes cooperation in a broad sense as the act or process of people working together; cooperative groups and cooperatives thereby become synonyms in this study. In contrast to literature that only recognise...

  12. National rural drinking water monitoring: progress and challenges with India's IMIS database

    OpenAIRE

    Wescoat, James; Fletcher, Sarah Marie; Novellino, Marianna

    2015-01-01

    National drinking water programs seek to address monitoring challenges that include self-reporting, data sampling, data consistency and quality, and sufficient frequency to assess the sustainability of water systems. India stands out for its comprehensive rural water database known as Integrated Management Information System (IMIS), which conducts annual monitoring of drinking water coverage, water quality, and related program components from the habitation level to the district, state, and n...

  13. Land tenure insecurity and rural-urban migration in rural China

    NARCIS (Netherlands)

    Ma Xian lei, Xianlei; Heerink, N.B.M.; Ierland, van E.C.; Shi Xiaoping, X.

    2016-01-01

    This paper examines the impact of land tenure security perceptions on rural-urban migration decisions of rural households, using data collected in Minle County in Northwest China. We find that tenure security perceptions play a significant role in household migration decisions in villages without

  14. Urban trees and the risk of poor birth outcomes

    Science.gov (United States)

    Geoffrey H. Donovan; Yvonne L. Michael; David T. Butry; Amy D. Sullivan; John M. Chase

    2011-01-01

    This paper investigated whether greater tree-canopy cover is associated with reduced risk of poor birth outcomes in Portland, Oregon. Residential addresses were geocoded and linked to classified-aerial imagery to calculate tree-canopy cover in 50, 100, and 200 m buffers around each home in our sample (n=5696). Detailed data on maternal characteristics and additional...

  15. China's rural electrification and poverty reduction

    International Nuclear Information System (INIS)

    Yang Ming

    2003-01-01

    This paper aims at quantifying the impact of rural investment in power sector on the rural economic development and poverty reduction in China. An econometric model was developed and six Chinese provinces with different economic background are studied. These provinces comprise Jiangsu and Liaoning with well-developed rural economy, Hebei and Henan with medium-developed rural economy, and Shannxi and Xinjiang with the least-developed rural economy. Over 20-yr historical data for the six provincial rural areas--counties and below, was collected in rural economic development, households, population, per capita income, community infrastructure development, capital investment, electricity consumption, output values in agriculture sector, and township and village enterprises. SPSS V10.0 software program was used in the research. This paper concludes that priority of capital investment in rural power sector should be given to Jiangsu and Liaoning if the objective of the investment is to develop rural economy, and that the priority should be given to Hebei and Henan if the objective is to reduce poverty in rural area

  16. Reaching rural customers: the challenge of market-based rural electrification

    Energy Technology Data Exchange (ETDEWEB)

    Reinmueller, Dorothee [International Solar Energy Society (ISES), Freiburg (Germany); Adib, Rana [Fraunhofer Inst. for Solar Energy Systems ISE, Freiburg (Germany)

    2002-06-01

    The large number of households that need catering for in market based approaches to rural energy supply in developing countries makes different demands on all involved players: an extensive infrastructure for reaching the rural customer needs to be established, extensive investments have to be realised, financial sustainability must be assured, and the business must even show profit. Thus, for successful market and infrastructure development it is a major necessity to understand the mechanisms involved. The authors describe a new guide to assist governments, business, and financing organisations in providing energy to rural areas using renewables. (Author)

  17. Reaching rural customers: the challenge of market-based rural electrification

    International Nuclear Information System (INIS)

    Reinmueller, Dorothee; Adib, Rana

    2002-01-01

    The large number of households that need catering for in market based approaches to rural energy supply in developing countries makes different demands on all involved players: an extensive infrastructure for reaching the rural customer needs to be established, extensive investments have to be realised, financial sustainability must be assured, and the business must even show profit. Thus, for successful market and infrastructure development it is a major necessity to understand the mechanisms involved. The authors describe a new guide to assist governments, business, and financing organisations in providing energy to rural areas using renewables. (Author)

  18. Homeopathy in rural Australian primary health care: a survey of general practitioner referral and practice in rural and regional New South Wales, Australia.

    Science.gov (United States)

    Wardle, J; Adams, J; Sibbritt, D

    2013-07-01

    Homeopathy has attracted considerable recent attention from the Australian conventional medical community. However, despite such increased attention there has been little exploration of the interface between homeopathy and Australian conventional medical practice. This article addresses this research gap by exploring homeopathic practice and referral by rural and regional Australian general practitioners (GPs). A 27-item questionnaire was sent to all 1486 GPs currently practising in rural and regional New South Wales, Australia (response rate 40.7%). Few GPs in this study utilised homeopathy in their personal practice, with only 0.5% of GPs prescribing homeopathy in the past 12 months, and 8.5% referring patients for homeopathic treatment at least a few times over the past 12 months. Nearly two-thirds of GPs (63.9%) reported that they would not refer for homeopathy under any circumstances. Being in a remote location, receiving patient requests for homeopathy, observing positive responses from homeopathy previously, using complementary and alternative medicine (CAM) practitioners as information sources, higher levels of knowledge of homeopathy, and being interested in increasing CAM knowledge were all independently predictive of increased referral to homeopathy amongst GPs in this study. GPs in this study were less likely to refer to homeopathy if they used peer-reviewed literature as the major source of their information on CAM. Homeopathy is not integrated significantly in rural general practice either via GP utilisation or referral. There is significant opposition to homeopathy referral amongst rural and regional GPs, though some level of interaction with homeopathic providers exists. Copyright © 2013 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

  19. Seasonality of Rural Finance

    OpenAIRE

    Khandker, Shahidur R.; Samad, Hussain A.; Badruddoza, Syed

    2017-01-01

    Simultaneity of borrowing, withdrawal of savings, and loan defaults due to the pronounced seasonality of agriculture often leads to investment failure of rural financial institutions. Lack of borrowing leads to lack of in-come- and consumption-smoothing, and in turn, causes inefficient resource allocation by rural households. Financial institutions that are active in rural areas take diffe...

  20. Be known, be available, be mutual: a qualitative ethical analysis of social values in rural palliative care.

    Science.gov (United States)

    Pesut, Barbara; Bottorff, Joan L; Robinson, Carole A

    2011-09-28

    Although attention to healthcare ethics in rural areas has increased, specific focus on rural palliative care is still largely under-studied and under-theorized. The purpose of this study was to gain a deeper understanding of the values informing good palliative care from rural individuals' perspectives. We conducted a qualitative ethnographic study in four rural communities in Western Canada. Each community had a population of 10, 000 or less and was located at least a three hour travelling distance by car from a specialist palliative care treatment centre. Data were collected over a 2-year period and included 95 interviews, 51 days of field work and 74 hours of direct participant observation where the researchers accompanied rural healthcare providers. Data were analyzed inductively to identify the most prevalent thematic values, and then coded using NVivo. This study illuminated the core values of knowing and being known, being present and available, and community and mutuality that provide the foundation for ethically good rural palliative care. These values were congruent across the study communities and across the stakeholders involved in rural palliative care. Although these were highly prized values, each came with a corresponding ethical tension. Being known often resulted in a loss of privacy. Being available and present created a high degree of expectation and potential caregiver strain. The values of community and mutuality created entitlement issues, presenting daunting challenges for coordinated change. The values identified in this study offer the opportunity to better understand common ethical tensions that arise in rural healthcare and key differences between rural and urban palliative care. In particular, these values shed light on problematic health system and health policy changes. When initiatives violate deeply held values and hard won rural capacity to address the needs of their dying members is undermined, there are long lasting negative

  1. Be known, be available, be mutual: a qualitative ethical analysis of social values in rural palliative care

    Directory of Open Access Journals (Sweden)

    Bottorff Joan L

    2011-09-01

    Full Text Available Abstract Background Although attention to healthcare ethics in rural areas has increased, specific focus on rural palliative care is still largely under-studied and under-theorized. The purpose of this study was to gain a deeper understanding of the values informing good palliative care from rural individuals' perspectives. Methods We conducted a qualitative ethnographic study in four rural communities in Western Canada. Each community had a population of 10, 000 or less and was located at least a three hour travelling distance by car from a specialist palliative care treatment centre. Data were collected over a 2-year period and included 95 interviews, 51 days of field work and 74 hours of direct participant observation where the researchers accompanied rural healthcare providers. Data were analyzed inductively to identify the most prevalent thematic values, and then coded using NVivo. Results This study illuminated the core values of knowing and being known, being present and available, and community and mutuality that provide the foundation for ethically good rural palliative care. These values were congruent across the study communities and across the stakeholders involved in rural palliative care. Although these were highly prized values, each came with a corresponding ethical tension. Being known often resulted in a loss of privacy. Being available and present created a high degree of expectation and potential caregiver strain. The values of community and mutuality created entitlement issues, presenting daunting challenges for coordinated change. Conclusions The values identified in this study offer the opportunity to better understand common ethical tensions that arise in rural healthcare and key differences between rural and urban palliative care. In particular, these values shed light on problematic health system and health policy changes. When initiatives violate deeply held values and hard won rural capacity to address the needs of

  2. Rural youth and violence: a gender perspective.

    Science.gov (United States)

    Hall, Barry L; Kulig, Judith; Grant Kalischuk, Ruth

    2011-01-01

    The public health system must consider violence as an all too common reality in modern life. Violence can contribute to long-lasting negative consequences for individuals and communities. Research on violence has primarily focused on urban environments. Research examining youth violence within rural communities is limited. This is particularly the case for the links between gender and violence in small rural settings. The purpose of this study was to examine rural violence from a gender perspective by examining four variables: meaning, causes, consequences and solutions. A survey was completed in Central Alberta, Canada with 178 students from grades 6 to 12. The schools' geographic locations represented two distinct economic settings: one natural resources and the other agriculture. The mean age of the participants was 16 years with 60% of the youth female and 40% male. The survey instrument was composed of demographic questions and 70 questions that focused on violence. Violence was a concern for all youth, but there were gender differences. Females viewed the meaning of violence as having the intent to harm others and causes contributing to violence included television, movies, video games and the internet. Females were more concerned than males about the emotional consequences of violence. For solutions, females were more accepting of intrusive means to control violence such as increased security and stricter school rules, and involving non-peer helpers such as teachers and community based agencies as a means to help combat violence. The results of this study indicate that violence exists among rural youth and causes a great deal of concern. In particular, the study underscores the fact that there are potential gender differences in relation to causes, meaning, impact and solutions to violence. All the youth believed that violence in their lives needs to be addressed and want to develop anti-violence strategies. Females in particular see the development of such

  3. Rural Gas Program manual

    Energy Technology Data Exchange (ETDEWEB)

    1987-11-01

    The intent and purpose of this manual is to describe the various guideliness and administrative procedures associated with the Alberta Rural Gas Program and to consolidate and expand upon the legislation under which the Program has been developed. It is intended primarily for the use and information of rural gas distributors, their agents, and other private or government parties having an interest in the Rural Gas Program. Information is presented on: rural gas franchises, technical applications, contracts and tenders, determination of system capital costs for grant support, grants, Gas Alberta brokerage arrangements, insurance coverage, utility rights-of-way, and lien notes.

  4. Implementation factors and their effect on e-Health service adoption in rural communities : a systematic literature review

    NARCIS (Netherlands)

    Hage, M.L.; Roo, J.P.; van Offenbeek, M.A.G.; Boonstra, A.

    2013-01-01

    Background: An ageing population is seen as a threat to the quality of life and health in rural communities, and it is often assumed that e-Health services can address this issue. As successful e-Health implementation in organizations has proven difficult, this systematic literature review considers

  5. producto turismo rural

    Directory of Open Access Journals (Sweden)

    Blanca García Henche

    2005-01-01

    Full Text Available El turismo rural lleva un largo periodo establecido en Europa, pero en los últimos años crece su importancia ya que supone un nuevo producto turístico y una fuente de ingresos para la economía rural. Actualmente, los turistas buscan experiencias distintas al tradicional turismo de sol y playa, prefieren un turismo más individualizado y flexible, buscan nuevas formas de alojamiento y muestran un interés creciente por el contacto con la naturaleza. La oferta turística rural ha de adaptarse a las exigencias de esta demanda, lo que implica más flexibilidad y alojamientos y pueblos adaptados a las necesidades emergentes. Se ha de definir el turismo rural como una alternativa de adaptación a los cambios en las necesidades de los consumidores. El presente documento muestra los componentes del turismo rural. Los recursos turísticos son la materia prima, a la que se ha de añadir los servicios. Estos servicios pueden ser básicos o complementarios. Además de los servicios hay que añadir las actividades complementarias e infraestructuras No hay duda de que el turismo rural puede beneficiarse de la aplicación del marketing. El marketing implica entender qué es lo que los consumidores desean y crear productos para satisfacer sus necesidades, además de comercializar el producto correctamente.

  6. Constructing and Reconstructing the "Rural School Problem": A Century of Rural Education Research

    Science.gov (United States)

    Biddle, Catharine; Azano, Amy Price

    2016-01-01

    This chapter examines 100 years of rural education research in the context of the demographic, migratory, economic, and social changes that have affected rural America in the past century. The authors conducted a systematic review of the literature on rural teacher recruitment, retention, and training as a case study to examine the constancy and…

  7. Rural Health Concerns

    Science.gov (United States)

    People in rural areas face some different health issues than people who live in towns and cities. Getting health care can ... long distances to get routine checkups and screenings. Rural areas often have fewer doctors and dentists, and ...

  8. An Evaluation of a Decade of a Rural Field-Based Special and Elementary Teacher Training Program.

    Science.gov (United States)

    Medina, Catherine; Redsteer, Denise; Prater, Greg; Minner, Sam

    To address the need for special education teachers trained in rural and culturally diverse settings, a field-based special education program was implemented in Kayenta Unified School District (KUSD), Arizona, on the Navajo Nation. KUSD provided teacher housing, classroom space, sites for practicum coursework, and some student teaching placements.…

  9. The impact of transport of critically ill pediatric patients on rural emergency departments in Manitoba.

    Science.gov (United States)

    Hansen, Gregory; Beer, Darcy L; Vallance, Jeff K

    2017-01-01

    Although the interfacility transport (IFT) of critically ill pediatric patients from rural to tertiary health centres may improve outcomes, the impact of IFTs on the rural referring centre is not known. The purpose of this study was to investigate how the IFT of critically ill children affects staffing and functionality of rural emergency departments (EDs) in Manitoba. In 2015, surveys were emailed to the medical directors of all 15 regional EDs within 2 hours' travel time from a tertiary pediatric hospital. The survey consisted of 9 questions that addressed baseline characteristics of the regional EDs and duration of ED staffing changes or closures due to IFT of critically ill pediatric patients. Ten surveys were received (67% response rate); a regional ED catchment population of about 130 000 people was represented. Interfacility transport caused most EDs (60%, with an average catchment population of 15 000) to close or to alter their staffing to a registered nurse only. These temporary changes lasted a cumulative total of 115 hours. Interfacility transport of critically ill pediatric patients resulted in ED closures and staffing changes in rural Manitoba. These findings suggest that long-term sustainable solutions are required to improve access to emergency care.

  10. On rurality - Sreten Vujović: Rural development sociology, Zavod za udžbenike, Beograd, 2016

    Directory of Open Access Journals (Sweden)

    Hodžić Alija H.

    2017-01-01

    Full Text Available This text, both a review and an overview, refers to the notion of rurality, the supporting concept of the collection of papers “Rural Development Sociology”. It points to the complexity and historicity, perception and politics of the social reality that the notion of rurality covers, and to the importance of the Collection for possible rural and regional development policy.

  11. Community-Engaged Attribute Mapping: Exploring Resources and Readiness to Change the Rural Context for Obesity Prevention.

    Science.gov (United States)

    John, Deborah; Winfield, Tammy; Etuk, Lena; Hystad, Perry; Langellotto, Gail; Manore, Melinda; Gunter, Kathy

    2017-01-01

    Individual risk factors for obesity are well-known, but environmental characteristics that influence individual risk, especially in rural communities, are not confirmed. Rural communities face unique challenges to implementing environmental strategies, such as walkability, aimed at supporting weight healthy lifestyles. Cooperative Extension, a community-embedded weight health partner, convened and engaged community members in self-exploration of local resources and readiness to change environmental characteristics perceived to promote unhealthy eating and inactivity. This approach leveraged Extension's mission, which includes connecting rural communities with land-grant university resources. HEAL MAPPS™ (Healthy Eating Active Living Mapping Attributes using Participatory Photographic Surveys) was developed as a participatory action research methodology. Adopted by Extension community partners, HEAL MAPPS™ involved residents in photomapping, characterizing, and communicating lived experiences of their rural community, and prioritizing interventions to change the obesogenic context. Extension educators serving rural communities in six Western U.S. states were trained to implement HEAL MAPPS™. Extension engaged community members who mapped and evaluated their encounters with environmental attributes that shape their dietary and activity patterns. The method partnered residents with decision makers in identifying issues, assessing resources and readiness, and prioritizing locally relevant environmental strategies to reduce access disparities for rural populations with high obesity risk. HEAL MAPPS™ revealed differences in resource availability, accessibility, and affordability within and among rural communities, as well as in readiness to address the obesogenic context. Extension functioned successfully as the backbone organization, and local community health partner, cooperatively implementing HEAL MAPPS™ and engaging constituents in shaping weight healthy

  12. Measuring the attractiveness of rural communities in accounting for differences of rural primary care workforce supply.

    Science.gov (United States)

    McGrail, Matthew R; Wingrove, Peter M; Petterson, Stephen M; Humphreys, John S; Russell, Deborah J; Bazemore, Andrew W

    2017-01-01

    Many rural communities continue to experience an undersupply of primary care doctor services. While key professional factors relating to difficulties of recruitment and retention of rural primary care doctors are widely identified, less attention has been given to the role of community and place aspects on supply. Place-related attributes contribute to a community's overall amenity or attractiveness, which arguably influence both rural recruitment and retention relocation decisions of doctors. This bi-national study of Australia and the USA, two developed nations with similar geographic and rural access profiles, investigates the extent to which variations in community amenity indicators are associated with spatial variations in the supply of rural primary care doctors. Measures from two dimensions of community amenity: geographic location, specifically isolation/proximity; and economics and sociodemographics were included in this study, along with a proxy measure (jurisdiction) of a third dimension, environmental amenity. Data were chiefly collated from the American Community Survey and the Australian Census of Population and Housing, with additional calculated proximity measures. Rural primary care supply was measured using provider-to-population ratios in 1949 US rural counties and in 370 Australian rural local government areas. Additionally, the more sophisticated two-step floating catchment area method was used to measure Australian rural primary care supply in 1116 rural towns, with population sizes ranging from 500 to 50 000. Associations between supply and community amenity indicators were examined using Pearson's correlation coefficients and ordinary least squares multiple linear regression models. It was found that increased population size, having a hospital in the county, increased house prices and affluence, and a more educated and older population were all significantly associated with increased workforce supply across rural areas of both countries

  13. Energy for rural India

    International Nuclear Information System (INIS)

    Urban, Frauke; Benders, Rene M.J.; Moll, Henri C.

    2009-01-01

    About 72 million households in rural India do not have access to electricity and rely primarily on traditional biofuels. This research investigates how rural electrification could be achieved in India using different energy sources and what the effects for climate change mitigation could be. We use the Regional Energy Model (REM) to develop scenarios for rural electrification for the period 2005-2030 and to assess the effects on greenhouse gas emissions, primary energy use and costs. We compare the business-as-usual scenario (BAU) with different electrification scenarios based on electricity from renewable energy, diesel and the grid. Our results indicate that diesel systems tend to have the highest CO 2 emissions, followed by grid systems. Rural electrification with primarily renewable energy-based end-uses could save up to 99% of total CO 2 emissions and 35% of primary energy use in 2030 compared to BAU. Our research indicates that electrification with decentralised diesel systems is likely to be the most expensive option. Rural electrification with renewable energy tends to be the most cost-effective option when end-uses are predominantly based on renewable energy, but turns out to be more costly than grid extensions when electric end-use devices are predominantly used. This research therefore elaborates whether renewable energy is a viable option for rural electrification and climate change mitigation in rural India and gives policy recommendations.

  14. Epidemiologic profile of patients seen in primary care clinics in an urban and a rural setting in Haiti, 2010-11.

    Science.gov (United States)

    Dickstein, Yaakov; Neuberger, Ami; Golus, Miri; Schwartz, Eli

    2014-09-01

    This study examined the demographic and epidemiological differences between patient populations presenting to a rural and an urban clinic in Haiti. A primary health clinic was established in urban Leogane, and a once-weekly clinic was established in Magandou, a rural village. Patient data were recorded for all individuals presenting to each clinic. Over 7 months, 6632 patients (median age 25) were seen in the urban clinic, and 567 (median age 47) in the rural clinic. There was a female majority at both sites. Hypertension was diagnosed in 41.9% (238/567) of the rural population over 40 years of age, while 29.5% (1956/6632) of patients in the urban setting had the same diagnosis (pHaiti must address the wide rural prevalence. STDs are a major urban health issue requiring treatment for both patients and their partners. Vector-borne disease was unseen in the rural clinic, despite an altitude insufficient to prevent mosquito-borne illness. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Greenways for rural sustainable development

    DEFF Research Database (Denmark)

    Ottomano Palmisano, Giovanni; Govindan, Kannan; Loisi, Rosa V.

    2016-01-01

    within the CAP because they help to protect and manage environmental heritage, promote economic activities and enhance the social assets of rural areas; furthermore, given their natural ability to simultaneously connect these resources, greenways promote Rural Sustainable Development (RSD......Policy makers have recently begun to agree on environmental, economic and social aspects of rural areas that are enhanced according to the European Union (EU) Common Agricultural Policy (CAP), and in particular in the national Rural Development Programmes (RDPs).Greenways are an acknowledged tool...... Aiding (MCDA) technique "Group Analytic Hierarchy Process" (GAHP). The validity of this MC-SDSS was tested on three rural municipalities of Apulia Region (Southern Italy). In particular, a GIS was used to detect the rural resources and existing linear elements, which were used to perform overlay mapping...

  16. Building energy efficiency in rural China

    International Nuclear Information System (INIS)

    Evans, Meredydd; Yu, Sha; Song, Bo; Deng, Qinqin; Liu, Jing; Delgado, Alison

    2014-01-01

    Rural buildings in China now account for more than half of China's total building energy use. Forty percent of the floorspace in China is in rural villages and towns. Most of these buildings are very energy inefficient, and may struggle to provide for basic needs. They are cold in the winter, and often experience indoor air pollution from fuel use. The Chinese government plans to adopt a voluntary building energy code, or design standard, for rural homes. The goal is to build on China's success with codes in urban areas to improve efficiency and comfort in rural homes. The Chinese government recognizes rural buildings represent a major opportunity for improving national building energy efficiency. The challenges of rural China are also greater than those of urban areas in many ways because of the limited local capacity and low income levels. The Chinese government wants to expand on new programs to subsidize energy efficiency improvements in rural homes to build capacity for larger-scale improvement. This article summarizes the trends and status of rural building energy use in China. It then provides an overview of the new rural building design standard, and describes options and issues to move forward with implementation. - Highlights: • Building energy use is larger in rural China than in cities. • Rural buildings are very energy intensive, and energy use is growing with incomes. • A new design standard aims to help rural communities build more efficiently. • Important challenges remain with implementation

  17. The Moderating Effect of Social Support on the Relationship Between Impulsivity and Suicide in Rural China.

    Science.gov (United States)

    Zhang, Jie; Lin, Lin

    2015-07-01

    This study was to investigate the relationship among social support, impulsivity, and suicide, so as to test the hypothesis that social support moderates the effect of impulsivity on suicide for the rural young suicides in China. Subjects were 392 consecutively recruited suicides aged 15-34 years and 416 community controls of the same age range sampled in China. The case-control data were obtained using psychological autopsy. The results showed that high social support had the protective effect among individuals with low impulsivity. It can be concluded that impulsivity is a potential area for further study of suicidal behavior. The suicide prevention efforts in rural China may address impulsivity.

  18. The influence of rural clinical school experiences on medical students' levels of interest in rural careers.

    Science.gov (United States)

    Isaac, Vivian; Watts, Lisa; Forster, Lesley; McLachlan, Craig S

    2014-08-28

    Australian Rural Clinical School (RCS) programmes have been designed to create experiences that positively influence graduates to choose rural medical careers. Rural career intent is a categorical evaluation measure and has been used to assess the Australian RCS model. Predictors for rural medical career intent have been associated with extrinsic values such as students with a rural background. Intrinsic values such as personal interest have not been assessed with respect to rural career intent. In psychology, a predictor of the motivation or emotion for a specific career or career location is the level of interest. Our primary aims are to model over one year of Australian RCS training, change in self-reported interest for future rural career intent. Secondary aims are to model student factors associated with rural career intent while attending an RCS. The study participants were medical students enrolled in a RCS in the year 2013 at the University of New South Wales (UNSW) and who completed the newly developed self-administered UNSW Undergraduate Destinations Study (UDS) questionnaire. Data were collected at baseline and after one year of RCS training on preferred location for internship, work and intended specialty. Interest for graduate practice location (career intent) was assessed on a five-variable Likert scale at both baseline and at follow-up. A total of 165 students completed the UDS at baseline and 150 students after 1 year of follow-up. Factors associated with intent to practise in a rural location were rural background (χ2 = 28.4, P influence practice intent (toward rural practice) and interest levels (toward greater interest in rural practice).

  19. A Mirage or a Rural Life Line? Analysing the impact of Mahatma Gandhi Rural Employment Guarantee Act on Women Beneficiaries of Assam

    Directory of Open Access Journals (Sweden)

    Rituparna Bhattacharyya

    2013-05-01

    Full Text Available The National Rural Employment Guarantee Act (NREGA, launched in February 2006 was renamed in October 02, 2009 as the Mahatma Gandhi National Rural Employment Guarantee Act (henceforth, MGNREGA. It is an anti-poverty flagship programme of the Government of India. The key purpose of MGNREGA is to enhance wage employment in the rural areas by providing at least 100 days of guaranteed employment to every household in a financial year.  The MGNREGA implementation status report for the financial year 2012-2013 unfolds that the programme has already provided employment to 44.9 million households across 28 districts and five union territories. Hence, it is becoming increasingly difficult to ignore the impact of MGNREGA on women beneficiaries. A plethora of research argues that MGNREGA, which promotes inclusive growth, is a vehicle of change, a lifeline for rural women. So far, however, there has been very little discussion about the impact of MGNREGA on women beneficiaries of Assam. This research is an attempt to examine the participation of women in MGNREGA, Assam. It critically looks at the issues, problems and challenges confronted by the women while working at MGNREGA. Written from a feminist perspective on gender, poverty and women’s empowerment, the research seeks to address the problems of the women beneficiaries through their lived experiences. For this, we conducted in-depth interviews with the women beneficiaries in the months of August and September, 2009 in four remote areas namely, Burka, Chandrapur, Barbhang and Muguriya, the first two situated in Kamrup, while the third and the fourth in Barpeta districts of Assam, where the programme of MGNREGA is on-going. The findings of the research suggest measures so that the programme can be made more effective in the long run.

  20. Rural labour markets and rural conflict in Spain before the Civil War (1931-1936)

    OpenAIRE

    Domènech Feliu, Jordi

    2012-01-01

    This paper looks at the causes of rural conflict in 1930s Spain. Rather than stressing bottom-up forces of mobilisation linked to poor harvests and rural unemployment or the inability of the state to enforce reformist legislation, this paper explores the role of state policy in sorting out the acute coordination and collective action problems of mobilising rural labourers. I do so by looking at the effects of intervention on rural labour markets in dry-farming areas of Spain (parts of Castile...

  1. Use of Free, Open Access Medical Education and Perceived Emergency Medicine Educational Needs Among Rural Physicians in Southwestern Ontario.

    Science.gov (United States)

    Folkl, Alex; Chan, Teresa; Blau, Elaine

    2016-09-21

    Free, open access medical education (FOAM) has the potential to revolutionize continuing medical education, particularly for rural physicians who practice emergency medicine (EM) as part of a generalist practice. However, there has been little study of rural physicians' educational needs since the advent of FOAM. We asked how rural physicians in Southwestern Ontario obtained their continuing EM education. We asked them to assess their perceived level of comfort in different areas of EM. To understand how FOAM resources might serve the rural EM community, we compared their responses with urban emergency physicians. Responses were collected via survey and interview. There was no significant difference between groups in reported use of FOAM resources. However, there was a significant difference between rural and urban physicians' perceived level of EM knowledge, with urban physicians reporting a higher degree of confidence for most knowledge categories, particularly those related to critical care and rare procedures. This study provides the first description of EM knowledge and FOAM resource utilization among rural physicians in Southwestern Ontario. It also highlights an area of educational need -- that is, critical care and rare procedures. Future work should address whether rural physicians are using FOAM specifically to improve their critical care and procedural knowledge. As well, because of the generalist nature of rural practice, future work should clarify whether there is an opportunity cost to rural physicians' knowledge of other clinical domains if they chose to focus more time on continuing education in critical care EM.

  2. RURAL TOURISM IN DOBRUDGEA

    Directory of Open Access Journals (Sweden)

    Elena, SIMA

    2014-11-01

    Full Text Available The natural and anthropic tourism resources of a certain area generate specific tourism forms, which complete each other within the different destination categories.The rural area in Dobrudja has diversified tourism potential, provided by the contrast of natural environment factors, ranging from the oldest and to the youngest relief units, natural protected areas, spa resources and cultural, historical, religious sites, as well as multicultural local customs and traditions of the rural area. This potential can be used under various kinds in the rural area: cultural tourism, historical tourism, religious tourism, ecotourism, fishing tourism or bird-watching tourism, and other kinds of rural tourism. By linking these tourism resources and tourism forms, tourism routes can result, which together with the local customs, traditions and cuisine may contribute to the social and economic development of Dobrudja's rural area, through sustainable tourism as alternative to seasonal seashore tourism.

  3. Urbanizing rural waters

    NARCIS (Netherlands)

    Hommes, Lena; Boelens, Rutgerd

    2017-01-01

    This article studies how urbanization processes and associated rural-urban water transfers in the Lima region (Peru) create water control hierarchies that align the municipal drinking water company, hydropower plants and rural communities on unequal positions. By scrutinizing the history of water

  4. APRECIERI ASUPRA FENOMENULUI TURISTIC RURAL

    Directory of Open Access Journals (Sweden)

    Puiu NISTOREANU

    2007-06-01

    Full Text Available The rural areas are rich in their ecological and cultural diversity. The dimension and complexity of the rural communities make difficult a generalization regarding their problems or values, even if some common characteristics exist. For a long time in their existence, the rural communities have relied on the abundance of natural resources. But, in the 20th century, the great technological, political and economical changes have brought a profound transformation in agriculture, and other renewable industrial resources, fact which led the rural communities to a dependency towards these. Although these changes occurred, many reasons for optimism still exist. Involvement of new households in offering touristic services constitutes a new dimension of the development of the rural areas, and on a secondary plane the touristic activity in the rural environment registers new ways of manifestation. Even more, we are able to appreciate the dimensions and evolution of one of the most spectacular social – economic phenomena; the rural tourism.

  5. Migration intentions of rural youth in the Westhoek, Flanders, Belgium and the Veenkoloniën, The Netherlands

    NARCIS (Netherlands)

    Thissen, F.; Droogleever Fortuijn, J.; Strijker, D.; Haartsen, T.

    2010-01-01

    ‘Should I stay or should I leave my home region?’ is one of the key life course questions that many young people must address as they grow to maturity. Social mobility increasingly presupposes geographical mobility, especially in rural areas. The consequences of the selective out-migration of

  6. Rural Renewal of China in the Context of Rural-Urban Integration: Governance Fit and Performance Differences

    Directory of Open Access Journals (Sweden)

    Rongyu Wang

    2018-02-01

    Full Text Available In recent years, rural-urban integrated development has become a vital national strategy in China. In this context, many regions have implemented rural renewal projects to enhance the vitality and development of rural areas. The objective of this study is to reveal the reasons why different rural renewal modes have emerged in contemporary China and assess their ability to facilitate rural-urban integration. An analytical framework, the Institution of Sustainability (IoS and a comparative analysis of two cases are used for the rural renewal evaluation. Our findings indicate that the properties of transactions and the characteristics of the actors involved jointly determine the governance structures of rural renewal. Furthermore, different governance structures contribute to performance differences, particularly differences in the physical outcomes, distribution effects and process efficiency. Finally, we suggest relevant policy recommendations.

  7. Reducing Food Poverty and Vulnerability among the Rural Elderly with Chronic Diseases: The Role of the New Rural Pension Scheme in China

    Directory of Open Access Journals (Sweden)

    Zhaohua Zhang

    2018-06-01

    Full Text Available Vulnerability to food poverty is the probability of an individual falling below the food poverty line in the near future, which provides a forward-looking welfare analysis. Applying a nationally representative survey dataset, this study investigates the role of the New Rural Pension Scheme (NRPS in reducing food poverty and vulnerability among the rural elderly with chronic diseases. By designing province-specific food poverty lines to account for variations in the elderly’s needs, as well as the prices across provinces using a least-cost linear programming approach, the food poverty incidences among the elderly with chronic diseases are calculated. Applying a three-stage feasible generalized least squares (FGLS procedure, the vulnerability to food poverty is estimated. Our results show that food poverty incidence and vulnerability of the elderly with chronic diseases in rural China is 41.9% and 35% respectively, which is 8% and 6% higher, respectively, than the elderly that are in good health. To address the potential endogeneity of pension payment, a fuzzy regression discontinuity (RD regression is employed to investigate the effects of pension income on food poverty and vulnerability for different population groups. We found that pension income decreases the probability of being food poor and the vulnerability to food poverty among the elderly with chronic diseases by 12.9% and 16.8% respectively, while it has no significant effect on the elderly in good health.

  8. Rural Runaways: Rurality and Its Implications for Services to Children and Young People Who Run Away

    Science.gov (United States)

    Franks, Myfanwy; Goswami, Haridhan

    2010-01-01

    This article debates options for service provision to young rural runaways in the UK. Using data drawn from two national surveys and follow-on qualitative studies, the authors trace urban myths of rurality and their effects on runaway provision. The authors review models of rural refuge, systemic advocacy and mobile services for rural runaways.…

  9. Strengthening training in rural practice in Germany: new approach for undergraduate medical curriculum towards sustaining rural health care.

    Science.gov (United States)

    Holst, Jens; Normann, Oliver; Herrmann, Markus

    2015-01-01

    After decades of providing a dense network of quality medical care, Germany is facing an increasing shortage of medical doctors in rural areas. Current graduation rates of generalists do not counterbalance the loss due to retirement. Informed by international evidence, different strategies to ensure rural medical care are under debate, including innovative teaching approaches during undergraduate training. The University of Magdeburg in Saxony-Anhalt was the first medical school in Germany to offer a rural elective for graduate students. During the 2014 summer semester, 14 medical students attended a two-weekend program in a small village in Northern Saxony-Anhalt that allowed them to become more familiar with a rural community and rural health issues. The elective course raised a series of relevant topics for setting up rural practice and provided students with helpful insight into living and working conditions in rural practice. Preliminary evaluations indicate that the rural medicine course allowed medical students to reduce pre-existing concerns and had positive impact on their willingness to set up a rural medical office after graduation. Even short-term courses in rural practice can help reduce training-related barriers that prevent young physicians from working in rural areas. Undergraduate medical training is promising to attenuate the emerging undersupply in rural areas.

  10. INTERVENTION STRATEGIES USED TO ADDRESS ALCOHOL ABUSE IN THE NORTH WEST PROVINCE, SOUTH AFRICA

    Directory of Open Access Journals (Sweden)

    Setlalentoa, Marilyn

    2015-09-01

    Full Text Available One of the purposes of the Alcohol Sub-Study of the Prospective Urban and Rural Epidemiological (PURE study was to identify the socio-economic effects of binge drinking from the perspective of community support networks and assess their intervention efforts to address the alcohol abuse problem in the selected areas of study. Emphasis was placed on implementation of plans and legislation; however, eradication of the problem seems to be insignificant for various reasons. This article reports on these identified challenges and proposes appropriate intervention strategies that take cognisance of the nature of the communities for which intervention efforts are intended

  11. Delinquent Behavior of Dutch Rural Adolescents

    NARCIS (Netherlands)

    Weenink, D.

    2011-01-01

    This article compares Dutch rural and non-rural adolescents’ delinquent behavior and examines two social correlates of rural delinquency: communal social control and traditional rural culture. The analyses are based on cross-sectional data, containing 3,797 participants aged 13–18 (48.7% females).

  12. Rural tourism development

    African Journals Online (AJOL)

    BarneyM

    Recently, a link between rural tourism and poverty alleviation ..... intellectual springboard for development of goods and services, crafts, local foods, music, dance, ..... established tourism market as well as the positive attitude of the respondents ... improve the congruence between the rural destination image and the visitor.

  13. A Carbon Consumption Comparison of Rural and Urban Lifestyles

    Directory of Open Access Journals (Sweden)

    Seppo Junnila

    2011-08-01

    Full Text Available Sustainable consumption has been addressed from different perspectives in numerous studies. Recently, urban structure-related lifestyle issues have gained more emphasis in the research as cities search for effective strategies to reduce their 80% share of the global carbon emissions. However, the prevailing belief often seen is that cities would be more sustainable in nature compared to surrounding suburban and rural areas. This paper will illustrate, by studying four different urban structure related lifestyles in Finland, that the situation might be reversed. Actually, substantially more carbon emissions seem to be caused on a per capita level in cities than in suburban and rural areas. This is mainly due to the higher income level in larger urban centers, but even housing-related emissions seem to favor less urbanized areas. The method of the study is a consumption-based life cycle assessment of carbon emissions. In more detail, a hybrid life cycle assessment (LCA model, that is comprehensive in providing a full inventory and can accommodate process data, is utilized.

  14. Spatiotemporal Changes in Rural Settlement Land and Rural Population in the Middle Basin of the Heihe River, China

    Directory of Open Access Journals (Sweden)

    Manjiang Shi

    2016-06-01

    Full Text Available Understanding the relationship between the spatiotemporal expansion of rural settlement land and the variation of rural population is the foundation of rational and specific planning for sustainable development. Based on the integration of Landsat TM, ETM+, and OLI images and demographic data, using mathematical models, landscape indexes, and a decoupling model, the spatiotemporal changes of the rural settlement land area and its decoupling relationship with the rural registered population were analyzed for the middle basin of the Heihe River in China. During the period 1986–2014, the following changes occurred: (1 The study area experienced increases of 124.94%, 55.16%, and 1.56% in rural settlement land area, number of patches, and rural registered population, respectively; (2 Edge-expansion, dispersion, and urban encroachment were the dominant patterns of dynamic changes in the studied rural settlement land. Among these, edge-expansion was the most prevalent development pattern; it contributed more than half of the total increase in the number of patches and the total area growth; (3 The annual growth rate of the rural registered population increased from 0.7% in 1986–2002 to −0.5% in 2002–2014. By that time the rural settlement land area had undergone a gentle increase from 3.4% to 3.6%. Generally, the rural registered population and rural settlement land has experienced a shift from weakly decoupled in 1986–2009 to strongly decoupled in 2009–2014; (4 From 1986 to 2014, rural urbanization and modernization were the main causes that led to the decline in the rural registered population; however, economic growth promoted the expansion of rural settlement land during this same period. We believe that with the rapid development of urbanization, the decoupling relationship between the rural settlement land area and the reduction in the rural registered population cannot be completely reversed in the short term. It is recommended that

  15. Tensions between the local and the global: contemporary rural and teaching in rural schools

    Directory of Open Access Journals (Sweden)

    Elizeu Clementino de Souza

    2012-05-01

    Full Text Available The paper aims to investigate potential tensions between local and global context of contemporary ruralities, emphasizing the times, rhythms and spaces constructed from the experiences of teachers and students in the organization of the routines of rural schools. The paper presents theoretical considerations resulting from two studies in the Graduate Program in Education and Contemporary - PPGEduC / UNEB. The clipping and analysis undertaken focus on education developed in rural areas and tensions present in this context in view, discuss issues concerning the new ruralities contemporary. This discussion has as its central theme the issues of timing and the rhythm in schools with multigrade classes Island Tide that articulates with dilemmas and tensions surrounding the experience lived by teachers of geography of the city engaged in teaching in rural areas in semi-arid region of Bahia. Research has pointed to difficulties faced by rural school to consider the different temporalities that exist in rural areas in their educational processes, as well as difficulties of articulation in these contexts of learning, between the local-global dimensions through which passes the contemporary space. This movement creates stress for teachers’ work, since it complicates the relationship between the times established, standardized and rigid, with times of personal students and teachers, covering aspects such as age, life histories, movements and experiences socio-historical and geographical subjects involved in the processes of teaching and learning in rural settings in contemporary times.

  16. 50 CFR Figure 4 to Subpart E of... - Prince William Sound Rural and Non-Rural Areas

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Prince William Sound Rural and Non-Rural Areas 4 Figure 4 to Subpart E of Part 300 Wildlife and Fisheries INTERNATIONAL FISHING AND RELATED... to Subpart E of Part 300—Prince William Sound Rural and Non-Rural Areas ER04NO09.010 [74 FR 57110...

  17. A comparison of mental health, substance use, and sexual risk behaviors between rural and non-rural transgender persons.

    Science.gov (United States)

    Horvath, Keith J; Iantaffi, Alex; Swinburne-Romine, Rebecca; Bockting, Walter

    2014-01-01

    The aim of this study was to compare the mental health, substance use, and sexual risk behaviors of rural and non-rural transgender persons. Online banner advertisements were used to recruit 1,229 self-identified rural and non-rural transgender adults (18+ years) residing in the United States. Primary findings include significant differences in mental health between rural and non-rural transmen; relatively low levels of binge drinking across groups, although high levels of marijuana use; and high levels of unprotected sex among transwomen. The results confirm that mental and physical health services for transgender persons residing in rural areas are urgently needed.

  18. Interest in rural clinical school is not enough: Participation is necessary to predict an ultimate rural practice location.

    Science.gov (United States)

    Playford, Denese; Puddey, Ian B

    2017-08-01

    Rural exposure during medical school is associated with increased rural work after graduation. How much of the increase in rural workforce by these graduates is due to pre-existing interest and plans to work rurally and how much is related to the extended clinical placement is not known. This cohort study compared the employment location of medical graduates who professed no rural interest as undergraduates (negative control), with those who applied but did not participate in Rural Clinical School of Western Australia (RCSWA) (positive control), and those who applied and participated in RCSWA (participants). All 1026 University of Western Australia students who had an opportunity to apply for a year-long rotation in RCSWA from 2004 to 2010, and who had subsequently graduated by the end of 2011, were included. Graduates' principal workplace location (AHPRA, Feb 2014). The three groups differed significantly in their graduate work locations (χ 2 = 39.2, P rural background (OR 2.99 (95% CI 1.85, 4.85), P Rural Bonded Scholarship (OR 3.36 (95% CI 1.68, 6.73, P = 0.001) and actually participating in the RCSWA remained significantly related to rural work (OR 3.10 (95% CI 1.95, 4.93), P rural work, RCSWA graduates were three times more likely to work rurally than either control group. These data suggest that RCSWA has a significant independent effect on rural workforce. © 2016 National Rural Health Alliance Inc.

  19. Probable psychiatric disorder in a rural community of West Bengal, India.

    Science.gov (United States)

    Barik, Anamitra; Sarkhel, Sujit; Basu, Saugata; Chowdhury, Abhijit; Rai, Rajesh Kumar

    2017-12-01

    India faces multiple challenges to mitigate a high burden of psychiatric disorders. The risk of developing psychiatric disorder among the rural Indian population is poorly investigated. This study aims to understand the factors associated with probable psychiatric disorder (PPD) among a select rural Indian population. Data from the Birbhum population project of the society for health and demographic surveillance, West Bengal, India, were utilized. Cross-sectional data covering a sample of 31,135 respondents (male 15,384 and female 15,751) aged ≥ 16 years were used. The General Health Questionnaire-28 was administered and the responses were computed into three categories: psychological case, psychological caseness, and normal. Bivariate and multivariate ordered logit regression analyses were applied to attain the study objective. Of the total population, 26% of respondents were identified with PPD. People aged ≥ 60 years, females, divorced/separated/widowed individuals, the unemployed and people with no formal education, individuals from the poorest economic group, and people with a history of selling or mortgaging assets towards their healthcare expenditure had a higher prevalence of psychiatric case within their respective group. A high burden of PPD was estimated in the select rural community. While designing an intervention for measuring and addressing psychiatric disorders, the socioeconomic gradient of PPD could be helpful.

  20. Rural youth and struggle for citizenship: limits and possibilities of socialization

    Directory of Open Access Journals (Sweden)

    Inés Olivera Rodríguez

    2009-12-01

    Full Text Available This article is based on ethnographic fieldwork I conducted between January and March of 2007 in a small rural village on the north coast of Peru as part of the research for my Master’s Degree thesis. It addresses the ways that the rural youth give their own school experience. During the fieldwork, I lived in Chaquira for two months and conducted 18 in depth interviews with young people. I also visited the local high school and had informal conversations with different demographic groups in the village, mainly young parents (between 30 and 45 years old. Based on a definition of citizenship and a description of the youth’s every day life, this paper analyzes the processes of exclusion, not only as a structural problem, but also as the situation of internal oppression within a determined social space. The objective is to think about social space of rural youth as spaces that enable or hinder the formation of participatory citizens. For this reason, I focuse on the aspects of school experiences and on socia1 factors that contribute to the construction and exercise of citizenship.

  1. Geospatial Analysis of Pediatric EMS Run Density and Endotracheal Intubation

    Directory of Open Access Journals (Sweden)

    Matthew Hansen

    2016-09-01

    Full Text Available Introduction: The association between geographic factors, including transport distance, and pediatric emergency medical services (EMS run clustering on out-of-hospital pediatric endotracheal intubation is unclear. The objective of this study was to determine if endotracheal intubation procedures are more likely to occur at greater distances from the hospital and near clusters of pediatric calls. Methods: This was a retrospective observational study including all EMS runs for patients less than 18 years of age from 2008 to 2014 in a geographically large and diverse Oregon county that includes densely populated urban areas near Portland and remote rural areas. We geocoded scene addresses using the automated address locator created in the cloud-based mapping platform ArcGIS, supplemented with manual address geocoding for remaining cases. We then use the Getis-Ord Gi spatial statistic feature in ArcGIS to map statistically significant spatial clusters (hot spots of pediatric EMS runs throughout the county. We then superimposed all intubation procedures performed during the study period on maps of pediatric EMS-run hot spots, pediatric population density, fire stations, and hospitals. We also performed multivariable logistic regression to determine if distance traveled to the hospital was associated with intubation after controlling for several confounding variables. Results: We identified a total of 7,797 pediatric EMS runs during the study period and 38 endotracheal intubations. In univariate analysis we found that patients who were intubated were similar to those who were not in gender and whether or not they were transported to a children’s hospital. Intubated patients tended to be transported shorter distances and were older than non-intubated patients. Increased distance from the hospital was associated with reduced odds of intubation after controlling for age, sex, scene location, and trauma system entry status in a multivariate logistic

  2. Action Learning Sets and Social Capital: Ameliorating the Burden of Clergy Isolation in One Rural Diocese

    Science.gov (United States)

    Muskett, Judith A.; Village, Andrew

    2016-01-01

    Rural clergy often lack colleagues and may struggle with isolation, especially if over-extended in multi-parish benefices. Theory suggests that this sense of isolation could be addressed by launching clergy action learning sets, which have the potential to establish a peer support network through the formation of social capital as a by-product of…

  3. A community-based approach and its impact to sustainable rural water supply – A case of Kgotlopong ‘Mountain Water Harvesting’

    CSIR Research Space (South Africa)

    Maponya, G

    2013-07-01

    Full Text Available communities, especially in the remote rural areas, that face daunting challenges in accessing basic water. To address these challenges, other communities have developed community-based water supply initiatives. This paper takes a keen interest...

  4. Low Impact Development Intensive Rural Construction Planning in Xu Fu Village Ningbo, China: Planning Review through Rural Resilience Perspective

    Directory of Open Access Journals (Sweden)

    Roosmayri Lovina Hermaputi

    2017-08-01

    Full Text Available Xu Fu Village Ningbo LID Intensive Rural Construction Planning is a cooperation project between Zhejiang University and Ningbo Institute of Technology which named "12th Five-Year National Science and Technology support program-the comprehensive demonstration of the key technology of the beautiful rural construction in the rapid urbanization area of the Yangtze River Delta". This plan focuses on intensive rural construction as part of rural development and construction project that applies the principles of low impact development. Xu Fu Village located in the Yangtze River Delta Region. Currently, the rural growth brings the high impact of development, as a result of rapid urbanization growth arising several issues, such as low land use efficiency, dispersed rural residence, homestead occupies more, rural roads covering over, etc. Meanwhile, Xu Fu village wishes to develop its tourism potential. Thus, the intensive rural construction should be done to avoid the severe effect. The project result hopefully can improve the quality and level of rural residential planning, design, and construction; improve their living environment; save construction land and water use; and improve energy efficiency. The aim of this study is to review the Low Impact Development (LID Intensive Rural Construction in Xu Fu Village, Ningbo City through the rural resilience perspective. This paper will describe the project plan first, then review it through rural resilience perspective. This paper will elaborate the rural resilience theory and then review the rural resiliency through two parts; the first part is identifying rural resilience in rural infrastructure development based on the criteria created by Ayyob S. and Yoshiki Y. (2014, about urban resiliency criteria, and then the second part is reviewing Xu Fu Village resilience through Arup Resilience Qualities (2012, considering three rural resilience domain (economy, ecology, and cultural.

  5. Gender dimensions of rural employment in agriculture and public works programmes experiences from South Africa: Differentiated pathways out of poverty

    CSIR Research Space (South Africa)

    Mashiri, M

    2010-12-01

    Full Text Available rural livelihoods (Department of Public Works, 1997). It also addresses gender dimensions of the projects. As methodology, a mixed-method approach was employed to assess the experiences and impacts of the Siyatentela 56 (Mpumalanga Province), Gundo Lashu...

  6. Globalización, paisaje y vivienda rural / Globalization, landscape and rural housing.

    Directory of Open Access Journals (Sweden)

    Pino Silva, Fernando

    2006-06-01

    Full Text Available Las transformaciones del paisaje rural de Chile Central durante los últimos veinte años, el surgimiento de una arquitectura diferente de la vivienda rural, los nuevos patrones de organización espacial y los cambios en el uso del suelo, son algunos de los resultados que pueden ser explicados como una consecuencia de la globalización. (Proyecto DI – U.CHILE, MULT 04/29 – 2./The rural landscape changes during the last twenty years in Central Chile, the emergence of a different architecture to the rural housing, the new patterns of space organization and land use changes, are some of the effects that can be explained as a consequence of a globalization process. (Proyecto DI – U.CHILE, MULT 04/29 – 2

  7. Economic and Social Sustainable Synergies to Promote Innovations in Rural Tourism and Local Development

    Directory of Open Access Journals (Sweden)

    Giovanni Quaranta

    2016-07-01

    Full Text Available The role of tourism in rural areas is pivotal for the integration and valorization of territorial resources and it is strengthened by the capacity to promote local community participation in processes of development. The paper addresses the issue by presenting and discussing a case study of a rural area of southern Italy where a territorial network for the development of local tourism has been set up. The innovative initiative aimed, firstly, to facilitate a closer connection between production and consumption by reducing transaction costs and, secondly, to connect local production with quality conscious consumers looking for traditional products. The network project also aimed to create conditions conducive to increasing the competitiveness of the local production chain and tourism sector. The case study shows how the challenge for many rural territories lies in increasing levels of trust and rebuilding social capital as a precondition of developing the tourism sector and fostering socio-economic development as a whole. Traditional institutions, as well as hybrid institutions, with the support of research organizations, can play a key role.

  8. Metabolic syndrome among rural Indian adults.

    Science.gov (United States)

    Barik, Anamitra; Das, Kausik; Chowdhury, Abhijit; Rai, Rajesh Kumar

    2018-02-01

    To prevent an increasing level of mortality due to type 2 diabetes mellitus and cardiovascular disease among the rural Indian population, a management strategy of the metabolic syndrome (MetS) should be devised. This study aims to estimate the burden of MetS and its associated risk factors. Data from the Birbhum Population Project covering 9886 individuals (4810 male and 5076 female population) aged ≥18 years were used. The burden of metabolic syndrome, as defined by the Third Report of the National Cholesterol Education Program Adult Treatment Panel, was determined. Bivariate and multivariate (logistic regression) analyses were used to attain the study objective. Over 10.7% of the males and 20.3% of the females were diagnosed with MetS. Irrespective of sex, older individuals, being overweight/obese (body mass index of ≥23 kg/m 2 ) had higher probability of developing MetS, whereas being underweight is deemed a protective factor against MetS. Low physical activity among women appeared to be a risk factor for MetS. The prevalence of MetS is concerning even in rural India. Any intervention designed to address the issue could emphasize on weight loss, and physical activity, focusing on women and people at an advanced stage of life. Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

  9. Rural energetic troubles in Ecuador; Problemas de la Energizacion rural en Ecuador

    Energy Technology Data Exchange (ETDEWEB)

    Barriga, A [Facultad de Ingenieria Mecanica, Escuela superior politecnica del Litoral, ESPOL, Guayaquil (Ecuador)

    1994-07-01

    The present work presents a general situation of Ecuador, its demand of Energy, programs of electrification rural, energy requirements in the hydroelectric rural sector, central sector built in Ecuador and the priorities of energy use.

  10. State-level employment, accessibility and rurality

    Directory of Open Access Journals (Sweden)

    Casey Abington

    2014-09-01

    Full Text Available Employment and economic growth in rural areas as a policy issue has been recently highlighted by the federal government. In August 2011, the White House released a report entitled “Jobs and Economic Security for Rural America”. While the document listed various programs and policies that have reportedly benefited rural America, it also stated that rural communities are still facing many challenges. For example, many rural communities have lower incomes and higher poverty rates than more urban areas. One possible reason for rural communities being at a disadvantage compared to urban areas involves transportation, especially in terms of journey to work. Thus, one can ask how employment rates vary with accessibility, as measured by journey to work times, as well as location (rural versus urban. Using 2007 state level data, OLS analysis is used to examine the relationship between employment rates and journey to work times and rurality. The analysis confirms that employment rates decrease with increased journey to work times. However, measures of rurality were only marginally significant and the negative coefficient on each measure indicates that employment rates decrease with greater urbanization. Improving accessibility between (very rural and larger areas might improve employment opportunities. Although weighing the benefits of such (reduced unemployment against the costs of providing better highways or public transit might lead to a different conclusion.

  11. Eliciting and utilizing rural students' funds of knowledge in the service of science learning: An action research study

    Science.gov (United States)

    Lloyd, Ellen M.

    Several researchers have pointed out the failures of current schooling to adequately prepare students in science and called for radical reform in science education to address the problem. One dominant critique of science education is that several groups of students are not well served by current school science practices and discourses. Rural students represent one of these underserved populations. Yet, there is little in the literature that speaks specifically to reforming the science education of rural students. Utilizing action research as a methodology, this study was designed to learn more about the unique knowledge and life experiences of rural students, and how these unique knowledge, skills and interests could suggest new ways to improve science education in rural schools. Informed by this ultimate goal, I created an after school science club where the participating high school students engaged in solving a local watershed problem, while explicitly bringing to bear their unique backgrounds, local knowledge and life experiences from living in a rural area of Upstate New York. Using Funds of Knowledge as the theoretical framework, this after-school club served as the context to investigate the following research questions: (1) What science-related funds of knowledge do rural high school students have? (2) How were these funds of knowledge capitalized on to support science learning in an after-school setting?

  12. Energy for sustainable rural development

    NARCIS (Netherlands)

    Hulscher, W.S.; Hulscher, W.S.; Hommes, E.W.; Hommes, E.W.

    1992-01-01

    Rural energy in developing countries is discussed with a view to sustainable development. The project-oriented approach in rural energy which has often dominated in the past, is contrasted with an overall strategy for sustainable rural energy demand and supply. An outline for a demand-oriented

  13. Inclusive education in schools in rural areas

    Directory of Open Access Journals (Sweden)

    J. Antonio Callado Moreno

    2015-07-01

    Full Text Available Since Spain decided to embark on the development of inclusive schooling, studies have taken place to see if the inclusive principle is being developed satisfactorily. Inclusive schooling implies that all students, regardless of their particular characteristics, may be taught in ordinary schools, and in the majority of cases receive help in the classroom in which they have been integrated in order to cover any special educational needs. Our research aims to find out if schools situated in rural areas follow this principle and, once it has been put into practice, what strategies are being used. To this end, we designed a questionnaire addressed to Infant and Primary school teachers in the Sierra Sur area in the province of Jaén, in an agricultural context where most of the population live on olive picking and the cultivation of olive groves. Given the extension of the area, our research concentrated on schools situated in urban nuclei with a population of less than one thousand five hundred inhabitants. The results obtained demonstrate that rural areas do not take full advantage of the context they are in to favour inclusion processes and continue to develop proposals that are merely integrative.

  14. Health professional students' rural placement satisfaction and rural practice intentions: A national cross-sectional survey.

    Science.gov (United States)

    Smith, Tony; Sutton, Keith; Pit, Sabrina; Muyambi, Kuda; Terry, Daniel; Farthing, Annie; Courtney, Claire; Cross, Merylin

    2018-02-01

    The aim of this study was to profile students undertaking placements at University Departments of Rural Health (UDRHs) and investigate factors affecting students' satisfaction and intention to enter rural practice. Cross-sectional survey comprising 21 core questions used by all UDRHs. Eleven UDRHs across Australia that support students' placements in regional, rural and remote locations. Medical, nursing and allied health students who participated in UDRH placements between July 2014 and November 2015 and completed the questionnaire. Key dependent variables were placement satisfaction and rural practice intention. Descriptive variables were age, gender, Aboriginal or Torres Strait Islander (ATSI) background, location of placement, healthcare discipline, year of study and type and length of placement. A total of 3328 students responded. The sample was predominantly female (79%), the mean age was 26.0 years and 1.8% identified as ATSI. Most placements (69%) were >2 but ≤12 weeks, 80% were in Modified Monash 3, 4 or 5 geographical locations. Public hospitals and community health made up 63% of placements. Students satisfied with their placement had 2.33 higher odds of rural practice intention. Those satisfied with Indigenous cultural training, workplace supervision, access to education resources and accommodation had higher odds of overall satisfaction and post-placement rural practice intention. The majority of students were highly satisfied with their placement and the support provided by rural clinicians and the UDRHs. UDRHs are well placed to provide health professional students with highly satisfactory placements that foster rural practice intention. © 2017 National Rural Health Alliance Inc.

  15. Educating Physicians for Rural America: Validating Successes and Identifying Remaining Challenges With the Rural Medical Scholars Program.

    Science.gov (United States)

    Wheat, John R; Leeper, James D; Murphy, Shannon; Brandon, John E; Jackson, James R

    2018-02-01

    To evaluate the Rural Medical Scholars (RMS) Program's effectiveness to produce rural physicians for Alabama. A nonrandomized intervention study compared RMS (1997-2002) with control groups in usual medical education (1991-2002) at the University of Alabama School of Medicine's main and regional campuses. Participants were RMS and others admitted to regular medical education, and the intervention was the RMS Program. Measures assessed the percentage of graduates practicing in rural areas. Odds ratios compared effectiveness of producing rural Alabama physicians. The RMS Program (N = 54), regional campuses (N = 182), and main campus (N = 649) produced 48.1% (odds ratio 6.4, P rural physicians, respectively. The RMS Program, contrasted to other local programs of medical education, was effective in producing rural physicians. These results were comparable to benchmark programs in the Northeast and Midwest USA on which the RMS Program was modeled, justifying the assumption that model programs can be replicated in different regions. However, this positive effect was not shared by a disparate rural minority population, suggesting that models for rural medical education must be adjusted to meet the challenge of such communities for physicians. © 2017 National Rural Health Association.

  16. Medicaid managed care for mental health services: the survival of safety net institutions in rural settings.

    Science.gov (United States)

    Willging, Cathleen E; Waitzkin, Howard; Nicdao, Ethel

    2008-09-01

    Few accounts document the rural context of mental health safety net institutions (SNIs), especially as they respond to changing public policies. Embedded in wider processes of welfare state restructuring, privatization has transformed state Medicaid systems nationwide. We carried out an ethnographic study in two rural, culturally distinct regions of New Mexico to assess the effects of Medicaid managed care (MMC) and the implications for future reform. After 160 interviews and participant observation at SNIs, we analyzed data through iterative coding procedures. SNIs responded to MMC by nonparticipation, partnering, downsizing, and tapping into alternative funding sources. Numerous barriers impaired access under MMC: service fragmentation, transportation, lack of cultural and linguistic competency, Medicaid enrollment, stigma, and immigration status. By privatizing Medicaid and contracting with for-profit managed care organizations, the state placed additional responsibilities on "disciplined" providers and clients. Managed care models might compromise the rural mental health safety net unless the serious gaps and limitations are addressed in existing services and funding.

  17. Prevalence of risk factors for non-communicable diseases in rural & urban Tamil Nadu

    Science.gov (United States)

    Oommen, Anu Mary; Abraham, Vinod Joseph; George, Kuryan; Jose, V. Jacob

    2016-01-01

    Background & objectives: Surveillance of risk factors is important to plan suitable control measures for non-communicable diseases (NCDs). The objective of this study was to assess the behavioural, physical and biochemical risk factors for NCDs in Vellore Corporation and Kaniyambadi, a rural block in Vellore district, Tamil Nadu, India. Methods: This cross-sectional study was carried out among 6196 adults aged 30-64 yr, with 3799 participants from rural and 2397 from urban areas. The World Health Organization-STEPS method was used to record behavioural risk factors, anthropometry, blood pressure, fasting blood glucose and lipid profile. Multiple logistic regression was used to assess associations between risk factors. Results: The proportion of tobacco users (current smoking or daily use of smokeless tobacco) was 23 per cent in the rural sample and 18 per cent in the urban, with rates of smoking being similar. Ever consumption of alcohol was 62 per cent among rural men and 42 per cent among urban men. Low physical activity was seen among 63 per cent of the urban and 43 per cent of the rural sample. Consumption of fruits and vegetables was equally poor in both. In the urban sample, 54 per cent were overweight, 29 per cent had hypertension and 24 per cent diabetes as compared to 31, 17 and 11 per cent, respectively, in the rural sample. Physical inactivity was associated with hypertension, body mass index (BMI) ≥25 kg/m2, central obesity and dyslipidaemia after adjusting for other factors. Increasing age, male sex, BMI ≥25 kg/m2 and central obesity were independently associated with both hypertension and diabetes. Interpretation & conclusions: Diabetes, hypertension, dyslipidaemia, physical inactivity and overweight were higher in the urban area as compared to the rural area which had higher rates of smokeless tobacco use and alcohol consumption. Smoking and inadequate consumption of fruits and vegetables were equally prevalent in both the urban and rural samples

  18. Balancing Rural and Urban Development: Applying Coordinated Urban–Rural Development (CURD Strategy to Achieve Sustainable Urbanisation in China

    Directory of Open Access Journals (Sweden)

    Ling-Hin Li

    2017-10-01

    Full Text Available Land in rural China has been under a separate and closed management system for decades even after the urban land reform that started in the late 1980s. The blurred property rights over rural land have been hindering the rural welfare as surplus rural land in sub-urban areas cannot be circulated into more economic use without first being requisitioned by the state. This traditional conversion process creates a lot of problems, among them are the compensation standard as well as displacement of rural residents to the city, where they cannot find adequate welfare protection. The prolonged disparity in economic outcomes for rural and urban residents in China in the process of urbanisation has made the authority realise that land-based local finance is no longer an option. Coordinated Urban and Rural Development (CURD ideology arises to set a level playing field by giving the rural residents comparable welfare status as their urban counterparts’ one. The CURD ideology is basically linked to the strategic development of the three main issues in the rural area of China, or in the Chinese terminology: San Nong. These three issues are rural villages, rural enterprises and rural farmers (nong cun, nong ye, nong min. CURD ideology is to preserve the livelihood of rural villages, facilitate and promote rural enterprises and increase the living standard of rural farmers. Most importantly, however, CURD policy package bestows rural residents with property rights over their farmland so that they could sub-co1ntract the user-rights to other urban commercial entities for higher benefits. While CURD policies are applied in a lot of different regions in China including Chongqing in the West, Qingdao in the North, Zhongshan in the South and Wuhan in the middle, we focus our examination in Chengdu as the Chengdu model has been widely documented and highly regarded as the most successful model in implementing the CURD strategies. From our case study, we find that

  19. Municipal service provision in rural communities

    DEFF Research Database (Denmark)

    Nørgaard, Helle

    EU policies for rural development stress the importance of investments rather than subsidies and aim at integrating different sectoral policies in order to improve the coherence and effectiveness of public expenditure. Policies also emphasize a place-based approach for rural development and thereby...... hierarchies and considering local resources and place bound potentials.  This paper draws on a study of rural municipalities in Denmark examining how service adjustments e.g. closing of local schools are managed by rural municipalities and local communities. The paper further discusses whether rural...... municipalities can plan strategically, manage service provision and support place bound potential in rural communities in light of a competitive framework for local development....

  20. Rural Depopulation Pattern at Yogyakarta Special Province (DIY

    Directory of Open Access Journals (Sweden)

    M Baiquni

    2004-01-01

    This paper is based on a secondary data research i.e. statistical data at rural levels in Yogyakarta, thematics maps and other documents. Statistical methodes and map pattern analysis are employed to analysis data. The result of this research are as follows: a the rural depopulation in DIY can be found in 189 rural areas of 393 rural areas (48.09%; b the spatial distribution of the rural depopulation are in Gunung Kidul District (80 rural areas, Kulon Progo District (59 rural areas Sleman District (33 rural areas, and Bantul District (17 rural areas; c the rural depopulation in Yogyakarta at least related to six factors whih have been identified as out – migration, local resources, carrying capacity, geographycal location or accessibility, rural infrastructure, and service availability.