Abrol, R; Nehru, V I; Venkatramana, Y
A survey on 10.000 adults between the age of 20 and 79 years out of a total population of 66.186 persons in rural settlements under the inrisduction of Union Territory of Chandigarh between June 1993 to June 1995 was conducted to find out the prevalence and various causes of vertigo. In general community, in rural population, we found that more people suffer from non-otologic vertigo rather than otologic vertigo. We found overall prevalence of vertigo in rural adult community to be 0.71%. Vertigo secondary to cardiovascular disease was most common and prevalent in 0.32% of population. Neurologic disease accounted for vertigo in 0.14%, metabolic disease in 0.09% and otologic disease 0.08%. Miscellaneous disorders were present in remaining 0.08% of population studied. To the best of our knowledge this study represents the first population based survey of prevalence of various causes of vertigo in general community in adult rural population.
Abrol, Raman; Nehru, Vikas I.; Venkatramana, Y.
A survey on 10.000 adults between the age of 20 and 79 years out of a total population of 66.186 persons in rural settlements under the inrisduction of Union Territory of Chandigarh between June 1993 to June 1995 was conducted to find out the prevalence and various causes of vertigo. In general community, in rural population, we found that more people suffer from non-otologic vertigo rather than otologic vertigo. We found overall prevalence of vertigo in rural adult community to be 0.71%. Ver...
Sinha, Sati P; Shrivastava, Saurabh R; Ramasamy, Jegadeesh
With a rapidly aging society, geriatric mental health is emerging as an important public health concern. According to the WHO, prevalence of depression in adults aged ≥60 years in developed and developing countries was 0.5 million and 4.8 million respectively in 2004. In India, increased life expectancy led to a rise in the older adult population between 2001 and 2011, expected to reach 324 million by 2050. To estimate the prevalence of depression and assess association between sociodemographic parameters and depression among older adults in a rural Indian community. A cross-sectional descriptive study was conducted in February and March 2012 in the rural village of Sembakkam, Kancheepuram District in the state of Tamil Nadu, India; the village has a population of 5948, 3.1% of whom are aged ≥60 years. Universal sampling technique was employed, in which every household in the community was visited and all elderly persons were selected. After obtaining written informed consent (a thumbprint was taken if the person was illiterate), participants were assessed face to face for depression using the Short Form Geriatric Depression Scale. The inclusion criterion was a score >24 on the mini-mental state examination. Final sample size was 103. Study variables included sociodemographic parameters such as age, sex, education, occupation, socioeconomic status, and marital status. Data entry and statistical analysis used SPSS version 17. Of 103 respondents interviewed, 73 (70.9%) were aged 60-69 years and 58 (56.3%) were male. Forty-four (42.7%) individuals (17 males, 27 females) were found to be depressed; 23 (22.3%) with mild depression, 14 (13.6%) moderate depression and 7 (6.8%) severe depression. Female sex and widowhood were significantly associated with depression. Depression, particularly mild depression, is common in this rural population of older adults, particularly among women and widowed elderly. These study findings can help program managers implement a more
Su, Meifang; Fu, Chaowei; Li, Songtao; Ying, Xuhua; He, Na; Jiang, Qingwu
To examine the prevalence of hyperlipidemia and its related factors in adults in rural Yuhuan, China. A cross-sectional study was carried out as a baseline study of Rural Yuhuan Health Population Cohort in all communities in Yuhuan County, Zhejiang Province, China. A total of 118,571 subjects aged 35 years old or above participated in this study. The trained health/medical workers collected the general information, health conditions and so on by the face-to-face interview. Totally, 5 ml blood samples were taken. Hyperlipidemia was defined as blood triglyceride > or = 1.70 mmol/L and/or total cholesterols > or = 5.18 mmol/L. SPSS 16.0 was used for statistical analysis. Data of the fifth China population census 2000 was used as the standard population. Among 118,571 eligible subjects, the averages of blood triglyceride and total cholesterols were (1.71 +/- 14.42) mmol/L and (5.48 +/- 40.25 ) mmol/L, respectively, and there was a statistical difference in gender on blood triglyceride (t = 4.163, P education levels, smoking, alcohol consumption and body mass index were significantly related to hyperlipidemia. Hyperlipidemia, especial hypercholesterolemia, was common in adults aged 35 years old or above living in rural China.
Kurmi, Om P; Semple, Sean; Devereux, Graham S; Gaihre, Santosh; Lam, Kin Bong Hubert; Sadhra, Steven; Steiner, Markus FC; Simkhada, Padam; Smith, William CS; Ayres, Jon G
Background Half of the world’s population is exposed to household air pollution from biomass burning. This study aimed to assess the relationship between respiratory symptoms and biomass smoke exposure in rural and urban Nepal. Methods A cross-sectional study of adults (16+ years) in a rural population (n = 846) exposed to biomass smoke and a non-exposed urban population (n = 802) in Nepal. A validated questionnaire was used along with measures of indoor air quality (PM2.5 and CO) and outdoor...
Sparks, P. Johnelle; Sparks, Corey S.
This paper assesses individual and social environment determinants of obesity in the adult Mexican population based on socioeconomic position, rural residence, and areal deprivation. Using a nationally representative health and nutrition survey, this analysis considers individual and structural determinants of obesity from a socioeconomic position and health disparities conceptual framework using multilevel logistic regression models. We find that more than thirty percent of Mexican adults we...
Li, Chengbo; Chi, Iris; Zhang, Xu; Cheng, Zhaowen; Zhang, Lei; Chen, Gong
This study compared urban and rural factors associated with life satisfaction among older adults in mainland China. Study data were extracted at random from 10% of the Sample Survey on Aged Population in urban/rural China in 2006 for 1980 participants aged 60 and older, including 997 from urban cities and 983 from rural villages. In this study, 54.6% of urban older adults and 44.1% of rural older adults reported satisfaction with their lives. Binary logistic regression analysis showed that financial strain, depressive symptoms, filial piety, and accessibility of health services were significantly associated with life satisfaction for both urban and rural participants, but age and financial exchange with children were only associated with life satisfaction among urban older adults. Findings are consistent with some previous studies that indicated the importance of financial strain, depressive symptoms, filial piety, and accessibility of health services to life satisfaction among the older adults in both urban and rural areas. This study also demonstrated the importance of age and family financial exchange to the life satisfaction of urban older adults.
Robertson, E; Donnermeyer, J F
This article examines illegal drug use among adults living in nonmetropolitan and rural areas of the United States using data from the National Household Survey on Drug Abuse. Subjects were classified into three categories by residence: nonmetropolitan-urban, metropolitan-rural, and nonmetropolitan-rural. Respondents indicate about 10% of adults were current users of marijuana or other illegal drugs. Discriminant analysis was used to examine differences among groups of individuals classified as current users, past users, and nonusers. For both marijuana and other illegal drugs, the variables that accounted most for group differences were age, marital, status, employment status, occupation, and income. Only minor differences in drug use were exhibited across the three residential categories. It is recommended that future research on the rural and nonmetropolitan adult population incorporate both structural level measures of socioeconomic and demographic characteristics of localities, and individual level measures of peer influence, work stress, family factors, and psychosocial characteristics.
Gómez-Olivé, Francesc X.; Rohr, Julia K.; Houle, Brian C.; Kabudula, Chodziwadziwa W.; Wagner, Ryan G.; Salomon, Joshua A.; Kahn, Kathleen; Berkman, Lisa F.; Tollman, Stephen M.; Bärnighausen, Till
Objective: To identify the unmet needs for HIV prevention among older adults in rural South Africa. Methods: We analyzed data from a population-based sample of 5059 men and women aged 40 years and older from the study Health and Aging in Africa: Longitudinal Studies of INDEPTH Communities (HAALSI), which was carried out in the Agincourt health and sociodemographic surveillance system in the Mpumalanga province of South Africa. We estimated the prevalence of HIV (laboratory-confirmed and self-reported) and key sexual behaviors by age and sex. We compared sexual behavior profiles across HIV status categories with and without age–sex standardization. Results: HIV prevalence was very high among HAALSI participants (23%, 95% confidence interval [CI]: 21 to 24), with no sex differences. Recent sexual activity was common (56%, 95% CI: 55 to 58) across all HIV status categories. Condom use was low among HIV-negative adults (15%, 95% CI: 14 to 17), higher among HIV-positive adults who were unaware of their HIV status (27%, 95% CI: 22 to 33), and dramatically higher among HIV-positive adults who were aware of their status (75%, 95% CI: 70 to 80). Casual sex and multiple partnerships were reported at moderate levels, with slightly higher estimates among HIV-positive compared to HIV-negative adults. Differences by HIV status remained after age–sex standardization. Conclusions: Older HIV-positive adults in an HIV hyperendemic community of rural South Africa report sexual behaviors consistent with high HIV transmission risk. Older HIV-negative adults report sexual behaviors consistent with high HIV acquisition risk. Prevention initiatives tailored to the particular prevention needs of older adults are urgently needed to reduce HIV risk in this and similar communities in sub-Saharan Africa. PMID:27926667
Rosenberg, Molly S; Gómez-Olivé, Francesc X; Rohr, Julia K; Houle, Brian C; Kabudula, Chodziwadziwa W; Wagner, Ryan G; Salomon, Joshua A; Kahn, Kathleen; Berkman, Lisa F; Tollman, Stephen M; Bärnighausen, Till
To identify the unmet needs for HIV prevention among older adults in rural South Africa. We analyzed data from a population-based sample of 5059 men and women aged 40 years and older from the study Health and Aging in Africa: Longitudinal Studies of INDEPTH Communities (HAALSI), which was carried out in the Agincourt health and sociodemographic surveillance system in the Mpumalanga province of South Africa. We estimated the prevalence of HIV (laboratory-confirmed and self-reported) and key sexual behaviors by age and sex. We compared sexual behavior profiles across HIV status categories with and without age-sex standardization. HIV prevalence was very high among HAALSI participants (23%, 95% confidence interval [CI]: 21 to 24), with no sex differences. Recent sexual activity was common (56%, 95% CI: 55 to 58) across all HIV status categories. Condom use was low among HIV-negative adults (15%, 95% CI: 14 to 17), higher among HIV-positive adults who were unaware of their HIV status (27%, 95% CI: 22 to 33), and dramatically higher among HIV-positive adults who were aware of their status (75%, 95% CI: 70 to 80). Casual sex and multiple partnerships were reported at moderate levels, with slightly higher estimates among HIV-positive compared to HIV-negative adults. Differences by HIV status remained after age-sex standardization. Older HIV-positive adults in an HIV hyperendemic community of rural South Africa report sexual behaviors consistent with high HIV transmission risk. Older HIV-negative adults report sexual behaviors consistent with high HIV acquisition risk. Prevention initiatives tailored to the particular prevention needs of older adults are urgently needed to reduce HIV risk in this and similar communities in sub-Saharan Africa.
Jie, Yu; Isa, Zaleha Md; Jie, Xu; Ju, Zhang Long; Ismail, Noor Hassim
, particularly in winter. Moreover, exposure to ETS is common at home or at work in urban areas.There is evidence that asthma prevalence and morbidity is less common in rural than in urban areas. The possible reasons are that rural residents are exposed early in life to stables and to farm milk production, and such exposures are protective against developing asthma morbidity. Even so, asthma morbidity is disproportionately high among poor inner-city residents and in rural populations. A higher proportion of adult residents of nonmetropolitan areas were characterized as follows:aged 55 years or older, no previous college admission, low household income, no health insurance coverage, and could not see a doctor due to healthcare service availability, etc. In rural areas, biomass fuels meet more than 70% of the rural energy needs. Progress in adopting modern energy sources in rural areas has been slow. The most direct health impact comes from household energy use among the poor, who depend almost entirely on burning biomass fuels in simple cooking devices that are placed in inadequately ventilated spaces. Prospective studies are needed to assess the long-term effects of biomass smoke on lung health among adults in rural areas.Geographic differences in asthma susceptibility exist around the world. The reason for the differences in asthma prevalence in rural and urban areas may be due to the fact that populations have different lifestyles and cultures, as well as different environmental exposures and different genetic backgrounds. Identifying geographic disparities in asthma hospitalizations is critical to implementing prevention strategies,reducing morbidity, and improving healthcare financing for clinical asthma treatment. Although evidence shows that differences in the prevalence of asthma do exist between urban and rural dwellers in many parts of the world, including in developed countries, data are inadequate to evaluate the extent to which different pollutant exposures
Cohen, Steven A; Cook, Sarah K; Sando, Trisha A; Sabik, Natalie J
Rural-urban health disparities are well-documented and particularly problematic for older adults. However, determining which specific aspects of rural or urban living initiate these disparities remains unclear. The purpose of this study was to assess associations between place-based characteristics of rural-urban status and health among adults age 65+. Data from the 2012 Behavioral Risk Factor Surveillance System were geographically linked to place-based characteristics from the American Community Survey. Self-reported health (SRH), obesity, and health checkup within the last year were modeled against rural-urban status (distance to nearest metropolitan area, population size, population density, percent urban, Urban Influence Codes [UIC], Rural-Urban Continuum Codes [RUCC], and Rural-Urban Commuting Area [RUCA]) using generalized linear models, accounting for covariates and complex sampling, overall, and stratified by area-level income. In general, increasing urbanicity was associated with a reduction in negative SRH for all 7 measures of rural-urban status. For low-income counties, this association held for all measures and characteristics of rural-urban status except population density. However, for high-income counties, the association was reversed-respondents living in areas of increasing urbanicity were more likely to report negative SRH for 4 of the 7 measures (RUCC, UIC, RUCA, and percent urban). Findings were mixed for the outcome of obesity, where rural areas had higher levels, except in low-income counties, where the association between rurality and obesity was reversed (OR 1.033, 95%CI: 1.002-1.064). These results suggest that rural-urban status is both a continuum and multidimensional. Distinct elements of rural-urban status may influence health in nuanced ways that require additional exploration in future studies. © 2017 National Rural Health Association.
Chan, Stephen; Hixon, Brian; Adkins, Margaret; Shinn, Jennifer B; Bush, Matthew L
The objective of this study was to compare the timing of hearing aid (HA) acquisition between adults in rural and urban communities. We hypothesized that time of acquisition of HA after onset of hearing loss is greater in rural adults compared with urban adults. Secondary objectives included assessment of socioeconomic/educational status and impact of hearing loss and hearing rehabilitation of urban and rural HA recipients. Cross-sectional questionnaire survey. We assessed demographics, timing of HA fitting from onset of hearing loss, and impact of hearing impairment in 336 adult HA recipients (273 urban, 63 rural) from a tertiary referral center. Amplification benefit was assessed using the International Outcome Inventory for Hearing Aids (IOI). The time to HA acquisition was greater for rural participants compared to urban participants (19.1 vs. 25.7 years, P = 0.024) for those with untreated hearing loss for at least 8 years. Age at hearing loss onset was correlated with time to HA acquisition (P = -0.54, P hearing specialists (68 vs. 32 minutes, P Hearing impairment caused job performance difficulty in 60% of all participants. Rural adults are at risk for delayed HA acquisition, which may be related to distance to hearing specialists. Further research is indicated to investigate barriers to care and expand access for vulnerable populations. 4. Laryngoscope, 127:2362-2367, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.
Elholm, G; Linneberg, A; Husemoen, L L N
BACKGROUND: The reported prevalence of allergic sensitization among children is lower in rural areas than in urban areas of the world. The aim was to investigate the urban-rural differences of allergic sensitization to inhalant allergens in adults depending on childhood exposure living in an indu......BACKGROUND: The reported prevalence of allergic sensitization among children is lower in rural areas than in urban areas of the world. The aim was to investigate the urban-rural differences of allergic sensitization to inhalant allergens in adults depending on childhood exposure living...... in an industrialized country as Denmark. METHODS: A total of 1236 male participants of 30-40 years of age recruited from two epidemiological studies were divided into four groups with regard to place of upbringing; city, town, rural area and farm. Allergic sensitization was assessed by skin prick tests (SPTs) to 10...... sensitization and specific allergen sensitization in adults depending on their childhood exposure. In this highly homogenous western population, exposure to a less urbanized childhood was associated with lower risk of allergic sensitization and disease as an adult....
Full Text Available The paper attempts to assess the extent of fi nancial exclusion of the rural population in Poland. One of the most basic measures of fi nancial exclusion is percentage of adult residents lacking a bank account. This and other measures verifying the population’s use of fundamental banking services and the statistical data on development of banking infrastructure in the territorial context were then employed to conduct an assessment of the extent and causes of fi nancial exclusion with a particular emphasis on the rural areas. The fi ndings show that, like in many other countries, the extent of provision of fi nancial services among the rural population is more limited compared to the urban population. The fi nancial exclusion, has much deeper roots going beyond the geographical factors. The real causes of the fi nancial exclusion lie not only in access to banking services but also in their price, the population’s income, as well as being strongly aff ected by information and behaviour.
Chrisman, Matthew; Nothwehr, Faryle; Yang, Ginger; Oleson, Jacob
Qualitative research can be used to examine multiple factors associated with physical activity and help practitioners identify language used by the rural adult population when discussing this behavior. Three focus groups were conducted among 19 residents of multiple towns in a rural Midwestern county to examine the language and influences on rural physical activity. Focus group members were asked to define physical activity, exercise, community, and neighborhood. They were asked about the activities they engaged in and facilitators and barriers to those activities. A guidebook was developed to capture major themes and common patterns that emerged in the responses to the topics discussed. The data were reviewed for repeated statements and points that were agreed on by multiple participants. Important factors associated with physical activity include the importance of social support and modeling physical activity behavior. Also, the influence of pets and children was important for engaging these adults in physical activity. The focus group members engaged in walking and bicycling in their neighborhood streets and community trails, and desired to see community buildings be open to the public for exercise. This study revealed contextual issues and culturally relevant language for practitioners to use in tailoring physical activity measurement tools or designing interventions for a rural adult population. Social support (specifically, seeing others being active and using pets as motivators for being active) and policy attitudes may be targeted for interventions to increase physical activity in rural adults. © 2014 Society for Public Health Education.
Jardim, Thiago Veiga; Reiger, Sheridan; Abrahams-Gessel, Shafika; Gomez-Olive, F Xavier; Wagner, Ryan G; Wade, Alisha; Bärnighausen, Till W; Salomon, Joshua; Tollman, Stephen; Gaziano, Thomas A
Assess awareness, treatment, and control of hypertension, as an indication of its management, in rural South Africa, especially regarding modifiers of these variables. A population-representative sample of adults aged at least 40 years residing in the rural Agincourt subdistrict (Mpumalanga Province) covered by a long-term health and sociodemographic surveillance system was recruited. In-person interviews, physical exams, and dried blood spots were collected. Hypertension awareness, treatment, and control rates were assessed. A regression model was built to identify predictors of those outcomes. The mean age of the 2884 hypertensive participants was 64.1 ± 12.7 years. Hypertension awareness rate was 64.4%, treatment among those aware was 89.3 and 45.8% of those treated were controlled. Considering aware and unaware hypertensives, treatment rate was 49.7% and control 22.8%. In the multivariable regression model, awareness was predicted by female sex, age at least 60 years, higher social economic status, prior cardiovascular disease (CVD), nonimmigrant status, literacy, and physical limitation. Improved control among those treated was predicted by age at least 60 years. Blood pressure control among all hypertensive study participants was predicted by female sex, being HIV-negative, age at least 60 years, nonimmigrant status, and prior CVD. High rates of awareness and treatment of hypertension as well as good levels of control were found in this population, probably explained by the long-term surveillance program conducted in the area. Considering the predictors of hypertension management, particular attention should be given to men, residents younger than 60 years, immigrants, and study participants without CVD as these characteristics were predictors of poor outcome.
Hart, Peter D
Little is known about physical activity (PA) and health-related quality of life (HRQOL) among rural adults. The purpose of this study was to investigate the relationship between meeting recommended levels of PA and HRQOL in a rural adult population. This study analyzed data from 6,103 rural adults 18 years of age and older participating in a 2013 survey. Respondents reporting at least 150 minutes a week of moderate-intensity (or moderate-vigorous combination) PA during the past month were categorized as meeting PA guidelines. Five health variables were used to assess HRQOL. A continuous HRQOL ability score was also created using item response theory (IRT). Rural adults who met recommended levels of PA were significantly more likely to report good HRQOL in adjusted models of physical health (OR: 1.99; 95% CI: 1.54-2.56), mental health (OR: 1.96; 95% CI: 1.46-2.64), inactivity health (OR: 2.14; 95% CI: 1.54-2.97), general health (OR: 1.69; 95% CI: 1.35-2.13), and healthy days (OR: 1.98; 95% CI: 1.58-2.47), compared to those who did not meet recommended levels. Furthermore, rural adults meeting recommended levels of PA also had a significantly greater HRQOL ability score (51.7 ± 0.23, Mean ± SE), compared to those not meeting recommended levels (48.4 ± 0.33, p meeting recommended levels of PA increases the likelihood of reporting good HRQOL in rural adults. These results should be used to promote the current PA guidelines for improved HRQOL in rural populations.
Full Text Available Introduction: Oral health is an integral component of general health and is essential for well-being. India is one of the most populated countries in the world and majority of them resides in rural areas. Moradabad is one of the oldest cities of Uttar Pradesh with diverse culture and beliefs. Aim: The aim was to evaluate the periodontal health status of the rural Moradabad population. Materials and Methods: A representative transversal study on 550 adults aged 20-49 years of rural Moradabad was conducted from February 2011 to June 2011. The survey was carried out using a self-designed questionnaire. Periodontal health was assessed using WHO criteria (1997. Results: Overall the prevalence of periodontal diseases among study subjects was overall 91.6%. Males had a higher prevalence of periodontal disease (93.8% as compared to females (89.5%. Out of total subjects 37.8% had Community Periodontal Index (CPI score 4 and 32.5% had score 3. About 7.3% of subjects had loss of attachment (LOA with 20.2% of them having LOA score 1. Statistically, there was a significant difference (P 35 years, smoking, tobacco chewing (independent risk factors were significantly associated with CPI > 2 (dependent variable (P < 0.05. Conclusion: The current periodontal health status of rural adult population of Moradabad city can be attributed to low literacy along with socio economic status and oral habits. To improve the periodontal health status of the rural population of Moradabad, it is suggested that a community-based approach can be designed.
Background The elderly population is growing in Turkey, as it is worldwide. The average age of residents in rural areas of Turkey is relatively high and is gradually increasing. The purpose of this study is to summarize the fitness and frailty of elderly adults living in a rural area of Turkey characterized by a relatively low level of socioeconomic development. Material/Methods This study was designed as a prospective, cross-sectional study, and was conducted in a rural area of Kars Province. A total of 168 elderly adults (≥65 years old) from 12 central villages were included in the study. The Fried Frailty Criteria was used to assess the frailty of the participants. In addition to frailty, the physical, social, and mental status of elderly adults was examined. Results The prevalence of frailty in this rural area of Turkey was 7.1%. The study group ranged in age from 65 to 96 years (mean 72.70±7.73 years), and 53.6% were female. Among the elderly adult group, 84.3% had not completed elementary school, and 43.29% had a monthly income of ≤500 Turkish liras ($200). No significant relationship was identified between gender and frailty. There was a statistically significant relationship between frailty and older age, lower education level, lower economic level, co-morbidities, polypharmacy, diabetes, chronic obstructive pulmonary disease, gastric disease, arthritis, generalized pain, benign prostatic hyperplasia, urinary incontinence, auditory impairment, impaired oral care, caregiver burden, impaired cognitive function, depression, or a lack of social support (social isolation). Conclusions It is believed that this study will contribute considerably to understanding the health status and needs of elderly adults in Turkey and the health problems of this population as well as to planning the development of public health and geriatric services based on regional needs. PMID:25925800
Cleland, Verity; Hughes, Clarissa; Thornton, Lukar; Venn, Alison; Squibb, Kathryn; Ball, Kylie
Despite increasing evidence that the physical environment impacts on physical activity among urban-dwellers, little attention has been devoted to understanding this relationship in rural populations. Work in this area is further hindered by a lack of environmental measures specifically designed for rural settings. This qualitative study aimed to explore the salience of urban physical activity environment constructs among rural adults. In 2011, 49 rural men and women from three distinct areas (coastal, animal-based farming, forestry/plant-based farming) of rural Tasmania, Australia, were purposively recruited to participate in semi-structured interviews. Interviews explored features of the built and social environment commonly examined in studies of urban adults, including functional characteristics (eg, lighting, footpaths, roads/verges), road and personal safety, availability and accessibility of places to be active, destinations, and aesthetics. Interviews were recorded, transcribed verbatim and analysed using a content-thematic approach using QSR NVivo software. While some urban environmental constructs were salient to these rural adults, such as availability of and accessibility to places to be active, some constructs were operationalised differently, such as road safety (where large trucks and winding roads rather than traffic density was of concern), or were not considered relevant (eg, personal safety related to crime, availability of walkable destinations, aesthetics). The measurement of the physical environment in rural populations may require reconsideration and/or modification to ensure salience and appropriate quantification of associations with physical activity in future studies.
Full Text Available Despite increasing evidence that the physical environment impacts on physical activity among urban-dwellers, little attention has been devoted to understanding this relationship in rural populations. Work in this area is further hindered by a lack of environmental measures specifically designed for rural settings. This qualitative study aimed to explore the salience of urban physical activity environment constructs among rural adults.In 2011, 49 rural men and women from three distinct areas (coastal, animal-based farming, forestry/plant-based farming of rural Tasmania, Australia, were purposively recruited to participate in semi-structured interviews. Interviews explored features of the built and social environment commonly examined in studies of urban adults, including functional characteristics (eg, lighting, footpaths, roads/verges, road and personal safety, availability and accessibility of places to be active, destinations, and aesthetics. Interviews were recorded, transcribed verbatim and analysed using a content-thematic approach using QSR NVivo software.While some urban environmental constructs were salient to these rural adults, such as availability of and accessibility to places to be active, some constructs were operationalised differently, such as road safety (where large trucks and winding roads rather than traffic density was of concern, or were not considered relevant (eg, personal safety related to crime, availability of walkable destinations, aesthetics.The measurement of the physical environment in rural populations may require reconsideration and/or modification to ensure salience and appropriate quantification of associations with physical activity in future studies.
Full Text Available Background: Obesity is most common nutritional disorder in developed countries and is assuming significant dimensions in developing countries. Objectives: To find out the prevalence of overweight and obesity in adults aged 18 years and above and socio-demographic factors affecting overweight and obesity in rural population of Meerut. To suggest measures for prevention of overweight and obesity in adults population of rural Meerut. Material and Methods: In present community based cross sectional study 1382 individuals aged 18 years and above were covered from 400 families spread over 5 villages with the help of systemic random sampling in rural area of Meerut District. The Individuals were interviewed and examined personally using Pre-designed and Pre-tested Questionnaire. Results: Out of 1382 individuals 244 (17.7% were having BMI ≥ 25. Prevalence of obesity in females (22% was found more than males (13.8%. Prevalence of Overweight and Obesity increased with advancing age, maximum being in age group 50-59 years (22.2%. Maximum numbers of males (19.9% were overweight in their most productive life (30 -39 years whereas maximum females were overweight in their menopausal decade i.e. 40-49 years (32.8%. Overweight was more in persons who were married (18.9%, professional/Technical person (33.3%, Savarna upper caste (23.1%, belonging to high standard of living index (21.0%, person living in joint families (18.2%, and Alcoholics (18.6% while smokers were having lower prevalence of overweight (10.6%. Conclusion: The prevalence of Overweight and Obesity is increasing in adult population of rural area. Various socio-demographic correlates are affecting the prevalence of Overweight and Obesity in Rural population.
Nag, Tanmay; Ghosh, Arnab
This study aimed to find out the prevalence of cardiovascular disease (CVD) risk factor clustering in a rural adult population of West Bengal, India. This cross-sectional study was carried out among 1007 participants (645 males and 362 females) aged ≥20 years in a rural community. All participants were grouped: Group I (20-39 years); Group II (40-59 years); Group III (≥60 years). Anthropometric measures were collected using standard techniques. Metabolic profiles and blood pressure were also measured. Mean of minimum waist circumference (MWC), waist-hip ratio (WHR), trunk-extremity ratio (TER), fat free mass (FFM), basal metabolic rate (BMR), intra-abdominal visceral fat (IVF) and arm muscle area (AMA) was found to be higher among males in comparison to females, whereas, the mean of body mass index (BMI), maximum hip circumference (MHC), waist-height ratio (WHtR), sum of four skinfolds (∑SF4), percentage of body fat (%BF), fat mass (FM), insulin, HOMA-IR and arm fat area (AFA) was higher in females. 37% of individuals (males 25% and females 49%) with high triglyceride (TG) also had low high density lipoprotein (HDL), whereas, 25% individuals (males 25% and females 24%) with overweight also had high fasting blood glucose (FBG). The prevalence of high systolic blood pressure (SBP) among individuals having high %BF was higher in the age groups of 40-59 years for both sexes. The study showed that prevalence of CVD risk factor clustering is high in the study population and warranted early intervention to safeguard the cardiovascular health of the nation. Copyright © 2015 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.
2 rounds of the national sample surveys, conducted by the central statistical office of Ethiopia during 1964-1967 and 1969-1971, provide the only comprehensive demographic data for the country and are the basis for this discussion of rural Ethiopia's population dynamics. The population of Ethiopia is predominantly rural. Agglomerations of 2000 and over inhabitants constitute about 14% of the population, and this indicates that Ethiopia has a low level of urbanization. In rural Ethiopia, international migration was negligent in the 1970's and the age structure can be assumed to be the results of past trends of fertility and mortality conditions. The reported crude birthrate (38.2), crude death rate (12.3) and infant mortality rate (90) of rural Ethiopia fall short of the averages for African countries. Prospects of population growth of rural Ethiopia would be immense. At the rate of natural increase of between 2.4 and 3.0% per annum, the population would double in 24-29 years. Regarding population issues, the programs of the National Democratic Revolution of Ethiopia faces the following main challenging problems: 1) carrying out national population censuses in order to obtain basic information for socialist planning; 2) minimizing or curtailing the existing high urban growth rates; 3) reducing rapidly growing population; and 5) mobilizing Ethiopian women to participate in the social, economic and political life of the country in order to create favorable conditions for future fertility reduction.
Carvalho, Edilaine Oliveira; da Rocha, Emersom Ferreira
It is a transverse study where a questionnaire of alimentary frequency was applied (QAF) in 150 adults resident of the rural area of the city of Ibatiba (ES, Brazil). QAF classified the alimentary consumption as: habitual (>4 times in the week), not habitual (chayote, carrot, beet, pumpkin, juice of fruits, banana, orange, guava, mango and tangerine. It can be concluded that the feeding habit presented by the studied population it can come to increase in a medium or long period the prevalence and occurrences of chronic-degenerative diseases as hypertension, diabetes, obesity and coronary diseases. The alimentary consumption of this population needs concern, because when compared with the national patterns, it is observed some inadequacies, and it is known that this picture comes to every day causing damages the public health.
Dyck, Delfien Van; Cardon, Greet; Deforche, Benedicte; De Bourdeaudhuij, Ilse
Recent research in urban planning and public health has drawn attention to the associations between urban form and physical activity in adults. Because little is known on the urban-rural differences in physical activity, the main aims of the present study were to examine differences in physical activity between urban and rural adults and to investigate the moderating effects of the physical environment on the relationship between psychosocial factors and physical activity. In Flanders, Belgium, five rural and five urban neighborhoods were selected. A sample of 350 adults (20-65 years of age; 35 adults per neighborhood) participated in the study. Participants wore a pedometer for 7 days, and self-reported physical activity and psychosocial data were also collected. Results showed that urban adults took more steps/day and reported more walking and cycling for transport in the neighborhood, more recreational walking in the neighborhood, and more walking for transportation outside the neighborhood than rural adults. Rural adults reported more recreational cycling in the neighborhoods. The physical environment was a significant moderator of the associations between several psychosocial factors (modeling from family, self-efficacy, and perceived barriers) and physical activity. In rural participants, adults with psychosocial scores above average were more physically active, whereas there were no differences in physical activity according to psychosocial factors in urban participants. These results are promising and plead for the development of multidimensional interventions, targeting specific population subgroups. In rural environments, where changing the environment would be a very challenging task, interventions focusing on modifiable psychosocial constructs could possibly be effective.
Full Text Available Some global models to predict the risk of diabetes may not be applicable to local populations. We aimed to develop and validate a score to predict type 2 diabetes mellitus (T2DM in a rural adult Chinese population. Data for a cohort of 12,849 participants were randomly divided into derivation (n = 11,564 and validation (n = 1285 datasets. A questionnaire interview and physical and blood biochemical examinations were performed at baseline (July to August 2007 and July to August 2008 and follow-up (July to August 2013 and July to October 2014. A Cox regression model was used to weigh each variable in the derivation dataset. For each significant variable, a score was calculated by multiplying β by 100 and rounding to the nearest integer. Age, body mass index, triglycerides and fasting plasma glucose (scores 3, 12, 24 and 76, respectively were predictors of incident T2DM. The model accuracy was assessed by the area under the receiver operating characteristic curve (AUC, with optimal cut-off value 936. With the derivation dataset, sensitivity, specificity and AUC of the model were 66.7%, 74.0% and 0.768 (95% CI 0.760-0.776, respectively. With the validation dataset, the performance of the model was superior to the Chinese (simple, FINDRISC, Oman and IDRS models of T2DM risk but equivalent to the Framingham model, which is widely applicable in a variety of populations. Our model for predicting 6-year risk of T2DM could be used in a rural adult Chinese population.
Kurmi, Om P; Semple, Sean; Devereux, Graham S; Gaihre, Santosh; Lam, Kin Bong Hubert; Sadhra, Steven; Steiner, Markus F C; Simkhada, Padam; Smith, William C S; Ayres, Jon G
Half of the world's population is exposed to household air pollution from biomass burning. This study aimed to assess the relationship between respiratory symptoms and biomass smoke exposure in rural and urban Nepal. A cross-sectional study of adults (16+ years) in a rural population (n = 846) exposed to biomass smoke and a non-exposed urban population (n = 802) in Nepal. A validated questionnaire was used along with measures of indoor air quality (PM2.5 and CO) and outdoor PM2.5. Both men and women exposed to biomass smoke reported more respiratory symptoms compared to those exposed to clean fuel. Women exposed to biomass were more likely to complain of ever wheeze (32.0 % vs. 23.5%; p = 0.004) and breathlessness (17.8% vs. 12.0%, p = 0.017) compared to males with tobacco smoking being a major risk factor. Chronic cough was similar in both the biomass and non-biomass smoke exposed groups whereas chronic phlegm was reported less frequently by participants exposed to biomass smoke. Higher PM2.5 levels (≥2 SDs of the 24-hour mean) were associated with breathlessness (OR = 2.10, 95% CI 1.47, 2.99) and wheeze (1.76, 1.37, 2.26). The study suggests that while those exposed to biomass smoke had higher prevalence of respiratory symptoms, urban dwellers (who were exposed to higher ambient air pollution) were more at risk of having productive cough.
Noor Hassim, I; Norazman, M R; Diana, M; Khairul Hazdi, Y; Rosnah, I
Cardiovascular disease (CVD) caused significant burden to Malaysia as it accounted for 36% of total deaths. This study aims to evaluate the burden of cardiovascular risk factors among Malaysian adult and assess the difference between urban and rural population in the selected communities. This study is part of the ongoing Prospective Urban Rural Epidemiology (PURE) database, whereby the baseline data were collected since June 2008. CVD risk was measured using INTERHEART risk score which comprised of eleven risk factors i.e. age and gender, family history of heart attack, smoking status, exposure to second hand smoke, diabetes mellitus, hypertension status, waist-hip ratio, self-reported stress, depression, dietary habits and physical activity status. Majority of the studied participants had low cardiovascular risk (57%). Participants from rural area were generally older, had lower educational status, higher prevalence of smokers, obesity, hypertension, diabetes, and more likely to be depressed. In comparison, urbanites had lower physical activities and more likely to be stressful. Mean INTERHEART score among rural participants were higher, especially for male, in comparison to urbanite (11.5±5.83 vs. 10.01±5.74, p<0.001). Contradict to common beliefs, participants in rural areas generally have higher cardiovascular risk factors compared to their urban counterparts. The rural population should be targeted for focused preventive interventions, taking account the socioeconomic and cultural context.
Barik, Anamitra; Das, Kausik; Chowdhury, Abhijit; Rai, Rajesh Kumar
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.
Full Text Available EO Asekun-Olarinmoye,1 PO Akinwusi,2 WO Adebimpe,1 MA Isawumi,3 MB Hassan,3 OA Olowe,4 OB Makanjuola,4 CO Alebiosu,2 TA Adewole51Department of Community Medicine, 2Department of Medicine, 3Department of Surgery, 4Department of Microbiology, 5Department of Chemical Pathology, College of Health Sciences, Osun State University, Osogbo, Osun State, NigeriaBackground: The purpose of this study was to determine the prevalence of hypertension in two rural communities of Osun State, Nigeria.Methods: A consenting adult population of the Alajue and Obokun rural communities in southwestern Nigeria that presented for the screening exercise participated in this community-based cross-sectional descriptive study. Two hundred and fifty-nine respondents aged older than 18 years completed a standardized, pretested, structured questionnaire as part of activities celebrating World Kidney Day and World Glaucoma Day in 2011. Anthropometric data and blood pressure were recorded, and the data were analyzed using the Statistical Package for Social Sciences version 17.Results: The mean age of the respondents was 49.7 ± 1.6 years, 100 (38.6% were males, 84 (32.4% were farmers, and 111 (42.9% were traders. The prevalence of hypertension was 13.16% (present in 34 respondents. Seventeen (6.6% had isolated systolic hypertension, while 11 (4.2% had isolated diastolic hypertension. Two hundred and thirty-six (91.1% undertook daily exercise lasting at least 30 minutes and 48 (18.5% had ever taken antihypertensive drugs on a regular basis. Four respondents (1.6% claimed a family history of hypertension. The average body mass index (BMI among respondents was 23.4 ± 4.9 kg/m2, 51 (19.6% had a BMI of 25.0–29.9, and 30 (11.5% had a BMI ≥ 30. A significant association existed between age older than 40 years and having hypertension (P 0.05. Rates of older age and high BMI were significantly higher among hypertensives than among normotensives. Respondents with BMI < 25 had at
Arroyo, Pedro; Fernández, Victoria; Loría, Alvar; Pardío, Jeannette; Laviada, Hugo; Vargas-Ancona, Lizardo; Ward, Ryk
To characterize body morphology and blood pressure of adults of the Mexican state of Yucatan. Rural-urban differences in weight, height, waist, and hip circumferences, and blood pressure were analyzed in 313 urban and 271 rural subjects. No rural-urban differences in prevalence of obesity and overweight were found. Hypertension was marginally higher in urban subjects. Rural abnormal waist circumference was higher in young men and young women. Comparison with two national surveys and a survey in the aboriginal population (rural mixtecos) showed similar prevalence of obesity as ENSA-2000 and higher than mixtecos and ENEC-1993. Abnormal waist circumference was intermediate between ENSANUT-2006 and mixtecos and hypertension was intermediate between ENEC and mixtecos. The Maya and mestizo population of Yucatan showed a high prevalence of obesity and abnormal waist circumference not accompanied by a comparable higher hypertension frequency. This finding requires further confirmation.
Swanoski Michael T
Full Text Available Abstract Background Understanding the signs and symptoms of heart attacks and strokes are important not only in saving lives, but also in preserving quality of life. Findings from recent research have yielded that the prevalence of cardiovascular disease risk factors are higher in rural populations, suggesting that adults living in rural locales may be at higher risk for heart attack and/or stroke. Knowledge of heart attack and stroke symptomology as well as calling 911 for a suspected heart attack or stroke are essential first steps in seeking care. This study sought to examine the knowledge of heart attack and stroke symptoms among rural adults in comparison to non-rural adults living in the U.S. Methods Using multivariate techniques, a cross-sectional analysis of an amalgamated multi-year Behavioral Risk Factor Surveillance Survey (BRFSS database was performed. The dependent variable for this analysis was low heart attack and stroke knowledge score. The covariates for the analysis were: age, sex, race/ethnicity, annual household income, attained education, health insurance status, having a health care provider (HCP, timing of last routine medical check-up, medical care deferment because of cost, self-defined health status and geographic locale. Results The weighted n for this study overall was 103,262,115 U.S. adults > =18 years of age. Approximately 22.0% of these respondents were U.S. adults living in rural locales. Logistic regression analysis revealed that those U.S. adults who had low composite heart attack and stroke knowledge scores were more likely to be rural (OR = 1.218 95%CI 1.216-1.219 rather than non-rural residents. Furthermore, those with low scores were more likely to be: male (OR = 1.353 95%CI 1.352-1.354, >65 years of age (OR = 1.369 95%CI 1.368-1.371, African American (OR = 1.892 95%CI 1.889-1.894, not educated beyond high school (OR = 1.400 955CI 1.399-1.402, uninsured (OR = 1.308 95%CI 1
Arcury, Thomas A.; Savoca, Margaret R.; Anderson, Andrea M.; Chen, Haiying; Gilbert, Gregg H.; Bell, Ronny A.; Leng, Xiaoyan; Reynolds, Teresa; Quandt, Sara A.
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
Venkatachalam, Jayaseelan; Natesan, Murugan; Eswaran, Muthurajesh; Johnson, Abel K Samuel; Bharath, V; Singh, Zile
Osteoarthritis (OA) is one of the most common degenerative disorders among the elderly population; although aging is the most important cause, research has shown that it is a complex disease with many etiologies. It is not an inevitable part of aging but rather the result of a combination of factors, many of which can be modified or prevented. The objective of this study was to assess the burden and determinants of OA knee among the adult population. A community-based, cross-sectional study among 1986 adult persons living in a rural area in Kanchipuram district, Tamil Nadu, South India, was interviewed and examined from January 2014 to December 2014. Data collection was done by the postgraduates, trained health workers under the supervision of principal investigator. Written and informed consent was obtained before data collection. OA was diagnosed using the criteria laid down by the American College of Rheumatology, and it was validated and tested in the study area. A total of 1986 adult respondents were interviewed out of which 27.1% had OA of knee. Age more than 50 years, female gender, tobacco usage, illiteracy, lower socioeconomic class, positive family history of OA, diabetes, and hypertension were found to be associated with OA knee (P < 0.05). The burden of osteoarthritis knee was high in this region. Hence, effective preventive strategy has to be taken to minimize this burden.
Edwards, Katie M; Greaney, Kayleigh; Palmer, Kelly M
To document rural young adults' reasons for emotional reactions to participating in intimate partner violence (IPV) research as well as to hear young adults' perspectives on how to most effectively conduct comprehensive IPV research in their rural communities. The data presented in this paper draw from 2 studies (ie, an online survey study and an in-person or telephone interview study) that included the same 16 US rural counties in New England and Appalachia. Participants, 47% of whom were in both studies, were young (age range 18-24), white (92%-94%), heterosexual (89%-90%), female (62%-68%), and mostly low to middle income. Nine percent of participants reported they were upset by the questions due to personal experiences with IPV or for other reasons not related to personal IPV experiences. Forty percent of participants reported they personally benefited from participating in the study, and they provided various reasons for this benefit. Regarding suggestions for conducting IPV research with rural young adults, participants believed that both online recruitment and online data collection methods were the best ways to engage young adults, although many participants suggested that more than 1 modality was ideal, which underscores the need for multimethod approaches when conducting research with rural young adults. These findings are reassuring to those committed to conducting research on sensitive topics with rural populations and also shed light on best practices for conducting this type of research from the voices of rural young adults themselves. © 2015 National Rural Health Association.
Martin, Julie L; Boyd, Linda D; Tapias-Perdigón, Helena; LaSpina, Lisa M
Purpose: The purpose of this study was to assess the oral health needs of community-dwelling older adults participating in congregate meal centers and to determine whether differences exist in the oral health needs of older adult populations residing in urban versus rural communities in the state of Texas. Methods: Study participants were recruited at 6 congregate meal centers located in identified rural and urban communities in the greater metropolitan area of Austin, Texas. (N=78) Participants completed a validated, modified questionnaire containing 20 items on the following topics: self-reported oral health, tooth loss, dental insurance, frequency of dental visits, time since last dental visit, access to dental care, dry mouth, and oral cancer screening. Each participant received an oral health screening based on the Association of State and Territorial Dental Directors Basic Screening Survey for Older Adults. The examiners received hands-on training prior to the study to ensure the validity of their findings and to test for inter-examiner reliability.The chi-square test of independence was performed to analyze the participants' responses on the Basic Screening Survey to identify any relationships between the variables. Results: There were no significant differences in oral health conditions of older adults residing in urban versus rural communities. Over 50% of the participants (64.9% urban; 56.1% rural) reported incomes below $15,000 and lacked dental insurance to cover all or a portion of their oral health care needs. Eighty-seven percent of the participants reported tooth loss due to dental caries, 35% required periodontal care, and 37% reported occasional and 43% reported frequent oral pain over the last 12 months. Conclusions: Oral health promotion and disease prevention is an emergent need for older adult populations residing in urban and rural communities of the state of Texas. Analysis revealed that the majority of the older adult populations in both
Fong, M S
An overview of the relationship between demographic factors and rural poverty in developing countries is presented. The author examines both the micro- and macro-level perspectives of this relationship and the determinants and consequences of population growth. The author notes the prospects for a rapid increase in the rural labor force and considers its implications for the agricultural production structure and the need for institutional change. Consideration is also given to the continuing demand for high fertility at the family level and the role of infant and child mortality in the poverty cycle. "The paper concludes by drawing attention to the need for developing the mechanism for reconciliation of social and individual optima with respect to family size and population growth." The need for rural development projects that take demographic factors into account is stressed as is the need for effective population programs. (summary in FRE, ITA) excerpt
Yang, K; Li, Y; Mao, Z; Liu, X; Zhang, H; Liu, R; Xue, Y; Tu, R; Liu, X; Zhang, X; Li, W; Wang, C
The purpose of this study was to explore the association between spicy flavor, spicy food frequency, and general obesity in Chinese rural adults. A total of 15,683 subjects (5907 males, 9776 females) aged 35-74 years from the RuralDiab Study were recruited for this cross-sectional study. Analysis of covariance was used to determine the differences of participant characteristics across body mass index (BMI) categories. Logistic regression yielded adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for obesity associated with the level of spicy flavor and frequency of spicy food intake. A meta-analysis was conducted to validate the result of the cross-sectional study. The crude and standardized prevalence of obesity were 16.78% and 17.57%, respectively. Compared with No spicy flavor, the adjusted ORs (95% CIs) of Mild, Middle, and Heavy spicy flavor for obesity were 1.232 (1.117-1.359), 1.463 (1.290-1.659), and 1.591 (1.293-1.958), respectively (P trend food consumption, the adjusted ORs (95% CIs) of 1 or 2 days/week, 3-5 days/week, and 6 or 7 days/week were 1.097 (0.735-1.639), 1.294 (0.932-1.796), and 1.250 (1.025-1.525), respectively (P trend = 0.026). The point estimate and 95% CI of mean BMI difference between the spicy food consuming group and spicy food non-consuming group was 0.37 (95% CI: 0.30-0.44) in the meta-analysis. The data indicated that spicy flavor and spicy food frequency were positively associated with general obesity in Chinese rural populations. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.
Full Text Available Introduction: Prevention is the most appropriate measure to control H1N1 flu pandemic and awareness of H1N1 flu is ranked very high in preventive measures. Keeping this in view, study was designed to assess the awareness level and to compare it among urban and rural participants. Aims and objectives: To assess the knowledge, attitude and practices regarding swine flu among adult population, to assess whether there is any difference among rural and urban population and to assess the response generated by the media coverage and the Government efforts.Methods: This cross-sectional study was done from April to July 2015 on 300 houses from the urban area and 150 houses from rural area, chosen from study population by random sampling. Mean and standard deviation for continuous variables and percentages for categorical were calculated. Results: 94% of urban and 91.3% of the rural participants had previously heard about swine flu, main source being TV. 46% of urban and 74% of rural participants had myth about spread of swine flu by eating pork. 41.3% of urban and 8.7% of rural population thought that government measures are sufficient for controlling swine flu. Conclusion: Knowledge regarding swine flu pandemic is good among study participants but role of health care providers is minimal and requires more dedicated effort. Lack of awareness among study population regarding some key focus areas like health promoting habits, vaccination and myths regarding the spread is of serious concern and needs to be addressed by the media, health workers and the Government efforts
Full Text Available OBJECTIVES: To assess trends in average blood pressure levels and prevalence, awareness, treatment, and control of hypertension among adults in a rural area of Northwest China, and to determine associated risk factors. METHODS: Four cross-sectional population-based surveys were conducted between 1982 and 2010 among randomly selected adults in rural areas of Hanzhong, in Northwest China. Data on blood pressure, body mass index, family history of hypertension, and socio-demographic and lifestyle characteristics were collected in similar way by trained investigators in four surveys. Data of 8575 participants aged 35-64 years was analyzed. Averages and proportions were adjusted for age and sex. RESULTS: Average blood pressure in the population has increased since 1982 from 76.9 mm Hg to 79.6 mm Hg in 2010 (diastolic and from 120.9 to 129.7 mm Hg (systolic. Prevalence of hypertension increased from 18.4% in 1982 to 30.5% in 2010, and awareness of hypertension increased from 16.8% to 38.4% in 2010. Treatment of hypertension increased from 1.0% in 1982 to 17.4% in 2010, and control of hypertension increased from 0.1% in 1982 to 3.5% in 2010. All these gradients were statistically significant (P<0.01 for trend. Population blood pressure and prevalence, awareness and treatment of hypertension were positively associated with increasing age, body mass index and having family history of hypertension. CONCLUSIONS: Average blood pressure levels and the prevalence, awareness, treatment and control of hypertension among adults in rural areas of Hanzhong have increased since 1982. However, awareness, treatment and control rates remain low. Public health programs and practical strategies are required to improve prevention and control of hypertension in rural Northwest China. In particular, attention should be given to the elderly and obese, and to those with a family history of hypertension, while raising awareness and treatment among younger adults.
Zhao, Y; Zhang, M; Luo, X; Yin, L; Pang, C; Feng, T; Ren, Y; Wang, B; Zhang, L; Li, L; Zhang, H; Yang, X; Han, C; Wu, D; Zhou, J; Shen, Y; Wang, C; Zhao, J; Hu, D
Limited information is available on the prevalence of obesity and high blood pressure (HBP) in rural China. We conducted a cross-sectional survey in a rural adult Chinese population during July to August of 2007 and 2008. The relationship between various obesity categories and HBP was analysed by gender for 20 194 participants. Obesity categories were classified as general and central obesity in terms of body mass index (BMI) and waist circumference (WC), respectively; cross-classification of BMI and WC created another four groups: both BMI and WC normal (BNWN), BMI obesity and WC normal (BOWN), BMI normal and WC obesity (BNWO), and both BMI and WC obesity (BOWO). The rates of HBP for BNWN, BOWN, BNWO and BOWO groups were 20.8, 63.3, 39.8 and 48.7%, respectively, for men and 20.1, 28.0, 34.7 and 54.2%, respectively, for women. As compared with BNWN group, the adjusted odds ratio (OR) and 95% confidence interval (CI) of BOWN and BOWO for having HBP in men were 6.227 (2.712-14.300) and 4.842 (4.036-5.808), respectively. As compared with BNWN women, BNWO and BOWO women showed increased risk of HBP (adjusted OR=1.342, 95%CI=1.139-1.581 and adjusted OR=4.530, 95%CI=4.004-5.124, respectively). The prevalence of general and central obesity was strongly related to HBP. Men with obese BMI but normal WC may be at increased risk of HBP. Women should pay more attention to changes in visceral adipose distribution and keep both BMI and WC values within normal ranges to reduce obesity-related health problems.
Context: Identifying ways to meet the health care needs of older adults is important because their numbers are increasing and they often have more health care issues. High resilience level may be one factor that helps older adults adjust to the hardships associated with aging. Rural community-dwelling older adults often face unique challenges such…
Asiki, Gershim; Baisley, Kathy; Kamali, Anatoli; Kaleebu, Pontiano; Seeley, Janet; Newton, Robert
To characterise trends over time in smoking and alcohol consumption in a rural Ugandan population between 1994 and 2011. We used self-reported data from a long-standing population cohort - the General Population Cohort. From 1989 to 1999, the study population comprised about 10 000 residents of 15 adjacent villages. From 1999, 10 more villages were added, doubling the population. Among adults (≥13 years, who comprise about half of the total study population), data on smoking were collected in 1994/1995, 2008/2009 and in 2010/2011. Data on alcohol were collected in 1996/1997, 2000/2001, 2009/2010 and 2010/2011. The reported prevalence of smoking among men was 17% in 1994/1995, 14% in 2008/2009 and 16% in 2010/2011; equivalent figures for women were 1.5%, 1% and 2%. In the most recent time period, for both sexes combined, prevalence of smoking increased from 1.5% in those aged <29 years, to 18% in those 50+ years (P < 0.001); prevalence was 14.8% in the lowest tertile of socio-economic status, decreasing to 3.7% in the highest (P < 0.001). For alcohol consumption, current drinking was reported by 39% in 1996/1997, 35% in 2000/2001 and 28% in 2010/2011; men were more likely to drink than women (32.9% vs. 23.5% in 2010/2011) and consumption increased with age (P < 0.001); and was associated with low socio-economic status, riskier sexual behaviour and being HIV positive (P < 0.001). In this rural Ugandan population, consumption of cigarettes and alcohol is higher among men than women, increases with age and is more frequent among those with low socio-economic status. We find no evidence of increases in either exposure over time. © 2014 John Wiley & Sons Ltd.
Full Text Available Differences in the bacterial community structure associated with 7 skin sites in 71 healthy people over five days showed significant correlations with age, gender, physical skin parameters, and whether participants lived in urban or rural locations in the same city. While body site explained the majority of the variance in bacterial community structure, the composition of the skin-associated bacterial communities were predominantly influenced by whether the participants were living in an urban or rural environment, with a significantly greater relative abundance of Trabulsiella in urban populations. Adults maintained greater overall microbial diversity than adolescents or the elderly, while the intragroup variation among the elderly and rural populations was significantly greater. Skin-associated bacterial community structure and composition could predict whether a sample came from an urban or a rural resident ~5x greater than random.
Full Text Available To evaluate the prevalence and determinants of metabolic syndrome (MetS among adults in a rural area of Northwest China.A population-based cross-sectional study was conducted in 2010 among adults aged 18 to 80 years in rural areas of Hanzhong, in Northwest China. Interview, physical and clinical examinations, and fasting blood glucose and lipid measurements were completed for 2990 adults. The definitions of MetS proposed by the Third Report of the National Cholesterol Education Program Expert Panel (Adults Treatment Panel III, ATP III and the International Diabetes Federation (IDF, and the modified ATP III definition for Asian population were used and compared. Proportions were adjusted for age and sex.The prevalence of MetS was 7.9%, 10.8% and 15.1% according to ATP III, IDF and modified ATP III criteria, respectively. Agreement between ATP III and IDF criteria and that between ATP III and modified ATP III criteria were moderate (Kappa = 0.52 and 0.64, respectively, whereas agreement between IDF and modified ATP III criteria was good (Kappa = 0.83. The prevalence of MetS increased with age, and was higher in women than in men (10.4% versus 5.4%, 13.6% versus 8.1% and 17.4% versus 12.8%, according to ATP III, IDF and modified ATP III criteria, respectively. The most common MetS component was high blood pressure. Having family history of hypertension, lack of physical activity, high economical level, overweight and obesity were positively associated with MetS.MetS is prevalent among rural adults in Northwest China and high blood pressure is the most common MetS component. Prevention and treatment of hypertension and MetS should be a public health priority to reduce cardiovascular diseases in rural areas of Northwest China. More attention should be given to the elderly, women, people with family history of hypertension and obese people who are at high risk of MetS.
Byker Shanks, Carmen; Haack, Sarah; Tarabochia, Dawn; Bates, Kate; Christenson, Lori
Nutrition is an essential component in promoting health and quality of life into the older adults years. The purpose of this qualitative research is to explore how the rural food environment influences food choices of older adults. Four focus groups were conducted with 33 older adults (50 years of age and older) residing in rural Montana communities. Four major themes related to factors influencing food choices among rural older adults emerged from this study: perception of the rural community environment, support as a means of increasing food access, personal access to food sources, and dietary factors. The findings from this current study warrant further research and promotion of specifically tailored approaches that influence the food choices of older adults in the rural western USA, including the developing and expanding public transportation systems, increasing availability of local grocers with quality and affordable food options, increasing awareness and decreasing stigma surrounding community food programs, and increasing nutrition education targeting senior health issues.
Veerakumar, Arumugam Mariappan; Kar, Sitanshu Sekhar
Awareness regarding cancer signs and symptoms and their screening and treatment method was low in India. To assess the awareness level of common cancers, perception regarding prevention and treatment of common cancers, association between sociodemographic variables with the awareness level of common cancers in the adult population. A cross-sectional study was conducted among 299 adults from the field practice areas of Our Rural Health Centre, Puducherry, during April-May 2014. Using systematic random sampling, 299 adults were interviewed through a pretested semi-structured questionnaire. Data were entered into EpiData version 3.1 and were analyzed by Statistical Package for Social Sciences version 20. Chi-square test was used. Nearly, 64% were in the age group of ≥40 years, the majorities were females (56.2%) and 64% were in lower socioeconomic class. Symptoms reported majorities were unusual bleeding (41.6%), followed by nagging cough (34.1%). Risk factors reported majorities were smoking (65%), chewing tobacco (59%) followed by alcohol use (46.5%). Only 10% reported cancer could be diagnosed early and 27% perceived cancer could be preventable. Only 6% perceived cancer could be cured fully. The adequate awareness level regarding lung and oral cancer were 14%, but breast and cervical cancer were <5%. The younger age group (<40 years) had more adequate awareness level compared to age group ≥40 years ( P < 0.05). The awareness level of common cancers was very poor. Vigorous health education program should improve the status of early diagnosis and proper treatment for common cancers such as oral, breast, and cervical cancer.
Schmidt, Laurie; Rempel, Gwen; Murray, Terra C; McHugh, Tara-Leigh; Vallance, Jeff K
As physical activity can improve health and reduce the risk of chronic disease, it is important to understand the contributing factors to physical activity engagement among older adults, particularly those living in rural communities to assist in remaining active and healthy as long as possible. The purpose of this study was to gain a deeper understanding of the socio-ecological factors that influence or contribute to physical activity among rural-dwelling older adults in rural Saskatchewan, Canada. This qualitative description explored the perceptions of physical activity among older adults living in two rural communities in the Canadian province of Saskatchewan. Semi-structured interviews were conducted with 10 adults aged 69-94. Using content analysis techniques, transcribed interview data were coded and categorized. Participants identified socio-ecological elements facilitating physical activity such as improved health, independence, and mobility as well as social cohesion and having opportunities for physical activity. The most common perceived environmental barrier to engaging in physical activity was the fear of falling, particularly on the ice during the winter months. Participants also cited adverse weather conditions, aging (e.g., arthritis), and family members (e.g., encouraged to "take it easy") as barriers to physical activity. Hearing directly from older adults who reside in rural Saskatchewan was determined to have the potential to improve awareness of physical activity in rural communities to support the implementation of programs and practices that will facilitate active lifestyles for older adults.
Full Text Available Objective: As physical activity can improve health and reduce the risk of chronic disease, it is important to understand the contributing factors to physical activity engagement among older adults, particularly those living in rural communities to assist in remaining active and healthy as long as possible. The purpose of this study was to gain a deeper understanding of the socio-ecological factors that influence or contribute to physical activity among rural-dwelling older adults in rural Saskatchewan, Canada. Methods: This qualitative description explored the perceptions of physical activity among older adults living in two rural communities in the Canadian province of Saskatchewan. Semi-structured interviews were conducted with 10 adults aged 69–94. Using content analysis techniques, transcribed interview data were coded and categorized. Results: Participants identified socio-ecological elements facilitating physical activity such as improved health, independence, and mobility as well as social cohesion and having opportunities for physical activity. The most common perceived environmental barrier to engaging in physical activity was the fear of falling, particularly on the ice during the winter months. Participants also cited adverse weather conditions, aging (e.g., arthritis, and family members (e.g., encouraged to “take it easy” as barriers to physical activity. Conclusion: Hearing directly from older adults who reside in rural Saskatchewan was determined to have the potential to improve awareness of physical activity in rural communities to support the implementation of programs and practices that will facilitate active lifestyles for older adults.
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
Njenga, Sammy M; Mwandawiro, Charles S; Muniu, Erastus; Mwanje, Mariam T; Haji, Fatma M; Bockarie, Moses J
Neglected tropical diseases (NTDs) are major public health problems in developing countries where they contribute to suffering of populations living in poor settings. As part of a research project started in September 2009 in Kwale district, Coast Region, Kenya, a baseline cross-sectional survey was conducted in 5 rural villages to provide information on the status of NTDs, including urinary schistosomiasis, soil-transmitted helminthiasis (STH), and lymphatic filariasis. This paper presents the results of a parasitological investigation among adults in the study villages. A total of 599 adults in the 5 study villages were tested for NTD infections in urine, stool and blood. The presence of Schistosoma haematobium infection was determined by the urine filtration method. The presence of STH in stool was determined by Kato-Katz method while filarial antigenaemia was determined using immunochromatographic (ICT) test. The study revealed high prevalence of hookworm (41.7%) and schistosomiasis (18.2%) infections among adults in the study villages. Of the 599 individuals examined, 50.1% had one or more helminthic infections. There was low level of polyparasitism with helminthic NTDs in the study population with 9.5% and 1.7% of the participants having two and three infections, respectively. In the current study, hookworm and schistosomiasis infections were identified as important infections among adults living in areas of high endemicity for these infections. Thus, if this section of the population is left untreated it may remain an important potential reservoir and a source of re-infection for school-age children treated in school deworming programmes. Therefore, there is a need to design novel strategies for preventive chemotherapy interventions that could allow inclusion of adults in an effort to reduce force of infection in high endemic communities.
Kolahdooz, Fariba; Spearing, Kerry; Sharma, Sangita
Food quality, determined by micronutrient content, is a stronger determinant of nutritional status than food quantity. Health concerns resulting from the co-existence of over-nutrition and under-nutrition in low income populations in South Africa have been fully recognized in the last two decades. This study aimed to further investigate dietary adequacy amongst adults in rural KwaZulu-Natal, by determining daily energy and nutrient intakes, and identifying the degree of satisfaction of dietary requirements. Cross-sectional study assessing dietary adequacy from 24-hour dietary recalls of randomly selected 136 adults in Empangeni, KwaZulu-Natal, South Africa. Results are presented for men (n = 52) and women (n = 84) 19-50 and >50 years old. Mean energy intake was greatest in women >50 years (2852 kcal/day) and exceeded Dietary Reference Intake's for both men and women, regardless of age. Mean daily energy intake from carbohydrates was 69% for men and 67% for women, above the Dietary Reference Intake range of 45-65%. Sodium was also consumed in excess, and the Dietary Reference Intakes of vitamins A, B12, C, D, and E, calcium, zinc and pantothenic acid were not met by the majority of the population. Despite mandatory fortification of staple South African foods, micronutrient inadequacies are evident among adults in rural South African communities. Given the excess caloric intake and the rising prevalence of obesity and other non-communicable diseases in South Africa, a focus on diet quality may be a more effective approach to influence micronutrient status than a focus on diet quantity.
Vijaykumar K More
Full Text Available Background: The increasing production, distribution, promotion and easy availability of alcohol have resulted in alcohol-related problems emerging as a major public health concern. It is a causal factor in more than 60 major types of diseases and injuries and results in approximately 2.5 million deaths each year. It is also a known risk factor for increasing crime, work absenteeism, loss of productivity, damage to property and physical and emotional abuse of women and children. Objectives: The aim was to find out the pattern, health related problems and social aspects associated with alcohol use among adults of a rural population of Pune, Maharashtra. Materials and Methods: A cross-sectional study was carried out in a rural field practice area of the Medical College in Pune among 300 respondents during January 12 and February 12. Pretested WHO designed alcohol survey questionnaire was used for collecting data by interview after obtaining informed consent. Results: Out of 300 respondents 45.7% (137 were found to be alcohol-user. Among these 35.77% were "daily drinkers.′ The most common alcoholic drink consumed was desi (country liquor (33.5%. Daily drinking was found to be related to adverse health related events. Poor health status, deprivation of family, increasing occurrence of unintentional and intentional injury, the greater extent of health problems were significantly higher among users. Conclusion: Alcohol consumption was high among adults in rural population. The study has also revealed negative impact of alcohol on both, user and their family.
Full Text Available The paper aimed to analyze the dynamics of Romania’s population and mainly of the rural population in the period 2005-2010. The following indicators were used: total population, rural population, the share of rural population in the total population, active population at national level, in the rural areas and the share of the rural active population in the total population, employment, unemployment, activity rate, employment rate, unemployment rate, employment rate by educational level, employment in agriculture by population’s age, active persons by age group. As a conclusion, Romania’s rural population accounts for 45 % of total population. A series of restraining factors such as: ageing, low training level, low capital and financial resources, lack of investments and other job alternatives affect the development of the rural areas where most of the population is dealing with agriculture. Rural space requires a multifunctional development meaning to achieve a balanced combination between agriculture, connected industries and services which could create jobs and raise the population income and living standard. This means investments both in agricultural and non-agricultural activities, a new national and local policy concerning the development of rural communities.
Ding, Ding; Sallis, James F; Hovell, Melbourne F; Du, Jianzhong; Zheng, Miao; He, Haiying; Owen, Neville
Modernisation and urbanisation have led to lifestyle changes and increasing risks for chronic diseases in China. Physical activity and sedentary behaviours among rural populations need to be better understood, as the rural areas are undergoing rapid transitions. This study assessed levels of physical activity and sedentary behaviours of farming and non-farming adults in rural Suixi, described activity differences between farming and non-farming seasons, and examined correlates of leisure-time physical activity (LTPA) and TV viewing. A random sample of rural adults (n=287) in Suixi County, Guangdong, China were surveyed in 2009 by trained interviewers. Questionnaires assessed multiple physical activities and sedentary behaviours, and their correlates. Analysis of covariance compared activity patterns across occupations, and multiple logistic regressions assessed correlates of LTPA and TV viewing. Quantitative data analyses were followed by community consultation for validation and interpretation of findings. Activity patterns differed by occupation. Farmers were more active through their work than other occupations, but were less active and more sedentary during the non-farming season than the farming season. Rural adults in Suixi generally had a low level of LTPA and a high level of TV viewing. Marital status, household size, social modelling for LTPA and owning sports equipment were significantly associated with LTPA but not with TV time. Most findings were validated through community consultation. For chronic disease prevention, attention should be paid to the currently decreasing occupational physical activity and increasing sedentary behaviours in rural China. Community and socially-based initiatives provide opportunities to promote LTPA and prevent further increase in sedentary behaviours. © 2011 Ding et al; licensee BioMed Central Ltd.
Yang, Wen-Yan; Li, Jun; Zhao, Chun-Hua; Qian, Deng-Juan; Niu, Zhiqiang; Shen, Wei; Yuan, Yuansheng; Zhong, Hua; Pan, Chen-Wei
Dai ethnicity is one of the major Chinese ethnic minorities with a population of about 1.2 million. We aimed to determine the prevalence and potential causes of visual impairment (VI) among ethnic Dai adults aged 50 years or older in a rural community in China. A population-based survey including 2163 ethnic Dai people (80.5%) was undertaken using a random cluster sampling strategy. The detailed eye examination was performed after pupil dilation by trained study ophthalmologists and optometrists. Presenting visual acuity (PVA) and best-corrected visual acuity (BCVA) was measured using the Early Treatment Diabetic Retinopathy Study logMAR chart and VI was defined as a VA of less than 20/63 in the better-seeing eye. The overall prevalence of presenting blindness and low vision was 3.0% (95% CI, 2.3-3.7) and 13.3% (95% CI, 11.9-14.8), respectively. The prevalence estimates were reduced to 2.1% (95% CI, 1.5-2.8) and 6.7% (95% CI, 5.7-7.8) when BCVA was considered. Men were more likely to be affected by low vision but less likely to be blind compared with women. Cataract accounted for 62.7% of presenting low vision and 68.8% of presenting blindness, respectively. In conclusion, VI was a significant health concern in Dai Chinese in China.
Noonan, D.; Silva, S.; Njuru, J.; Bishop, T.; Fish, L. J.; Simmons, L. A.; Choi, S. H.; Pollak, K. I.
Text-based interventions are effective for smoking cessation, but have not been tested in rural older adults. The purpose of this study was to compare the feasibility, acceptability and preliminary efficacy of a text-based Scheduled Gradual Reduction (SGR) program to a non-SGR text messaging support condition among rural older adults. Adults over…
Quandt, Sara A.; Chen, Haiying; Bell, Ronny A.; Savoca, Margaret R.; Anderson, Andrea M.; Leng, Xiaoyan; Kohrman, Teresa; Gilbert, Gregg H.; Arcury, Thomas A.
Purpose: Dietary variation is important for health maintenance and disease prevention among older adults. However, oral health deficits impair ability to bite and chew foods. This study examines the association between oral health and foods avoided or modified in a multiethnic rural population of older adults. It considers implications for…
Full Text Available BACKGROUND: Food quality, determined by micronutrient content, is a stronger determinant of nutritional status than food quantity. Health concerns resulting from the co-existence of over-nutrition and under-nutrition in low income populations in South Africa have been fully recognized in the last two decades. This study aimed to further investigate dietary adequacy amongst adults in rural KwaZulu-Natal, by determining daily energy and nutrient intakes, and identifying the degree of satisfaction of dietary requirements. METHODS: Cross-sectional study assessing dietary adequacy from 24-hour dietary recalls of randomly selected 136 adults in Empangeni, KwaZulu-Natal, South Africa. RESULTS: Results are presented for men (n = 52 and women (n = 84 19-50 and >50 years old. Mean energy intake was greatest in women >50 years (2852 kcal/day and exceeded Dietary Reference Intake's for both men and women, regardless of age. Mean daily energy intake from carbohydrates was 69% for men and 67% for women, above the Dietary Reference Intake range of 45-65%. Sodium was also consumed in excess, and the Dietary Reference Intakes of vitamins A, B12, C, D, and E, calcium, zinc and pantothenic acid were not met by the majority of the population. CONCLUSION: Despite mandatory fortification of staple South African foods, micronutrient inadequacies are evident among adults in rural South African communities. Given the excess caloric intake and the rising prevalence of obesity and other non-communicable diseases in South Africa, a focus on diet quality may be a more effective approach to influence micronutrient status than a focus on diet quantity.
Darlene Mara dos Santos Tavares
Full Text Available Objective: To compare sociodemographic variables to error rate in categories of Mini-Mental State Examination (mmse among elderly adults both with and without cognitive impairment. Methodology: This is an analytical, cross-sectional study, conducted with 955 elderly adults living in rural areas of Minas Gerais municipality, Brazil. A descriptive analysis was carried out and the chi-square test was applied (p < 0.05. Results: No association was found between sex and cognitive impairment. For its part, cognitive impairment was associated with a wider age range, a lower educational level, and widowhood. With regard to mmse, categories most affected were Attention and Calculation, Visual Capacity Building and Memory Recall. Conclusion: The results from our study put emphasis on the need to carry out health activities in order to prevent cognitive impairment, and to improve functions related to patients’ cognitive performance. Descriptors: Health of the Elderly; Cognition; Rural Population (source: decs, bireme.
Vejarano, Gilberto M.; And Others
This booklet presents the ideas that came out of the Regional Meeting for Adult Literacy and Rural Development. The meeting took place in September 1981 at the Regional Center for Adult Education and Functional Literacy for Latin America (CREFAL) in Mexico. Basically, a discussion of adult literacy in the rural areas of Latin America is presented.…
Full Text Available Abstract Background Self-medication is an important driver of antimicrobial overuse as well as a worldwide problem. The aim of the present study was to estimate the use of antibiotics, without medical prescription, in a sample of rural population presenting in primary care in southern Greece. Methods The study included data from 1,139 randomly selected adults (545 men/594 women, mean age ± SD: 56.2 ± 19.8 years, who visited the 6 rural Health Centres of southern Greece, between November 2009 and January 2010. The eligible participants were sought out on a one-to-one basis and asked to answer an anonymous questionnaire. Results Use of antibiotics within the past 12 months was reported by 888 participants (77.9%. 508 individuals (44.6% reported that they had received antibiotics without medical prescription at least one time. The major source of self-medication was the pharmacy without prescription (76.2%. The antibiotics most frequently used for self-medication were amoxicillin (18.3%, amoxicillin/clavulanic acid (15.4%, cefaclor (9.7%, cefuroxim (7.9%, cefprozil (4.7% and ciprofloxacin (2.3%. Fever (41.2%, common cold (32.0% and sore throat (20.6% were the most frequent indications for the use of self-medicated antibiotics. Conclusion In Greece, despite the open and rapid access to primary care services, it appears that a high proportion of rural adult population use antibiotics without medical prescription preferably for fever and common cold.
Background Self-medication is an important driver of antimicrobial overuse as well as a worldwide problem. The aim of the present study was to estimate the use of antibiotics, without medical prescription, in a sample of rural population presenting in primary care in southern Greece. Methods The study included data from 1,139 randomly selected adults (545 men/594 women, mean age ± SD: 56.2 ± 19.8 years), who visited the 6 rural Health Centres of southern Greece, between November 2009 and January 2010. The eligible participants were sought out on a one-to-one basis and asked to answer an anonymous questionnaire. Results Use of antibiotics within the past 12 months was reported by 888 participants (77.9%). 508 individuals (44.6%) reported that they had received antibiotics without medical prescription at least one time. The major source of self-medication was the pharmacy without prescription (76.2%). The antibiotics most frequently used for self-medication were amoxicillin (18.3%), amoxicillin/clavulanic acid (15.4%), cefaclor (9.7%), cefuroxim (7.9%), cefprozil (4.7%) and ciprofloxacin (2.3%). Fever (41.2%), common cold (32.0%) and sore throat (20.6%) were the most frequent indications for the use of self-medicated antibiotics. Conclusion In Greece, despite the open and rapid access to primary care services, it appears that a high proportion of rural adult population use antibiotics without medical prescription preferably for fever and common cold. PMID:20691111
Full Text Available BACKGROUND: The prevalence of chronic kidney disease (CKD has increased and will continue to rise worldwide. However, data regarding the prevalence of CKD in a rural area of China are limited. We therefore investigated the prevalence and associated risk factors of impaired renal function and urinary abnormalities in an adult rural population in southern China. METHODS: Between December 2006 and January 2007, residents older than 20 years from four villages in Zhuhai city were randomly selected using a stratified, multistage sampling technique. All participants were interviewed and tested for hematuria, albuminuria and estimated glomerular filtration rate (eGFR. The associations between age, gender, diabetes mellitus, hypertension, hyperuricemia, education level and indicators of renal damage were examined. RESULTS: Overall, 1,214 subjects were enrolled in this study. After adjustment for age and gender, the prevalence of albuminuria was 7.1% (95% CI: 4.5, 8.1, reduced eGFR was 2.6% (95% CI: 1.7%, 3.3%, and hematuria was 4.6% (95% CI: 3.3%, 6.0%. Approximately 13.6% (95% CI: 12.0%, 15.1% of the patients had at least one indicator of renal damage, but only 8.3% were previously aware. Age, diabetes, hyperlipidemia, hypertension, hyperuricemia, use of nephrotoxic medications, coronary heart disease and history of CKD were independently associated with impaired renal function and urinary abnormalities. Additionally, age, diabetes, and hypertension were independently associated with albuminuria. Age, hypertension, hyperuricemia, central obesity, and coronary heart disease were independently associated with reduced renal function. CONCLUSIONS: The high prevalence and low awareness of impaired renal function and urinary abnormalities in this population illustrates the urgent need to implement a CKD prevention program in the rural areas of southern China.
Xu, Hanzhang; Ostbye, Truls; Vorderstrasse, Allison A; Dupre, Matthew E; Wu, Bei
The place of residence has been linked to cognitive function among adults in developed countries. This study examined how urban and rural residence was associated with cognitive function among adults in India. The World Health Organization Study on Global AGEing and Adult Health data was used to examine cognition among 6,244 community-residing adults age 50+ in 6 states in India. Residential status was categorized as urban, rural, urban-to-urban, rural-to-urban, rural-to-rural, and urban-to-rural. Cognition was assessed by immediate and delayed recall tests, digit span test, and verbal fluency test. Multilevel models were used to account for state-level differences and adjusted for individual-level sociodemographic, psychosocial, and health-related factors. Urban residents and urban-to-urban migrants had the highest levels of cognition, whereas rural residents and those who migrated to (or within) rural areas had the lowest cognition. The differences largely persisted after adjustment for multiple covariates; however, rural-to-urban migrants had no difference in cognition from urban residents once socioeconomic factors were taken into account. Cognition among adults in India differed significantly according to their current and past place of residence. Socioeconomic factors played an important role in the cognitive function of adults in urban areas. © 2018 S. Karger AG, Basel.
Population in sub-Saharan Africa continues to grow at an unprecedented scale. This will translate into a massive expansion of the labour force, which will account for two thirds of the global increase. Both urban and rural areas are affected but, due to a delayed and stabilized pace of urbanization, population in rural areas continues to grow steadily. This results in a challenging densification of rural areas, with direct impacts on rural livelihoods, increased mobility and diversification o...
The author discusses the question of whether the size of China's rural population, representing approximately 85 percent of the total population, is too large. Suggestions for reducing the size of the rural population are considered, including the development of brigade- and commune-level enterprises, the development of industries in newly emerging urban areas, the development of satellite towns, and the encouragement of internal migration.
Full Text Available Rural Australians are less physically active than their metropolitan counterparts, and yet very little is known of the candidate intervention targets for promoting physical activity in rural populations. As rural regions are economically, socially and environmentally diverse, drivers of regular physical activity are likely to vary between regions. This study explored the region-specific correlates of daily walking among middle age and older adults in rural regions with contrasting dominant primary industries. Participants were recruited through print and electronic media, primary care settings and community organisations. Pedometers were worn by 153 adults for at least four days, including a weekend day. A questionnaire identified potential intra-personal, social and environmental correlates of physical activity, according to a social ecological framework. Regression modelling identified independent correlates of daily walking separately in the two study regions. In one region, there were independent correlates of walking from all levels of the social ecological framework. In the other region, significant correlates of daily walking were almost all demographic (age, education and marital status. Participants living alone were less likely to be physically active regardless of region. This study highlights the importance of considering region-specific factors when designing strategies for promoting regular walking among rural adults.
Black, Pamela; Hendy, Helen M
Nonmedical use of painkillers has increased in recent years, with some authors suggesting that painkillers serve as "hillbilly heroin": a drug chosen by rural adults to cope with psychosocial stresses in their lives. The present study compared rural and urban adults for their reported use of 5 drugs during the past year (painkillers, marijuana, cocaine, methamphetamine, heroin) and for associations between these 5 drugs and their reported psychosocial stressors. This study conducted secondary analyses of anonymous survey data provided by the 2014 National Survey on Drug Use and Health with responses from 8,699 rural and 18,481 urban adults. The survey included demographics (gender, age, race, education, marital status, family income), reports of whether participants had used each of 5 illicit drugs during the past year, and measures of psychological distress and social functioning problems. Controlling for demographics, rural adults showed no greater prevalence of painkiller use than urban adults, but rural adults were more likely than urban adults to use methamphetamine and less likely to use marijuana, cocaine, and heroin. Controlling for demographics, rural adults showed no associations between psychological or social stressors and the use of painkillers, but such stressors were significantly associated with the use of marijuana, methamphetamine, and heroin. Urban adults showed significant associations of psychological and social stressors with the use of painkillers, as well as with the use of marijuana, cocaine, and heroin. Results suggest that painkillers are unlikely to serve as "hillbilly heroin" for rural adults, but they may serve as "big-city heroin" for urban adults.
Basu, N; Steven, M
There is evidence to suggest that remote populations have poorer clinical outcomes in certain disease processes such as asthma and cancer. This study looks to identify any disparities in the management of patients with rheumatoid arthritis in the context of rurality. A retrospective observational study was performed on all 1314 patients with a diagnosis of rheumatoid arthritis who have been under the care of the principal rheumatologist at Raigmore Hospital, Inverness, between the years 1994 and 2004 inclusive. Rurality was defined according to the Scottish Household Survey. Populations were assessed in terms of age; sex; duration of diagnosis; number of years of Disease Modifying AntiRheumatic Drugs (DMARD) therapy, prednisolone use and the number of musculoskeletal practical interventions undertaken (eg joint aspiration or replacement). Two thirds of patients were considered rural dwellers. No significant difference was established between the populations with regards to management. DMARD therapy had been prescribed in 77% of rural patients vs 70% of their city counterparts for a mean 5.4 and 4.0 years respectively. The proportion of patients exposed to prednisolone therapy and who underwent musculoskeletal procedures were equivalent. Rural dwellers, with rheumatoid arthritis in the Highlands of Scotland, do not appear to be disadvantaged in regards to their disease management in comparison to the urban population.
Hu, Hongwei; Cao, Qi; Shi, Zhenzhen; Lin, Weixia; Jiang, Haixia; Hou, Yucheng
Depressive symptom disparity between urban and rural older adults is an important public health issue in China. Social support is considered as an effective way to alleviate depression of older adults. This study aimed to investigate the extent to which social support could explain the depressive symptom disparity between urban and rural older adults in China. This study used data drawn from the 2011 China Health and Retirement Longitudinal Study with 6,772 observations. Multiple data analysis strategies were adopted, including descriptive analyses, bivariate analyses, regression analyses and decomposition analyses. There were significant depressive symptom disparities between urban and rural older adults in China. Social support had significant association with depressive symptom of older adults while adjusting for covariates. About 25%-28% of the depressive symptom disparities could be attributed to urban-rural gaps in social support, in which community support contributed 21%-25%. Educational level and physical health status also contributed to the disparities. This study only established correlations between social support and depressive symptom disparity rather than casual relationships; and the self-reported measurement of depressive symptom and the unobservable cultural factors might cause limitations. The urban-rural gap in social support, especially community support was a prime explanation for depressive symptom disparities between urban and rural older adults in China. To reduce the depressive symptom disparities, effective community construction in rural China should be put into place, including improving the infrastructure construction, strengthening the role of social organizations, and encouraging community interpersonal interactions for older adults. Copyright © 2018 Elsevier B.V. All rights reserved.
Full Text Available One of the basic demographic characteristics of Croatia is the inherited dispersed population density with a large number of small settlements and the undeveloped system of regional and micro-regional centres. Such settlement structure was entirely inappropriate in the conditions of accelerated and urban-based industrialization after the Second World War. This period was characterised by a mass transition of agricultural population into non-agricultural activities, along with the abandonment of rural settlements. In addition to the strong emigration from rural areas in which younger age groups participated for the most part, there was a continuous reduction in fertility, too. All this has led to the narrowing of young age groups and consequently to the increase in the proportion of the elderly. An important factor of demographic ageing is the reduction in mortality of persons over 30 years of age and longer life respectively. Life expectancy of the Croatian population was 64.8 years in 1960 and 77.2 years in 1972. The average age constantly increased: it was 32.5 years in 1961, 35.4 in 1981 and it reached the high 41.7 years in 2011. The aggression and war against Croatia happened in the 1990s. Dramatic events affected the general social conditions and processes, strongly accelerating negative demographic trends. All this had further affected the socio-demographically eroded rural areas. There was a particularly difficult situation in the regions directly affected by the war; part of these areas had had the features of extreme demographic regression before the war sufferings and the war only further strengthened it. The overall population of Croatia is characterised by decreasing fertility, natural depopulation (negative natural change, total depopulation (since 1990 and intense population ageing. The duration and intensity of these processes clearly testifies to the demographic development of Croatia being very unfavourable. All this also
Sartorius, Benn; Kahn, Kathleen; Collinson, Mark A.; Sartorius, Kurt; Tollman, Stephen M.
A longitudinal dataset was used to investigate adult mortality in rural South Africa in order to determine location, trends, high impact determinants and policy implications. Adult (15-59 years) mortality data for the period 1993-2010 were extracted from the health and socio-demographic surveillance system (HDSS) in the rural sub-district of Agincourt. A Bayesian geostatistical frailty survival model was used to quantify significant associations between adult mortality and various multilevel (individual, household and community) variables. It was found that adult mortality significantly increased over time with a reduction observed late in the study period. Non-communicable disease mortality appeared to increase and decrease in parallel with communicable mortality, whilst deaths due to external causes remained constant. Male gender, unemployment, circular (labour) migrant status, age and gender of household heads, partner and/or other household death, low education and low household socioeconomic status (SES) were identified as significant and highly attributable determinants of adult mortality. Health facility remoteness was also a risk for adult mortality and households falling outside a critical buffering zone were identified. Spatial foci of higher adult mortality risk were observed indicating a strong non-random pattern. Communicable diseases differed from non-communicable diseases with respect to spatial distribution of mortality. Areas with significant excess mortality risk (hotspots) were found to be part of a complex interaction of highly attributable factors that continues to drive differential space-time risk patterns of communicable (HIV/AIDS and Tuberculosis) mortality in Agincourt. The impact of HIV mortality and its subsequent lowering due to the introduction of antiretroviral therapy (ART) was found to be clearly evident in this rural population. PMID:23733287
Patterson, Paul Daniel; Moore, Charity G.; Probst, Janice C.; Shinogle, Judith Ann
Context and Purpose: Obesity and physical inactivity are common in the United States, but few studies examine this issue within rural populations. The present study uses nationally representative data to study obesity and physical inactivity in rural populations. Methods: Data came from the 1998 National Health Interview Survey Sample Adult and…
DiNapoli, Elizabeth A; Pierpaoli, Christina M; Shah, Avani; Yang, Xin; Scogin, Forrest
We examined the effects of home-delivered cognitive-behavioral therapy (CBT) for depression on anxiety symptoms in an ethnically diverse, low resource, and medically frail sample of rural, older adults. This was a secondary analysis of a randomized clincial trial with 134 rural-dwelling adults 65 years and older with decreased quality of life and elevated psychological symptomatology. Anxiety symptoms were assessed with the anxiety and phobic anxiety subscales of the Symptom Checklist-90-Revised (SCL-90-R). Compared to a minimal support control condition, CBT for depression resulted in significantly greater improvements in symptoms of anxiety and phobic anxiety from pre-treatment to post-treatment. Home-delivered CBT for depression can be an effective treatment for anxiety in a hard-to-reach older populations. Additional research should explore integrated anxiety and depression protocols and other treatment modalities, including bibliotherapy or telehealth models of CBT, to reduce costs associated with its in home delivery. Flexibility in administration and adaptations to the CBT protocol may be necessary for use with vulnerable, rural older adults.
Full Text Available Research Question: What are the social problems of aged persons in a rural population? Objectives: i To study social problems of aged. ii To identify measures to eliminate them. Study design: Cross- sectional. Setting: Rural areas of Machhra Rural Health & Training Centre attached with Deptt. of SPM, Medical College, Meerut. Participants: Population above 60 years of age. Sample Size: 1000 households from 5 villages, which had 464 participants. Study Variables: Chi- square test. Results: In all, 259 (55.8% aged persons were engaged in productive work while 205 (44.2% were not doing any productive work. Of 376 aged persons living in joint families, 207 (55% were being respected, 71(18.9% were indifferently treated and 98 (26.1% were being neglected by family members. Recommendations: It is a strong case for proper planning to improve the lot of old age population especially for their social problems at the earliest.
The health of rural communities depends, in part, on the education level of rural adults. Economic vitality is impacted by degree completion, and the rate of degree completion by rural adults lags behind that of their urban and suburban counterparts. Low completion rates suggest that there are conditions for rural students that prevent them from…
Beck, Laurie F; Downs, Jonathan; Stevens, Mark R; Sauber-Schatz, Erin K
Motor-vehicle crashes are a leading cause of death in the United States. Compared with urban residents, rural residents are at an increased risk for death from crashes and are less likely to wear seat belts. These differences have not been well described by levels of rurality. 2014. Data from the Fatality Analysis Reporting System (FARS) and the Behavioral Risk Factor Surveillance System (BRFSS) were used to identify passenger-vehicle-occupant deaths from motor-vehicle crashes and estimate the prevalence of seat belt use. FARS, a census of U.S. motor-vehicle crashes involving one or more deaths, was used to identify passenger-vehicle-occupant deaths among adults aged ≥18 years. Passenger-vehicle occupants were defined as persons driving or riding in passenger cars, light trucks, vans, or sport utility vehicles. Death rates per 100,000 population, age-adjusted to the 2000 U.S. standard population and the proportion of occupants who were unrestrained at the time of the fatal crash, were calculated. BRFSS, an annual, state-based, random-digit-dialed telephone survey of the noninstitutionalized U.S. civilian population aged ≥18 years, was used to estimate prevalence of seat belt use. FARS and BRFSS data were analyzed by a six-level rural-urban designation, based on the U.S. Department of Agriculture 2013 rural-urban continuum codes, and stratified by census region and type of state seat belt enforcement law (primary or secondary). Within each census region, age-adjusted passenger-vehicle-occupant death rates per 100,000 population increased with increasing rurality, from the most urban to the most rural counties: South, 6.8 to 29.2; Midwest, 5.3 to 25.8; West, 3.9 to 40.0; and Northeast, 3.5 to 10.8. (For the Northeast, data for the most rural counties were not reported because of suppression criteria; comparison is for the most urban to the second-most rural counties.) Similarly, the proportion of occupants who were unrestrained at the time of the fatal crash
Alvarado-Esquivel, Cosme; Sánchez-Anguiano, Luis Francisco; Hernández-Tinoco, Jesús
The magnitude of Leptospira exposure in rural Mexico is largely unknown. We sought to determine the seroprevalence of Leptospira IgG antibodies in adults in rural Durango, Mexico, and to determine the sociodemographic, behavioral, and housing characteristics of the subjects associated with Leptospira seropositivity. We performed a cross-sectional study in 282 adults living in rural Durango, Mexico. Sera from participants were analyzed for Leptospira IgG antibodies using a commercially available enzyme immunoassay. Seroprevalence association with the characteristics of the subjects was analyzed by bivariate and multivariate analyses. Of the 282 rural subjects (42.91 ± 17.53 years old) studied, 44 (15.6%) had anti-Leptospira IgG antibodies. Seropositivity to Leptospira was not associated with gender, educational level, employment, socioeconomic status, contact with animals or soil, or type of floors at home. In contrast, multivariate analysis showed that Leptospira exposure was associated with national trips (OR = 2.09; 95% CI: 1.05-4.16; P = 0.03) and poor education of the head of the family (OR = 2.96; 95% CI: 1.51-5.78; P = 0.001). We demonstrated serological evidence of Leptospira exposure in adults in rural northern Mexico. The contributing factors associated with Leptospira exposure found in the present study may be useful for optimal planning of preventive measures against Leptospira infection.
Parrado, Emilio A.; Kandel, William A.
We analyze the relationship between Hispanic population growth and changes in U.S. rural income inequality from 1990 through 2000. Applying comparative approaches used for urban areas we disentangle Hispanic population growth's contribution to inequality by comparing and statistically modeling changes in the family income Gini coefficient across…
Goins, R. Turner; Spencer, S. Melinda; Williams, Kimberly
Purpose: Self-perceptions of health vary depending on one's social and cultural context. Rural residents have been characterized as having a distinct culture, and health differences by residence have been well documented. While there is evidence of poor health among rural older adults, little research has examined how they perceive and define…
Full Text Available Natural change and migration are important determinants of the economy and environment. In the EU strategic documents the socio-economic developmental priorities have a territorial aspect, referring to all the regions of the member states. Achievement of the Union’s sustainable growth policy objectives could be limited due to unfavourable demographic trends in rural areas. The paper, using the Eurostat data and selected measures of population reproduction, describes the changes in number of rural inhabitants in 2007-2010 and their main determinants. In the analysed period the rural population size increased. However, contrary to the urban and intermediate regions, since 2009 as a result of a surplus number of deaths over births, in the rural areas the negative values of population increase were observed.
Fernanda D.B. Abadio Finco
Full Text Available The purpose of this study was to investigate the nutritional situation of rural adults in the Brazilian Amazon. Anthropometric measurements (height, weight and waist circumference were taken from all participants. BMI was calculated. Dietary intake was assessed by 24 h recall and food patterns were assessed by food frequency questionnaires (FFQ. Energy expenditure was calculated from the resting metabolic rate multiplied by an activity factor based on physical activity. Linear regression was applied to assess variables associated to BMI. Participants of the study comprised 58 men and 50 women. The mean (±standard deviation age of the study population was 44.0 ± 12 years for women and 47.0 ± 15.0 year for men. The BMI for normal weight men was 22.16 ± 1.57 whereas for the overweight group was 28.33 ± 2.58 kg. Overweight and obese adults together comprise 60.2% of the study sample and therefore were considered as one group. Normal weight individuals had higher values of PAL (physical activity level than overweight persons for both sex. There was no statistical difference between the groups concerning the intake of protein, kilocalories from protein and percentage of energy from protein. The physical activity level of participants describes a sedentary profile for women in the rural communities for both groups. The food pattern of surveyed people is based on rice, beans and meat as daily food. The prevalence of overweight and obesity altogether is comparable to that reported by other studies for Brazilian rural areas. The dietetic assessment revealed that energy expenditure was significantly different between normal weight and overweight women. Physical activity was shown to be a relevant factor for overweight in the two rural communities. The food pattern of the two communities expresses a monotonous diet.
Moy, Foong-Ming; Darus, Azlan; Hairi, Noran Naqiah
Handgrip strength is useful for screening the nutritional status of adult population as it is strongly associated with physical disabilities and mortality. Therefore, we aimed to determine the predictors of handgrip strength among adults of a rural community in Malaysia using a cross-sectional study design with multistage sampling. All adults aged 30 years and older from 1250 households were invited to our study. Structured questionnaire on sociodemographic characteristics, medical history, occupation history, lifestyle practices, and measurements, including anthropometry and handgrip strength were taken. There were 2199 respondents with 55.2% females and majority were of Malay ethnicity. Their mean (standard deviation) age was 53.4 (13.2) years. The response rate for handgrip strength was 94.2%. Females had significantly lower handgrip strength than males (P < .05). In the multiple linear regression models, significant predictors of handgrip strength for males were age, height, job groups, and diabetes, while for females, the significant predictors were age, weight, height, and diabetes. © 2013 APJPH.
Full Text Available General public views and expectations around the use of antibiotics can influence general practitioners' antibiotic prescribing decisions. We set out to describe the knowledge, attitudes and beliefs about the use of antibiotics for respiratory tract infections in adults in Poland, and explore differences according to where people live in an urban-rural continuum.Face to face survey among a stratified random sample of adults from the general population.1,210 adults completed the questionnaire (87% response rate; 44.3% were rural; 57.9% were women. 49.4% of rural respondents and 44.4% of urban respondents had used an antibiotic in the last 2 years. Rural participants were less likely to agree with the statement "usually I know when I need an antibiotic," (53.5% vs. 61.3% respectively; p = 0.015 and reported that they would consult with a physician for a cough with yellow/green phlegm (69.2% vs. 74.9% respectively; p = 0.004, and were more likely to state that they would leave the decision about antibiotic prescribing to their doctor (87.5% vs. 85.6% respectively; p = 0.026. However, rural participants were more likely to believe that antibiotics accelerate recovery from sore throat (45.7% vs. 37.1% respectively; p = 0.017. Use of antibiotic in the last 2 years, level of education, number of children and awareness of the problem of developing antimicrobial resistance predicted accurate knowledge about antibiotic effectiveness.There were no major differences in beliefs about antibiotics between urban and rural responders, although rural responders were slightly less confident in their knowledge about antibiotics and self-reported greater use of antibiotics. Despite differences in the level of education between rural and urban responders, there were no significant differences in their knowledge about antibiotic effectiveness.
Raza, N.; Zaidi, K.
To determine area of origin of adult varicella patients, whether rural or urban, to compare the mean interval between leaving the area of origin and onset of varicella in adults of rural origin in comparison with those of urban origin and to observe its complications. All patients over the age of 18 years, presenting with acute illness clinically, suggestive of varicella were included in the study. A specially designed proforma was filled for each patient separately, which included demographic features as well as area of origin, whether rural or urban, and the age at which they left the area of origin. These patients were examined, treated and assessed clinically on regular basis for the progress of the disease as well as for its possible local or systemic complications. Data analysis was done by using statistical programme SPSS-10. Out of 9155 adult patients, 156 (1.70%) had varicella, including 128 (82.1%) males and 28 (17.9%) females. Origin was rural in 125 (80.1%) and urban in 31 (19.9%) patients. Mean interval between leaving area of origin and developing varicella in those of rural origin was 01.79+01.78 years and that in patients of urban origin was 03.37+05.72 years (p+0.009). None of the patients developed any complication of the disease. Varicella in adults is generally a benign illness. It is more common among adult males of rural origin and the interval between leaving the area of origin and onset of varicella in these patients is significantly less as compared to that in adults of urban origin. (author)
Full Text Available Background: In China, suicide is one of the major causes of death among adolescents and young adults aged 15 to 34 years. Aim: The current study examines how risk factors vary by age groups in rural China, referring to those aged 15 to 24 years and those aged 25 to 34 years. Method: A case-control psychological autopsy (PA study is conducted in sixteen counties from three Chinese provinces, including 392 suicide cases and 416 community living controls in the sample. Results: In China, young adults aged 25 to 34 years have a higher risk for suicide than adolescents aged 15 to 24 years, and it holds true even controlling for relevant social factors. In addition, age-related factors such as education, marital status, whether having children, status in the family, physical health, and personal income all have varying degrees of impact on suicide risks for rural youth. Conclusions: This study shows that there are some age-related risk factors for suicide at certain life stages and emphasizes that young adults in rural China aged 25 to 34 years have an increased risk of suicide as a result of experiencing more psychological strains with age.
Rudel, T I
Studies that have assessed the impact of population change on the environment in rural areas of selected developing countries are reviewed. The implications are that both developed and developing countries might focus on single aspects of a much larger global problem. Rural areas were selected because the bulk of the world's population lives in rural areas. Population environment interactions are 1st discussed at the global level. Studies on changing import patterns of developing countries are usless in accounting for agricultural policy shifts or other factors that may be unrelated to population growth but may be related to food imports. When the magnitude of food production and population growth is examined, there is a balance established between the two. However, analysis of the spatial distribution of desertification and soil degradation shows greater local level effects. Population/environment relationships are examined in critical ecological zones: tropical deforestation, desertification, land degradation in resource poor zones, and responses to population pressures and resource degradation. The conclusions reached are that better statistics on degradation are needed and that the trends in the human ecology of rural populations have clear implications for government policies on the environment. Agricultural development has been uneven and inequitable such that many peasant populations have suffered a decline in standards of living, particularly in Africa. There has also been an accelerated increase in rates of land degradation in resource poor areas, which are densely populated. The population response has been migration shifts out of resource poor areas to ecologically marginal areas, which has resulted in extensive desertification and deforestation. Expansion of the areas under cultivation has not just increased agricultural production but agriculture and population have invaded ecologically marginal zones in deserts and rain forests. Measurement of the
Quinteros, Maria E; Cáceres, Dante D; Soto, Alex; Mariño, Rodrigo J; Giacaman, Rodrigo A
To determine whether there is a relationship between the use of dental services and caries experience in adults and older adults from central Chile. A sample of 453 adults, 35-44 years of age, and 438 older adults, 65-74 years of age, was interviewed and examined using World Health Organisation (WHO) methods. Sociodemographic variables were also registered. Caries experience was assessed using the Decayed, Missing and Filled teeth (DMFT) index. Multiple linear regression models were used to determine whether there was an association between the independent variables and caries experience. Caries prevalence was 99.6% for adults [DMFT score = 14.89 (±6.16)] and 99.8% for older adults [DMFT score = 25.68 (±6.49)]. Less than half of the population - 41.7% of adults and 31.5% of older adults - received dental care. Regardless of the age group, there were no differences in the DMFT score between those who received and those who did not receive attention (P > 0.05). When the DMFT findings were analysed in greater detail, people who received dental care and urban participants had more fillings (P dental damage from caries. Although rurality and use of services do not seem to affect caries experience, they are associated with differences in fillings and missing teeth. © 2014 FDI World Dental Federation.
Niedomysl, Thomas; Amcoff, Jan
Rural depopulation is a concern in many countries, and various policy initiatives have been taken to combat such trends. This article examines whether hidden potential for rural population growth can be found in Sweden. If such potential exists, it implies that the development prospects for many rural areas are not as unpromising as they may seem…
National Aeronautics and Space Administration — The Low Elevation Coastal Zone (LECZ) Urban-Rural Estimates consists of country-level estimates of urban, rural and total population and land area country-wide and...
Gupta, Noopur; Vashist, Praveen; Tandon, Radhika; Gupta, Sanjeev K; Kalaivani, Mani; Dwivedi, S N
To determine the type and nature of traditional eye medicine (TEM), their sources and use and practices related to self-medication for ophthalmic diseases in a rural Indian population. A population-based, cross-sectional study was conducted in 25 randomly selected clusters of Rural Gurgaon, Haryana, India as part of CORE (Cornea Opacity Rural Epidemiological) study. In addition to comprehensive ophthalmic examination, health-seeking behavior and use of self-medication and TEM was assessed in the adult population using a semi-structured questionnaire. Physical verification of available ophthalmic medications in the enumerated households was conducted by the study team. Descriptive statistics were computed along with multivariable logistic regression analysis to determine associated factors for use of self-medication and TEM. Of the 2160 participants interviewed, 396 (18.2%) reported using ophthalmic medications without consulting an ophthalmologist, mainly for symptoms like watering (37.1%), redness (27.7%), itching (19.2%) and infection (13.6%). On physical verification of available eye drops that were being used without prescription, 26.4% participants were practicing self-medication. Steroid, expired/unlabeled and indigenous eye drops were being used by 151(26.5%), 120(21.1%) and 75 (13.2%) participants respectively. Additionally, 25.7% (529) participants resorted to home remedies like 'kajal'(61.4%), honey (31.4%), ghee (11.7%) and rose water (9.1%). Use of TEM is prevalent in this population. The rampant use of steroid eye drops without prescription along with use of expired or unlabelled eye drops warrants greater emphasis on safe eye care practices in this population. Public awareness and regulatory legislations must be implemented to decrease harmful effects arising due to such practices.
Gannon, Brittany N; Stacciarini, Jeanne-Marie R
Globally, aging populations and older persons living with HIV (OPLWH) are emerging socioeconomic and health care concerns. Aging adults living in rural communities have less access to and lower utilization of health care services; they rely heavily on available peer and family networks. Although social networks have been linked to positive mental and physical health outcomes, there is a lack of understanding about social networks in rural-dwelling OPLWH. The purpose of this integrative literature review was to compare emerging themes in the social network components of rural versus urban-dwelling OPLWH and network benefits and barriers. Overarching themes include: limited and/or fragile networks, social inclusion versus social isolation, social capital, and health outcomes. Results demonstrate an overall lack of rural-focused research on OPLWH and a universal lack of informal and formal networks due to isolation, lack of health care services, and omnipresent HIV stigma. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.
Full Text Available Abstract Background In Guatemala, diabetes is an emerging public health concern. Guatemala has one of the largest indigenous populations in Latin America, and this population frequently does not access the formal health care system. Therefore, knowledge about the emergence of diabetes in this population is limited. Methods Interview participants (n=23 were recruited from a convenience sample of indigenous adults with type 2 diabetes at one rural diabetes clinic in Guatemala. A structured interview was used to assess knowledge about diabetes and its complications; access to diabetes-related health care and treatment; dietary and lifestyle changes; and family and social supports for individuals living with diabetes. Interviews were supplemented with two group interviews with community leaders and health care providers. Thematic analysis was used to produce insights into diabetes knowledge, attitudes, and practices. In addition, a chart review of the clinic’s electronic medical record identified all adult patients (n=80 presenting in one calendar year for a first-time diabetic consultation. Sociodemographic and clinical variables were extracted and summarized from these records. Results Salient demographic factors in both the structured interview and chart review samples included low educational levels and high indigenous language preference. In the interview sample, major gaps in biomedical knowledge about diabetes included understanding the causes, chronicity, and long-term end-organ complications of diabetes. Medication costs, medical pluralism, and limited social supports for dietary and lifestyles changes were major practical barriers to disease management. Quantitative data from medical records review revealed high rates of poor glycemic control, overweight and obesity, and medication prescription. Conclusions This study provides a preliminary sketch of type 2 diabetes in an indigenous Guatemalan population. Combined qualitative and
Gill, M S
Except for the decade 1941-1951, in which Punjab's population declined because of a huge exchange of population between India and Pakistan and a large loss of life, the decade 1971-1981 was the 1st decade since 1911 to experience a deceleration in the growth rate of the rural population of Punjab, India. The deceleration was due to out-migration to urban areas. The scheduled caste population increased 28.37% between 1971 and 1981, while the nonscheduled caste population increased by only 13.32%, which was considerably below the rate of natural increase. Nonscheduled castes had experienced substantial out-migration because of 1) improved transport and communication facilities which enabled them to move to urban centers; 2) mechanization of main farming operations and easy availability of migrant laborers which lessened the need for family labor; 3) the rise of a relatively mobile younger generation with a high literacy rate; 4) rapidly decreasing land holdings which strengthened the push factor in the countryside; and 5) rising aspirations, especially among the younger generation. In 1981, Sikhs constituted 71.3% of the rural population in Punjab, followed by Hindus (26.51%), Christians (1.25%), and Muslims (.89%). From 1971-1981, Muslims experienced the greatest increase (49.29%). Sikhs grew by 20.74% and Hindus by 9.02%. The Sikhs high growth rate was due to 1) a new technique for counting religious affiliation in which all members of a household are considered the same religion as the head of household and 2) conversion of Hindus to Sikhism. Hindus had a low growth rate because 1) the new method of counting religious affiliation and 2) rural-urban migration. The area with the lowest population increase resulted from industrialists and other nonagriculturists buying farmland, causing the agriculturists to move away to less desirable land. Conclusions are 1) the sharp rural-urban division along religious lines should be lessened, 2) Sikhs' lag in urbanization and
This article uses unique community-level data aggregated from censuses of associations to analyze growth and volatility in rural populations of grassroots associations. A qualitative comparative analysis (QCA) shows that the two main paths to growth were (1) centralization in polycephalous (multicentered) municipalities and (2) population growth…
Wilson, Stephan M.; Peterson, Gary W.
Examined possible predictors of life satisfaction among 322 low-income young adults from rural Appalachia. Both objective and subjective conditions of life were predictors of life satisfaction: financial resources, self-esteem, and proximity to childhood home were positive predictors; frustrations about limited job opportunities and community size…
De Graft-johnson, K T
While the population of Ghana is expected to double in 25 years at the current rate of increase (approximately 2.5% per annum), the population of urban centers is increasing even faster. The 1970 census shows the urban population growing by 4.8% per annum. This is mainly the result of rural to urban migration and, to a smaller extent, the increase in the number of urban centers from 39 in 1948 to 98 in 1960 to 135 in 1970. In the 1970 census only 57.1% of the population were enumerated in their locality of birth and only 20.9% in a locality other than their place of birth but in the same region. 4.1% were born outside Ghana, mostly in another West African country. 1 striking difference between urban and rural areas is the differing sex ratio of the working population. In rural areas there are 91.0 males aged 15-64 years for every 100 females while in urban areas there are 107.1. Most migration in Africa is for employment and those most likely to migrate are working-age males. Because secondary schools are scarce in rural areas, urban dwellers generally have a higher education level. There are no significant differences between overall labor force participation rates for females. The nationwide participation rate was 38.9% for both males and females (males 43.8%, females 34.1%); in urban areas the total was 40.0% (males 46.3%, females 33.7%) and in rural areas 38.5% (males 42.7%, females 34.3%). Ghanaian women have traditionally occupied a prominent place in the labor force. The theory that urban migration is due to urban-rural income disparities is not confirmed by figures. Considering the high amount of unemployment in urban areas, a rural dweller can average as much as a city dweller. In fact, poorly educated migrants are the ones most affected by urban unemployment. A recent study by Kodwo Ewusi considered the impact of many variables on migration; he found depressed social conditions at the place of origin are more compelling motivations than economic factors
He, Qian; Cui, Yanjie; Liang, Ling; Zhong, Qi; Li, Jie; Li, Yuancheng; Lv, Xiaofeng; Huang, Fen
The present study aimed to reflect the current situation of social participation in rural areas of China, willingness to participate in social activities, association between health-related quality of life and social participation, and factors related to social participation. A total of 2644 rural adults aged 60 years and older were randomly selected and surveyed with a self-rating questionnaire. We used the unified definition of social participation in our study. The Medical Outcomes Study Short-Form Health Survey was used to measure health-related quality of life. The overall engagement of social activities was 26%. Those who participated in social activities were more likely to have high scores of health-related quality of life. Older men with a high educational level (OR 1.59, 95% CI 1.01-2.29) living alone or with a spouse (OR 1.51, 95% CI 1.08-2.12), high objective social support (OR 1.08, 95% CI 1.00-1.17) and high support utilization (OR 1.13, 95% CI 1.07-1.21) were inclined to engage in social participation. Older women with high individual income (OR 1.74, 95% CI 1.25-2.43), single marital status (OR 1.53, 95% CI 1.11-2.10), normal weight (OR 1.92, 95% CI 1.10-3.34), overweight (OR 2.28, 95% CI 1.24-4.19), living alone or with a spouse (OR 1.55, 95% CI 1.20-2.00), objective social support (OR 1.11, 95% CI 1.04-1.18) and subjective social support (OR 1.15, 95% CI 1.10-1.20) were more willing to engage in social participation. Engagement in social activities is relatively low in rural areas, and associations of willingness and health-related quality of life with social participation were found. Policy-makers and government workers should make appropriate types of encouragement policies around social participation for older adults in rural areas. Geriatr Gerontol Int 2017; 17: 1593-1602. © 2016 Japan Geriatrics Society.
Ahmad, Abdul Razaq; Abiddin, Norhasni Zainal; Azman, Norzaini; Mustapha, Ramlee; Sail, Rahim Md; Kasa, Zakaria; Ismaill, Ismi Ariff
This article discusses the goals and challenges of adult education in Malaysia. In addition, it reports on the evaluation of two programmes--Computer Literacy and Civic Development--offered by a government agency called the Community Development Department (KEMAS) to rural communities. In both programmes, the respondents scored high in cognitive…
Full Text Available Purpose: To determine "awareness of eye donation" and corneal transplantation in an adult population of southern India. Methods: 507 participants chosen by systematic random sampling were interviewed using a structured questionnaire. Participants were selected among patients attending two community outreach programmes at different sites, and from patients presenting directly to the hospital. Results: 257 participants (50.69% were aware of eye donations. The major source of awareness was publicity campaigns (n=105. Only 22 (4.34% participants were aware that eye donation had to be done within 6 hours of death. Four hundred and three (79.50% participants were not aware of corneal transplantation. Illiteracy and rural residence were more likely predictors of ignorance. Conclusion: Although multiple strategies are currently followed to increase awareness of eye donations and corneal transplants, more innovative strategies have to be developed, especially to target illiterate and rural populations.
Pan, Chen-Wei; Li, Jun; Zhong, Hua; Shen, Wei; Niu, Zhiqiang; Yuan, Yuansheng; Chen, Qin
Purpose To describe the ethnic differences in central corneal thickness (CCT) in population-based samples of ethnic Bai, Yi and Han people living in rural China. Methods 6504 adults (2119 ethnic Bai, 2202 ethnic Yi and 2183 ethnic Han) aged 50 years or older participated in the study. Each subject underwent standardized ocular examinations and interviewer-administered questionnaires for risk factor assessment. CCT was measured for both eyes using an ultrasound pachymeter. Regression and princ...
Stroud, Peter; Lockwood, Craig
The objective is to identify and synthesise the best available evidence on the obstacles to the take-up of health-care provision by adult rural and remote dwelling males in Australia seeking mental health services. Men's health, in general health-care practice, is defined as the global management of mental, emotional, and physical health conditions, and related risk factors, that are specific to men in order to promote and generate optimal health.Research and practice tends to suggest that health-care and mental-health care practitioners seem to be confronted with obstacles such as distance clients need to travel and rurality in delivering care to adult rural males. Possible issues might be whether, or to what extent, care providers are conscious of these obstacles. Another issue might be how care providers work with these obstacles in practice, and whether or not they may, also to some extent, share some of the responsibility for the existence of these obstacles, on their own, or in conjunction with other factors which might be said to exist purely in the rural context. There is also a need to explore the contributions to obstacles from the adult rural male side as well. There may also be factors at work in the particular unique nature of rural and remote health-care and mental-health care as well, which could also be involved in the creation of obstacles.The structure and functioning of rural care available to adult males of all cultural backgrounds and the obstacles to the take-up of that care represents an area which warrants further exploration and understanding. A foundation paper in this field by Karoski suggests that obstacles exist in health-care provision, particularly in the field of mental-health care to adult males. Other research suggests that, while obstacles in service provision are common to all areas, some obstacles are more significant for rural and remote areas.The reasons for framing this review in terms of the adult rural and remote male (ARRM
Lim, Ka Keat; Sivasampu, Sheamini; Mahmud, Fatihah
To examine the extent of equity in access to health care, their determinants and reasons of unmet need of a rural population in Malaysia. Exploratory cross-sectional survey administered by trained interviewers among participants of a health screening program. A rural plantation estate in the West Coast of Peninsular Malaysia. One hundred and thirty out of 142 adults above 18 years old who attended the program. Percentages of respondents reporting realised access and unmet need to health care, determinants of both access indicators and reasons for unmet need. Realised access associated with need but not predisposing or enabling factors and unmet need not associated with any variables were considered equitable. A total of 88 (67.7%) respondents had visited a doctor (realised access) in the past 6 months and 24.8% (n = 31) experienced unmet need in the past 12 months. Using logistic regression, realised access was associated with presence of chronic disease (OR 6.97, P RM 2000 per month) (OR 51.27, P population, the latter associated with education level, subjective health status and income. Despite not being generalisable, the findings highlight the need for a national level study on equity in access before the country reforms its health system. © 2016 National Rural Health Alliance Inc.
Santric-Milicevic, Milena; Jankovic, Janko; Trajkovic, Goran; Terzic-Supic, Zorica; Babic, Uros; Petrovic, Marija
The global burden of mental disorders is rising. In Serbia, anxiety is the leading cause of disability-adjusted life years. Serbia has no mental health survey at the population level. The information on prevalence of mental disorders and related socioeconomic inequalities are valuable for mental care improvement. To explore the prevalence of mental health disorders and socioeconomic inequalities in mental health of adult Serbian population, and to explore whether age years and employment status interact with mental health in urban and rural settlements. Cross-sectional study. This study is an additional analysis of Serbian Health Survey 2006 that was carried out with standardized household questionnaires at the representative sample of 7673 randomly selected households - 15563 adults. The response rate was 93%. A multivariate logistic regression modeling highlighted the predictors of the 5 item Mental Health Inventory (MHI-5), and of chronic anxiety or depression within eight independent variables (age, gender, type of settlement, marital status and self-perceived health, education, employment status and Wealth Index). The significance level in descriptive statistics, chi square analysis and bivariate and multivariate logistic regressions was set at pinequalities contributed by differences in age, education, employment, marriage and the wealth status of the adult population.
Bell, Ronny A; Arcury, Thomas A; Stafford, Jeanette M; Golden, Shannon L; Snively, Beverly M; Quandt, Sara A
Diabetes self-management is important for achieving successful health outcomes. Different levels of self-management have been reported among various populations, though little is known about ownership of equipment that can enhance accomplishment of these tasks. This study examined diabetes self-management equipment ownership among rural older adults. Participants included African American, American Indian, and white men and women 65 years of age and older. Data included equipment ownership overall and by ethnicity and sex across diabetes self-management domains (glucose monitoring, foot care, medication adherence, exercise, and diet). Associations between equipment ownership and demographic and health characteristics were assessed using logistic regression. Equipment ownership ranged from 85.0% for blood glucose meters to less than 11% for special socks, modified dishes, and various forms of home exercise equipment. Equipment ownership was associated with ethnicity, living arrangements, mobility, poverty status, and formal education. Rural older adults with diabetes are at risk because they lack equipment to perform some self-management tasks. Providers should be sensitive to and assist patients in overcoming this barrier.
Loslier, Julie; Vanasse, Alain; Niyonsenga, Théophile; Courteau, Josiane; Orzanco, Gabriela; Hemiari, Abbas
There is abundant evidence of health inequities between urban and rural populations. The purpose of this paper is to describe the socioeconomic characteristics of Québec urban and rural populations and the relation between rurality and incidence of myocardial infarction (MI), care management and outcomes. Socioeconomic data by census subdivisions were available from the 1996 Canadian census, representing 7,137,245 individuals. Data on patients with MI were taken from the provincial administrative health database (MED-ECHO), which is managed by the Ministry of Health and contains clinical and demographic information collected when patients are released from acute care hospitals in Québec. We included a total of 37,678 cases compiled over the 3 years of follow-up in the analyses. Residents of rural areas with low urban influence have higher MI incidence rates than all of the other populations in the study. In comparison with urban populations, their observed rural counterparts are at a disadvantage with regard to education, employment and income. Although angioplasty and coronary artery bypass graft surgery rates were higher in more urban areas, the survival rate was lower than in rural areas. This study revealed geographic heterogeneity of MI incidence, revascularization rates and survival rates among urban and rural populations.
Bärnighausen Till W
Full Text Available Abstract Background KwaZulu-Natal is the South African province worst affected by HIV and the focus of early modeling studies investigating strategies of antiretroviral treatment (ART delivery. The reality of antiretroviral roll-out through primary care has differed from that anticipated and real world data are needed to inform the planning of further scaling up of services. We investigated the factors associated with uptake of antiretroviral treatment through a primary healthcare system in rural South Africa. Methods Detailed demographic, HIV surveillance and geographic information system (GIS data were used to estimate the proportion of HIV positive adults accessing antiretroviral treatment within northern KwaZulu-Natal, South Africa in the period from initiation of antiretroviral roll-out until the end of 2008. Demographic, spatial and socioeconomic factors influencing the likelihood of individuals accessing antiretroviral treatment were explored using multivariable analysis. Results Mean uptake of ART among HIV positive resident adults was 21.0% (95%CI 20.1-21.9. Uptake among HIV positive men (19.2% was slightly lower than women (21.8%, P = 0.011. An individual's likelihood of accessing ART was not associated with level of education, household assets or urban/rural locale. ART uptake was strongly negatively associated with distance from the nearest primary healthcare facility (aOR = 0.728 per square-root transformed km, 95%CI 0.658-0.963, P = 0.002. Conclusions Despite concerns about the equitable nature of antiretroviral treatment rollout, we find very few differences in ART uptake across a range of socio-demographic variables in a rural South African population. However, even when socio-demographic factors were taken into account, individuals living further away from primary healthcare clinics were still significantly less likely to be accessing ART
Del Brutto, Victor J; Zambrano, Mauricio; Mera, Robertino M; Del Brutto, Oscar H
Prevalence of cerebral microbleeds (CMB) in white and Asian populations range from 4% to 15%. However, there is no information from indigenous Latin American people. We aimed to assess prevalence and cerebrovascular correlates of CMB in stroke-free older adults living in rural Ecuador. Of 311 Atahualpa residents aged ≥60 years identified during a door-to-door survey, 258 (83%) underwent brain magnetic resonance imaging. Twenty-one were further excluded for a diagnosis of overt stroke. Using multivariate logistic regression models, adjusted for demographics and cardiovascular risk factors, we evaluated whether CMB were independently associated with silent strokes, white matter hyperintensities, and global cortical atrophy. Twenty-six (11%) of 237 participants had CMB, which were single in 54% of cases. CMB were deep in 11 patients, cortical in 9, and located both deep and cortical in 6. In univariate analyses, CMB were associated with age, systolic blood pressure, moderate-to-severe white matter hyperintensities, silent lacunar infarcts, and cortical atrophy. Mean (±SD) values for systolic blood pressure were 155±27 mm Hg in patients who had CMB versus 142±26 mm Hg in those who did not (P=0.017). In the adjusted models, moderate-to-severe white matter hyperintensities (P=0.009), silent lacunar infarcts (P=0.003), and global cortical atrophy (P=0.04) were independently associated with CMB. Prevalence of CMB in stroke-free older adults living in Atahualpa is comparable with those reported from other ethnic groups. There is a strong relationship between CMB and increased age, high systolic blood pressure, silent markers of cerebral small vessel disease, and cortical atrophy. © 2015 American Heart Association, Inc.
Inna Yurievna Yurova
Full Text Available The article presents the analysis of factors that may influence the attitudes of rural population with occupational diseases to medical service. The analysis is based on the results of the survey that has been conducted in Saratov region in 2013-2014. Ten experts, doctors involved in treating rural population with occupational diseases in Saratov region, formed the sample.It was revealed that refusal from pre-arranged treatment and hospitalization as well as execution of documents on disability is often determined by financial factor, i.e. unwillingness of rural population to lose their job, the only source of income. According to the experts the main factors that may influence the incidence of in- and out-patient visits in rural regions are low accessibility to medical institutions due to isolated location of many rural territories, insufficiency of professional staff able to cope with occupational pathologies in central regional hospitals, lack of medical equipment and facilities. The factors preventing health-saving behavior are as follows: life style and educational level.
Chen, Quanrun; Dietzenbacher, Erik; Los, Bart
This paper estimates China's future population and labour force by developing a novel forecasting model for population. It combines information about age-specific parameters on fertility and mortality for both rural and urban areas using information about rural-urban migration and the transformation
Laura V. Alston
Full Text Available Abstract Background Rural Australians are known to experience a higher burden of ischaemic heart disease (IHD than their metropolitan counterparts and the reasons for this appear to be highly complex and not well understood. It is not clear what interventions and prevention efforts have occurred specifically in rural Australia in terms of IHD. A summary of this evidence could have implications for future action and research in improving the health of rural communities. The aim of this study was to review all published interventions conducted in rural Australia that were aimed at the primary and/or secondary prevention of ischaemic heart disease (IHD in adults. Methods Systematic review of the peer-reviewed literature published between January 1990 and December 2015. Search terms were derived from four major topics: (1 rural; (2 ischaemic heart disease; (3 Australia and; (4 intervention/prevention. Terms were adapted for six databases and three independent researchers screened results. Studies were included if the published work described an intervention focussed on the prevention or reduction of IHD or risk factors, specifically in a rural population of Australia, with outcomes specific to participants including, but not limited to, changes in diet, exercise, cholesterol or blood pressure levels. Results Of 791 papers identified in the search, seven studies met the inclusion criteria, and one further study was retrieved from searching reference lists of screened abstracts. Typically, excluded studies focused on cardiovascular diseases without specific reference to IHD, or presented intervention results without stratification by rurality. Larger trials that included metropolitan residents without stratification were excluded due to differences in the specific needs, characteristics and health service access challenges of rural populations. Six interventions were primary prevention studies, one was secondary prevention only and one included both
John A. Batsis MD
Full Text Available Objective: Assess the feasibility and acceptability of Fitbit for supporting behavioral change in rural, older adults with obesity. Method: Eight adults aged ≥65 with a body mass index (BMI ≥30kg/m 2 were recruited from a rural practice and provided a Fitbit Zip device for 30 days. Participants completed validated questionnaires/interviews. Results: Mean age was 73.4 ± 4.0 years (50% female with a mean BMI of 34.5 ± 4.5kg/m 2 . We observed reductions in exercise confidence (sticking to it: 34.5 ± 3.3 to 30.9 ± 4.3, p = .04; making time: 18.9 ± 1.3 to 17.0 ± 2.6, p = .03 but no changes in patient activation (45.4 ± 4.3 vs. 45.0 ± 3.9. All reported high satisfaction, seven (87.5% found Fitbit easy to use, and five (62.5% found the feedback useful. The majority ( n = 6 [75.0%] were mostly/very satisfied with the intervention. Consistent themes emerged regarding the benefit of self-monitoring and participant motivation. Common concerns included finding time to exercise and lack of a peer group. Conclusion: Use of Fitbit is feasible/acceptable for use among older rural obese adults but may lead to reduced confidence.
Wood, Jamie; Mulrennan, Siobhain; Hill, Kylie; Cecins, Nola; Morey, Sue; Jenkins, Sue
Introduction A significant proportion (15%, n = 28) of the adults with cystic fibrosis (CF) in Western Australia (WA) live in rural and remote areas and have difficulty accessing specialist care at the state adult CF centre, located in Perth. We aimed to increase access by offering telehealth clinics, and evaluate the impact on health outcomes. Methods Telehealth clinics were offered via videoconference over a 12-month period, with uptake and satisfaction measured at the end of the intervention. Participants could still attend in person clinics at the CF centre if requested. Other outcomes comprised healthcare utilisation (HCU), spirometry, weight and health-related quality of life. Results In 21 participants, total clinic visits increased from 46 (median (range) per participant 2 (0-6)) in the 12-month period preceding the study to 100 (5 (2-8), p vitality domain of the Cystic Fibrosis Questionnaire - Revised ( p < 0.05). Discussion Telehealth had good uptake and increased clinic attendance in adults with CF living in rural and remote WA, and had high satisfaction amongst participants. The increase in HCU, resulting from increased detection and treatment of exacerbations, may improve long-term outcomes in this population.
Cleland, Verity; Hughes, Clarissa; Thornton, Lukar; Squibb, Kathryn; Venn, Alison; Ball, Kylie
Social-ecological models of health behaviour acknowledge environmental influences, but research examining how the environment shapes physical activity in rural settings is limited. This study aimed to explore the environmental factors that act as barriers or facilitators to physical activity participation among rural adults. Forty-nine adults from three regions of rural Tasmania, Australia, participated in semi-structured interviews that explored features of the environment that supported or hindered physical activity. Interviews were digitally recorded, transcribed verbatim and analysed thematically. Four key themes emerged: functionality, diversity, spaces and places for all and realistic expectations. 'Functionality' included connectivity with other destinations, distance, safety, continuity, supporting infrastructure and surfacing. While there was limited 'diversity' of structured activities and recreational facilities, the importance of easy and convenient access to a natural environment that accommodated physical activity was highlighted. 'Spaces and places for all' highlighted the importance of shared-use areas, particularly those that were family- and dog-friendly. Despite desires for more physical activity opportunities, many participants had 'realistic expectations' of what was feasible in rural settings. Functionality, diversity, spaces and places for all and realistic expectations were identified as considerations important for physical activity among rural adults. Further research using quantitative approaches in larger samples is needed to confirm these findings. SO WHAT? Urban-centric views of environmental influences on physical activity are unlikely to be entirely appropriate for rural areas. Evidence-based recommendations are provided for creating new or modifying existing infrastructure to support active living in rural settings.
Ramadass, Balamurugan; Rani, B Sandya; Pugazhendhi, Srinivasan; John, K R; Ramakrishna, Balakrishnan S
The relevance of the gut microbiota to human health is increasingly appreciated. The objective of this study was to compare the gut microbiota of a group of adult tribals with that of healthy adult villagers in Tamil Nadu, India. Faeces were collected from 10 healthy tribal adults (TAs) in the Jawadhi hills and from 10 healthy villagers [rural adults (RAs)] in Vellore district, Tamil Nadu. DNA was extracted, and 456 bp segments comprising hypervariable regions 3 and 4 of the 16S rRNA gene were amplified, barcoded and 454 sequenced. Totally 227,710 good-quality reads were analyzed. TAs consumed a millets-based diet, ate pork every day, and did not consume milk or milk products. RAs consumed a rice-based diet with meat intake once a week. In both groups, Firmicutes was the most abundant phylum, followed by Proteobacteria, Bacteroidetes and Actinobacteria. The median Firmicutes-to-Bacteroidetes ratio was 34.0 in TA and 92.9 in RA groups. Actinobacteria were significantly low in TA, possibly due to non-consumption of milk. Clostridium constituted the most abundant genus in both groups, but was significantly more abundant in TAs than RAs, while Streptococcus was significantly more abundant in RA (P<0.05). Analyses of genetic distance revealed that the microbiota were distinctly different between TA and RA, and principal component analysis using 550 distinct taxonomically identifiable sequences revealed a clear separation of microbiota composition in the two groups. Phylogenetic analysis of major microbiota indicated clustering of microbial groups at different major branch points for TAs and RAs. Phylum Firmicutes and genus Clostridium constituted the bulk of the faecal microbiota, while significant differences in composition between the groups were probably due to differences in diet and lifestyle.
Igudina, A I; Ioffe, G V
"Rural population change within the Non-Chernozem zone of the RSFRS [Russian Soviet Federated Socialist Republic] is examined over the period 1959-79 at several levels of analysis: the Non-Chernozem zone as a whole, its major economic regions, individual oblasts, individual rayons and individual farms and rural places. The overriding tendency at all levels of analysis has been the increasing spatial concentration of rural population." The authors observe that "this concentration assumes a variety of forms, from the concentration of rural population in the suburban zones of large cities and the immediate surroundings of rayon seats to a decline in the number of rural places (from 180,000 in 1959 to 118,000 in 1979) and the growth of local centers against a general background of rural population decline. The authors hint that the observed tendency is a positive development, in keeping with the policy of converting Soviet agriculture to a more intensive path of development." excerpt
Full Text Available Background: Studies of the prevalence of substance abuse in rural and urban population in different countries revealed variable results regarding to the study method, study population, age group and measuring tools. The purpose of this research is to compare the patterns of substance abuse disorders in urban and rural population in Mashhad.Materials and Method: Two groups consecutively admitted patients who referred to substance treatment clinics of Mashhad, were selected (110 urban and 100 rural patients. Samples were evaluated with structured demographic questionnaire and Structured Clinical Interview (SCID for DSM-IV. Data were analyzed by χ2 and independent t-test.Results: This study showed statistically significant differences between two groups in marital status, education level, monthly income and job. Also the samples were differed in substance type, history of injection and quit, abuse of nicotine, cannabis and alcohol in long life. Conclusion: Rural and urban societies have differences in patterns of substance abuse that can be originated from social-context differences
Ferdous, F; Ahmed, S; Farzana, F D; Das, J; Malek, M A; Das, S K; Salam, M A; Faruque, A S G
The objective of our analysis was to describe the aetiology, clinical features, and socio-demographic background of adults with diarrhoea attending different urban and rural diarrhoeal disease hospitals in Bangladesh. Between January 2010 and December 2011, a total of 5054 adult diarrhoeal patients aged ⩾20 years were enrolled into the Diarrhoeal Disease Surveillance Systems at four different hospitals (two rural and two urban) of Bangladesh. Middle-aged [adjusted odds ratio (aOR) 0·28, 95% confidence interval (CI) 0·23-0·35, P economic and other progress made, conditions facilitating transmission of V. cholerae and Shigella prevail in adults with diarrhoea in Bangladesh and further efforts are needed to control these infections.
Martin, Michelle Y.; Kohler, Connie; Kim, Young-il; Kratt, Polly; Schoenberger, Yu-Mei; Litaker, Mark S.; Prayor-Patterson, Heather M.; Clarke, Stephen J.; Andrews, Shiquina; Pisu, Maria
Control of hypertension remains poor, and lack of adherence to medication is considered a primary reason. Few studies have examined the reasons for medication nonadherence in African American, lower-income, rural adults receiving medications at no personal cost. Moreover, our understanding of how the provider-patient relationship influences adherence in this population is limited. In this study, the authors (1) examined reasons for taking less medication than prescribed and (2) examined the a...
Edilaine Oliveira Carvalho
Full Text Available Trata-se de um estudo transversal no qual foi aplicado um questionário de frequência alimentar (QFCA em 150 adultos residentes em área rural da cidade de Ibatiba (ES. O QFCA classificou o consumo alimentar como: habitual (> 4 vezes na semana, não habitual (It is a transverse study where a questionnaire of alimentary frequency was applied (QAF in 150 adults resident of the rural area of the city of Ibatiba (ES, Brazil. QAF classified the alimentary consumption as: habitual (> 4 times in the week, not habitual (<4 times in the week and rarely (1 time a month, with objective of correlating the alimentary consumption with the chronic-degenerative diseases. The results evidenced a habitual consumption of rice, breads, stalk, bean, cow milk, animal fat, margarine, sugar and coffee, and a non habitual consumption of cake, potato, cookies, manioc, sweet potato, chayote, carrot, beet, pumpkin, juice of fruits, banana, orange, guava, mango and tangerine. It can be concluded that the feeding habit presented by the studied population it can come to increase in a medium or long period the prevalence and occurrences of chronic-degenerative diseases as hypertension, diabetes, obesity and coronary diseases. The alimentary consumption of this population needs concern, because when compared with the national patterns, it is observed some inadequacies, and it is known that this picture comes to every day causing damages the public health.
van der Wielen, Nele; Channon, Andrew Amos; Falkingham, Jane
This paper examines the relationship between national health insurance enrolment and the utilisation of inpatient and outpatient healthcare for older adults in rural areas in Ghana. The Ghanaian National Health Insurance Scheme (NHIS) aims to improve affordability and increase the utilisation of healthcare. However, the system has been criticised for not being responsive to the needs of older adults. The majority of older adults in Ghana live in rural areas with poor accessibility to healthcare. With an ageing population, a specific assessment of whether the scheme has benefitted older adults, and also if the benefit is equitable, is needed. Using the Ghanaian Living Standards Survey from 2012 to 2013, this paper uses propensity score matching to estimate the effect of enrolment within the NHIS on the utilisation of inpatient and outpatient care among older people aged 50 and over. The raw results show higher utilisation of healthcare among NHIS members, which persists after matching. NHIS members were 6% and 9% more likely to use inpatient and outpatient care, respectively, than non-members. When these increases were disaggregated for outpatient care, the non-poor and females were seen to benefit more than their poor and male counterparts. For inpatient care, the benefits of enrolment were equal by poverty status and sex. However, overall, poor older adults use health services much less than the non-poor older adults even when enrolled. The results indicate that NHIS coverage does increase healthcare utilisation among rural older adults but that inequalities remain. The poor are still at a great disadvantage in their use of health services overall and benefit less from enrolment for outpatient care. The receipt of healthcare is significantly influenced by a set of auxiliary barriers to access to healthcare even where insurance should remove the financial burden of ad hoc out of pocket payments.
Supiyev, Adil; Nurgozhin, Talgat; Zhumadilov, Zhaxybay; Peasey, Anne; Hubacek, Jaroslav A; Bobak, Martin
Despite high cardiovascular mortality in Central Asian republics of the former Soviet Union, there is limited information about major risk factors, including blood lipids. We investigated the prevalence of impaired concentrations of blood lipids, the awareness, treatment and control of hypercholesterolemia, and factors associated with these indicators in urban and rural populations in Kazakhstan. We conducted a cross-sectional study of random urban and rural population samples (the state capital Astana and Akmol village). Men and women aged 50-74 years were examined; a total of 954 adults participated (response rate 59%). Serum concentrations of total, LDL and HDL cholesterol and triglycerides and a range of other cardiovascular risk factors were measured. The overall prevalence of hypercholesterolemia (total cholesterol ≥6.2 mmol/l) was 37%; among subjects with hypercholesterolemia, 57% were aware of their condition, 41% took medication and 23% had total cholesterol <6.2 mmol/l (4.5% <5 mmol/l). The prevalence, awareness, treatment, and control of hypercholesterolemia were all higher in the urban than the rural area. Similarly, the proportions of subjects with impaired concentrations of specific lipids fractions were also considerably higher in the urban population. Most associations with other covariates were in the expected direction. This study found relatively high prevalence of dyslipidemia in the Kazakh population, and the blood lipid profile was less favourable in the urban area. These pronounced urban-rural differences may be related to urbanization, the associated nutrition transition and to access to health care.
Zhou, X; Guan, H; Zheng, L; Li, Z; Guo, X; Yang, H; Yu, S; Sun, G; Li, W; Hu, W; Guo, L; Pan, G; Xing, L; Zhang, Y; Sun, Y
To clarify the diabetes prevalence trends among the rural population in northern China. All eligible permanent residents aged ≥ 35 years in selected rural villages of Liaoning province were invited to participate in the study. A total of 11 600 people completed all questionnaires and were included in the study. The response rate was 85.3%. Fasting plasma glucose levels were measured after at least 12 h of fasting and diabetes was diagnosed according to WHO criteria, i.e. fasting plasma glucose ≥ 7 mmol/l and/or being on treatment for diabetes. Impaired fasting glucose was defined according to the 1997 and the 2010 American Diabetes Association (ADA) criteria (6.1-6.9 and 5.6-6.9 mmol/l, respectively). Previous diagnoses of diabetes were assessed on the basis of self-reports. The prevalence of diabetes among adults in the rural population was 10.6% (10.0% in men and 11.1% in women). The prevalence of impaired fasting glucose was 13.0 and 36.1% according to the 1997 and the 2010 ADA criteria, respectively. The prevalence of previously diagnosed diabetes was 4.3% among the whole population (3.3% in men and 5.1% in women). The prevalence of previously diagnosed diabetes was 34.8% in men and 50.2% in women. Only 29.6% of men and 42% of women with diabetes had taken oral hypoglycaemic agents or insulin to lower their blood sugar. In multivariate analysis, age, drinking habits, BMI, dyslipidaemia and family history of diabetes were identified as independent risk factors for diabetes, and occupational physical activity, smoking and lean meat intake were identified as independent protective factors for diabetes. The prevalence of diabetes and impaired fasting glucose were found to be high in this rural population. Although the rate of treatment of people with diabetes has increased, the glycaemic control rate was still at a low level. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.
Angie L. Dahl
Full Text Available The rural context at times is characterized by heteronormativity and conservatism. For individuals who identify as a sexual minority (lesbian, gay, bisexual, transgender and/or queer, the rural context may pose particular challenges to the development of a healthy, coherent sense of self. Seven young adults (18–24 who identified as gay or lesbian participated in in-depth interviews regarding their experiences coming out in a rural Appalachian context. Findings suggest sexual minority individuals experience both trials and triumphs coming out in the rural context. Two overarching themes and six subthemes are discussed with implications for supporting sexual minority youth in the rural context.
Tkatch, Rifky; Musich, Shirley; MacLeod, Stephanie; Alsgaard, Kathleen; Hawkins, Kevin; Yeh, Charlotte S.
Background: The older adult population is expanding, living longer, with multiple chronic conditions. Understanding and managing their needs over time is an integral part of defining successful aging. Population health is used to describe the measurement and health outcomes of a population. Objectives: To define population health as applied to older adults, summarize lessons learned from current research, and identify potential interventions designed to promote successful aging and improved health for this population. Method: Online search engines were utilized to identify research on population health and health interventions for older adults. Results: Population health management (PHM) is one strategy to promote the health and well-being of target populations. Interventions promoting health across a continuum tend to be disease, risk, or health behavior specific rather than encompassing a global concept of health. Conclusion: Many existing interventions for older adults are simply research based with limited generalizability; as such, further work in this area is warranted. PMID:28680938
Wesley R. Dean
Full Text Available Background: Sugar-sweetened beverage (SSB consumption is associated with the increasing prevalence of overweight and obesity in the United States; however, little is known about how less-healthy eating behaviors influence high levels of SSB consumption among rural adults. Objective: We assessed the frequency of SSB consumption among rural and urban adults, examined the correlates of frequent SSB consumption, and determined difference in correlates between rural and urban adults in a large region of Texas. Design: A cross-sectional study using data on 1,878 adult participants (urban = 734 and rural = 1,144, who were recruited by random digit dialing to participate in the seven-county 2006 Brazos Valley Community Health Assessment. Data included demographic characteristics, eating behaviors (SSB consumption, frequency of fast-food meals, frequency of breakfast meals, and daily fruit and vegetable intake, and household food insecurity. Results: The prevalence of any consumption of SSB and the prevalence of high consumption of SSB were significantly higher among rural adults compared with urban counterparts. The multivariable logistic regression models indicated that a high level of SSB consumption (≥3 cans or glasses SSB/day was associated with demographic characteristics (poverty-level income and children in the home, frequent consumption of fast-food meals, infrequent breakfast meals, low fruit and vegetable intake, and household food insecurity especially among rural adults. Conclusions: This study provides impetus for understanding associations among multiple eating behaviors, especially among economically and geographically disadvantaged adults. New strategies are needed for educating consumers, not only about how to moderate their SSB intake, but also how to simultaneously disrupt the co-occurrence of undesirable eating and promote healthful eating.
Leung, Janni; Macleod, Catriona; McLaughlin, Deirdre; Woods, Laura M; Henderson, Robert; Watson, Angus; Kyle, Richard G; Hubbard, Gill; Mullen, Russell; Atherton, Iain
To test the hypothesis that rural populations had lower uptake of screening mammography than urban populations in the Scottish and Australian setting. Scottish data are based upon information from the Scottish Breast Screening Programme Information System describing uptake among women residing within the NHS Highland Health Board area who were invited to attend for screening during the 2008 to 2010 round (N = 27,416). Australian data were drawn from the 2010 survey of the 1946-51 cohort of the Australian Longitudinal Study on Women's Health (N = 9890 women). Contrary to our hypothesis, results indicated that women living in rural areas were not less likely to attend for screening mammography compared to women living in urban areas in both Scotland (OR for rural = 1.17, 95% CI = 1.06-1.29) and Australia (OR for rural = 1.15, 95% CI = 1.01-1.31). The absence of rural-urban differences in attendance at screening mammography demonstrates that rurality is not necessarily an insurmountable barrier to screening mammography.
Yu, Shasha; Yang, Hongmei; Guo, Xiaofan; Zhang, Xingang; Zheng, Liqiang; Sun, Yingxian
Our latest study reported the grim status of hypertension in rural China with the prevalence of hypertension reached 51.1%. However, we lack the latest data about the prevalence and epidemiological features of dyslipidemia among hypertensive residents in rural China. A cross-sectional survey was conducted from July 2012 to August 2013 through a cluster multistage sampling to a resident group of 4048 individuals (2152 men, 2896 women) with hypertension, age ≥ 35 years, in the rural Northeast China. Serum lipids level were proposed by National Cholesterol Education Program Adult Treatment Panel III. Of the hypertension residents without antihypertension treatment, 34.5% had borderline high total cholesterol, 19.2% had high total cholesterol, 11.4% had low high-density lipoprotein cholesterol and 37.4% had high non HDL-C. The population with borderline high, high, and very high low-density lipoprotein cholesterol was 20.9, 6.7 and 2.3%, respectively. In addition, 14.3% had borderline high triglycerides, 17.4% had high TG and 2.4% had very high TG. The awareness rate of dyslipidemia among the study population was 5.9%. After adjusting for independent variables, fasting plasma glucose, body mass index, Han nationality, current drinking and smoking, higher annual income and classification of blood pressure were risk factors for dyslipidemia while moderate physical activity was protective factor for dyslipidemia. On the contrary, gender and current drinking decrease the risk of HDL-C. The prevalence of dyslipidemia was dramatically high and dyslipidemia screening was in-need in all diagnosed hypertensive individuals.
Liu, Xiao-Kun; Xiao, Shui-Yuan; Zhou, Liang; Hu, Mi; Zhou, Wei; Liu, Hui-Ming
The aims of this study were to investigate the distribution of sleep quality and its relationship with the prevalence of pain among rural Chinese people and to explore the association between sleep quality and pain intensity among the general population in real-life settings. This cross-sectional survey included a total of 2052 adults from rural areas in Liuyang, Hunan Province, recruited through random multistage sampling. The distributions of sleep quality and pain prevalence among the participants over a 4-week period were described. Because of multicollinearity among variables, the influence of self-rated sleep quality and psychosocial covariates on pain intensity was explored using a ridge regression model. The data showed that participants reporting all categories of sleep quality experienced some degree of pain. Sleep quality, along with physical and mental health, was a negative predictor of pain intensity among the general population. Symptoms of depression positively predicted pain intensity. Poor sleep quality increased pain intensity among the participants. Both previous research and the present data suggest that improving sleep quality may significantly decrease pain intensity in the general population. The relationship between sleep and pain may be bidirectional. This finding also suggests that treatment for sleep disorders and insomnia should be addressed in future efforts to alleviate pain intensity.
Full Text Available Multiparameter flow cytometry has revealed extensive phenotypic and functional heterogeneity of CD4 T cell responses in mice and humans, emphasizing the importance of assessing multiple aspects of the immune response in correlation with infection or vaccination outcome. The aim of this study was to establish and validate reliable and feasible flow cytometry assays, which will allow us to characterize CD4 T cell population in humans in field studies more fully.We developed polychromatic flow cytometry antibody panels for immunophenotyping the major CD4 T cell subsets as well as broadly characterizing the functional profiles of the CD4 T cells in peripheral blood. We then validated these assays by conducting a pilot study comparing CD4 T cell responses in distinct populations of healthy adults living in either rural or urban Kenya. This study revealed that the expression profile of CD4 T cell activation and memory markers differed significantly between African and European donors but was similar amongst African individuals from either rural or urban areas. Adults from rural Kenya had, however, higher frequencies and greater polyfunctionality among cytokine producing CD4 T cells compared to both urban populations, particularly for "Th1" type of response. Finally, endemic exposure to malaria in rural Kenya may have influenced the expansion of few discrete CD4 T cell populations with specific functional signatures.These findings suggest that environmentally driven T cell activation does not drive the dysfunction of CD4 T cells but is rather associated with greater magnitude and quality of CD4 T cell response, indicating that the level or type of microbial exposure and antigenic experience may influence and shape the functionality of CD4 T cell compartment. Our data confirm that it is possible and mandatory to assess multiple functional attributes of CD4 T cell response in the context of infection.
The discussion of the changing structure in urban and rural areas due to changing migration patterns reflects the effect on crop designation and production, the connection to development and fertility issues, and the labor force structure. Different patterns of migration by sex occur between Ethiopia where female rural-to-urban migration is the dominant trend and Indonesia where males moving to urban areas occurs. When countries are identified as primarily male urban and female rural, the migration pattern is male rural-to-urban and is concentrated in African countries, whereas the reverse with female urban and male rural occurs in Latin America and developed countries. The tendency of the age structure in developed and developing countries is for the concentration of the 20 -49 year olds in urban areas and the under 20 and over 49 in rural areas. It is determined that those under 20 have 3 times greater importance in developing rather than developed countries. While in Tunisia and the Near East the over-age-49 rural population has increased, in Cameroon, Myanmar, and Bangladesh, the rural under-age-30 population has increased suggesting different migration patterns; however, there is insufficient computerized data for analysis of regional world trends. The migration pattern of child bearing age women affects the aging rural population in either of two ways. 1) Women stay and bear children and help with farm production while male migrate, thus increasing the youth and over 50 populations. 2) Whole families move with only the aging remaining. The determinants of migration are complex. When there is inequality in land distribution, the most mobile population are those without land or with very small holdings. If agricultural workers are dependent on a landlord, then migration is decreased. Technology and mechanization which have predominated in the last decades can both displace labor in rural areas when situated next to farms and increase labor when multiple
Amelia Catharine Crampin
Full Text Available Abstract Background The emerging burden of cardiovascular disease and diabetes in sub-Saharan Africa threatens the gains made in health by the major international effort to combat infectious diseases. There are few data on distribution of risk factors and outcomes in the region to inform an effective public health response. A comprehensive research programme is being developed aimed at accurately documenting the burden and drivers of NCDs in urban and rural Malawi; to design and test intervention strategies. The programme includes population surveys of all people aged 18 years and above, linking individuals with newly diagnosed hypertension and diabetes to healthcare and supporting clinical services. The successes, challenges and lessons learnt from the programme to date are discussed. Results Over 20,000 adults have been recruited in rural Karonga and urban Lilongwe. The urban population is significantly younger and wealthier than the rural population. Employed urban individuals, particularly males, give particular recruitment challenges; male participation rates were 80.3 % in the rural population and 43.6 % in urban, whilst female rates were 93.6 and 75.6 %, respectively. The study is generating high quality data on hypertension, diabetes, lipid abnormalities and risk factors. Conclusions It is feasible to develop large scale studies that can reliably inform the public health approach to diabetes, cardiovascular disease and other NCDs in Sub-Saharan Africa. It is essential for studies to capture both rural and urban populations to address disparities in risk factors, including age structure. Innovative approaches are needed to address the specific challenge of recruiting employed urban males.
Full Text Available The primary objective of this study was to investigate the prevalence and risk factors of restless legs syndrome (RLS in an adult Chinese population living in a rural community. We also aimed to determine the predictive diagnostic value of the 4-item screening questionnaire for RLS in this population.This study was designed as a 2-phase survey. In phase 1 we performed a face-to-face interview of eligible individuals living in a rural community in Shanghai using a 4-item screening questionnaire. In phase 2, sleep specialists performed a phone interview of the individuals who screened positive to diagnosis RLS.Forty-one RLS cases were confirmed among 2941 eligible individuals 18 years of age or older in the study community. The prevalence of RLS was 1.4% (95% confidence interval (CI = 1.0-1.9%, with a significantly higher rate observed in females (1.9% [95%CI =1.3-2.7%] than that in males (0.9% [95%CI = 0.5-1.5%], p = 0.019. The prevalence rate increased significantly with age, from 0.2% (95% CI = 0.08-0.6% in those 18-39 years old to 4.1% (95% CI = 2.1-7.9% in those ≥ 70 years old (p < 0.001. The multivariate logistic regression analysis indicated that gastritis, anemia and hypertension were risk factors for RLS. The sensitivity and specificity of the 4-item screening questionnaire used in this study were 63.4% and 97.5%, respectively.RLS prevalence is relatively low among Chinese adults living in rural Shanghai. Furthermore, population-based studies with a larger sample size and a longitudinal follow-up may help to determine the risk factors of RLS and potential interventions for RLS.
Jhunu Shamsun Nahar
Full Text Available Background: Psychiatric disorders are more prevalent among women than men worldwide. The lifetime risk of depression and dysthymia are twice as common in women as men. Rural women usually undergoes more stressful situations and also scores more on stress scale than that of urban and slum population. Objectives: The research objectives of this study are: 1 To find out the prevalence of psychiatric disorders among the study population. 2 To compare the disorders among the rural and slum female population. 3 To find out the influence of existing socio-demographic factors on psychiatric disorders. Method: This is a community-based study, which is also cross sectional and descriptive in nature. The sample for the main study constituted 366 randomly selected respondents. A two-staged screening procedure was carried in the study. First, the total population was studied by screening test-Self Reporting Questionnaire (SRQ to divide the sample into 'screen positive' and 'screen negative' subjects. In the second stage, full assessment of a mixture of all 'screen positive' and 25% 'screen negative' was carried out by structured clinical interview for diagnosis (SCID-NP. Later SCID filled by the respondents was assessed by consultant psychiatrists by using DSMIV in order to put exact clinical diagnosis. Stress was scored according to Presumptive Stressful Life Events Scale (PSLE. The total duration of the study was from July 2010 to June 2011. Results: Higher prevalence of psychiatric morbidity was found among rural sample (22.8% than slum (10.90% population. Regarding pattern of psychiatric disorders among rural sample (22.8% than slum (10.9% population.See the PDF for the rest of the abstract.
Full Text Available The early life environment appears to have a persistent impact on asthma risk. We hypothesize that environmental factors related to rural life mediate lower asthma prevalence in rural populations, and aimed to investigate an urban-rural gradient, assessed by place of upbringing, for asthma. The population-based Respiratory Health In Northern Europe (RHINE study includes subjects from Denmark, Norway, Sweden, Iceland and Estonia born 1945–1973. The present analysis encompasses questionnaire data on 11,123 RHINE subjects. Six categories of place of upbringing were defined: farm with livestock, farm without livestock, village in rural area, small town, city suburb and inner city. The association of place of upbringing with asthma onset was analysed with Cox regression adjusted for relevant confounders. Subjects growing up on livestock farms had less asthma (8% than subjects growing up in inner cities (11% (hazard ratio 0.72 95% CI 0.57–0.91, and a significant urban-rural gradient was observed across six urbanisation levels (p = 0.02. An urban-rural gradient was only evident among women, smokers and for late-onset asthma. Analyses on wheeze and place of upbringing revealed similar results. In conclusion, this study suggests a protective effect of livestock farm upbringing on asthma development and an urban-rural gradient in a Northern European population.
Quandt, Sara A.; Graham, Christopher N.; Bell, Ronny A.; Snively, Beverly M.; Golden, Shannon L.; Stafford, Jeanette M.; Arcury, Thomas A.
Diabetes mellitus disproportionately affects ethnic minorities and has serious economic, social, and personal implications. This study examines the effect of diabetes disease burden and social resources on health-related quality of life (HRQOL) among older rural adults with diabetes. Data come from a population-based cross-sectional survey of 701 adults (age ≥65 years) with diabetes in North Carolina from three ethnic groups: African American, Native American, and White. HRQOL was assessed using the 12-item short-form health survey (SF-12). Mean scores were 35.1 ± 11.4 and 50.5 ± 10.8 for the physical and mental components of the SF-12, respectively. In bivariate analyses, scores were significantly lower for Native Americans than Whites for both components. In multivariate analyses, higher physical HRQOL was associated with male sex, greater mobility ability, fewer chronic conditions, exercising vs not exercising, fewer depressive symptoms, and not receiving process assistance. Higher mental HRQOL was associated with greater mobility ability, fewer chronic conditions, and a high school education or more. Diabetes appears to have a substantial effect on physical HRQOL. Physical disability associated with diabetes may have a greater impact in the rural environment than in other areas. Aspects of rural social milieu may help to keep mental HRQOL high, even in the face of severe chronic disease. Ethnic differences in HRQOL are largely accounted for by diabetes disease burden and, to a lesser extent, social resources. Strategies to reduce diabetes-related complications (long term) and assist mobility (short term) may reduce ethnic disparities in HRQOL. (Ethn Dis. 2007;17:471–476) PMID:17985500
Villatoro, Federico J; Sepúlveda, Maximiliano A; Stowhas, Paulina; Silva-Rodríguez, Eduardo A
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.
Elshof, Hans; Bailey, Ajay
Population decline in rural areas has an impact on rural villages. This research investigates to what extent families with children in rural villages experience consequences of population decline, in which ways they respond to these experiences, and how that plays a role in their individual social
Background: Obesity has been associated with cardiovascular diseases, type 2 diabetes mellitus, several cancers and numerous other Non-Communicable Diseases (NCDs).The objective of this study was to determine the prevalence of overweight and obesity among rural adults in North Central Nigeria. Methods: A ...
Larisa Alexandrovna Tretiakova
Full Text Available The purpose of this study is theoretical justification of socio-economic foundations of sustainable livelihoods in rural areas and development of practical recommendations for evaluating and improving quality of life in rural areas. The subject of this study is a system of socio-economic relations that defines processes and patterns of sustainable livelihoods in rural areas. Methodological basis is a systematic approach and method of dialectical cognition, which examine processes of development of rural territories in relationship and complementarity. The results described in this paper are: the degree of differentiation of rural population under qualitative levels of well-being was studied; the authors’ system of indicators of regional socio-economic development on a basis of detailed hierarchical structure was presented; priority areas for improving standards and quality of life of the rural population were identified. A scope of results was developed and science-based recommendations and suggestions for sustainable development of rural territories based on authors’ methodology for evaluating quality life in rural areas may be subject to legislative and executive authorities in development socio-economic projects and programmes aimed at enhancing rural employment and income were made. The conclusions are: sustainable development of rural territories involves not only increase of efficiency of rural economy, but, above all, increasing and improving the quality of life of the rural population; on a system of complementarities, the evaluation of sustainability of livelihood strategies should take into account the economic, environmental, social and institutional factors
Full Text Available Background: Massive rural-to-urban migration in China has profoundly altered the family life of rural older adults, as adult children remain the primary caretakers of their elderly parents. And yet little is known about the health and well-being of the parents of adult migrants in rural China whose main source of support has been displaced. Objective: This study takes a comprehensive view and compares the trajectories of self-rated health among the rural elderly and examines how these health trajectories are associated with adult children's migration. Methods: We analyze older adults aged 55 years and over in rural China, using four waves of data from the China Health and Nutrition Survey (1997, 2000, 2004, 2006 and multilevel growth curve models. Results: The results show that parents of migrants persistently scored worse self-rated health across ages than their counterparts whose children had not migrated. Long-term migration of adults takes a heavier toll on the health of their elderly parents than short-term migration. However, these associations with children's migration are driven by the migration of sons. The migration of daughters and of children of both genders may have disparate effects on the health trajectories of elderly men and women. Conclusions: The findings suggest that the interplay of gendered family dynamics and migration processes affects the health outcomes of older adults. Contribution: The findings contribute to current debates on the health and well-being of family members left behind by migrants and call for further study of the relationship between migration and family processes in the well-being of migrant families.
Wedgeworth, Monika; LaRocca, Michael A; Chaplin, William F; Scogin, Forrest
The mental health of elderly individuals in rural areas is increasingly relevant as populations age and social structures change. While social support satisfaction is a well-established predictor of quality of life, interpersonal sensitivity symptoms may diminish this relation. The current study extends the findings of Scogin et al by investigating the relationship among interpersonal sensitivity, social support satisfaction, and quality of life among rural older adults and exploring the mediating role of social support in the relation between interpersonal sensitivity and quality of life (N = 128). Hierarchical regression revealed that interpersonal sensitivity and social support satisfaction predicted quality of life. In addition, bootstrapping resampling supported the role of social support satisfaction as a mediator between interpersonal sensitivity symptoms and quality of life. These results underscore the importance of nurses and allied health providers in assessing and attending to negative self-perceptions of clients, as well as the perceived quality of their social networks. Copyright © 2016 Elsevier Inc. All rights reserved.
Background Rural residents are increasingly identified as being at greater risk for health disparities. These inequities may be related to health behaviors such as adequate fruits and vegetable consumption. There is little national-level population-based research about the prevalence of fruit and vegetable consumption by US rural population adults. The objective of this study was to examine the prevalence differences between US rural and non-rural adults in consuming at least five daily servings of combined fruits and vegetables. Methods Cross-sectional analysis of weighted 2009 Behavioral Risk Factor Surveillance Survey (BRFSS) data using bivariate and multivariate techniques. 52,259,789 US adults were identified as consuming at least five daily servings of fruits and vegetables of which 8,983,840 were identified as living in rural locales. Results Bivariate analysis revealed that in comparison to non-rural US adults, rural adults were less likely to consume five or more daily servings of fruits and vegetables (OR = 1.161, 95% CI 1.160-1.162). Logistic regression analysis revealed that US rural adults consuming at least five daily servings of fruits and vegetables were more likely to be female, non-Caucasian, married or living with a partner, living in a household without children, living in a household whose annual income was > $35,000, and getting at least moderate physical activity. They were also more likely to have a BMI of fruits and vegetables and 11 States a higher prevalence of the same. Conclusions This enhanced understanding of fruit and vegetable consumption should prove useful to those seeking to lessen the disparity or inequity between rural and non-rural adults. Additionally, those responsible for health-related planning could benefit from the knowledge of how their state ranks in comparison to others vis-à-vis the consumption of fruits and vegetables by rural adults---a population increasingly being identified as one at risk for health
Tüzün, Nedim; Op de Beeck, Lin; Brans, Kristien I; Janssens, Lizanne; Stoks, Robby
The rapidly increasing rate of urbanization has a major impact on the ecology and evolution of species. While increased temperatures are a key aspect of urbanization ("urban heat islands"), we have very limited knowledge whether this generates differentiation in thermal responses between rural and urban populations. In a common garden experiment, we compared the thermal performance curves (TPCs) for growth rate and mortality in larvae of the damselfly Coenagrion puella from three urban and three rural populations. TPCs for growth rate shifted vertically, consistent with the faster-slower theoretical model whereby the cold-adapted rural larvae grew faster than the warm-adapted urban larvae across temperatures. In line with costs of rapid growth, rural larvae showed lower survival than urban larvae across temperatures. The relatively lower temperatures hence expected shorter growing seasons in rural populations compared to the populations in the urban heat islands likely impose stronger time constraints to reach a certain developmental stage before winter, thereby selecting for faster growth rates. In addition, higher predation rates at higher temperature may have contributed to the growth rate differences between urban and rural ponds. A faster-slower differentiation in TPCs may be a widespread pattern along the urbanization gradient. The observed microgeographic differentiation in TPCs supports the view that urbanization may drive life-history evolution. Moreover, because of the urban heat island effect, urban environments have the potential to aid in developing predictions on the impact of climate change on rural populations.
Zhang, Xufan; Dupre, Matthew E; Qiu, Li; Zhou, Wei; Zhao, Yuan; Gu, Danan
Studies have shown that inadequate access to healthcare is associated with lower levels of health and well-being in older adults. Studies have also shown significant urban-rural differences in access to healthcare in developing countries such as China. However, there is limited evidence of whether the association between access to healthcare and health outcomes differs by urban-rural residence at older ages in China. Four waves of data (2005, 2008/2009, 2011/2012, and 2014) from the largest national longitudinal survey of adults aged 65 and older in mainland China (n = 26,604) were used for analysis. The association between inadequate access to healthcare (y/n) and multiple health outcomes were examined-including instrumental activities of daily living (IADL) disability, ADL disability, cognitive impairment, and all-cause mortality. A series of multivariate models were used to obtain robust estimates and to account for various covariates associated with access to healthcare and/or health outcomes. All models were stratified by urban-rural residence. Inadequate access to healthcare was significantly higher among older adults in rural areas than in urban areas (9.1% vs. 5.4%; p China. The associations between access to healthcare and health outcomes were generally stronger among older adults in rural areas than in urban areas. Our findings underscore the importance of providing adequate access to healthcare for older adults-particularly for those living in rural areas in developing countries such as China.
Sternäng, Ola; Lövdén, Martin; Kabir, Zarina N; Hamadani, Jena D; Wahlin, Åke
Most research in cognitive aging is based on literate participants from high-income and Western populations. The extent to which findings generalize to low-income and illiterate populations is unknown. The main aim was to examine the structure of between-person differences in cognitive functions among elderly from rural Bangladesh. We used data from the Poverty and Health in Aging (PHA) project in Bangladesh. The participants (n = 452) were in the age range 60-92 years. Structural equation modeling was used to estimate the fit of a five-factor model (episodic recall, episodic recognition, verbal fluency, semantic knowledge, processing speed) and to examine whether the model generalized across age, sex, and literacy. This study demonstrates that an established model of cognition is valid also among older persons from rural Bangladesh. The model demonstrated strong (or scalar) invariance for age, and partial strong invariance for sex and literacy. Semantic knowledge and processing speed showed weak (or metric) sex invariance, and semantic knowledge demonstrated also sensitivity to illiteracy. In general, women performed poorer on all abilities. The structure of individual cognitive differences established in Western populations also fits a population in rural Bangladesh well. This is an important prerequisite for comparisons of cognitive functioning (e.g., declarative memory) across cultures. It is also worth noting that absolute sex differences in cognitive performance among rural elderly in Bangladesh differ from those usually found in Western samples.
Mathew A. Mwanyangala
Full Text Available Background: Increasingly, human populations throughout the world are living longer and this trend is developing in sub-Saharan Africa. In developing African countries such as Tanzania, this demographic phenomenon is taking place against a background of poverty and poor health conditions. There has been limited research on how this process of ageing impacts upon the health of older people within such low-income settings. Objective: The objective of this study is to describe the impacts of ageing on the health status, quality of life and well-being of older people in a rural population of Tanzania. Design: A short version of the WHO Survey on Adult Health and Global Ageing questionnaire was used to collect information on the health status, quality of life and well-being of older adults living in Ifakara Health and Demographic Surveillance System, Tanzania, during early 2007. Questionnaires were administered through this framework to 8,206 people aged 50 and over. Results: Among people aged 50 and over, having good quality of life and health status was significantly associated with being male, married and not being among the oldest old. Functional ability assessment was associated with age, with people reporting more difficulty in performing routine activities as age increased, particularly among women. Reports of good quality of life and well-being decreased with increasing age. Women were significantly more likely to report poor quality of life (odds ratio 1.31; p<0.001, 95% CI 1.15–1.50. Conclusions: Older people within this rural Tanzanian setting reported that the ageing process had significant impacts on their health status, quality of life and physical ability. Poor quality of life and well-being, and poor health status in older people were significantly associated with marital status, sex, age and level of education. The process of ageing in this setting is challenging and raises public health concerns.
Zou, Yaming; Leung, Ricky; Lin, Shao; Yang, Mingan; Lu, Tao; Li, Xianyun; Gu, Jing; Hao, Chun; Dong, Guanghui; Hao, Yuantao
Suicide intervention programs have been guided by findings that attitude towards suicide and suicidal behavior may be causally linked. These findings also make it imperative to identify the factors that influence attitudes towards suicide. However, there has been little research on attitudes towards suicide among the general population, especially in low-income and middle-income countries. This population-based, cross-sectional study investigated the associated factors of attitudes towards suicide among a representative sample of urban and rural adult residents in China. A multi-stage, stratified random sampling approach was implemented to select participants. Data were collected by a survey using the Scale of Public Attitudes about Suicide (SPAS). The survey also collected some socio-demographic factors and suicidal history of participants. Statistical tests were conducted to identify associated factors that account for variations in attitudes towards suicide. The residents in China generally hold a neutral attitude towards suicide. Attitudes towards suicide among Chinese residents were associated with age, duration of formal education, marital status, job and suicidal ideation. Different attitudinal subscales seemed not to share the same risk factors. However, gender, ethnicity, religious belief, housing style and economic status might not influence residents' attitudes towards suicide. Attitudes towards suicide among Chinese urban and rural residents generally had no statistical difference with one notable exception: opinions on whether or not suicides and suicide attempts are different phenomena. Age, duration of formal education, marital status, job and suicidal ideation seem to have an impact on attitudes towards suicide among residents. Urban and rural residents have similar attitudes towards suicide with the only statistically significance difference being their opinions on whether or not suicides and suicide attempts are different phenomena.
Full Text Available Background: Cardiovascular morbidity is a major contributor towards old age health problems which requires specialized care and if left unattended can deteriorate the quality of life and also lead to mortality. Therefore a study was planned to find out the prevalence of cardiovascular morbidity among geriatric population living in rural and urban areas ofKanpur.Objective: To find out the prevalence of cardiovascular morbidity in geriatric population in rural and urban area of Kanpur and also to study the pattern of cardiovascular morbidity in two areas.Material and methods: a cross sectional study was carried out in a randomly selected rural and urban area of Kanpur. 443 geriatrics in rural and 401 in urban area were interviewed and physically examined.Results: Geriatrics constituted 8.2% and 7.7% of total population in rural and urban area respectively. Majority ofpopulation in both areas belonged to 60-70years age group i.e. 78.8% and 75.8% respectively. 12.2% of rural geriatric and 12.5% of urban geriatric were suffering from some or other kind of cardiovascular morbidity. In rural area 39.1%>of geriatric population is hypertensive while in urban area hypertension is prevalent in 41.6%> of geriatric population. 98. l%>of morbid in rural and 86.0% in urban area were not doing any kind of exercise. A majority of population suffering from cardiovascular morbidity were not smoking currently. Majority i.e. 72.2% of geriatric population suffering from cardiovascular morbidity in rural area were having BMJ between 18.5-24.99 while in urban area 57.4% of them were having BMl>-25. Hypertensives consitiuted 57.4% in rural and 66.0% in urban area towards those who are suffering from cardiovascular morbidity.
Full Text Available Background: Cardiovascular morbidity is a major contributor towards old age health problems which requires specialized care and if left unattended can deteriorate the quality of life and also lead to mortality. Therefore a study was planned to find out the prevalence of cardiovascular morbidity among geriatric population living in rural and urban areas ofKanpur. Objective: To find out the prevalence of cardiovascular morbidity in geriatric population in rural and urban area of Kanpur and also to study the pattern of cardiovascular morbidity in two areas. Material and methods: a cross sectional study was carried out in a randomly selected rural and urban area of Kanpur. 443 geriatrics in rural and 401 in urban area were interviewed and physically examined. Results: Geriatrics constituted 8.2% and 7.7% of total population in rural and urban area respectively. Majority ofpopulation in both areas belonged to 60-70years age group i.e. 78.8% and 75.8% respectively. 12.2% of rural geriatric and 12.5% of urban geriatric were suffering from some or other kind of cardiovascular morbidity. In rural area 39.1%>of geriatric population is hypertensive while in urban area hypertension is prevalent in 41.6%> of geriatric population. 98. l%>of morbid in rural and 86.0% in urban area were not doing any kind of exercise. A majority of population suffering from cardiovascular morbidity were not smoking currently. Majority i.e. 72.2% of geriatric population suffering from cardiovascular morbidity in rural area were having BMJ between 18.5-24.99 while in urban area 57.4% of them were having BMl>-25. Hypertensives consitiuted 57.4% in rural and 66.0% in urban area towards those who are suffering from cardiovascular morbidity.
ABSTRACT Background The study was undertaken among the rural and black communities of the Uthungulu health district of the KwaZulu-Natal province, South Africa. Method A cross-sectional community-based descriptive study was conducted. A multi-stage sampling strategy was adopted to obtain a representative sample of the communities. Results The mean age of the population was 27 years and majority was female (54%). Among the adult population only 30% were educated, 19% were engaged in some form of economic activities while 9% were in the formal employment sector. The average monthly income per household was R1 301 (95% CI, R1 283; R1 308). The illnesses were reported by 27% of the total population over a period of one month. Notably higher rates of female individuals (29%) were sick compared to males (24%, p < 0.001). The rates of illnesses among adult females (39%) were also significantly higher than among males (31%, p < 0.009). Most of them (69%) attended primary health care (PHC) clinics for medical services, while 67% reported chronic conditions. Age (OR = 1.4), gender (OR = 0.711), education (OR = 0.64) and economic activities (OR = 1.9) were found to be associated with being ill or not. Conclusion The rural black communities are underdeveloped and deprived, which results in higher prevalence of illnesses; however, the utilisation of PHC facilities is comparatively higher than in the rest of the province and other parts of the country. Interventions to improve community health care services among the deprived population should be focused through public health strategies such as all-encompassing PHC that includes health promotion, education and basic essential amenities.
Lu, Qing; Congdon, Nathan; He, Xiangdong; Murthy, Gudlavalleti V S; Yang, Amy; He, Wei
To evaluate the impact of near-vision impairment on visual functioning and quality of life in a rural adult population in Shenyang, northern China. A population-based, cross-sectional study was conducted among persons aged 40+ years, during which functional presbyopia (correctable presenting near vision vision-related quality of life and spectacle usage questionnaires were administered by trained interviewers to determine the degree of self-rated difficulty with near tasks. A total of 1008 respondents (91.5% of 1102 eligible persons) were examined, and 776 (78%) of completed the questionnaires (mean age, 57.0 ± 10.2 years; 63.3% women). Near-vision spectacle wearers obtained their spectacles primarily from markets (74.5%) and optical shops (21.7%), and only 1.14% from eye clinics. Among 538 (69.3%) persons with functional presbyopia, self-rated overall (distance and near) vision was worse (P vision. Compared to persons without presbyopia, presbyopic persons were more likely to report diminished accomplishment due to vision (P = 0.01, adjusted for age, sex, education, and distance vision.) Difficulties with activities of daily living and resulting social impediments are common due to presbyopia in this setting. Most spectacle wearers with presbyopia in rural China obtain near correction from sources that do not provide comprehensive vision care.
Sikalengo, George; Hella, Jerry; Mhimbira, Francis; Rutaihwa, Liliana K; Bani, Farida; Ndege, Robert; Sasamalo, Mohamed; Kamwela, Lujeko; Said, Khadija; Mhalu, Grace; Mlacha, Yeromin; Hatz, Christoph; Knopp, Stefanie; Gagneux, Sébastien; Reither, Klaus; Utzinger, Jürg; Tanner, Marcel; Letang, Emilio; Weisser, Maja; Fenner, Lukas
Differences in rural and urban settings could account for distinct characteristics in the epidemiology of tuberculosis (TB). We comparatively studied epidemiological features of TB and helminth co-infections in adult patients from rural and urban settings of Tanzania. Adult patients (≥ 18 years) with microbiologically confirmed pulmonary TB were consecutively enrolled into two cohorts in Dar es Salaam, with ~ 4.4 million inhabitants (urban), and Ifakara in the sparsely populated Kilombero District with ~ 400 000 inhabitants (rural). Clinical data were obtained at recruitment. Stool and urine samples were subjected to diagnose helminthiases using Kato-Katz, Baermann, urine filtration, and circulating cathodic antigen tests. Differences between groups were assessed by χ 2 , Fisher's exact, and Wilcoxon rank sum tests. Logistic regression models were used to determine associations. Between August 2015 and February 2017, 668 patients were enrolled, 460 (68.9%) at the urban and 208 (31.1%) at the rural site. Median patient age was 35 years (interquartile range [IQR]: 27-41.5 years), and 454 (68%) were males. Patients from the rural setting were older (median age 37 years vs. 34 years, P = 0.003), had a lower median body mass index (17.5 kg/m 2 vs. 18.5 kg/m 2 , P urban Tanzania. There was no significant difference in frequencies of HIV infection, diabetes mellitus, and haemoglobin concentration levels between the two settings. The overall prevalence of helminth co-infections was 22.9% (95% confidence interval [CI]: 20.4-27.0%). The significantly higher prevalence of helminth infections at the urban site (25.7% vs. 17.3%, P = 0.018) was predominantly driven by Strongyloides stercoralis (17.0% vs. 4.8%, P rural setting (adjusted odds ratio [aOR]: 3.97, 95% CI: 1.16-13.67) and increasing age (aOR: 1.06, 95% CI: 1.02-1.10). Clinical characteristics and helminth co-infections pattern differ in TB patients in urban and rural Tanzania. The
Siddiqui, Md Zakaria; Donato, Ronald
To investigate the extent to which individual-level as well as macro-level contextual factors influence the likelihood of underweight across adult sub-populations in India. Population-based cross-sectional survey included in India's National Health Family Survey conducted in 2005-06. We disaggregated into eight sub-populations. Multistage nationally representative household survey covering 99 % of India's population. The survey covered 124 385 females aged 15-49 years and 74 369 males aged 15-54 years. A social gradient in underweight exists in India. Even after allowing for wealth status, differences in the predicted probability of underweight persisted based upon rurality, age/maturity and gender. We found individual-level education lowered the likelihood of underweight for males, but no statistical association for females. Paradoxically, rural young (15-24 years) females from more educated villages had a higher likelihood of underweight relative to those in less educated villages; but for rural mature (>24 years) females the opposite was the case. Christians had a significantly lower likelihood of underweight relative to other socio-religious groups (OR=0·53-0·80). Higher state-level inequality increased the likelihood of underweight across most population groups, while neighbourhood inequality exhibited a similar relationship for the rural young population subgroups only. Individual states/neighbourhoods accounted for 5-9 % of the variation in the prediction of underweight. We found that rural young females represent a particularly highly vulnerable sub-population. Economic growth alone is unlikely to reduce the burden of malnutrition in India; accordingly, policy makers need to address the broader social determinants that contribute to higher underweight prevalence in specific demographic subgroups.
Full Text Available Biogas technology is useful technology to produce a renewable, high-quality fuel i.e. biogas. In Rural areas people use biomass fuels (firewood and dried dung for meeting their energy utilization demands. This demand is fulfilled by deforestation and land degradation which results in different health and societal problems and also cause excessive emission of greenhouse gases. The rural population of developing countries is in dire need of biogas for cooking, lighting, heating and feedstock etc. The biogas production derives from various agricultural resources, such as manure and harvest remains enormously available. Biogas technology represents a sustainable way to produce energy for household, particularly in developing countries. It can be cost-effective and environment friendly technology for the people in rural areas. So, Biogas can be a best substitute of biomass fuels for use in rural areas. This review evaluates the use of biogas in developing rural areas and glances at problems and challenges as well as benefits and success factors.
Ali, S.; Nasreen, Z.; Usman, S.; Zahra, N.
Biogas technology is useful technology to produce a renewable, high-quality fuel i.e. biogas. In Rural areas people use biomass fuels (firewood and dried dung) for meeting their energy utilization demands. This demand is fulfilled by deforestation and land degradation which results in different health and societal problems and also cause excessive emission of greenhouse gases. The rural population of developing countries is in dire need of biogas for cooking, lighting, heating and feedstock etc. The biogas production derives from various agricultural resources, such as manure and harvest remains enormously available. Biogas technology represents a sustainable way to produce energy for household, particularly in developing countries. It can be cost-effective and environment friendly technology for the people in rural areas. So, Biogas can be a best substitute of biomass fuels for use in rural areas. This review evaluates the use of biogas in developing rural areas and glances at problems and challenges as well as benefits and success factors. (author)
Bio energy is a renewable resource. It is a product of the abundant solar energy. The plant kingdom collects solar energy by photosynthesis and stores it as biomass. This is a big source of energy that sustains the mankind in many ways-food, fuel, fibre and several others. The non-food biomass like agro-waste and forest residues already constitute a large component of the traditional energy sources of most rural population the world over. A scientific study and proper planning are required for an optimum use of this abundant renewable bio energy (biomass). This paper discusses various options to evolve workable technologies for an efficient use of biomass as a sustainable energy resource for rural areas where it is mostly produced. An integrated strategy is proposed. (author)
Mendes, Larissa Loures; Gazzinelli, Andréa; Velásquez-Meléndez, Gustavo
This study explores the relations of anthropometric, body composition assessments, biochemical and hemodynamic parameters with insulin resistance in two rural communities. Sample was composed by adults aged 18 or older, both sexes. Participants were excluded if pregnant and diabetic. Data collection included demographic lifestyle, hemodynamic, anthropometric and biochemical variables. From the 567 subjects, 50.4% were men and 49.6%, women. Most of the sample was non-white (75.7%), lived with partner (69.3%) and had low educational level. Overweight and obesity prevalences were 17.4% and 5.5%, respectively. Multivariate analysis found risk factors associated to insulin resistance for non-diabetic adults with low income and educational level: overweight, obesity, elevated waist-to-hip ratio, C-reactive protein and skin color.
Costa da Silva, Diego Firmino; Elhorst, J. Paul; Silveira Neto, Raul da Mota
Urban and rural population growth in a spatial panel of municipalities. Regional Studies. Using Bayesian posterior model probabilities and data pertaining to 3659 Brazilian minimum comparable areas (MCAs) over the period 1970-2010, two theoretical settings of population growth dynamics resulting in
Beltrán-Sánchez, Hiram; Crimmins, Eileen M.; Teruel, Graciela M.; Thomas, Duncan
Objectives This study examines links between early life circumstances and adult socioeconomic status and obesity and hypertension in the adult Mexican population. Methods We use data from the Mexican Family Life Survey (MxFLS) collected in 2002 for people aged 20 or older (N=14, 280). Results We found that men with low education and women with more education have significantly lower obesity. Women with higher education also have significantly less hypertension. Obesity triples the likelihood of hypertension among both men and women. Better childhood experiences are associated with less hypertension among women, but more hypertension among men in rural areas. Discussion Recent changes in income, nutrition, and infection in Mexico may be responsible for the observed high prevalence of overweight and obesity and the extremely high odds of hypertension among obese young adults. PMID:21948773
Full Text Available Little is known about the variability of CD4 counts in the general population of sub-Saharan Africa countries affected by the HIV epidemic. We investigated factors associated with CD4 counts in a rural area in South Africa with high HIV prevalence and high antiretroviral treatment (ART coverage.CD4 counts, health status, body mass index (BMI, demographic characteristics and HIV status were assessed in 4990 adult resident participants of a demographic surveillance in rural KwaZulu-Natal in South Africa; antiretroviral treatment duration was obtained from a linked clinical database. Multivariable regression analysis, overall and stratified by HIV status, was performed with CD4 count levels as outcome.Median CD4 counts were significantly higher in women than in men overall (714 vs. 630 cells/µl, p<0.0001, both in HIV-uninfected (833 vs. 683 cells/µl, p<0.0001 and HIV-infected adults (384.5 vs. 333 cells/µl, p<0.0001. In multivariable regression analysis, women had 19.4% (95% confidence interval (CI 16.1-22.9 higher CD4 counts than men, controlling for age, HIV status, urban/rural residence, household wealth, education, BMI, self-reported tuberculosis, high blood pressure, other chronic illnesses and sample processing delay. At ART initiation, HIV-infected adults had 21.7% (95% CI 14.6-28.2 lower CD4 counts than treatment-naive individuals; CD4 counts were estimated to increase by 9.2% (95% CI 6.2-12.4 per year of treatment.CD4 counts are primarily determined by sex in HIV-uninfected adults, and by sex, age and duration of antiretroviral treatment in HIV-infected adults. Lower CD4 counts at ART initiation in men could be a consequence of lower CD4 cell counts before HIV acquisition.
Estela-Ayamamani, David; Espinoza-Figueroa, Jossué; Columbus-Morales, Mauricio; Runzer-Colmenares, Fernando; Parodi, José F; Mayta-Tristán, Percy
Living at high altitudes requires the inhabitants to adapt biologically and socially to the environment. The objective of this study was to determine the difference in physical performance (PP) in rural populations at sea level and at high altitude. A cross-sectional study was conducted in rural communities in Ancash, Peru, located at 3.345 meters above sea level (m.a.s.l.) and also in communities located in coastal areas at 6m.a.s.l. PP was measured by the Short Physical Performance Battery (SPPB) and other associated factors. Adjusted prevalence ratios (aPR) were calculated. A total of 130 older adults were assessed in the high altitude communities and 129 on the coast. The median age was 71.4 years, and 55.6% were female. Low physical performance (SPPB ≤ 6) was 10.0% at high altitude and 19.4% on the coast (p<0.05). Factors associated with low physical performance were residing at the coast (aPR: 2.10, 95% CI 1.02 to 4.33), self-reported poor health (aPR: 2.48, 95% CI 1.21 -5.08), hypertension (aPR: 1.73, 95% CI 1.01 to 2.98), and age (aPR: 1.04, 95% CI 1.01 to 1.07), while being a farmer (aPR: 0.49, 95% CI 0.25 to 0.97), and being independent (aPR: 0.37, 95% CI 0,20-, 072) were found to be protective factors. It was also found that the inhabitants of the coast have a mean of 0.86 points lower total SPPB than the high altitude ones (p=0.004). There is an association between altitude of residence and PP in older adults. The prevalence of a low PP in older adults in rural areas at sea level is twice as high compared to those living in high altitude rural communities. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.
Peek, Gina G.; Bishop, Alex J.
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…
Chrisman, Matthew; Nothwehr, Faryle; Yang, Jingzen; Oleson, Jacob
In response to calls for more specificity when measuring physical activity, this study examined perceived correlates of this behavior in rural adults separately by the domain in which this behavior occurs (ie, home care, work, active living, and sport). A cross-sectional survey was completed by 407 adults from 2 rural towns in the Midwest. The questionnaire assessed the perceived social and physical environment, including neighborhood characteristics, as well as barriers to being active. The Kaiser Physical Activity Survey captured domain-specific activity levels. The response rate was 25%. Multiple regression analyses were conducted to examine the associations between social and physical environment factors and domain-specific physical activity. Having a favorable attitude toward using government funds for exercise and activity-friendly neighborhood characteristic were positively associated with active living. Friends encouraging exercise was positively associated with participation in sport. Barriers were inversely associated with active living and sport. Total physical activity was positively associated with workplace incentives for exercise, favorable policy attitudes toward supporting physical education in schools and supporting the use of government funds for biking trails, and it was inversely associated with barriers. There were no factors associated with physical activity in the domains of work or home care. Correlates of physical activity are unique to the domain in which this behavior occurs. Programs to increase physical activity in rural adults should target policy attitudes, neighborhood characteristics, and social support from friends while also working to decrease personal barriers to exercise. © 2014 National Rural Health Association.
Specker, Bonny; Binkley, Teresa; Fahrenwald, Nancy
Despite reports of lower fracture risk among rural versus urban populations, few studies have investigated rural versus urban differences in bone mineral content (BMC) and bone mineral density (BMD). Population differences in cross-sectional bone geometry and understanding lifestyle factors responsible for these differences may reveal insights into the reason for differences in fracture risk. We hypothesized that if lifestyle differences in bone mass, size, and geometry are a result of muscle strength, activity, or dietary differences, Hutterite and rural populations should have greater bone mass compared to nonrural populations. The study population consisted of 1189 individuals: 504 rural Hutterites (188 men), 349 rural individuals (>75% life farming, 184 men), and 336 nonrural individuals (never lived on farm, 134 men) aged 20 to 66 years. BMC, bone area, and areal BMD (aBMD) of the total body (TB), hip, femoral neck (FN), and spine by DXA; volumetric BMD (vBMD) and bone geometry at the 4% and 20% radius; polar stress strain index (pSSI), a measure of bone strength, at the 20% pQCT site; and strength, 7-day activity recall, and 24-h diet recall were collected and compared among groups. Hutterite women and men had greater grip strength compared to rural and nonrural populations (both, P BMC and areal size than the nonrural population, while Hutterites had greater BMC and areal size than rural population at some (TB, FN for females only), but not all (proximal hip), sites. Cortical vBMD was inversely associated with periosteal circumference at the 20% radius in women (r=-0.25, P BMC, aBMD, vBMD, or bone size.
Full Text Available Objective: The present study aimed to estimate prevalence of hypertension among adults in rural remote areas of Xinjiang, China and evaluate the associated factors of hypertension. Methods: The survey was based on questionnaire interviews and clinical measurements of 11,340 individuals (≥18 years old, and was conducted during 2009–2010 via a stratified cluster random sampling method in the remote rural areas of Xinjiang, about 4407 km away from the capital Beijing. Hypertension was defined according to WHO/ISH criteria. Results: Systolic blood pressure (SBP and diastolic blood pressure (DBP of the population were (126.3 ± 21.4 and (80.9 ± 13.4 mmHg. Compared with Han nationality subjects, SBP and DBP of Kazakh nationality subjects were significantly high (p < 0.05, while the SBP and DBP of Uyghur subjects were significantly low (Kazakh: (128.7 ± 23.9 and (83.0 ± 14.6 mmHg, Uyghur: (123.6 ± 19.3 and (77.4 ± 12.7 mmHg, Han: (126.5 ± 20.5 and (82.6 ± 11.9 mmHg, p < 0.05. Prevalence of hypertension of the population was 32.1%, and was greater among Kazakhs and lower among Uyghur than Han (Kazakh: 36.9%, Uyghur: 26.1%, Han: 33.7%, p < 0.05. The age-standardized prevalence of hypertension was 30.2%, and was greater among Kazakhs while lower among Uyghurs than Han subjects (Kazakh: 37.0%, Uyghur: 26.0%, Han: 33.8%, p < 0.05, p < 0.05. Multivariate logistic regression analyses showed Gender (OR = 1.324, age (OR = 2.098, 3.681, 6.794, 9.473, 14.646, nationality (OR = 1.541, occupation (OR = 1.659, 1.576, education (OR = 1.260, BMI (OR = 1.842, WC (OR = 1.585, WHR (OR = 1.188, WHR (OR = 1.188, diabetes (OR = 1.879, hypertriglyceridemia (OR = 1.361, hypercholesterolemia (OR = 1.131 and high blood low density lipoprotein cholesterol (LDL-C (OR = 1.956 were all positively correlated with hypertension, while low blood high density lipoprotein cholesterol (HDL-C (OR = 0.765 was negatively correlated with hypertension. Conclusions: Prevalence of
Full Text Available Abstract Background Non-alcoholic fatty liver disease (NAFLD is recognized as a metabolic disorder largely seen in urbanized populations. The purpose of this study was to assess prevalence and risk factors for NAFLD in a rural, physically active, economically deprived population in Sri Lanka. Methods By visiting individual households in the community, 35-64 year old adults resident in two selected estates in the Nuwara Eliya District of Sri Lanka, were invited to participate in the study. Blood pressure and anthropometric measurements were made on all participants. Blood samples were obtained for the assay of fasting glucose, serum lipids, serum insulin and alanine aminotransferase. NAFLD was diagnosed on established ultrasound criteria for fatty liver in the absence of hepatitis B and C markers and high alcohol consumption. Results Of those invited, 403 (65% participated in the study. Almost all participants were either Indian or Sri Lankan Tamils and 53% were females. Prevalence of NAFLD was 18% in this population. Twice as many males were diagnosed as having NAFLD compared to females. Male sex, high BMI, high waist circumference, high diastolic blood pressure and high plasma glucose levels were significant predictors of NAFLD. Conclusion Nearly one in five people in this predominantly Indian Tamil, rural, physically active, economically deprived population had NAFLD. The condition was associated with constituent features of the metabolic syndrome. These results support studies reporting ethnic variations in disease susceptibility and suggest that genetic factors may also play a role in determining disease risk.
Gobbi, C; Salica, D; Pepe, G; Dotto, G; Petenian, E; Martínez, F
level and low bone mineral density of femoral neck (Spearman 0.51) CONCLUSIONS: Vitamin D insufficiency is high in the rural adult population of Pampa de Achala in Córdoba and it could be a major health problem in this population.
Full Text Available Abstract Background Previous researches aiming to estimate the association between metabolic syndrome and depressive symptoms come out with inconsistent results. Besides, most of them are conducted in the developed areas. There is lack of the data from rural China. The aim of this study is to confirm whether gender difference exists among the relationship between MetS, metabolic components and depressive symptoms in the rural Chinese population. Methods A cross-sectional analysis enrolled 11430 subjects’ aged ≥35 from rural Northeast China. Metabolic and anthropometric indicators were measured according to standard methods. Depressive symptoms were defined using the Patient Health Questionnaire-9 (PHQ-9. Results The prevalence of depressive symptoms was 6% among rural Northeast general population and the prevalence of MetS and its components were 39.0% for MetS, 42.9% for abdominal obesity, 67.1% for elevated blood pressure, 47.1% for hyperglycemia, 32.1% for hypertriglyceridemia, 29.5% for low HDL-C. Depressive symptoms were associated with triglyceride component (OR = 1.24, 95%CI: 1.05–1.46, P = 0.01 but not MetS (OR = 1.11, 95%CI: 0.94–1.30, P = 0.23. Moreover, depressive symptoms were associated with triglyceride component (OR = 1.21, 95% CI = 1.00–1.47, P = 0.05 in women only. But once adjusted for menopause status, depressive symptoms were no longer statically associated with triglyceride component (OR = 1.20, 95% CI = 0.99–1.46, P = 0.07. Conclusions Depressive symptoms were associated with triglyceride component but not MetS in rural Chinese population. Routine lipid screening should be recommended among rural depressed residents especially among female.
Hunter, Lori M; Boardman, Jason D.; Saint Onge, Jarron M.
Population growth in rural areas characterized by high levels of natural amenities has recently received substantial research attention. A noted concern with amenity-driven rural population growth is its potential to raise local costs-of-living while yielding only low-wage service sector employment for long-term residents. The work presented here…
Pan, Chen-Wei; Chen, Qin; Sheng, Xun; Li, Jun; Niu, Zhiqiang; Zhou, Hua; Wei, Tao; Yuan, Yuansheng; Zhong, Hua
To determine the prevalence of myopia and ocular biometry in population-based samples of ethnic Yi and Han people living in an inland rural community in China. A random cluster sampling strategy was used to select ethnic Han and Yi adults aged 50 years or older living in Yunnan. Refractive error was determined by subjective refraction and ocular biometric parameters, including axial length (AL), anterior chamber depth (ACD), vitreous chamber depth (VCD), and lens thickness (LT), which were measured using an Echoscan. Adults of Yi ethnicity had lower prevalence of myopia (10.3% vs. 8.1%; P = 0.02) and high myopia (2.3% vs. 1.6%; P = 0.10) than their counterparts of Han ethnicity. The prevalence of myopia increased with age (P for trend ethnic groups (both P for trend > 0.05). In multivariate analysis, time spent outdoors was associated with myopia (P = 0.003) and AL (P ethnicity and other risk factors on myopia (all P > 0.05). Adjustment for lens nuclear opacity score reduced the excess prevalence of myopia in Han ethnicity by 37.5%. There was little evidence showing that ethnic disparities existed in the prevalence and risk factors between the major and minor ethnic groups living in the same communities in rural China. The "cohort effect" on myopia observed in many other populations was not seen in this study.
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
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.
Matthew Lee Smith
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.
Milsom, Vanessa A; Middleton, Kathryn M Ross; Perri, Michael G
Few investigations of successful long-term weight loss beyond two years have been conducted, and none has examined weight changes in medically underserved rural populations of older adults. The purpose of this study was to assess long-term weight loss maintenance 3.5 years after the completion of an initial six-month lifestyle intervention for obesity among women aged 50-75 years residing in rural communities. One hundred and ten obese women with a mean (± standard deviation) age of 60.08 ± 6.17 years and mean body mass index of 36.76 ± 5.10 kg/m(2) completed an in-person assessment during which their weight and adherence to behavioral weight management strategies were evaluated. Participants showed a mean weight reduction of 10.17% ± 5.0% during the initial six- month intervention and regained 6.95% ± 9.44% from the completion of treatment to follow-up assessment 3.5 years later. A substantial proportion of participants (41.80%) were able to maintain weight reductions of 5% or greater from baseline to follow-up. "Successful" participants (those who maintained losses of 5% or greater at follow-up) reported weighing themselves, self-monitoring their intake and calories, planning meals in advance, and choosing lower calorie foods with greater frequency than "unsuccessful" participants (those who lost less than 5%). Collectively, these findings indicate that a large proportion of participants were able to maintain clinically significant weight losses for multiple years after treatment, and that self-monitoring was a key component of successful long-term weight management.
Fawad, A.; Alvi, S.F.D.; Hakeem, R.; Basit, A.; Ahmedani, M.Y.
Objective: To observe changing pattern in the risk factors for diabetes as overweight, obesity, smoking, hypertension and family history of diabetes in young adults in the rural area of Baluchistan. Methods: A community based observational study was carried out in the rural area of Baluchistan by conducting two surveys, in the years 2002 and 2009 respectively. The survey was further subdivided into two groups i.e. young adults (15-25 years) and adults (>25 years). In this study, data of young adults was analyzed. Data obtained in 2002 was also analyzed according to the current guidelines and compared with 2009 survey. Results: A total of 230 and 197 young adults participated in 2002 and 2009 surveys respectively. Obesity increased significantly (p <0.001) from 20 (10.15%) young adults in the year 2002 to 64 (27.82%) in 2009. Similarly 15 (7.61%) young adults were overweight in 2002 which increased to 24 (10.43%) in 2009 (p <0.317). Smoking increased from 8 (4.06%) to 49 (21.3%) in 2009 (p <0.001). Family history of diabetes mellitus also showed a significant increase (p <0.005). Hypertension increased from 13 (6.6%) young adults in 2002 survey to 17 (7.39%) in 2009, the increase was not statistically significant (p <0.749). Conclusion: The present study showed that risk factors for diabetes such as overweight, obesity, smoking, hypertension and family history of diabetes increased over time in the young adults of rural Baluchistan. (author)
Bennett, Keisa; McElroy, Jane A; Johnson, Andrew O; Munk, Niki; Everett, Kevin D
Sexual and gender minorities (SGM) smoke cigarettes at higher rates than the general population. Historically, research in SGM health issues was conducted in urban populations and recent population-based studies seldom have sufficient SGM participants to distinguish urban from rural. Given that rural populations also tend to have a smoking disparity, and that many SGM live in rural areas, it is vitally important to understand the intersection of rural residence, SGM identity, and smoking. This study analyzes the patterns of smoking in urban and rural SGM in a large sample. We conducted an analysis of 4280 adult participants in the Out, Proud, and Healthy project with complete data on SGM status, smoking status, and zip code. Surveys were conducted at 6 Missouri Pride Festivals and online in 2012. Analysis involved descriptive and bivariate methods, and multivariable logistic regression. We used GIS mapping to demonstrate the dispersion of rural SGM participants. SGM had higher smoking proportion than the non-SGM recruited from these settings. In the multivariable model, SGM identity conferred 1.35 times the odds of being a current smoker when controlled for covariates. Rural residence was not independently significant, demonstrating the persistence of the smoking disparity in rural SGM. Mapping revealed widespread distribution of SGM in rural areas. The SGM smoking disparity persists among rural SGM. These communities would benefit from continued research into interventions targeting both SGM and rural tobacco control measures. Recruitment at Pride Festivals may provide a venue for reaching rural SGM for intervention.
Loftus, John; Allen, Elizabeth M; Call, Kathleen Thiede; Everson-Rose, Susan A
Reduced access to care and barriers have been shown in rural populations and in publicly insured populations. Barriers limiting health care access in publicly insured populations living in rural areas are not understood. This study investigates rural-urban differences in system-, provider-, and individual-level barriers and access to preventive care among adults and children enrolled in a public insurance program in Minnesota. This was a secondary analysis of a 2008 statewide, cross-sectional survey of publicly insured adults and children (n = 4,388) investigating barriers associated with low utilization of preventive care. Sampling was stratified with oversampling of racial/ethnic minorities. Rural enrollees were more likely to report no past year preventive care compared to urban enrollees. However, this difference was no longer statistically significant after controlling for demographic and socioeconomic factors (OR: 1.37, 95% CI: 1.00-1.88). Provider- and system-level barriers associated with low use of preventive care among rural enrollees included discrimination based on public insurance status (OR: 2.26, 95% CI: 1.34-2.38), cost of care concerns (OR: 1.72, 95% CI: 1.03-2.89) and uncertainty about care being covered by insurance (OR: 1.70, 95% CI: 1.01-2.85). These and additional provider-level barriers were also identified among urban enrollees. Discrimination, cost of care, and uncertainty about insurance coverage inhibit access in both the rural and urban samples. These barriers are worthy targets of interventions for publicly insured populations regardless of residence. Future studies should investigate additional factors associated with access disparities based on rural-urban residence. © 2017 National Rural Health Association.
Zhu, Dawei; Guo, Na; Wang, Jian; Nicholas, Stephen; Wang, Zhen; Zhang, Guojie; Shi, Luwen; Wangen, Knut Reidar
Hepatitis B (HB) vaccination is the most effective way to prevent HB virus infection. While measures taken to control the prevalence of HB have achieved significant results, HB prevalence in rural China among adults remains problematic. This study sheds new light on the determinants of HB vaccine uptake and its inequality according to socioeconomic status in rural areas of China. We interviewed 22,283 adults, aged 18-59 years, from 8444 households, in 48 villages from 8 provinces. Vaccination status was modeled by using two logistic models: whether take at least one HB vaccine and whether to complete the entire vaccination regime. The Erreygers' concentration index ([Formula: see text]) was used to quantify the degree of inequality and the decomposition approach was used to uncover the determinants of inequality in vaccine uptake. We found that the coverage rate of HB vaccination is 20.2%, and the completion rate is 16.0%. The [Formula: see text] of at least one dose (0.081) and three doses (0.076) revealed a substantial pro-rich inequality. Income contributed the largest percentage to HB vaccination inequalities (52.17% for at least one dose and 52.03% for complete vaccinations). HB awareness was another important cause of inequality in HB vaccination (around 30%). These results imply that rich had a greater tendency to vaccinate and inequality favouring the rich was almost equal for the complete three doses. While the factors associated with HB vaccination uptake and inequalities were multifaceted, income status and HB awareness were the main barriers for the poor to take HB vaccine by adults in rural China.
Llibre Rodriguez, Juan J; Prina, A Matthew; Acosta, Daisy; Guerra, Mariella; Huang, Yueqin; Jacob, K S; Jimenez-Velasquez, Ivonne Z; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph D; Jotheeswaran, A T; Acosta, Isaac; Liu, Zhaorui; Prince, Martin J
There have been few cross-national studies of the prevalence of the frailty phenotype conducted among low or middle income countries. We aimed to study the variation in prevalence and correlates of frailty in rural and urban sites in Latin America, India, and China. Cross-sectional population-based catchment area surveys conducted in 8 urban and 4 rural catchment areas in 8 countries; Cuba, Dominican Republic, Puerto Rico, Venezuela, Peru, Mexico, China, and India. We assessed weight loss, exhaustion, slow walking speed, and low energy consumption, but not hand grip strength. Therefore, frailty phenotype was defined on 2 or more of 4 of the usual 5 criteria. We surveyed 17,031 adults aged 65 years and over. Overall frailty prevalence was 15.2% (95% confidence inteval 14.6%-15.7%). Prevalence was low in rural (5.4%) and urban China (9.1%) and varied between 12.6% and 21.5% in other sites. A similar pattern of variation was apparent after direct standardization for age and sex. Cross-site variation in prevalence of frailty indicators varied across the 4 indicators. Controlling for age, sex, and education, frailty was positively associated with older age, female sex, lower socioeconomic status, physical impairments, stroke, depression, dementia, disability and dependence, and high healthcare costs. There was substantial variation in the prevalence of frailty and its indicators across sites in Latin America, India, and China. Culture and other contextual factors may impact significantly on the assessment of frailty using questionnaire and physical performance-based measures, and achieving cross-cultural measurement invariance remains a challenge. A consistent pattern of correlates was identified, suggesting that in all sites, the frailty screen could identify older adults with multiple physical, mental, and cognitive morbidities, disability and needs for care, compounded by socioeconomic disadvantage and catastrophic healthcare spending. Copyright © 2017. Published
Full Text Available Vanessa A Milsom1,2, Kathryn M Ross Middleton2, Michael G Perri21Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 2Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USABackground: Few investigations of successful long-term weight loss beyond two years have been conducted, and none has examined weight changes in medically underserved rural populations of older adults. The purpose of this study was to assess long-term weight loss maintenance 3.5 years after the completion of an initial six-month lifestyle intervention for obesity among women aged 50–75 years residing in rural communities.Methods: One hundred and ten obese women with a mean (± standard deviation age of 60.08 ± 6.17 years and mean body mass index of 36.76 ± 5.10 kg/m2 completed an in-person assessment during which their weight and adherence to behavioral weight management strategies were evaluated.Results: Participants showed a mean weight reduction of 10.17% ± 5.0% during the initial six-month intervention and regained 6.95% ± 9.44% from the completion of treatment to follow-up assessment 3.5 years later. A substantial proportion of participants (41.80% were able to maintain weight reductions of 5% or greater from baseline to follow-up. "Successful" participants (those who maintained losses of 5% or greater at follow-up reported weighing themselves, self-monitoring their intake and calories, planning meals in advance, and choosing lower calorie foods with greater frequency than "unsuccessful" participants (those who lost less than 5%.Conclusion: Collectively, these findings indicate that a large proportion of participants were able to maintain clinically significant weight losses for multiple years after treatment, and that self-monitoring was a key component of successful long-term weight management.Keywords: obesity, weight loss, weight maintenance, lifestyle intervention, rural, health disparities
Roldán, José; Álvarez, Marsela; Carrasco, María; Guarneros, Noé; Ledesma, José; Cuchillo-Hilario, Mario; Chávez, Adolfo
Marginalization is a significant issue in Mexico, involving a lack of access to health services with differential impacts on Indigenous, rural and urban populations. The objective of this study was to understand Mexico’s public health problem across three population areas, Indigenous, rural and urban, in relation to degree of marginalization and health service coverage. The sampling universe of the study consisted of 107 458 geographic locations in the country. The study was retrospective, comparative and confirmatory. The study applied analysis of variance, parametric and non-parametric, correlation and correspondence analyses. Significant differences were identified between the Indigenous, rural and urban populations with respect to their level of marginalization and access to health services. The most affected area was Indigenous, followed by rural areas. The sector that was least affected was urban. Although health coverage is highly concentrated in urban areas in Mexico, shortages are mostly concentrated in rural areas where Indigenous groups represent the extreme end of marginalization and access to medical coverage. Inadequate access to health services in the Indigenous and rural populations throws the gravity of the public health problem into relief.
Y J Anupama
Full Text Available Prevalence of chronic kidney disease (CKD appears to be increasing in India. A few studies have studied the prevalence of CKD in urban populations, but there is a paucity of such studies in the rural populations. This project was undertaken to study the prevalence of CKD among adults in a rural population near Shimoga, Karnataka and to study the risk factor profile. Door-to-door screening of 2091 people aged 18 and above was carried out. Demographic and anthropometric data were obtained, urine was analyzed for protein by dipstick and serum creatinine was measured in all participants. Glomerular filtration rate was estimated (eGFR using the 4-variable modification of diet in renal disease (MDRD equation and Cockcroft-Gault equation corrected to the body surface area (CG-BSA. The total number of subjects studied was 2091. Mean age was 39.88 ± 15.87 years. 45.57% were males. The prevalence of proteinuria was 2.8%. CKD was seen in 131 (6.3% subjects when GFR was estimated by MDRD equation. The prevalence of CKD was 16.54% by the CG-BSA method. There was a statistically significant relationship of CKD with gender, advancing age, abdominal obesity, smoking, presence of diabetes and hypertension. The prevalence of CKD is higher compared to the previous studies from rural India and is comparable to that in the studies from the urban Indian populations. The wide difference between the CKD prevalence between MDRD and CG-BSA equations suggests the need for a better measure of kidney function applicable to Indian population.
Hansen, Andreas Wolff; Christensen, Dirk; Larsson, Melanie
Objective. To compare dietary patterns and food and macronutrient intakes among adults in three ethnic groups in rural Kenya. Design. In the present cross-sectional study, dietary intake was estimated in adult volunteers using two non-consecutive interactive 24 h recalls. Dietary patterns were...
Milena Santric Milicevic
Full Text Available Background: The global burden of mental disorders is rising. In Serbia, anxiety is the leading cause of disability-adjusted life years. Serbia has no mental health survey at the population level. The information on prevalence of mental disorders and related socioeconomic inequalities are valuable for mental care improvement. Aims: То explore the prevalence of mental health disorders and socioeconomic inequalities in mental health of adult Serbian population, and to explore whether age years and employment status interact with mental health in urban and rural settlements. Study Design: Cross-sectional study. Methods: This study is an additional analysis of Serbian Health Survey 2006 that was carried out with standardized household questionnaires at the representative sample of 7673 randomly selected households – 15563 adults. The response rate was 93%. A multivariate logistic regression modeling highlighted the predictors of the 5 item Mental Health Inventory (MHI-5, and of chronic anxiety or depression within eight independent variables (age, gender, type of settlement, marital status and self-perceived health, education, employment status and Wealth Index. The significance level in descriptive statistics, chi square analysis and bivariate and multivariate logistic regressions was set at p<0.05. Results: Chronic anxiety or depression was seen in 4.9% of the respondents, and poor MHI-5 in 47% of respondents. Low education (Odds Ratios 1.32; 95% confidence intervals=1.16-1.51, unemployment (1.36; 1.18-1.56, single status (1.34; 1.23-1.45, and Wealth Index middle class (1.20; 1.08-1.32 or poor (1.33; 1.21-1.47 were significantly related with poor MHI-5. Unemployed persons in urban settlements had higher odds for poormMHI-5 than unemployed in rural areas (0.73; 0.59-0.89. Single (1.50; 1.26-1.78, unemployed (1.39; 1.07-1.80 and inactive respondents (1.42; 1.10-1.83 had a higher odds of chronic anxiety or depression than married individuals, or
Ford, Lorelei; Bharadwaj, Lalita; McLeod, Lianne; Waldner, Cheryl
Safe drinking water is a global challenge for rural populations dependent on unregulated water. A scoping review of research on human health risk assessments (HHRA) applied to this vulnerable population may be used to improve assessments applied by government and researchers. This review aims to summarize and describe the characteristics of HHRA methods, publications, and current literature gaps of HHRA studies on rural populations dependent on unregulated or unspecified drinking water. Peer-reviewed literature was systematically searched (January 2000 to May 2014) and identified at least one drinking water source as unregulated (21%) or unspecified (79%) in 100 studies. Only 7% of reviewed studies identified a rural community dependent on unregulated drinking water. Source water and hazards most frequently cited included groundwater (67%) and chemical water hazards (82%). Most HHRAs (86%) applied deterministic methods with 14% reporting probabilistic and stochastic methods. Publications increased over time with 57% set in Asia, and 47% of studies identified at least one literature gap in the areas of research, risk management, and community exposure. HHRAs applied to rural populations dependent on unregulated water are poorly represented in the literature even though almost half of the global population is rural.
Price, Alison J; Crampin, Amelia C; Amberbir, Alemayehu; Kayuni-Chihana, Ndoliwe; Musicha, Crispin; Tafatatha, Terence; Branson, Keith; Lawlor, Debbie A; Mwaiyeghele, Elenaus; Nkhwazi, Lawrence; Smeeth, Liam; Pearce, Neil; Munthali, Elizabeth; Mwagomba, Beatrice M; Mwansambo, Charles; Glynn, Judith R; Jaffar, Shabbar; Nyirenda, Moffat
Sub-Saharan Africa is in rapid demographic transition, and non-communicable diseases are increasingly important causes of morbidity and mortality. We investigated the burden of diabetes, overweight and obesity, hypertension, and multimorbidity, their treatment, and their associations with lifestyle and other factors in Malawi, a very poor country with a predominantly rural-but rapidly growing urban-population, to identify high-risk populations and inform appropriate interventions. In this cross-sectional, population-based study, we enrolled all adults (≥18 years) residing in two defined geographical areas within Karonga District and Lilongwe city. All adults self-defining as usually resident in the study areas were eligible, and recruited at household level. Participants were interviewed, had anthropometry and blood pressure measured, and had fasting blood samples collected. The study outcomes were prevalence estimates and risk ratios for diabetes (defined as fasting blood glucose of at least 7·0 mmol/L or self-report of a previous diagnosis of diabetes), hypertension (systolic blood pressure of at least 140 mm Hg, diastolic blood pressure of at least 90 mm Hg, or self-report of current antihypertensive medication), overweight (BMI of 25·0-29·9 kg/m 2 ) and obesity (BMI of 30·0 kg/m 2 or more), and multimorbidity (two or more of the above conditions) by location-specific (urban vs rural), age-specific, and sex-specific groups, calculated using negative binomial regression. We used χ 2 likelihood ratio tests to assess heterogeneity by age, location, and sex. Between May 16, 2013, and Feb 8, 2016, we enrolled 15 013 (62%) of 24 367 eligible urban adults in Lilongwe and 13 878 (88%) of 15 806 eligible rural adults in Karonga District. Overweight and obesity, hypertension, and diabetes were highly prevalent, more so in urban residents, the less poor, and better educated than in rural, the poorest, and least educated participants. 18% of urban men (961 of
Sun, Fei; Park, Nan Sook; Klemmack, David L.; Roff, Lucinda L.; Li, Zhihong
This article examined the differences between rural/urban older adults in their trajectories of activities of daily living (ADL) over a 4-year period. The sample included 2,490 community dwelling older adults who completed three waves (1998, 2000, and 2002) of the Chinese Longitudinal Healthy Longevity Survey. Among them, 63.5% were from rural…
Full Text Available Background: Inappropriate self medication is one of the leading causes of growing antibiotic resistance in developing nations which poses a major public health threat worldwide and assessment of self medication practices is essential for better understanding of the problem. Aim and Objectives: To find out the predictors of self medication use among the residents of Nellikuppam village, Kancheepuram District, Tamil Nadu. To assess the self medication practices among the residents of Nellikuppam village, Kancheepuram District, Tamil Nadu. Material and Methods: This was a descriptive cross sectional study conducted among 335 adult households with six months recall period in Nellikuppam village of Tamil Nadu during May to October, 2014 using a pretested semi-structured questionnaire. Results: Prevalence of self medication among adult rural population was 53.43% and only half of the study population opined that it was harmful. Pharmacists (72.06% were the major source of drug information on self medication. Paracetomol (84.91% was the commonest drug used for self medication. Major predictors were perception of illness as minor ailment and unavailability of doctors in their locality. Nearly half of the current self medication users (47.49% were in the idea of practicing self medication in the future. Conclusion: This study results implies the need for proper enforcement of legal measures towards the restriction of over the counter medicine and creating awareness among general population on adverse reaction of self medication.
The world's population is ageing, with forecasts predicting this ageing is likely to be particularly severe in the rural areas of more developed countries. These forecasts are developed from nationally aggregated census and survey data and assume spatial homogeneity in ageing. They also draw on narrow understandings of older people and construct…
NikNadia, Nmn; Sam, I-Ching; Khaidir, Nasibah; Ngui, Romano; Lim, Yvonne A L; Goh, Xiang Ting; Choy, Seow Huey; Chan, Yoke Fun
Enterovirus A71 (EV-A71), which is transmitted by the fecal-oral route, causes hand, foot and mouth disease and, rarely, severe neurological complications. In Malaysia, the indigenous rural community (Orang Asli) has a high prevalence of parasitic diseases due to poor sanitation, water supply and hygiene practices. This cross-sectional study compared the seroepidemiology of EV-A71 among rural Orang Asli and urban Kuala Lumpur populations in West Malaysia, and determined the risk factors associated with EV-A71 seropositivity in rural Orang Asli. Seropositive rates were determined by neutralization assay. EV-A71 seropositivity was strongly associated with increasing age in both populations. Rural Orang Asli children ≤12 years had significantly higher EV-A71 seropositivity rates than urban Kuala Lumpur children (95.5% vs 57.6%, P water (adjusted OR 6.2, 95% CI 2.3-16.6, P water may reduce the risk of EV-A71 infection. With significantly higher EV-A71 seropositive rates, younger rural children should be a priority target for future vaccination programs in Malaysia.
Skinner, Mark W; Winterton, Rachel
Informed by a critical turn underway in rural gerontology, this article explores how the intersection of global and local trends relating to population aging and rural change create contested spaces of rural aging. The aim is to build our understanding of rural as a dynamic context within which the processes, outcomes, and experiences of aging are created, confronted, and contested by older adults and their communities. A review of key developments within gerontology and rural studies reveals how competing policies, discourses, and practices relating to healthy aging and aging in place, rural citizenship and governmentality, and social inclusion and inequality combine in particular ways to empower or disempower a diverse range of older rural adults aging in a diverse range of rural communities. The article provides a contextually sensitive perspective on potential sources of conflict and exclusion for older adults in dynamic rural spaces and further enhances our understanding of how rural physical and social environments are constructed and experienced in older age. A framework for interrogating emergent questions about aging in rural contexts is developed and implications for advancing research, policy, and practice are discussed. © The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Cai, Jiaoli; Coyte, Peter C; Zhao, Hongzhong
In recent decades, China has experienced tremendous economic growth and also witnessed growing socioeconomic-related health inequality. The study aims to explore the potential causes of socioeconomic-related health inequality in urban and rural areas of China over the past two decades. This study used six waves of the China Health and Nutrition Survey (CHNS) from 1991 to 2006. The recentered influence function (RIF) regression decomposition method was employed to decompose socioeconomic-related health inequality in China. Health status was derived from self-rated health (SRH) scores. The analyses were conducted on urban and rural samples separately. We found that the average level of health status declined from 1989 to 2006 for both urban and rural populations. Average health scores were greater for the rural population compared with those for the urban population. We also found that there exists pro-rich health inequality in China. While income and secondary education were the main factors to reduce health inequality, older people, unhealthy lifestyles and a poor home environment increased inequality. Health insurance had the opposite effects on health inequality for urban and rural populations, resulting in lower inequality for urban populations and higher inequality for their rural counterparts. These findings suggest that an effective way to reduce socioeconomic-related health inequality is not only to increase income and improve access to health care services, but also to focus on improvements in the lifestyles and the home environment. Specifically, for rural populations, it is particularly important to improve the design of health insurance and implement a more comprehensive insurance package that can effectively target the rural poor. Moreover, it is necessary to comprehensively promote the flush toilets and tap water in rural areas. For urban populations, in addition to promoting universal secondary education, healthy lifestyles should be promoted
Zandile J. Mchiza
Full Text Available One serious concern of health policymakers in South Africa is the fact that there is no national data on the dietary intake of adult South Africans. The only national dietary study was done in children in 1999. Hence, it becomes difficult to plan intervention and strategies to combat malnutrition without national data on adults. The current review consequently assessed all dietary studies in adults from 2000 to June 2015 in an attempt to portray typical adult dietary intakes and to assess possible dietary deficiencies. Notable findings were that, in South Africa micronutrient deficiencies are still highly prevalent and energy intakes varied between very low intakes in informal settlements to very high intakes in urban centers. The most commonly deficient food groups observed are fruit and vegetables, and dairy. This has been attributed to high prices and lack of availability of these food groups in poorer urban areas and townships. In rural areas, access to healthy foods also remains a problem. A national nutrition monitoring system is recommended in order to identify dietary deficiencies in specific population groups.
Perkins, Jessica M.; Subramanian, S.V.; Davey Smith, George
In this review, the potential causes and consequences of adult height, a measure of cumulative net nutrition, in modern populations are summarized. The mechanisms linking adult height and health are examined, with a focus on the role of potential confounders. Evidence across studies indicates that short adult height (reflecting growth retardation) in low- and middle-income countries is driven by environmental conditions, especially net nutrition during early years. Some of the associations of height with health and social outcomes potentially reflect the association between these environmental factors and such outcomes. These conditions are manifested in the substantial differences in adult height that exist between and within countries and over time. This review suggests that adult height is a useful marker of variation in cumulative net nutrition, biological deprivation, and standard of living between and within populations and should be routinely measured. Linkages between adult height and health, within and across generations, suggest that adult height may be a potential tool for monitoring health conditions and that programs focused on offspring outcomes may consider maternal height as a potentially important influence. PMID:26928678
Full Text Available The paper is focused on the issue of rural population incomes, their evolution, and changes in their structure that occurred in the period 2006-2012. It was performed a comparative analysis of the ratio between the available income per capita and subsistence minimum in rural and urban areas, and based on this, it was highlighted the gap between the welfare of urban and rural population. The result of the study proved that despite positive tendencies in reducing rural poverty, rural population income is still very low, without reaching the subsistence minimum. This fact, along with other negative aspects (reduced share of income from employment, increased share of social allowances and remittances leads to the decrease of the motivational effects of work payment and income from agricultural activity. Thus, it is obvious, that along with government social programs, to have more effective state actions targeted to business development in rural areas and hence creating new workplaces.
Felix F. Widjaja
Full Text Available Background: Prehypertension and hypertension were related with many complications of nearly every organ, but often neglected by young adults in rural area. This research was done to observe the prevalence of prehypertension and hypertension among young adult in a primary health care of rural area at Cicurug, Sukabumi District, West Java.Methods: This cross-sectional study was done in Cicurug Public Health Center, Sukabumi District, West Java. The subjects were consecutively recruited from the outpatient clinic on Monday until Saturday in September 2012,18–25 years old, not pregnant nor having shock. They were interviewed about their age, gender, physical activity, sitting hours, smoking habit, alcohol consumption, and family history and examined by trained health professionals (weight, height, body mass index [BMI], systolic and diastolic blood pressure.Results: From 111 young adults, 34.2% had prehypertension and 17.1% had hypertension. Within sex groups, the prevalence of prehypertension was higher in females, whereas hypertension was occurred more in males. Neither of family history from mother nor father were associated with prehypertension and hypertension compared with normotension. Total activity was not associated with prehypertension (OR = 2.6; p = 0.052 and hypertension (OR = 1.758; p = 0.498. BMI was associated with hypertension (OR = 3.354; p = 0.041 and not associated with prehypertension (OR = 2.343; p = 0.099.Conclusion: Prevalence of prehypertension and hypertension were relatively high among young adult in primary health care of rural area. Intervention to prevent further complications needs to be done early with lifestyle modification because blood pressure is associated with modifiable risk factors, such as BMI and total activity. (Med J Indones. 2013;22:39-45Keywords: Hypertension, prehypertension, rural area, young adult
Lou, Vivian W Q; Lu, Nan; Xu, Ling; Chi, Iris
This study tested the relationship between grandparent-grandchild family capital and self-rated health of older rural Chinese adults and the mediating role of the grandparent-parent relationship in terms of grandparent-grandchild family capital and self-rated health. Data were derived from a random sample of 1,027 adults aged 60 and older who were interviewed in the rural Chaohu region in 2009. Structural equation modeling was used to examine the direct effect of grandparent-grandchild family capital in terms of relations with the first child's family on self-rated health among respondents, as well as the mediating effect of the grandparent-parent relationship. The results showed the direct effect of grandparent-grandchild family capital on self-rated health of older rural Chinese adults. The grandparent-parent relationship had a partial mediation effect on the relationship between grandparent-grandchild family capital and self-rated health of respondents. Grandparent-grandchild family capital had a unique direct effect on the self-rated health of older rural Chinese adults, enriching our theoretical understanding of sources of family capital and their impacts in a collectivist cultural context that emphasizes intergenerational interaction and exchange. The findings also highlighted the mediation effects of grandparent-parent relationships on the relationship between grandparent-grandchild family capital and self-rated health of older rural Chinese adults, supporting the "grandchild-as-linkage" hypothesis in understanding the social determination of self-rated health in China.
Barik, Anamitra; Rai, Rajesh Kumar; Chowdhury, Abhijit
Aim To measure the prevalence of self-reported morbidity and its associated factors among adults (aged ⩾15 years) in a select rural Indian population. Self-reporting of smoking has been validated as population-based surveys using self-reported data provide reasonably consistent estimates of smoking prevalence, and are generally considered to be sufficiently accurate for tracking the general pattern of morbidity associated with tobacco use in populations. However, to gauge the true disease burden using self-reported morbidity data requires cautious interpretation. During 2010-2011, a cross-sectional survey was conducted under the banner of the Health and Demographic Surveillance System, Birbhum, an initiative of the Department of Health and Family Welfare, Government of West Bengal, India. With over 93.6% response rate from the population living in 12 300 households, this study uses the responses from 16 354 individuals: 8012 smokers, and 8333 smokeless tobacco users. Smokers and smokeless tobacco users were asked whether they have developed any morbidity symptoms due to smoking, or smokeless tobacco use. Bivariate, as well as multivariate logistic regression analyses were deployed to attain the study objective. Findings Over 20% of smokers and over 9% of smokeless tobacco users reported any morbidity. Odds ratio (OR) with 95% confidence interval (CI) estimated using logistic regression shows that women are less likely to report any morbidity attributable to smoking (OR: 0.69; CI: 0.54-0.87), and more likely to report any morbidity due to smokeless tobacco use (OR: 1.68; CI: 1.36-2.09). Non-Hindus have higher odds, whereas the wealthiest respondents have lower odds of reporting any morbidity. With a culturally appropriate intervention to change behaviour, youth (both men and women) could be targeted with comprehensive tobacco cessation assistance programmes. A focussed intervention could be designed for unprocessed tobacco users to curb hazardous effects of
Jung, Seung Eun; Parker, Stephany; Hermann, Janice; Phelps, Joshua; Shin, Yeon Ho
We explored rural older adults perceptions of health to inform health promotion program development, using social marketing as our framework. Participants in seven focus groups viewed independence and holistic health as indicators of health and identified healthful eating and physical activity as actions to promote health. Barriers to these…
Bryson Alberto Ndenga
Full Text Available Aedes aegypti is the main vector for yellow fever, dengue, chikungunya and Zika viruses. Recent outbreaks of dengue and chikungunya have been reported in Kenya. Presence and abundance of this vector is associated with the risk for the occurrence and transmission of these diseases. This study aimed to characterize the presence and abundance of Ae. aegypti adult mosquitoes from rural and urban sites in western and coastal regions of Kenya. Presence and abundance of Ae. aegypti adult mosquitoes were determined indoors and outdoors in two western (urban Kisumu and rural Chulaimbo and two coastal (urban Ukunda and rural Msambweni sites in Kenya. Sampling was performed using quarterly human landing catches, monthly Prokopack automated aspirators and monthly Biogents-sentinel traps. A total of 2,229 adult Ae. aegypti mosquitoes were collected: 785 (35.2% by human landing catches, 459 (20.6% by Prokopack aspiration and 985 (44.2% by Biogents-sentinel traps. About three times as many Ae. aegypti mosquitoes were collected in urban than rural sites (1,650 versus 579. Comparable numbers were collected in western (1,196 and coastal (1,033 sites. Over 80% were collected outdoors through human landing catches and Prokopack aspiration. The probability of collecting Ae. aegypti mosquitoes by human landing catches was significantly higher in the afternoon than morning hours (P<0.001, outdoors than indoors (P<0.001 and in urban than rural sites (P = 0.008. Significantly more Ae. aegypti mosquitoes were collected using Prokopack aspiration outdoors than indoors (P<0.001 and in urban than rural areas (P<0.001. Significantly more mosquitoes were collected using Biogents-sentinel traps in urban than rural areas (P = 0.008 and in western than coastal sites (P = 0.006. The probability of exposure to Ae. aegypti bites was highest in urban areas, outdoors and in the afternoon hours. These characteristics have major implications for the possible transmission of arboviral
Ettinger, Ronald L; Warren, John J; Levy, Steven M; Hand, Jed S; Merchant, James A; Stromquist, Ann M
Several studies have shown that oral health problems impact the quality of life of older adults. However, few data are available to describe the oral health status, barriers to care, and patterns of care for adults and older populations living in rural areas. The purpose of this study was to evaluate the perceived need for treatment of oral health problems by adult residents in a rural county in Iowa. The oral health component was part of a larger longitudinal health study of the residents. The sample was stratified into three groups by residence, that is, farm households, rural non-farm households and town households. The sample was subsequently post-stratified by gender and age group into young elderly, 65-74 years old, and old elderly, 75 years and older. Dentition status varied according to age and was related to the perception of treatment needs. Edentulous persons had fewer perceived treatment needs and utilized a dentist less frequently. Place of residence, education, and marital status were not associated with the subjects' perceived problems with eating and chewing. However, persons with difficulty chewing were more likely to have some missing upper teeth, have a perceived need to have denture work, and have smoked for a number of years. The results suggest that this rural population is retaining more teeth and consequently may need and may seek dental services more often than previous more edentulous cohorts.
National Aeronautics and Space Administration — The Low Elevation Coastal Zone (LECZ) Urban-Rural Population and Land Area Estimates, Version 2 data set consists of country-level estimates of urban population,...
Payne, Collin F; Davies, Justine I; Gomez-Olive, F Xavier; Hands, Katherine J; Kahn, Kathleen; Kobayashi, Lindsay C; Tipping, Brent; Tollman, Stephen M; Wade, Alisha; Witham, Miles D
Age cohort differences in haemoglobin concentrations and associations with physical and cognitive performance among populations of lower income and middle-income countries have not previously been described. We examined the association between these factors among older men and women in rural South Africa. We analysed cross-sectional data from a population-based study of rural South African men and women aged 40 and over (n=4499), with data drawn from questionnaire responses, a cognitive battery, objective physical function tests and blood tests. Anaemia was defined as a haemoglobin concentration age, grip strength, walk speed and a latent cognitive function z-score for men and women separately. We used unadjusted correlations and linear models to adjust for comorbidities and inflammation. In total, 1042 (43.0%) women and 833 (40.1%) men were anaemic. Haemoglobin concentrations were inversely correlated with age for men but not for women; in adjusted analyses, haemoglobin was 0.3 g/dL lower per decade older for men (95% CI 0.2 to 0.4 g/dL). In adjusted analyses, haemoglobin concentration was independently associated with grip strength in women (B=0.391, 95% CI 0.177 to 0.605), but this did not reach significance in men (B=0.266, 95% CI -0.019 to 0.552); no associations were observed between haemoglobin levels and walk speed or cognitive score. Anaemia was prevalent in this study population of middle-aged and older, rural South African adults, but in contrast to high-income countries, it was not associated with poor physical or cognitive function. Our findings need to be replicated in other populations. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
González, Lina María; Peñaloza, Rolando Enrique; Matallana, María Alexandra; Gil, Fabián; Gómez-Restrepo, Carlos; Landaeta, Angela Patricia Vega
Access to mental health services by people with mental disorders has traditionally been limited, and is associated with attitudinal, social, and structural variables. To analyse the factors that determine access to mental health services by the adult population (18-44 years old) in Colombia, from the results obtained in the 2015 National Mental Health Survey. Analysis of variables of access to attention in mental health care for adults. The reasons for not consulting were classified as barriers of behavioural supply and demand. To analyse the factors associated with access to mental health services in the Colombian adult population, the use of health services in the last 12 months for emotional, nervous or mental health problems was taken into account, as well as associated variables such as demographic characteristics, occupational activity, affiliation to social security, and health status variables. The relationships between these variables were estimated using bivariate multinomial logistic regression models. Rural residence, being married, and having a chronic disease were associated with the decision to consult or not to consult the doctor. Further studies should be conducted to evaluate the situation as regards mental health care access, as well as to determine the potential factors associated with these limitations. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
Using fieldnotes from the non-formal adult education classes run by a non-profit international education with ground operations in rural Mozambique, this article documents how the comments made by class facilitators and class participants in those classes reflect inherent power inequalities between non-profit staff and local participants. These…
Le Lait, Marie-Claire; Martinez, Erin M; Severtson, Stevan G; Lavery, Sarah A; Bucher-Bartelson, Becki; Dart, Richard C
Prescription opioid abuse and misuse are a serious problem in the U.S. today. Several studies have shown that the epidemic disproportionately affects rural areas. This paper uses three different rates to gain a more complete picture of opioid abuse in rural areas. This study examines prescription opioid intentional exposures using opioid classes tracked in the RADARS(®) System Poison Center Program. Intentional exposure rates were calculated adjusting for population and unique recipients of dispensed drug (URDD). These rates were analyzed using time (quarter) and the proportion of a three-digit zip code residing in a rural area as covariates. Additionally, the URDD per population rate was calculated to examine the proportion of the population filling prescriptions for opioids. After adjusting for population, intentional exposure cases significantly increased as the proportion of the population residing in a rural area increased. However, when adjusting for URDD, intentional exposure cases decreased with increasing rural population. The URDD per population increased as the proportion of people residing in a rural area increased. Using both population and URDD adjusted intentional exposure rates gives a more complete picture of opioid abuse in rural areas. Considering product availability can be used to develop opioid abuse prevention strategies and further the education of physicians serving rural areas about this epidemic. Copyright © 2014 John Wiley & Sons, Ltd.
Ahn, SangNam; Burdine, James N; Smith, Matthew Lee; Ory, Marcia G; Phillips, Charles D
The purposes of the study were (a) to identify disparities between urban and rural adults in oral health and (b) to examine contextual (i.e., external environment and access to dental care) and individual (i.e., predisposing, enabling, and lifestyle behavioral) factors associated with oral health problems in a community population. Study data were derived from a two-stage, telephone-mailed survey conducted in 2006. The subjects were 2,591 adults aged 18 years and older. Cochran-Mantel-Haenszel statistics for categorical variables were applied to explore conditional independence between both health access and individual factors and oral health problems after controlling for the urban or rural residence. Logistic regression was used to investigate the simultaneous associations of contextual and individual factors in both rural and urban areas. Approximately one quarter (24.1%) of the study population reported oral health problems. Participants residing in rural areas reported more oral health disparities. Oral health problems were significantly associated with delaying dental care. These problems also were more common among those who were less educated, were African American, skipped breakfast every day, and currently smoked. The study findings suggest that oral health disparities persist for people in rural areas, and improving oral health status is strongly related to better access to oral health care and improved lifestyles in both rural and urban areas.
Supiyev, Adil; Kossumov, Alibek; Kassenova, Aliya; Nurgozhin, Talgat; Zhumadilov, Zhaxybay; Peasey, Anne; Bobak, Martin
The evidence on the prevalence and distribution of diabetes and its determinants in Central Asia is sparse. The aim of the present study was to investigate the prevalence, awareness, treatment, and control of diabetes and factors associated with these characteristics in the population of Astana (capital) city and adjacent rural area in Kazakhstan. Participants aged 50-75 years old, residing in Astana city (the capital) and Akmol village were invited to participate in a cross-sectional study. The subjects were randomly selected from polyclinic registers. A total of 953 adults were interviewed (response rate 59%), and their fasting plasma glucose, blood pressure, height and weight were measured. Diabetes was defined as fasting plasma glucose (FPG) ≥ 7.0 mmol/l (126 mg/dl) and/or being on diabetes medication. The overall prevalence of diabetes was 12.5%, and it was almost twice higher in the urban residents (16.3%) than in the rural population (8.6%). Diabetes prevalence was associated with age, men sex, hypertension, obesity, and Russian ethnicity. Among subjects with diabetes, 72.3% were aware of their condition; 65.6% were on treatment and 27.7% had controlled fasting plasma glucose. The awareness, treatment and control of diabetes were substantially higher in the urban population and among women. The large differences in all diabetes indices between urban and rural regions, if confirmed in larger studies, may suggest an impact of westernised and urbanised lifestyle as well as access to health care. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
Full Text Available OBJETIVO: Caracterizar la antropometría y presión arterial de adultos del estado de Yucatán, México. MATERIAL Y MÉTODOS: Se evaluaron diferencias rural-urbanas por grupos sexo-edad en peso, talla, circunferencias de cintura y cadera, y presión arterial en 313 adultos de origen urbano y 271 del rural, de Yucatán. RESULTADOS: No hubo diferencias rural-urbanas en prevalencias de obesidad y sobrepeso, y en hipertensión los urbanos tuvieron valores marginalmente mayores. Se encontró mayor prevalencia rural de cintura anormal sólo en mujeres y hombres jóvenes. La comparación con dos encuestas nacionales y una regional (mixtecos rurales mostró obesidad similar a la notificada en la Encuesta Nacional de Salud 2000 (ENSA y mayor que mixtecos y la informada en la Encuesta Nacional de Enfermedades Crónicas 1993 (ENEC. La prevalencia de cintura anormal fue intermedia entre la indicada en la Encuesta Nacional de Salud y Nutrición 2006 (ENSANUT y mixtecos, y la de hipertensión intermedia entre la notificada en la ENEC y mixtecos. CONCLUSIONES: Las poblaciones maya y mestiza de Yucatán presentaron alta prevalencia de obesidad y cintura anormal que no se acompañaron de prevalencia mayor de hipertensión. Esta observación requiere confirmación.OBJECTIVE: To characterize body morphology and blood pressure of adults of the Mexican state of Yucatan. MATERIAL AND METHODS: Rural-urban differences in weight, height, waist, and hip circumferences, and blood pressure were analyzed in 313 urban and 271 rural subjects. RESULTS: No rural-urban differences in prevalence of obesity and overweight were found. Hypertension was marginally higher in urban subjects. Rural abnormal waist circumference was higher in young men and young women. Comparison with two national surveys and a survey in the aboriginal population (rural mixtecos showed similar prevalence of obesity as ENSA-2000 and higher than mixtecos and ENEC-1993. Abnormal waist circumference was
Khan, Aishah; Thapa, Janani R; Zhang, Donglan
This study aimed to assess the relationship between rural or urban residence and having a usual source of care (USC), and the utilization of preventive dental checkups among adults. Cross-sectional analysis was conducted using data from the Medical Expenditure Panel Survey 2012. We performed a logit regression on the relationship between rural and urban residence, having a USC, and having at least 1 dental checkup in the past year, adjusting for sociodemographic characteristics and health status. After controlling for covariates, rural adult residents had significantly lower odds of having at least 1 dental checkup per year compared to their urban counterparts (odds ratio [OR] = 0.73, 95% confidence interval [CI]: 0.62-0.86, P rural and urban residents, having a USC was significantly associated with an 11% (95% CI = 9%-13%) increase in the probability of having a preventive dental checkup within a year. Individuals with a USC were more likely to obtain a preventive dental visit, with similar effects in rural and urban settings. We attributed the lower odds of having a checkup in rural regions to the lower density of oral health care providers in these areas. Integration of rural oral health care into primary care may help mitigate the challenges due to a shortage of oral health care providers in rural areas. © 2017 National Rural Health Association.
Das, Biswa R.; Leatherman, John C.; Bressers, Bonnie M.
The Internet has potential for improving health information delivery and strengthening connections between rural populations and local health service providers. An exploratory case study six rural health care markets in Kansas showed that about 70% of adults use the Internet, with substantial use for accessing health information. While there are…
Berry, Narelle M; Coffee, Neil T; Nolan, Rebecca; Dollman, James; Sugiyama, Takemi
Although the health benefits of walking are well established, participation is lower in rural areas compared to urban areas. Most studies on walkability and walking have been conducted in urban areas, thus little is known about the relevance of walkability to rural areas. A computer-assisted telephone survey of 2402 adults (aged ≥18 years) was conducted to determine walking behaviour and perceptions of neighbourhood walkability. Data were stratified by urban (n = 1738) and rural (n = 664). A greater proportion of respondents reported no walking in rural (25.8%) compared to urban areas (18.5%). Compared to urban areas, rural areas had lower walkability scores and urban residents reported higher frequency of walking. The association of perceived walkability with walking was significant only in urban areas. These results suggest that environmental factors associated with walking in urban areas may not be relevant in rural areas. Appropriate walkability measures specific to rural areas should be further researched.
Stamenić, Valerija; Strnad, Marija
Aim To investigate urban-rural differences in the distribution of risk factors for breast cancer. Methods We analyzed the data from the first round of the “Mamma” population based-screening program conducted in Croatia between 2007 and 2009 and self-reported questionnaire results for 924 patients with histologically verified breast cancer. Reproductive and anthropometric characteristics, family history of breast cancer, history of breast disease, and prior breast screening history were compared between participants from the city of Zagreb (n = 270) and participants from 13 counties with more than 50% of rural inhabitants (n = 654). Results The screen-detected breast cancer rate was 4.5 per 1000 mammographies in rural counties and 4.6 in the city of Zagreb, while the participation rate was 61% in rural counties and 59% in Zagreb. Women from Zagreb had significantly more characteristics associated with an increased risk of breast cancer (P < 0.001 in all cases): no pregnancies (15% vs 7%), late age of first pregnancy (≥30 years) (10% vs 4%), and the most recent mammogram conducted 2-3 years ago (32% vs 14%). Women from rural counties were more often obese (41% vs 28%) and had early age of first live birth (<20 years) (20% vs 7%, P < 0.001 for both). Conclusion Identification of rural-urban differences in mammography use and their causes at the population level can be useful in designing and implementing interventions targeted at the reduction of inequalities and modifiable risk factors. PMID:21328724
Willis, H.L.; Buri, M.J. [ABB Automated Distribution Div., Raleigh, NC (United States); Finley, L.A. [Snohomish County PUD, Everett, WA (United States)
Modern computerized distribution load forecasting methods, although accurate when applied to urban areas, give somewhat less satisfactory results when forecasting load growth in sparsely populated rural areas. This paper examines the differences between rural and urban load growth histories, identifying a major difference in the observed behavior of load growth. This difference is exploited in a new simulation forecasting algorithm. Tests show the new method is as accurate in forecasting rural load growth and as useful for analyzing DSM impacts than past methods, while requiring considerably lower computer resources and data than other simulation methods of comparable accuracy.
Liu, Ruihua; Li, Yuqian; Wang, Fang; Liu, Xiaotian; Zhou, Hao; Wang, Panpan; Fan, Jingjing; Xu, Fei; Yang, Kaili; Hu, Dongsheng; Bie, Ronghai; Wang, Chongjian
The consistency and strength of the relationship between napping duration and type 2 diabetes mellitus (T2DM) remained uncertain, especially in the rural population. The purpose of this study was to explore the relationship between napping duration and T2DM in a Chinese rural population. A total of 12663 participants (4365 males and 8298 females) were derived from the RuralDiab study in China. Napping duration was obtained through a standardized questionnaire, and was divided into five categories: no napping (reference), 1∼, 31∼, 61∼, and ≥91 min. Fasting blood glucose was measured. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). A meta-analysis including seven studies was conducted to validate the result of the RuralDiab study. The crude and age-standardized prevalence of T2DM were 10.31% and 8.14%, respectively. Compared with no napping, the adjusted OR (95%CI) for napping duration ≥91 min was 1.23 (1.05-1.45). A similar relationship was found only in females aged 45-54 years, but not in males and other age group females. In addition, napping duration was associated with T2DM in a positive dose-dependent manner among females aged 45-54 years (P for trend napping duration compared with no napping was 1.28 (1.22-1.35). Longer napping duration is associated with higher risk of T2DM in the Chinese rural population, and this association varies across gender and age. Further multi-center prospective researches are needed to confirm the relationship and reveal underlying mechanisms. Copyright © 2016 Elsevier B.V. All rights reserved.
Shak, Joshua R; Sodikoff, Jamie B; Speckman, Rebecca A; Rollin, Francois G; Chery, Marie P; Cole, Conrad R; Suchdev, Parminder S
Anemia is a significant health concern worldwide and can be the result of nutritional, environmental, social, and infectious etiologies. We estimated the prevalence of anemia in 336 pre-school children and 132 adults in the rural Central Plateau of Haiti and assessed associations with age, sex, household size, water source, sanitation, and Helicobacter pylori seroreactivity using logistic regression analysis; 80.1% (269/336) of children and 63.6% (84/132) of adults were anemic. Among children, younger age was associated with increased prevalence of anemia (adjusted odds ratio [aOR] = 4.1, 95% confidence interval [CI] = 1.5-11.1 for children 6-11 months compared with children 48-59 months). Among adults, 50.8% were H. pylori-seropositive, and seropositivity was inversely associated with anemia (aOR = 0.4, 95% CI = 0.2-0.9). Anemia prevalence in this region of Haiti is very high and not attributable to sanitary conditions or a high prevalence of H. pylori infection.
Giles, H.; Kutchukhides, M.; Yagmur, K.; Noels, K. A.
This study extends previous research on age-group vitality around the Pacific Rim by examining the perceptions of urban and rural respondents from Turkey, Canada and the nation of Georgia towards young, middle-aged, and older adults. As in prior research, middle-aged targets were accorded the
Whitehead, J; Shaver, John; Stephenson, Rob
Prior studies have noted significant health disadvantages experienced by LGBT (lesbian, gay, bisexual, and transgender) populations in the US. While several studies have identified that fears or experiences of stigma and disclosure of sexual orientation and/or gender identity to health care providers are significant barriers to health care utilization for LGBT people, these studies have concentrated almost exclusively on urban samples. Little is known about the impact of stigma specifically for rural LGBT populations, who may have less access to quality, LGBT-sensitive care than LGBT people in urban centers. LBGT individuals residing in rural areas of the United States were recruited online to participate in a survey examining the relationship between stigma, disclosure and "outness," and utilization of primary care services. Data were collected and analyzed regarding LGBT individuals' demographics, health care access, health risk factors, health status, outness to social contacts and primary care provider, and anticipated, internalized, and enacted stigmas. Higher scores on stigma scales were associated with lower utilization of health services for the transgender & non-binary group, while higher levels of disclosure of sexual orientation were associated with greater utilization of health services for cisgender men. The results demonstrate the role of stigma in shaping access to primary health care among rural LGBT people and point to the need for interventions focused towards decreasing stigma in health care settings or increasing patients' disclosure of orientation or gender identity to providers. Such interventions have the potential to increase utilization of primary and preventive health care services by LGBT people in rural areas.
Full Text Available Prior studies have noted significant health disadvantages experienced by LGBT (lesbian, gay, bisexual, and transgender populations in the US. While several studies have identified that fears or experiences of stigma and disclosure of sexual orientation and/or gender identity to health care providers are significant barriers to health care utilization for LGBT people, these studies have concentrated almost exclusively on urban samples. Little is known about the impact of stigma specifically for rural LGBT populations, who may have less access to quality, LGBT-sensitive care than LGBT people in urban centers.LBGT individuals residing in rural areas of the United States were recruited online to participate in a survey examining the relationship between stigma, disclosure and "outness," and utilization of primary care services. Data were collected and analyzed regarding LGBT individuals' demographics, health care access, health risk factors, health status, outness to social contacts and primary care provider, and anticipated, internalized, and enacted stigmas.Higher scores on stigma scales were associated with lower utilization of health services for the transgender & non-binary group, while higher levels of disclosure of sexual orientation were associated with greater utilization of health services for cisgender men.The results demonstrate the role of stigma in shaping access to primary health care among rural LGBT people and point to the need for interventions focused towards decreasing stigma in health care settings or increasing patients' disclosure of orientation or gender identity to providers. Such interventions have the potential to increase utilization of primary and preventive health care services by LGBT people in rural areas.
Full Text Available Purpose – This paper aims to demonstrate the impact of two important socio-cultural factors on the level of the entrepreneurial activity of young individuals in rural regions. Design/methodology/approach – Our empirical study is based on a sample collected from an adult population survey, and analyzed using a logit model that controls for territorial and aging sources of heterogeneity. Our theoretical framework is anchored on a contingency perspective that emphasizes the unique influences of the contextual environment in driving entrepreneurial behavior. Findings – The main findings of our study is that in Spain the likelihood of being entrepreneurially active is no different for young and old individuals, and between rural and urban regions. Surprisingly, unlike shown in most studies, entrepreneurial role models do not have any effect on the entrepreneurship by young individuals in rural regions of Spain, while the negative impact of fear of failure in the entrepreneurship on young individuals in rural regions is much higher compared to the rest of the population. Originality/value – Our findings reveal that the context (regional has a more significant impact on entrepreneurship for some segments (younger individuals of the population than for others.
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,…
Szabo, Christopher P; Allwood, Clifford W
This study was undertaken as part of an exploration of the potential risk for future eating disorders in the black female population of South Africa. Previous research has documented eating attitudes suggesting that such a risk exists in urban populations. A translated version of the Eating Attitudes Test (EAT-26) was applied in a Zulu speaking, rural population (n=361). A prevalence of 3% for abnormal eating attitudes was established. In keeping with the hypothesis, the findings suggest that the risk for developing an eating disorder in a rural population is somewhat lower. In this regard, there does appear to be an urban-rural divide, which may have implications for the prevention of the emergence of eating disorders in black, South African adolescents. However, the validity of the EAT-26 in this population is a consideration in interpreting the data. PMID:16633489
Ndenga, Bryson Alberto; Mutuku, Francis Maluki; Ngugi, Harun Njenga; Mbakaya, Joel Omari; Aswani, Peter; Musunzaji, Peter Siema; Vulule, John; Mukoko, Dunstan; Kitron, Uriel; LaBeaud, Angelle Desiree
Aedes aegypti is the main vector for yellow fever, dengue, chikungunya and Zika viruses. Recent outbreaks of dengue and chikungunya have been reported in Kenya. Presence and abundance of this vector is associated with the risk for the occurrence and transmission of these diseases. This study aimed to characterize the presence and abundance of Ae. aegypti adult mosquitoes from rural and urban sites in western and coastal regions of Kenya. Presence and abundance of Ae. aegypti adult mosquitoes were determined indoors and outdoors in two western (urban Kisumu and rural Chulaimbo) and two coastal (urban Ukunda and rural Msambweni) sites in Kenya. Sampling was performed using quarterly human landing catches, monthly Prokopack automated aspirators and monthly Biogents-sentinel traps. A total of 2,229 adult Ae. aegypti mosquitoes were collected: 785 (35.2%) by human landing catches, 459 (20.6%) by Prokopack aspiration and 985 (44.2%) by Biogents-sentinel traps. About three times as many Ae. aegypti mosquitoes were collected in urban than rural sites (1,650 versus 579). Comparable numbers were collected in western (1,196) and coastal (1,033) sites. Over 80% were collected outdoors through human landing catches and Prokopack aspiration. The probability of collecting Ae. aegypti mosquitoes by human landing catches was significantly higher in the afternoon than morning hours (Paegypti mosquitoes were collected using Prokopack aspiration outdoors than indoors (Paegypti bites was highest in urban areas, outdoors and in the afternoon hours. These characteristics have major implications for the possible transmission of arboviral diseases and for the planning of surveillance and control programs. PMID:29261766
Penelope A Phillips-Howard
Full Text Available Non-communicable diseases (NCDs result in more deaths globally than other causes. Monitoring systems require strengthening to attribute the NCD burden and deaths in low and middle-income countries (LMICs. Data from health and demographic surveillance systems (HDSS can contribute towards this goal.Between 2003 and 2010, 15,228 deaths in adults aged 15 years (y and older were identified retrospectively using the HDSS census and verbal autopsy in rural western Kenya, attributed into broad categories using InterVA-4 computer algorithms; 37% were ascribed to NCDs, 60% to communicable diseases (CDs, 3% to injuries, and <1% maternal causes. Median age at death for NCDs was 66y and 71y for females and males, respectively, with 43% (39% male, 48% female of NCD deaths occurring prematurely among adults aged below 65y. NCD deaths were mainly attributed to cancers (35% and cardio-vascular diseases (CVDs; 29%. The proportionate mortality from NCDs rose from 35% in 2003 to 45% in 2010 (χ2 linear trend 93.4; p<0.001. While overall annual mortality rates (MRs for NCDs fell, cancer-specific MRs rose from 200 to 262 per 100,000 population, mainly due to increasing deaths in adults aged 65y and older, and to respiratory neoplasms in all age groups. The substantial fall in CD MRs resulted in similar MRs for CDs and NCDs among all adult females by 2010. NCD MRs for adults aged 15y to <65y fell from 409 to 183 per 100,000 among females and from 517 to 283 per 100,000 population among males. NCD MRs were higher among males than females aged both below, and at or above, 65y.NCDs constitute a significant proportion of deaths in rural western Kenya. Evidence of the increasing contribution of NCDs to overall mortality supports international recommendations to introduce or enhance prevention, screening, diagnosis and treatment programmes in LMICs.
Yang, Fan; Lou, Vivian W Q
Community restructuring is an important predictor for residents' mental health. However, few studies have investigated how it affects the depressive symptoms of rural ageing population. Using cross-sectional data from China Health and Retirement Longitudinal Study (CHARLS), this study examined how community restructuring was associated with depressive symptoms of Chinese rural mature and older adults and what community-level factors mediated the association. We found that people in restructuring communities reported .75 unit lower depression score (p < .01); community restructuring is associated with more infrastructure, recreational amenities, and grassroots organization (p < .001) in the community; and the availability of infrastructure (p < .01) and grassroots organization (p < .05) had significant indirect effect on the association between community restructuring and depressive symptoms. World countries' urbanization policy shall not only focus on community physical environment, but also on the development of grassroots organizations that involve and connect local people.
Danzig, Arnold; Vandegrift, Judith A.
Public policy implications for Arizona of the School-to-Work Opportunities Act are explored, specifically with regard to rural areas. It is argued that should additional resources become available to the state, population-based allocations to rural areas are likely to be insufficient for meaningful educational and economic-development reform. (SLD)
Full Text Available Abstract Background With rapid economic growth and globalization, lifestyle in China has been changing dramatically. This study aimed to describe the male and female adult Chinese population health status. Methods The Chinese Third National Health Services Survey was conducted in 2003 to collect information about health status and quality of life from randomly selected residents. Of the 193,689 respondents to the survey (response rate 77.8%, 139,831 (69,748 male and 70,083 female respondents who were 18 years of age or older were analyzed. Results Among the respondents, fewer males than females rated their overall wellbeing as being poor or very poor (4.8% versus 6.2%, reported illness in the last 2 weeks (14.1% versus 17.4%, presence of physician diagnosed chronic disease (15.0% versus 17.7% and at least one functional problem in seven items of the quality of life (26.9% versus 32.8%. More males than females were currently smoking (52.4% versus 3.4% and drank alcohol more than three times per week (16.5% versus 1.1%. Physically inactive rate was similar between males and females (85.8% versus 87.0%. Fewer rural respondents reported chronic disease than urban respondents (13.0% versus 19.9% for males and 15.5% versus 22.8% for females. In all seven items of the quality of life measured, rural respondents reported less problems than urban respondents (26.2% versus 28.7% for males and 32.0% versus 34.7% for females. Conclusion Males had better health status than females in terms of self-perceived wellbeing, presence of illness, chronic disease, and quality of life. However, smoking and frequent alcohol drinking was more prevalent among males than that among females. In contrast with the social-economic gradient in health commonly found in the literature, the wealthier urban population in China was not found to be healthier than the rural population in terms of physician diagnosed chronic disease.
Full Text Available In recent years changes have been noted in the motivations for acute suicidal poisonings among young people from various environments, which are due to psychosocial changes both in the urban and rural environments. Suicidal attempts are accompanied – especially in the rural environment – by low social status, difficulties with adapting to a free market economy, emotional tension within the family, at school, in the environment of young people, addiction to alcohol, drug overuse, including psychotropes. Based on clinical material concerning rural inhabitants hospitalized due to suicidal poisonings, the authors performed the analysis of attitudes, motivations and causes of acute poisonings among the young rural population. Among rural adolescents who continued school or university education the dominant causes of undertaking a suicidal attempt were: adolescent period problems, conflicts within the family, conflicts with mates, and disappointment in love. Among young adults the motivations were as follows: difficulties with finding employment in the place of residence, conflicts within the family, overuse of stimulants, and sometimes states of depression during the period of aggravation of a disease.
Whitehead, J.; Shaver, John; Stephenson, Rob
Background Prior studies have noted significant health disadvantages experienced by LGBT (lesbian, gay, bisexual, and transgender) populations in the US. While several studies have identified that fears or experiences of stigma and disclosure of sexual orientation and/or gender identity to health care providers are significant barriers to health care utilization for LGBT people, these studies have concentrated almost exclusively on urban samples. Little is known about the impact of stigma specifically for rural LGBT populations, who may have less access to quality, LGBT-sensitive care than LGBT people in urban centers. Methodology LBGT individuals residing in rural areas of the United States were recruited online to participate in a survey examining the relationship between stigma, disclosure and “outness,” and utilization of primary care services. Data were collected and analyzed regarding LGBT individuals’ demographics, health care access, health risk factors, health status, outness to social contacts and primary care provider, and anticipated, internalized, and enacted stigmas. Results Higher scores on stigma scales were associated with lower utilization of health services for the transgender & non-binary group, while higher levels of disclosure of sexual orientation were associated with greater utilization of health services for cisgender men. Conclusions The results demonstrate the role of stigma in shaping access to primary health care among rural LGBT people and point to the need for interventions focused towards decreasing stigma in health care settings or increasing patients’ disclosure of orientation or gender identity to providers. Such interventions have the potential to increase utilization of primary and preventive health care services by LGBT people in rural areas. PMID:26731405
Full Text Available A cross sectional study was conducted in eight selected villages of Meerut District [UJP.} to find out infant mortality rate alongwith other various health care delivery practices associated with this. An infant mortality rate of 106.7/1000 LB was found in the study population. Infant mortality was higher in female infants, infants of mothers not availed antenatal care, not received tetanus toxoid, delivered by untrained personnel and where cow-dung was applied to cord stump. Among the causes of infant deaths prematurity or low birth weight was the commonest cause followed by respiratory infections, diarrhoeal diseases and tetanus neonatorum Infant mortality in a rural population of meerut
Doll, Christopher N.H.; Pachauri, Shonali
A lack of access to energy and, in particular, electricity is a less obvious manifestation of poverty but arguably one of the most important. This paper investigates the extent to which electricity access can be investigated using night-time light satellite data and spatially explicit population datasets to compare electricity access between 1990 and 2000. We present here the first satellite derived estimates of rural population without access to electricity in developing countries to draw insights on issues surrounding the delivery of electricity to populations in rural areas. The paper provides additional evidence of the slow progress in expansion of energy access to households in Sub-Saharan Africa and shows how this might be ascribed in part due to the low population densities in rural areas. The fact that this is a continent with some of the lowest per-capita income levels aggravates the intrinsic difficulties associated with making the investments needed to supply electricity in areas with low population density and high dispersion. Clearly, these spatial dimensions of the distributions of the remaining unelectrified populations in the world have an impact on what options are considered the most appropriate in expanding access to these households and the relative attractiveness of decentralized options.
Imedashvili, Sopiko; Kekua, Ani; Ivchenko, Polina
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...
Steven A. Cohen
Full Text Available Introduction: Rural populations face numerous barriers to health, including poorer health care infrastructure, access to care, and other sociodemographic factors largely associated with rurality. Multiple measures of rurality used in the biomedical and public health literature can help assess rural-urban health disparities and may impact the observed associations between rurality and health. Furthermore, understanding what makes a place truly rural versus urban may vary from region to region in the United States.Purpose: The objectives of this study are to compare and contrast five common measures of rurality and determine how well-correlated these measures are at the national, regional, and divisional level, as well as to assess patterns in the correlations between the prevalence of obesity in the population aged 60+ and each of the five measures of rurality at the regional and divisional level.Methods: Five measures of rurality were abstracted from the US Census and US Department of Agriculture (USDA to characterize US counties. Obesity data in the population aged 60+ were abstracted from the Behavioral Risk Factor Surveillance System (BRFSS. Spearman’s rank correlations were used to quantify the associations among the five rurality measurements at the national, regional, and divisional level, as defined by the US Census Bureau. Geographic information systems were used to visually illustrate temporal, spatial, and regional variability. Results: Overall, Spearman’s rank correlations among the five measures ranged from 0.521 (percent urban-Urban Influence Code to 0.917 (Rural-Urban Continuum Code-Urban Influence Code. Notable discrepancies existed in these associations by Census region and by division. The associations between measures of rurality and obesity in the 60+ population varied by rurality measure used and by region. Conclusion: This study is among the first to systematically assess the spatial, temporal, and regional differences
Full Text Available Purpose: To assess the visual outcome after cataract surgery in a south Indian population. Materials and Methods: Population-based cross-sectional study of subjects aged 40 years or more. Three thousand nine hundred and twenty-four rural subjects from 27 contiguous villages and 3850 urban subjects from five randomly selected divisions were studied. All subjects underwent a comprehensive ophthalmic examination that included visual acuity, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, and dilated retinal examination. Statistical Analysis: Chi square test, t test and multivariate analysis were used. Results: Five hundred and twenty-eight (216 males, 312 females, 781 eyes rural subjects (13.5%, 95% confidence interval (CI 12.4% to 14.6% and 406 (197 males, 209 females, 604 eyes urban subjects (10.5%, 95% CI 9.6-11.5% had undergone cataract surgery. Outcome of cataract surgery was defined based on visual acuity. Using best-corrected visual acuity for classification, the single most important cause for visual impairment was cystoid macular edema in the aphakic group and posterior capsule opacification in the pseudophakic group. Aphakia (visual acuity of < 20/60 to ≤ 20/400 - odds ratio (OR 1.8; 95% CI 1.3 to 2.6%, visual acuity of < 20/400 - OR 6.2; 95% 4.0 to 9.8%, rural residence (visual acuity of < 20/60 to ≤ 20/400 - OR 3.2; 95% CI 2.2 to 4.5% and visual acuity of < 20/400 - OR OR 3.5; 95% CI 2.3 to 5.5% were associated with visual impairment. The urban cataract-operated population had significantly more pseudophakics ( P < 0.001, men ( P = 0.02 and literates ( P < 0.001. In the rural group the prevalence of cataract surgery (13.5% vs. 10.5%, P < 0.001 and number of people that had undergone cataract surgery within three years prior to examination ( P < 0.001 were significantly greater. In 30% of rural and 16% of urban subjects uncorrected refraction was the cause of visual impairment. Conclusions: Surgery
Su, Tin Tin; Goh, Jun Yan; Tan, Jackson; Muhaimah, Abdul Rahim; Pigeneswaren, Yoganathan; Khairun, Nasirin Sallamun; Normazidah, Abdul Wahab; Tharisini, Devi Kunasekaran; Majid, Hazreen Abd
Background This paper presents the level of colorectal cancer awareness among multi-ethnic rural population in Malaysia. Methods A rural-based cross sectional survey was carried out in Perak state in Peninsular Malaysia in March 2011. The survey recruited a population-representative sample using multistage sampling. Altogether 2379 participants were included in this study. Validated bowel/colorectal cancer awareness measure questionnaire was used to assess the level of colorectal cancer aware...
Gilman Robert H
Full Text Available Abstract Background Rural-to-urban migration in low- and middle-income countries causes an increase in individual cardiovascular risk. Cost-effective interventions at early stages of the natural history of coronary disease such as angina may stem an epidemic of premature coronary deaths in these countries. However, there are few data on the prevalence of angina in developing countries, whilst the understanding the aetiology of angina is complicated by the difficulty in measuring it across differing populations. Methods The PERU MIGRANT study was designed to investigate differences between rural-to-urban migrant and non-migrant groups in specific cardiovascular disease risk factors. Mass-migration seen in Peru from 1980s onwards was largely driven by politically motivated violence resulting in less 'healthy migrant' selection bias. The Rose angina questionnaire was used to record chest pain, which was classified definite, possible and non-exertional. Mental health was measured using the General Health Questionnaire (GHQ-12. Mantel-Haenszel odds ratios (adjusted for age, sex, cardiovascular disease risk factors and mental health were used to assess the risk of chest pain in the migrant and urban groups compared to the rural group, and further to assess the relationship (age and sex-adjusted between risk factors, mental health and chest pain. Results Compared to the urban group, rural dwellers had a greatly increased likelihood of possible/definite angina (multi-adjusted OR 2.82 (1.68- 4.73. Urban and migrant groups had higher levels of risk factors (e.g. smoking - 20.1% urban, 5.5% rural. No diabetes was seen in the rural dwellers who complained of possible/definite angina. Rural dwellers had a higher prevalence of mood disorder and the presence of a mood disorder was associated with possible/definite angina in all three groups, but not consistently with non-exertional chest pain. Conclusion Rural groups had a higher prevalence of angina as
Budukh, Atul; Palayekar, Vrushali; Maheshwari, Amita; Deodhar, Kedar; Purwar, Pallavi; Bagal, Sonali; Vadigoppula, Ashok; Lokhande, Manoj; Panse, Nandkumar; Dikshit, Rajesh; Badwe, Rajendra
In the rural areas of India, women generally use a piece of old cloth as a menstrual device. The aim of this study was to detect human papilloma virus (HPV) from menstrual blood on the menstrual pad and assess whether this could be a useful screening tool for cervical cancer. In Jamkhed area of rural Maharashtra, (population A), we collected menstrual pads from women who provided consent in the 30-50 year age group. The women who had provided menstrual pads underwent HC2 testing. We standardized the method for extracting DNA by PCR from the menstrual pad. The women who tested HPV positive, on the basis of HC2/PCR testing, underwent colposcopy. In the rural population of Pune area of Maharashtra state (population B), menstrual pads were collected. HPV was tested using the PCR method. HPV-positive women and a few HPV-negative women, selected randomly, underwent colposcopy and HC2 testing. In population A, 164 women provided their used menstrual pads and also underwent an HC2 screening test. Of these, six (3.2%) cases were reported as HPV positive. In population B, 365 women provided their used menstrual pads for HPV testing, of which 18 (4.9%) cases were diagnosed as HPV positive. The women who tested HPV positive, on the basis of PCR testing, and 10% randomly selected HPV-negative cases (37) and 18 women who voluntary requested testing underwent colposcopy and HC2 testing. The sensitivity of menstrual pad HPV testing compared with gold standard HC2 testing was 83% [95% confidence interval (CI): 0.47-0.97], 67% (95% CI: 0.30-0.91) and specificity was 99% (95% CI: 0.96-0.99), 88% (95% CI: 0.77-0.94) in population A and population B, respectively. The sensitivity of diagnosing CIN lesion was 83% (95% CI: 0.44-0.97) and specificity was 95% (95% CI: 0.91-0.97). On the basis of the sensitivity and specificity results, and the completely noninvasive, simple and convenient method of detecting HPV, menstrual pad might be considered a cervical cancer screening tool in rural
Juan Manuel Hernández Vázquez
Full Text Available This paper presents advances in understanding the influence of Mexican education on the perceptions of the adult population regarding their health. The analysis forms part of the oecd conceptual model for understanding the connections between education and social—but not economic—outcomes. Data from the 2006 National Survey on Health and Nutrition is employed to build a logistic model. The study confirmed the idea that people tend to feel healthier as their educational level rises, regardless of their economic condition, ethnicity, age, gender or whether they reside in a rural or urban area. The findings also showed that education is the single most positive influence on the perception of feeling healthy, more so even than economic situation.
Pan, Ling; Yang, Zhenhua; Wu, Yue; Yin, Rui-Xing; Liao, Yunhua; Wang, Jinwei; Gao, Bixia; Zhang, Luxia
To analyze the prevalence, awareness, treatment, control and epidemiological characteristics of dyslipidemia in Chinese adults. In this cross-sectional study, we adopted a multi-stage, stratified sampling method to obtain representative samples of the general population aged >18 years from different urban and rural regions in China. All subjects completed a lifestyle and medical history questionnaire and were examined for risk factors. Dyslipidemia was defined according to criteria of the 2007 Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. Continuous variables were compared using variance analysis. Multivariate logistic regression analysis was performed to explore the risk factors of dyslipidemia. The prevalence of dyslipidemia was 34.0% overall, and 35.1%, and 26.3% in urban and rural areas, respectively. The prevalence of dyslipidemia was significantly higher in men than women (41.9% vs 32.5%; P dyslipidemia. The prevalence of dyslipidemia among Chinese adults was high but awareness, treatment, and control of dyslipidemia were low. Urban high income earners and rural medium income earners show higher prevalence. Low income earners in urban and rural population have the worst awareness treatment, and control rate. There is an increased need for closely monitoring and controlling high risk factors in the populations including postmenopausal women, unhealthy lifestyle peoples and patients with chronic non-communicable diseases. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Shah, Avani; Scogin, Forrest; Presnell, Andrew; Morthland, Martin; Kaufman, Allan V.
This is a report on the treatment fidelity of in-home cognitive–behavioral therapy (CBT) delivered by a sample of clinically trained, master's-level social workers to a group of primarily rural, medically frail older adults as part of the Project to Enhance Aged Rural Living (PEARL) clinical trial. The social workers in this study received brief didactic and experiential CBT training. Audiotaped sessions were randomly selected and evaluated by independent reviewers. Results showed that the so...
Congdon, J G; Magilvy, J K
The culture and diversity of rural life and limitations of rural health systems to meet the changing health needs of an aging population lead to problems of obtaining appropriate care in rural America. In a program of nursing research involving three ethnographic studies in rural Colorado, transitions of older adults across differing levels of heath care were explored. The sample totaled 425 participants, of whom 25% were Hispanic. Five major themes emerged: circles of formal and informal care; integration of faith, spirituality, and family with health status; crisis nature of health care transitions; nursing homes as a housing option; and changing spirit of traditional rural nursing. Recommendations for providers included making their practices congruent with rural culture, being fully informed of available resources, facilitating acceptable health care decisions, and integrating physical, mental, and spiritual health care for elders and their families.
Natalie D. Pope
Full Text Available This paper uses qualitative methodology to explore the experience of growing old in rural Appalachia. Given the growing population of older adults seeking and utilizing services, it is important to understand the challenges and specific needs related to aging. Within the context of rural Appalachia, these challenges and needs may be different than those in urban areas or areas outside of the region itself. From interviews with 14 geriatric service providers in rural southeast Ohio, the authors were able to identity three prevalent themes associated with aging in rural North Central Appalachia: scarcity of resources, valuing neighbors and family, and the prevalence of drug use. These findings suggest that preparation and ongoing training of rural geriatric social workers should include attention to topics such as substance abuse and strengthening social support networks that often exist in these regions.
Rajagopalan, Archana; Balaji, Nisha
Since a few studies exist on the association of neck circumference (NC) and obesity with blood pressure (BP) among adolescents in India, we found it highly relevant to measure the NC and body mass index (BMI) using them as indicators of upper body subcutaneous fat and obesity and relate them to BP in a rural and urban adolescent population in North Tamil Nadu. This is a community-based cross-sectional study of descriptive design where 500 students from urban and rural areas were selected, and their BMI, NC, and BP were measured using standardized instruments. Among urban and rural population high and normal NC positively correlated with BMI, systolic BP (SBP) and diastolic BP (DBP), indicating that the data clearly reflects increase in BMI, SBP, and DBP values with increase in NC or vice versa. The correlation was statistically significant ( P < 0.001) significantly higher BMI ( P < 0.01), SBP ( P < 0.05), and NC ( P < 0.001) was observed in urban population than rural. DBP was not significantly different in rural and urban population. 95 th percentile values are significantly higher than rest in both urban and rural population. Only the 95 th percentile values correlate and reflect similar changes in BMI, SBP, and DBP. Our studies indicate a strong association of elevation in BP with high NC and increase in BMI. Overweight and obesity were positively correlated with increase in SBP and DBP.
Saad, P M
The accelerated urban growth of Sao Paulo between 1940-70 has continued during the period 1970-80, according to the 1980 censes. During 1970-80 the urban population increased 55.47%, while the rural population decreased 18.67%, bringing the percentage of the urban population to 88.6% of the total population of the state. This phenomenon has been common to all the 11 administrative regions of the state. The highest percentage of the urban population in 1980 was in the region of Greater Sao Paulo, followed by Litoral and Vale do Paraiba. The largest increases in urban population were in the regions of Sorocaba, Campinas, and Vale do Paraiba, while the highest decreases in rural population were in the regions of Sao Jose do Rio Preto, Aracatuba, Presidente Prudente, and Marilia. The document presents detailed data for each of the 11 administrative regions of the state, and for each municipality within a region.
Abela Mpobela Agnarson
Full Text Available OBJECTIVE: To analyse antiretroviral treatment (ART knowledge and HIV- and ART-related stigma among the adult population in a rural Tanzanian community. DESIGN: Population-based cross-sectional survey of 694 adults (15-49 years of age. METHODS: Latent class analysis (LCA categorized respondents' levels of ART knowledge and of ART-related stigma. Multinomial logistic regression assessed the association between the levels of ART knowledge and HIV- and ART-related stigma, while controlling for the effects of age, gender, education, marital status and occupation. RESULTS: More than one-third of men and women in the study reported that they had never heard of ART. Among those who had heard of ART, 24% were east informed about ART, 8% moderately informed, and 68% highly informed. Regarding ART-related stigma, 28% were least stigmatizing, 41% moderately stigmatizing, and 31% highly stigmatizing toward persons taking ART. Respondents that had at least primary education were more likely to have high levels of knowledge about ART (OR 3.09, 95% CI 1.61-5.94. Participants highly informed about ART held less HIV- and ART-related stigma towards ART patients (OR 0.26, 95% CI 0.09-0.74. CONCLUSION: The lack of ART knowledge is broad, and there is a strong association between ART knowledge and individual education level. These are relevant findings for both HIV prevention and HIV treatment program interventions that address ART-related stigma across the entire spectrum of the community.
Zhong, Hua; Chen, Qin; Li, Jun; Shen, Wei; Sheng, Xun; Niu, Zhiqiang; Zhou, Hua; Wei, Tao; Yuan, Yuansheng; Pan, Chen-Wei
To determine the prevalence and associations of pterygium in a multiethnic adult population in rural China and to examine potential ethnic differences Methods: A total of 6418 adults (2133 ethnic Bai, 2130 ethnic Yi, and 2155 ethnic Han) aged 50 years or older participated in the study. Anterior segment examination was performed without pupil dilation using a slit lamp. Pterygium was deﬁned as a raised ﬂeshy triangular ﬁbrovascular tissue growth of the conjunctiva encroaching onto a clear cornea. Pterygium was least prevalent among adults of Yi ethnicity (29.5%) compared with Bai (39.0%, p ethnicities. Those of Bai ethnicity were most likely to be affected by severe pterygium (7.5%), while Yi were least likely to be affected (3.8%). Multivariate analysis revealed that increasing age (odds ratio, OR, 1.017), female sex (OR 1.53), lower educational level (OR 1.25), higher blood pressure levels (OR 1.002), and greater time spent outdoors per day (OR 1.09) were significantly associated with a higher prevalence of pterygium, while Yi ethnicity (OR 0.65, comparing Yi with Han) and wearing brimmed hats outdoors (OR 0.82) were protective factors. Ethnicity was significantly associated with prevalence of pterygium. Our findings may be applicable to many other countries located within the "pterygium belt" for health resource allocation among different ethnic groups.
Perkins, Jessica M; Nyakato, Viola N; Kakuhikire, Bernard; Tsai, Alexander C; Subramanian, S V; Bangsberg, David R; Christakis, Nicholas A
To assess the association between food insecurity and depression symptom severity stratified by sex, and test for evidence of effect modification by social network characteristics. A population-based cross-sectional study. The nine-item Household Food Insecurity Access Scale captured food insecurity. Five name generator questions elicited network ties. A sixteen-item version of the Hopkins Symptom Checklist for Depression captured depression symptom severity. Linear regression was used to estimate the association between food insecurity and depression symptom severity while adjusting for potential confounders and to test for potential network moderators. In-home survey interviews in south-western Uganda. All adult residents across eight rural villages; 96 % response rate (n 1669). Severe food insecurity was associated with greater depression symptom severity (b=0·4, 95 % CI 0·3, 0·5, Pinsecurity and depression symptoms was stronger than for men on the periphery of their village social network, and for men with many poor personal network contacts, respectively. In this population-based study from rural Uganda, food insecurity was associated with mental health for both men and women. Future research is needed on networks and food insecurity-related shame in relation to depression symptoms among food-insecure men.
Hull, Melissa J; Fennell, Kate M; Vallury, Kari; Jones, Martin; Dollman, James
To assess the differences between farming and non-farming rural adults in perceived barriers to mental health service use. A cross-sectional survey, modified from the Barriers to Help-Seeking Scale (BHSS), was conducted using a computer-assisted telephone interview. Respondents (age 52.6 ± 11.6 years) were recruited from three rural regions of South Australia. Approximately, 78 non-farmers and 45 farmers were included in analyses. 78 retired and two unemployed participants were excluded from the analyses. Farmers and non-farmers were compared on domain scores and individual item responses from the adapted BHSS that represent 'agrarian' attitudes to support-seeking for mental health: stoicism, self-reliance, minimisation of the problem, stigma and distrust of health professionals. In the analysis of domain scores, 'Need for Control and Self-Reliance' was a stronger barrier for farmers than non-farmers (P = 0.009) with a trend (P = 0.07) towards stronger barriers among farmers in the 'Minimising Problem and Resignation' domain. In the analysis of item-level responses, there was a difference (P = 0.03) between farmers and non-farmers in responses to 'I find it difficult to understand my doctor/health professional', with 24.4% of the farmers agreeing that this is a barrier compared with 15.3% of the non-farmers. Long-held stereotypes of stoicism and self-reliance among farmers were somewhat supported, in the context of mental health. Mental health services and professionals in rural Australia might need to adapt their practices to successfully engage this population. © 2017 National Rural Health Alliance Inc.
Duma, Olga-Odetta; Roşu, Solange Tamara; Manole, M; Petrariu, F D; Constantin, Brânduşa
To identify the factors that may conduct to various forms of social exclusion of the population from the primary healthcare and to analyze health disparities as population-specific differences in the access to primary healthcare in rural compared to urban residence areas from Iasi, the second biggest county, situated in the North--East region of Romania. This research is a type of inquiry-based opinion survey of the access to primary healthcare in rural compared to urban areas of the county of Iasi. Data were collected by face-to-face interviews. There were taken into account the socioeconomic status (education level in the adult population, employment status, family income, household size) and two temporal variables (the interval of time spent to arrive at the primary healthcare office as a marker for the geographical access and the waiting time for a consultation). The study group consisted of two samples, from rural and urban area, each of 150 patients, all ages, randomly selected, who were waiting at the family doctor's practice. The study has identified disparities related to a poor economic status assessed through the employed status ("not working" 15% in urban and of 20% in rural).The income calculated per member of family and divided in terciles has recorded significant differences for "high" (36.7% urban and 14.7% rural) and "low", respectively (14.6% urban and 56.6% rural). High household size with more than five members represented 22.6% of the total subjects in rural and 15.3% in urban areas. The assessment of the education level in the adult population (> 18 years) revealed that in the rural areas more than a half (56%) of the sample is placed in the category primary and secondary incomplete, whereas the value for secondary complete and postsecondary was 37.3%. The proportion of respondents in the urban areas who have post-secondary education is five times higher than those in rural areas (15.4% vs. 2.7%). The reduced geographical access assessed as
Full Text Available Besides population decline, structurally weak rural areas in Austria face a new challenge related to demographic change: the increasing heterogeneity of their aging population. From the example of the so-called ‘best agers’ - comprising people aged 55 to 65 years - this contribution makes visible patterns and consequences of growing individualized spatial behaviour and spatial perception. Furthermore, contradictions between claims, wishes and expectations and actual engagement and commitment to their residential rural municipalities are being pointed out. These empirically-based facts are rounded off by considerations on the best agers’ future migration-behaviour and the challenges for spatial planning at the municipal level.
Johansson Blight, Karin; Persson, Jan-Olov; Ekblad, Solvig; Ekberg, Jan
Objective: Research into medical and licit drug use in resettled refugee populations is scarce, despite the fact that mental health status often has been found to be poorer than in general populations. Hence the aim of this study was to estimate the prevalence of self-rated use of medicine and licit drugs among adults who came to Sweden from Bosnia-Herzegovina (1993/94) and who in 2001 were living in either an urban (low employment context) or a rural (high employment context) region (n=4185). Methods: Prevalence was estimated from a cross-sectional questionnaire distributed to a representative sample (n=650) in 2001 (63.5% response rate). Results: The study population estimates of usage of sedatives (26.5%), sleeping tablets (26.2%) and antidepressants (22.3%) did not differ by gender but did so by region, with a higher urban prevalence. The consumption of alcohol (5.1%) and cigarettes (41.0%) did not differ by region but men reported higher alcohol consumption than women. Conclusion: The high consumption of medicine (compared with general populations) raises the question of treatment efficiency and the need for public health attention and evaluation many years after resettlement. Factors to consider for further research with analytic prerequisites concern indications that regional differences may be influenced, not only by urban employment being lower but also by urban/rural differences in prescription rates and/or access to health care; moreover, there might have been a selection to the urban region of older people, with a more vulnerable family situation, and/or poorer mental health. Finally, the overall alcohol (low) and cigarettes (high) consumption in the study population followed prevalence patterns found in Bosnia-Herzegovina rather than in Sweden. PMID:19742286
Van der Wielen, Nele; Channon, Andrew Amos; Falkingham, Jane
Population ageing presents considerable challenges for the attainment of universal health coverage (UHC), especially in countries where such coverage is still in its infancy. Ghana presents an important case study on the effectiveness of policies aimed at achieving UHC in the context of population ageing in low and middle-income countries. It has witnessed a profound recent demographic transition, including a large increase in the number of older adults, which coincided with the development and implementation of a National Health Insurance Scheme (NHIS), designed to help achieve UHC. The objective of this paper is to examine the community, household and individual level determinants of NHIS enrolment among older adults aged 50-69 and 70 plus. The latter are exempt from NHIS premium payments. Using the Ghanaian Living Standards Survey from 2012 to 2013, determinants of NHIS enrolment for individuals aged 50-69 and 70 plus living in rural Ghana are examined through the application of multilevel regression analysis. Previous studies have mainly focused on the enrolment of young and middle aged adults and considered mainly demographic and socio-economic factors. The novel inclusion of spatial barriers within this analysis demonstrates that levels of NHIS enrolment are determined in part by the community provision of healthcare facilities. In addition, the findings imply that insurance enrolment increases with household expenditure even for those aged 70 plus who are exempt from the NHIS premium payment. Adequate and appropriate infrastructure as well as health insurance is vital to ensure movement to UHC in low and middle income countries. Overall, the results confirm that there remain significant inequalities in enrolment by expenditure quintile that future policy reform will need to address.
Yunus, Raudah Mohd; Hairi, Noran Naqiah; Choo, Wan Yuen; Hairi, Farizah Mohd; Sooryanarayana, Rajini; Ahmad, Sharifah Nor; Abdul Razak, Inayah; Peramalah, Devi; Abdul Aziz, Suriyati; Mohammad, Zaiton Lal; Mohamad, Rosmala; Mohd Ali, Zainudin; Bulgiba, Awang
Our study aims at describing mortality among reported elder abuse experiences in rural Malaysia. This is a population-based cohort study with a multistage cluster sampling method. Older adults in Kuala Pilah (n = 1,927) were interviewed from November 2013 to May 2014. Mortality was traced after 2 years using the National Registration Department database. Overall, 139 (7.2%) respondents died. Fifteen (9.6%) abuse victims died compared to 124 (7.0%) not abused. Mortality was highest with financial abuse (13%), followed by psychological abuse (10.8%). There was a dose-response relationship between mortality and clustering of abuse: 7%, 7.7%, and 14.0% for no abuse, one type, and two types or more, respectively. Among abuse victims, 40% of deaths had ill-defined causes, 33% were respiratory-related, and 27% had cardiovascular and metabolic origin. Results suggest a link between abuse and mortality. Death proportions varied according to abuse subtypes and gender.
Wieland, Regi Leann
Interviews with adult residents and high school students in two rural Kansas communities that had consolidated their high schools found that adults in the community that lost its high school had more negative reactions and feelings of loss than adults in the community that retained its high school. Student reactions were generally positive.…
Stoller, Eleanor Palo; Grzywacz, Joseph G; Quandt, Sara A; Bell, Ronny A; Chapman, Christine; Altizer, Kathryn P; Arcury, Thomas A
Guided by Leventhal's self-regulatory model and Cockerham's theory of health lifestyles, we explore two questions regarding physician consultation among elderly rural adults: What symptom characteristics prompt patient-initiated physician consultation? Do participants' accounts of responses to symptoms, including the decision to consult a physician, incorporate descriptions of change over time? We analyze data from semistructured in-depth interviews with 62 older rural adults. Accounts of decisions to initiate contact with physicians support prior research. Some symptoms encouraged immediate consultation; others prompted periods of monitoring and lay management. Physicians were most often contacted if changes were new, unusually severe, persisted or worsened, or failed to respond to lay treatment. We characterize participants' responses to symptoms as bricolages to highlight their construction from available materials. Incorporating the integrating concept of bricolage and Cockerham's emphasis on both general dispositions and symptom-specific responses represents an important extension of Leventhal's conceptualization of illness behavior, including patient-initiated physician consultation.
Rigg, Khary K; Monnat, Shannon M
In the United States, prescription opioid misuse (POM) has increased dramatically over the past two decades. However, there are still questions regarding whether rural/urban differences in adult POM exist, and more important, which factors might be driving these differences. Using data from the 2011 and 2012 National Survey on Drug Use and Health, we conducted unadjusted and adjusted binary logistic regression analyses to determine the association between metropolitan status and POM. We found that urban adults were more likely to engage in POM compared to rural adults because of their higher use of other substances, including alcohol, cannabis, and other illicit and prescription drugs, and because of their greater use of these substances as children. This study fills an important gap in the literature by not only identifying urban/rural differences in POM, but by also pointing out factors that mediate those differences. Because patterns and predictors of POM can be unique to geographic region, this research is critical to informing tailored interventions and drug policy decisions. Specifically, these findings suggest that interventions should be aimed at urban illicit drug users and adults in manual labor occupations. Copyright © 2014 Elsevier B.V. All rights reserved.
Del Brutto, Oscar H; Mera, Robertino M; Zambrano, Mauricio
Studies investigating a possible correlation between metabolic syndrome and cognitive decline have been inconsistent. To determine whether metabolic syndrome or each of its components correlate with cognitive performance in community-dwelling older adults in rural Ecuador. Stroke-free Atahualpa residents aged ≥60 years were identified during a door-to-door survey. Metabolic syndrome was defined according to the International Diabetes Federation criteria. Cognition was evaluated by the use of the Montreal Cognitive Assessment (MoCA). Multivariate logistic regression models estimated the association between metabolic syndrome and each of its components with cognitive performance. A total of 212 persons (mean age: 69.2 ± 7.2 years, 64 % women) were enrolled. Of these, 120 (57 %) had metabolic syndrome. Mean scores in the MoCA were 18.2 ± 4.6 for persons with and 19 ± 4.7 for those without metabolic syndrome. In fully adjusted logistic models, MoCA scores were not associated with metabolic syndrome (p = 0.101). After testing individual components of metabolic syndrome with the MoCA score, we found that only hypertriglyceridemia was independently associated with the MoCA score (p = 0.009). This population-based study showed a poor correlation of metabolic syndrome with cognitive performance after adjusting for relevant confounders. Of the individual components of metabolic syndrome, only hypertriglyceridemia correlated with worse cognitive performance.
Bolin, Jane; Gamm, Larry; Kash, Bita; Peck, Mitchell
Successful implementation of disease management (DM) is based on the ability of an organization to overcome a variety of barriers to deliver timely, appropriate care of chronic illnesses. Such programs initiate DM services to patient populations while initiating self-management education among medication-resistant patients who are chronically ill. Despite formidable challenges, rural health care providers have been successful in initiating DM programs and have discovered several ways in which these programs benefit their organizations. This research reports on six DM programs that serve large rural and underserved populations and have demonstrated that DM can be successfully implemented in such areas.
Full Text Available Abstract Background To present and compare population-based and antenatal-care (ANC sentinel surveillance HIV prevalence estimates among women in a rural South African population where both provision of ANC services and family planning is prevalent and fertility is declining. With a need, in such settings, to understand how to appropriately adjust ANC sentinel surveillance estimates to represent HIV prevalence in general populations, and with evidence of possible biases inherent to both surveillance systems, we explore differences between the two systems. There is particular emphasis on unrepresentative selection of ANC clinics and unrepresentative testing in the population. Methods HIV sero-prevalence amongst blood samples collected from women consenting to test during the 2005 annual longitudinal population-based serological survey was compared to anonymous unlinked HIV sero-prevalence amongst women attending antenatal care (ANC first visits in six clinics (January to May 2005. Both surveillance systems were conducted as part of the Africa Centre Demographic Information System. Results Population-based HIV prevalence estimates for all women (25.2% and pregnant women (23.7% were significantly lower than that for ANC attendees (37.7%. A large proportion of women attending urban or peri-urban clinics would be predicted to be resident within rural areas. Although overall estimates remained significantly different, presenting and standardising estimates by age and location (clinic for ANC-based estimates and individual-residence for population-based estimates made some group-specific estimates from the two surveillance systems more predictive of one another. Conclusion It is likely that where ANC coverage and contraceptive use is widespread and fertility is low, population-based surveillance under-estimates HIV prevalence due to unrepresentative testing by age, residence and also probably by HIV status, and that ANC sentinel surveillance over
Samra, Haifa Abou; Beare, Tianna; Specker, Bonny
Purpose: This study assessed the accuracy with which a rural population reported daily walking distances using a 7-day activity recall questionnaire obtained quarterly compared to pedometer readings. Methods: Study participants were 48 Hutterite men and women aged 11-66 years. Findings: Pedometer-miles quartiles were associated with self-reported…
Nicholson, L; Cooper, S-A
Research suggests that social exclusion is a problem both for people with intellectual disabilities (ID) and for people living in rural areas. This may give rise to a double disadvantage for people with ID living in rural areas. Conversely, aspects of rural life such as community spirit and social support may protect against social exclusion in this population. This study was designed to compare a number of measures of social exclusion in adults with ID living in rural and urban areas, with the aim of identifying whether a double disadvantage exists. Adults with ID were recruited from a rural and an urban area in Scotland. Participants participated in a face-to-face interview and their medical notes were accessed. Social exclusion was investigated using a number of measures comprising: daytime opportunities and physical access to community facilities (using part of the British Institute of Learning Disabilities questionnaire), recent contact with others and the quality of personal relationships (using a modified Interview Measure of Social Relationships questionnaire) and area deprivation by postcode (using the Scottish Index of Multiple Deprivation). The data were analysed using a series of binary logistic regression models that adjusted for variables including age, gender, level of ID, mental illhealth and common physical co-morbidities. A representative sample of adults with ID from rural (n = 39) and urban (n = 633) areas participated. Participants from rural areas were significantly more likely to have any regular daytime opportunity [odds ratio (OR) = 10.8, 95% CI = 2.3-51.5] including employment (OR = 22.1, 95% CI = 5.7-85.5) and attending resource centres (OR = 6.7, 95% CI = 2.6-17.2) than were participants from urban areas. They were also more likely to have been on holiday (OR = 17.8, 95% CI = 4.9-60.1); however, were less likely to use community facilities on a regular basis. Participants from urban and rural areas had a similar number of contacts with
Ihejirika, John Chinedu
The purpose of this paper was to examine the concept of poverty and its causes in Nigeria and to analyze how adult and non-formal education programs can be utilized to reduce rural poverty in Nigeria. In spite of Nigeria's affluence in human and material resources, it is classified among countries with high level of poverty. Incidentally, the…
Previous research on digital storytelling (DST) has focused chiefly on children and youth, but we know little about how it is used in non-formal adult education. This article analyzes a DST class in rural Ireland, which was organized by a family literacy program and offered for parents at an elementary school. Data sources included fieldnotes,…
Pan, Chen-Wei; Li, Jun; Zhong, Hua; Shen, Wei; Niu, Zhiqiang; Yuan, Yuansheng; Chen, Qin
To describe the ethnic differences in central corneal thickness (CCT) in population-based samples of ethnic Bai, Yi and Han people living in rural China. 6504 adults (2119 ethnic Bai, 2202 ethnic Yi and 2183 ethnic Han) aged 50 years or older participated in the study. Each subject underwent standardized ocular examinations and interviewer-administered questionnaires for risk factor assessment. CCT was measured for both eyes using an ultrasound pachymeter. Regression and principal component analysis were performed to examine the relationship of ethnicity and other factors with CCT. The mean CCT readings were 536.4 ± 34.2 μm in ethnic Bai, 532.1 ± 32.1 μm in ethnic Yi and 529.6 ± 32.7 μm in ethnic Han adults (Pethnic groups. In multivariate linear regression models, increasing CCT was associated with younger age (Pethnicity, greater body mass index (PEthnicity contributed significantly to presence of thin cornea (60%; Pethnic groups. This study of more than 6500 multiethnic participants demonstrates significant ethnic variations in CCT, with Han ethnicity having the thinnest cornea compared with ethnic minorities. These data are essential to guide future multiethnic clinical trials on CCT-related ocular conditions such as glaucoma.
Thelin, A; Stiernström, E L; Holmberg, S
Farmers have a low risk for cardiovascular disease, which may be related to a favourable blood lipid profile. In order to study the blood lipid levels and evaluate the effect of other cardiovascular risk factors on the blood lipid profile, this cross-sectional study was made. A total of 1013 farmers and 769 non-farming rural men in nine different Swedish counties were examined, interviewed, and replied to questionnaires. The inter-relationships between different risk factors were analysed using a multivariate linear regression model. The farmers had a significantly more favourable blood lipid profile than the non-farmers although the total cholesterol levels were almost the same for the two groups. In the total study population there were significant positive relationships between total cholesterol level and body mass index (BMI), diastolic blood pressure and smoking. The high-density lipoprotein (HDL) level was positively related to physical workload and alcohol consumption, and negatively related to BMI, waist/hip ratio and smoking. Triglyceride levels showed a positive relationship to BMI, waist/hip ratio and blood pressure. Differences between farmers and other rural males were seen, especially with respect to the effect of physical activity and psychosocial factors. Among the farmers, a negative correlation between the Karasek-Theorell authority over work index and total cholesterol, the low-density lipoprotein (LDL)/HDL ratio and triglyceride levels was observed. This study indicated that diet is of minor significance for the blood lipid profile, whereas factors such as physical activity, body weight and the waist/hip ratio, smoking, alcohol consumption, and perhaps psychosocial working conditions are major independent factors affecting the blood lipid profile most prominently among farmers, but also among non-farming rural men.
IkeOluwapo O. Ajayi
Full Text Available Abstract Background Overweight and obesity are on the rise in developing countries including sub-Saharan Africa. We undertook a four-country survey to show the collective burden of these health conditions as they occur currently in sub-Saharan Africa and to determine the differences between urban and rural populations and other socio-economic factors. Methods Participants were nurses in two hospitals in Nigeria (200, school teachers in South Africa (489 and Tanzania (229, and village residents in one peri-urban (297 and one rural location in Uganda (200 who completed a standardised questionnaire. Their height and weight were measured and body mass index calculated. Factor analysis procedure (Principal component was used to generate a wealth index. Univariate and multivariate analyses with binary logistic regression models were conducted to examine the associations between potential correlates and the prevalence of overweight and obesity with 95 % confidence intervals. Results The prevalence of overweight and obese (combined was 46 %, 48 %, 68 %, 75 % and 85 % in rural Uganda, peri-urban Uganda, Nigeria, Tanzania and South Africa (SA, respectively. Rural Uganda, Peri- urban Uganda, Nigeria, Tanzania and SA had obesity prevalence of 10 %, 14 %, 31 %, 40 % and 54 %, respectively (p =25 kg/m2 in Nigeria [Age > =45 - AOR = 9.11; 95 % CI: 1.72, 48.16] and SA [AOR = 6.22; 95 % CI: 2.75, 14.07], while marital status was predictor of BMI > =25 kg/m2 only in peri-urban Uganda. [Married - AOR = 4.49; 95 % CI: 1.74, 11.57]. Those in Nigeria [AOR = 2.56; 95 % CI: 1.45, 4.53], SA [AOR = 4.97; 95 % CI: 3.18, 7.78], and Tanzania [AOR = 2.68; 95 % CI: 1.60, 4.49] were more likely to have BMI > =25 kg/m2 compared with the rural and peri-urban sites. Conclusion The high prevalence of overweight and obesity in these sub-Saharan African countries and the differentials in prevalence and risk factors further
Mobility is extremely important, especially in rural areas, which have dispersed populations and locations. : This study was conducted among rural minority populations to evaluate human transportation needs of the : underserved rural population in Ok...
Full Text Available Many rural areas, in Sweden and worldwide, experience population decline where the young leave for education and work in urban areas. Employment has declined in several rural industries, such as agriculture, forestry, and fishing, while growing in other industries are often located in urban areas. Politicians and organizations have put much hope in tourism as a tool of rural development, but can tourism help reverse the rural out-migration trend among young adults? This paper explores how tourism affects young inhabitants’ perceptions of and affective bonds to a rural area in Sweden, the ski resort of Sälen. Students from the 1993–1995 elementary school graduating classes were interviewed about their migration history, childhood, and view of and ties to Sälen. The respondents experience that tourism contributes to a more vital community incorporating influences from elsewhere, but without eliminating the positive aspects of rural life. The regular flow of people – tourists, seasonal workers, and entrepreneurs – passing through Sälen presents opportunities to extend one’s social network that are widely appreciated by respondents. The high in and out mobility constitutes a key part of Sälen’s character. Contributions from tourism – such as employment, entertainment, leisure, and opportunities to forge new social relationships – are available during the adult transition, the life phase when rural areas are often perceived as least attractive. Even though out-migration occurs in Sälen, and some respondents still find Sälen too small, tourism has clearly increased the available opportunities and contributed significantly to making Sälen more attractive to young adults.
Method: A cross-sectional community-based descriptive study was conducted. A multi-stage sampling strategy was adopted to obtain a representative sample of the communities. Results: The mean age of the population was 27 years and majority was female (54%. Among the adult population only 30% were educated, 19% were engaged in some form of economic activities while 9% were in the formal employment sector. The average monthly income per household was R1 301 (95% CI, R1 283; R1 308. The illnesses were reported by 27% of the total population over a period of one month. Notably higher rates of female individuals (29% were sick compared to males (24%, p < 0.001. The rates of illnesses among adult females (39% were also significantly higher than among males (31%, p < 0.009. Most of them (69% attended primary health care (PHC clinics for medical services, while 67% reported chronic conditions. Age (OR = 1.4, gender (OR = 0.711, education (OR = 0.64 and economic activities (OR = 1.9 were found to be associated with being ill or not. Conclusion: The rural black communities are underdeveloped and deprived, which results in higher prevalence of illnesses; however, the utilisation of PHC facilities is comparatively higher than in the rest of the province and other parts of the country. Interventions to improve community health care services among the deprived population should be focused through public health strategies such as all-encompassing PHC that includes health promotion, education and basic essential amenities.
Full Text Available To study the relationship between outdoor activity and risk of age-related cataract (ARC in a rural population of Taizhou Eye Study (phrase 1 report.A population-based, cross-sectional study of 2006 eligible rural adults (≥45 years old from Taizhou Eye Study was conducted from Jul. to Sep. 2012. Participants underwent detailed ophthalmologic examinations including uncorrected visual acuity (UCVA, best corrected visual acuity (BCVA, intraocular pressure (IOP, slit lamp and fundus examinations as well as questionnaires about previous outdoor activity and sunlight protection methods. ARC was recorded by LOCSⅢ classification system. The prevalence of cortical, nuclear and posterior subcapsular cataract were assessed separately for the risk factors and its association with outdoor activity.Of all 2006 eligible participants, 883 (44.0% adults were diagnosed with ARC. The prevalence rates of cortical, nuclear and posterior subcapsular cataract per person were 41.4%, 30.4% and 1.5%, respectively. Women had a higher tendency of nuclear and cortical cataract than men (OR = 1.559, 95% CI 1.204-2.019 and OR = 1.862, 95% CI 1.456-2.380, respectively. Adults with high myopia had a higher prevalence of nuclear cataract than adults without that (OR = 2.528, 95% CI 1.055-6.062. Multivariable logistic regression revealed that age was risk factor of nuclear (OR = 1.190, 95% CI 1.167-1.213 and cortical (OR = 1.203, 95% CI 1.181-1.226 cataract; eyes with fundus diseases was risk factor of posterior subcapsular cataract (OR = 6.529, 95% CI 2.512-16.970. Outdoor activity was an independent risk factor of cortical cataract (OR = 1.043, 95% CI 1.004-1.083. The risk of cortical cataract increased 4.3% (95% CI 0.4%-8.3% when outdoor activity time increased every one hour. Furthermore, the risk of cortical cataract increased 1.1% (95% CI 0.1%-2.0% when cumulative UV-B exposure time increased every one year.Outdoor activity was an independent risk factor for cortical
Echavarría-Pinto, Mauro; Hernández-Lomelí, Adrián; Alcocer-Gamba, Marco Antonio; Morales-Flores, Héctor; Vázquez-Mellado, Alberto
Metabolic syndrome is the main health problem in Mexico. Its two principal complications (ischemic cardiopathy and type-2 diabetes) are the two main causes of death in Mexico since 2000. To describe the prevalence of the metabolic syndrome in adults from 20 to 40 years old in a Mexican rural community (Senegal de Palomas, San Juan del Río, Querétaro) using the National Cholesterol Education Program (NCEP III) definition. A descriptive study with a random sample was carried out. We present a univariate analysis with a 95% confidence interval. 73 cases were studied. The prevalence of the metabolic syndrome was 45.2% slightly higher in men (48.4%) than in women (42.8%). The prevalence of hypertension was 27.3%. The prevalence of obesity was 26.1% using the definition of the WHO and this prevalence rises up to 49.4% using the definition of the Mexican Official Norm. 90.5% of women and 93.5% of men had low HDLc. The prevalence of metabolic syndrome in adults from 20 to 40 years old in this Mexican rural community is much higher than the national mean for the same age cohort. The results show the necessity to increase the research of our rural communities in order to identify the possible causes to this problem and to create therapeutic programs for patients with metabolic syndrome.
Roh, Soonhee; Brown-Rice, Kathleen A; Lee, Kyoung Hag; Lee, Yeon-Shim; Lawler, Michael J; Martin, James I
The purpose of this study was to examine the associations of physical health stressors and coping resources with depressive symptoms among American Indian older adults age 50 years or older. The study used a convenience sample of 227 rural American Indian older adults. A hierarchical multiple regression tested three sets of predictors on depressive symptoms: (a) sociodemographics, (b) physical health stressors (functional disability and chronic medical conditions), and (c) coping resources (social support and spirituality). Most participants reported little difficulty in performing daily activities (e.g., eating, dressing, traveling, and managing money), while presenting over two types of chronic medical conditions. Depressive symptoms were predicted by higher scores on perceived social support and lower scores on functional disability; women and those having no health insurance also had higher levels of depressive symptoms. Findings suggest that social work practitioners should engage family and community support, advocate for access to adequate health care, and attend to women's unique circumstances and needs when working with American Indian older adults.
Anuar, Tengku Shahrul; Hasim, Liyana; Moktar, Norhayati; Salleh, Fatmah Md; Al-Mekhlafi, Hesham M
Dientamoeba fragilis is a trichomonad parasite that can infect the gastrointestinal tract of humans causing gastrointestinal disease. Little is known about its epidemiology. We evaluated the prevalence of D. fragilis by conducting a cross sectional study of an Orang Asli population in rural Malaysia. We examined stool samples from 150 participants for D. fragilis using Wheatley's trichrome stain and collected demographic data from each participant using a structured questionnaire. Five participants (3.3%) had D. fragilis in their stool; four of these were aged population. Further studies are needed to determine the virulence, pathogenicity and mode of transmission of D. fragilis in the study population.
Hossain, Moazzem; Ahmed, Kamruddin; Marma, Aung Swi Prue; Hossain, Sohrab; Ali, Mohammad Azmat; Shamsuzzaman, Abul Khair Mohammad; Nishizono, Akira
Globally, Bangladesh ranks third in the number of human deaths from rabies. Although dogs are the principal known transmitters of rabies and knowledge of dog populations is essential for effective national control and proper planning, dog control programs are scarce in Bangladesh. Our objective was to count dogs in a rural area to understand the dog population of the country. For this purpose we selected six unions of Raipura upazila in Narsingdi district. Dog counting was done by direct observation following accepted guidelines. We determined the mean density of the dog population in Bangladesh to be 14 dog/km(2) (95% CI 3.7, 24) and the human:dog ratio to be 120 (95% CI 55, 184). Our paper contribute to the literature which shows great variation in the human:dog ratio across regions of the developing world. The human:dog ratio depends on the area's human (as well as dog) population, whereas dog density per unit area indicates the true number of dogs. We propose that extrapolating from the human:dog ratios of other regions not be relied upon for estimating dog populations, unless the ratios can be supplemented by actual counts of dogs within the target area. Copyright © 2013 Elsevier B.V. All rights reserved.
Menard, Lauren A.
Age and Time disparities in young adult research populations are common because young adults are defined by varying age spans; members of Generation X and Millennial generations may both be considered young adults; study years vary, affecting populations; and qualitative methods with limited age/year samples are frequently utilized. The current…
Daswani, Poonam G; Gholkar, Manasi S; Birdi, Tannaz J
The rural population in India faces a number of health problems and often has to rely on local remedies. Psidium guajava Linn. (guava), a tropical plant which is used as food and medicine can be used by rural communities due to its several medicinal properties. A literature search was undertaken to gauge the rural health scenario in India and compile the available literature on guava so as to reflect its usage in the treatment of multiple health conditions prevalent in rural communities. Towards this, electronic databases such as Pubmed, Science Direct, google scholar were scanned. Information on clinical trials on guava was obtained from Cochrane Central Register of Controlled Trials and Clinicaltrial.gov. The literature survey revealed that guava possesses various medicinal properties which have been reported from across the globe in the form of ethnobotanical/ethnopharmacological surveys, laboratory investigations and clinical trials. Besides documenting the safety of guava, the available literature shows that guava is efficacious against the following conditions which rural communities would encounter. (a) Gastrointestinal infections; (b) Malaria; (c)Respiratory infections; (d) Oral/dental infections; (e) Skin infections; (f) Diabetes; (g) Cardiovascular/hypertension; (h) Cancer; (i) Malnutrition; (j) Women problems; (k) Pain; (l) Fever; (m) Liver problems; (n) Kidney problems. In addition, guava can also be useful for treatment of animals and explored for its commercial applications. In conclusion, popularization of guava, can have multiple applications for rural communities.
Ajayi, IkeOluwapo O; Adebamowo, Clement; Adami, Hans-Olov; Dalal, Shona; Diamond, Megan B; Bajunirwe, Francis; Guwatudde, David; Njelekela, Marina; Nankya-Mutyoba, Joan; Chiwanga, Faraja S; Volmink, Jimmy; Kalyesubula, Robert; Laurence, Carien; Reid, Todd G; Dockery, Douglas; Hemenway, David; Spiegelman, Donna; Holmes, Michelle D
Overweight and obesity are on the rise in developing countries including sub-Saharan Africa. We undertook a four-country survey to show the collective burden of these health conditions as they occur currently in sub-Saharan Africa and to determine the differences between urban and rural populations and other socio-economic factors. Participants were nurses in two hospitals in Nigeria (200), school teachers in South Africa (489) and Tanzania (229), and village residents in one peri-urban (297) and one rural location in Uganda (200) who completed a standardised questionnaire. Their height and weight were measured and body mass index calculated. Factor analysis procedure (Principal component) was used to generate a wealth index. Univariate and multivariate analyses with binary logistic regression models were conducted to examine the associations between potential correlates and the prevalence of overweight and obesity with 95 % confidence intervals. The prevalence of overweight and obese (combined) was 46 %, 48 %, 68 %, 75 % and 85 % in rural Uganda, peri-urban Uganda, Nigeria, Tanzania and South Africa (SA), respectively. Rural Uganda, Peri- urban Uganda, Nigeria, Tanzania and SA had obesity prevalence of 10 %, 14 %, 31 %, 40 % and 54 %, respectively (p obesity, 414 (34 %). Female sex was a predictor of overweight and obesity (combined) in peri-urban Uganda [AOR = 8.01; 95 % CI: 4.02, 15.96) and obesity in rural Uganda [AOR = 11.22; 95%CI: 2.27, 55.40), peri-urban Uganda [AOR = 27.80; 95 % CI: 7.13, 108.41) and SA [AOR = 2.17; 95 % CI: 1.19, 4.00). Increasing age was a predictor of BMI > =25 kg/m 2 in Nigeria [Age > =45 - AOR = 9.11; 95 % CI: 1.72, 48.16] and SA [AOR = 6.22; 95 % CI: 2.75, 14.07], while marital status was predictor of BMI > =25 kg/m 2 only in peri-urban Uganda. [Married - AOR = 4.49; 95 % CI: 1.74, 11.57]. Those in Nigeria [AOR = 2.56; 95 % CI: 1.45, 4.53], SA [AOR = 4.97; 95 % CI: 3
Daniel R Feikin
Full Text Available BACKGROUND: Few comprehensive data exist on disease incidence for specific etiologies of acute respiratory illness (ARI in older children and adults in Africa. METHODOLOGY/PRINCIPAL FINDINGS: From March 1, 2007, to February 28, 2010, among a surveillance population of 21,420 persons >5 years old in rural western Kenya, we collected blood for culture and malaria smears, nasopharyngeal and oropharyngeal swabs for quantitative real-time PCR for ten viruses and three atypical bacteria, and urine for pneumococcal antigen testing on outpatients and inpatients meeting a ARI case definition (cough or difficulty breathing or chest pain and temperature >38.0 °C or oxygen saturation 5 years old (adjusted annual incidence 12.0 per 100 person-years, influenza A virus was the most common virus (22% overall; 11% inpatients, 27% outpatients and Streptococcus pneumoniae was the most common bacteria (16% overall; 23% inpatients, 14% outpatients, yielding annual incidences of 2.6 and 1.7 episodes per 100 person-years, respectively. Influenza A virus, influenza B virus, respiratory syncytial virus (RSV and human metapneumovirus were more prevalent in swabs among cases (22%, 6%, 8% and 5%, respectively than controls. Adenovirus, parainfluenza viruses, rhinovirus/enterovirus, parechovirus, and Mycoplasma pneumoniae were not more prevalent among cases than controls. Pneumococcus and non-typhi Salmonella were more prevalent among HIV-infected adults, but prevalence of viruses was similar among HIV-infected and HIV-negative individuals. ARI incidence was highest during peak malaria season. CONCLUSIONS/SIGNIFICANCE: Vaccination against influenza and pneumococcus (by potential herd immunity from childhood vaccination or of HIV-infected adults might prevent much of the substantial ARI incidence among persons >5 years old in similar rural African settings.
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…
Wu, Bei; Goins, R. Turner; Laditka, James N.; Ignatenko, Valerie; Goedereis, Eric
Purpose: Research suggests that men and women often differ in knowledge and beliefs about causes and treatments of a variety of diseases. This study examines gender differences in views about cognitive health and behaviors that have been associated with its maintenance, focusing on older adults living in rural areas. Design and Methods: We…
Full Text Available Abstract Background Although causing substantial morbidity, the burden of pneumococcal disease among older children and adults in Africa, particularly in rural settings, is not well-characterized. We evaluated pneumococcal bacteremia among 21,000 persons ≥5 years old in a prospective cohort as part of population-based infectious disease surveillance in rural western Kenya from October 2006-September 2008. Methods Blood cultures were done on patients meeting pre-defined criteria - severe acute respiratory illness (SARI, fever, and admission for any reason at a referral health facility within 5 kilometers of all 33 villages where surveillance took place. Serotyping of Streptococcus pneumoniae was done by latex agglutination and quellung reaction and antibiotic susceptibility testing was done using broth microdilution. We extrapolated incidence rates based on persons with compatible illnesses in the surveillance population who were not cultured. We estimated rates among HIV-infected persons based on community HIV prevalence. We projected the national burden of pneumococcal bacteremia cases based on these rates. Results Among 1,301 blood cultures among persons ≥5 years, 52 (4% yielded pneumococcus, which was the most common bacteria isolated. The yield was higher among those ≥18 years than 5-17 years (6.9% versus 1.6%, p 95%. The crude rate of pneumococcal bacteremia was 129/100,000 person-years, and the adjusted rate was 419/100,000 person-years. Nineteen (61% of 31 patients with HIV results were HIV-positive. The adjusted rate among HIV-infected persons was 2,399/100,000 person-years (Rate ratio versus HIV-negative adults, 19.7, 95% CI 12.4-31.1. We project 58,483 cases of pneumococcal bacteremia will occur in Kenyan adults in 2010. Conclusions Pneumococcal bacteremia rates were high among persons ≥5 years old, particularly among HIV-infected persons. Ongoing surveillance will document if expanded use of highly-active antiretroviral
Jose T. Ramos
Full Text Available Many physiologic differences between children and adults may result in age-related changes in pharmacokinetics and pharmacodynamics. Factors such as gastric pH and emptying time, intestinal transit time, immaturity of secretion and activity of bile and pancreatic fluid among other factors determine the oral bioavailability of pediatric and adult populations. Anatomical, physiological and biochemical characteristics in children also affect the bioavailability of other routes of administration. Key factors explaining differences in drug distribution between the pediatric population and adults are membrane permeability, plasma protein binding and total body water. As far as drug metabolism is concerned, important differences have been found in the pediatric population compared with adults both for phase I and phase II metabolic enzymes. Immaturity of glomerular filtration, renal tubular secretion and tubular reabsorption at birth and their maturation determine the different excretion of drugs in the pediatric population compared to adults.
Vuković, Predrag; Subić, Jonel; Cvijanović, Drago
Since the mid-nineties of the twentieth century begins a rapid expansion of rural tourism in Serbia. In the first initial phase, the development has taken place without a clear plan and program. The first achieved positive results, influenced that Serbian Government since 2008 started with appropriate funding with aim to improve rural tourism development. Also, until 2008 there was no system of education and training sessions of the local population. Farmers were not educated and trained t...
Moses Chapa Kiti
Full Text Available Improved understanding and quantification of social contact patterns that govern the transmission dynamics of respiratory viral infections has utility in the design of preventative and control measures such as vaccination and social distancing. The objective of this study was to quantify an age-specific matrix of contact rates for a predominantly rural low-income population that would support transmission dynamic modeling of respiratory viruses.From the population register of the Kilifi Health and Demographic Surveillance System, coastal Kenya, 150 individuals per age group (50 years exhibited the highest inter-generational contacts. Rural contact rates were higher than semiurban (18.8 vs 15.6, p = 0.002, with rural primary school students having twice as many assortative contacts as their semiurban peers.This is the first age-specific contact matrix to be defined for tropical Sub-Saharan Africa and has utility in age-structured models to assess the potential impact of interventions for directly transmitted respiratory infections.
Trung, Nguyen Vu; Hoi, Le Thi; Thuong, Nguyen Thi Hong; Toan, Tran Khanh; Huong, Tran Thi Kieu; Hoa, Tran Mai; Fox, Annette; Kinh, Nguyen van; van Doorn, H Rogier; Wertheim, Heiman F L; Bryant, Juliet E; Nadjm, Behzad
AbstractRickettsial infections are recognized as important causes of fever throughout southeast Asia. Herein, we determined the seroprevalence to rickettsioses within rural and urban populations of northern Vietnam. Prevalence of individuals with evidence of prior rickettsial infections (IgG positive) was surprisingly low, with 9.14% (83/908) testing positive to the three major rickettsial serogroups thought to circulate in the region. Prevalence of typhus group rickettsiae (TG)-specific antibodies (6.5%, 58/908) was significantly greater than scrub typhus group orientiae (STG)- or spotted fever group rickettsiae (SFG)-specific antibodies ( P < 0.05). The majority of TG seropositives were observed among urban rather than rural residents ( P < 0.05). In contrast, overall antibody prevalence to STG and SFG were both very low (1.1%, 10/908 for STG; 1.7%, 15/908 for SFG), with no significant differences between rural and urban residents. These results provide data on baseline population characteristics that may help inform development of Rickettsia serological testing criteria in future clinical studies.
Mojola, Sanyu A; Williams, Jill; Angotti, Nicole; Gómez-Olivé, F Xavier
South Africa has the highest number of people living with HIV in the world (over 6 million) as well as a rapidly aging population, with 15% of the population aged 50 and over. High HIV prevalence in rural former apartheid homeland areas suggests substantial aging with HIV and acquisition of HIV at older ages. We develop a life course approach to HIV vulnerability, highlighting the rise and fall of risk and protection as people age, as well as the role of contextual density in shaping HIV vulnerability. Using this approach, we draw on an innovative multi-method data set collected within the Agincourt Health and Demographic Surveillance System in South Africa, combining survey data with 60 nested life history interviews and 9 community focus group interviews. We examine HIV risk and protective factors among adults aged 40-80, as well as how and why these factors vary among people at older ages. Copyright © 2015 Elsevier Ltd. All rights reserved.
Ogunbodede, E O; Kida, I A; Madjapa, H S; Amedari, M; Ehizele, A; Mutave, R; Sodipo, B; Temilola, S; Okoye, L
Although there have been major improvements in oral health, with remarkable advances in the prevention and management of oral diseases, globally, inequalities persist between urban and rural communities. These inequalities exist in the distribution of oral health services, accessibility, utilization, treatment outcomes, oral health knowledge and practices, health insurance coverage, oral health-related quality of life, and prevalence of oral diseases, among others. People living in rural areas are likely to be poorer, be less health literate, have more caries, have fewer teeth, have no health insurance coverage, and have less money to spend on dental care than persons living in urban areas. Rural areas are often associated with lower education levels, which in turn have been found to be related to lower levels of health literacy and poor use of health care services. These factors have an impact on oral health care, service delivery, and research. Hence, unmet dental care remains one of the most urgent health care needs in these communities. We highlight some of the conceptual issues relating to urban-rural inequalities in oral health, especially in the African and Middle East Region (AMER). Actions to reduce oral health inequalities and ameliorate rural-urban disparity are necessary both within the health sector and the wider policy environment. Recommended actions include population-specific oral health promotion programs, measures aimed at increasing access to oral health services in rural areas, integration of oral health into existing primary health care services, and support for research aimed at informing policy on the social determinants of health. Concerted efforts must be made by all stakeholders (governments, health care workforce, organizations, and communities) to reduce disparities and improve oral health outcomes in underserved populations. © International & American Associations for Dental Research 2015.
Duboz, P; Touré, M; Hane, F; Macia, E; Coumé, M; Bâ, A; Boëtsch, G; Guèye, L; Chapuis-Lucciani, N
The objectives of this study were: to compare the prevalence of hypertension, overweight and obesity in rural (Ferlo) and urban (Dakar) Senegalese populations aged 50 and over. The survey was conducted on individuals aged 50 and older living in the rural area (N=478) and in the urban area (N=220). We have collected data about age, gender, marital status, education level, and knowledge, treatment of hypertension, height, weight and blood pressure. We have observed that overweight and obesity were more prevalent in the urban area (Dakar) than in the rural one (Ferlo). The risk of overweight or obesity decreased when age increased, and women had weight problems more often than men. The prevalence of arterial hypertension was lower in rural area (55.86%) than in Dakar (66.36%), but increased at an older age. However, the logistic regression showed that these increased proportion of hypertension in Dakar is linked to the more important proportion of overweight and obese people in this area. Moreover, rates of knowledge, treatment and control of hypertension are particularly low in the rural area of Senegal. In conclusion, age-associated diseases should be better managed in Senegal, particularly in rural areas.
Batsis, John A; Whiteman, Karen L; Lohman, Matthew C; Scherer, Emily A; Bartels, Stephen J
To ascertain whether rural status impacts self-reported health and whether the effect of rural status on self-reported health differs by obesity status. We identified 22,307 subjects aged ≥60 from the Medical Expenditure Panel Survey 2004-2013. Body mass index (BMI) was categorized as underweight, normal, overweight, or obese. Physical and mental component scores of the Short Form-12 assessed self-reported health status. Rural/urban status was defined using metropolitan statistical area. Weighted regression models ascertained the relative contribution of predictors (including rural and BMI) on each subscale. Mean age was 70.7 years. Rural settings had higher proportions classified as obese (30.7 vs 27.6%; P rural residents had lower physical health status (41.7 ± 0.3) than urban (43.4 ± 0.1; P rural/urban by BMI. Individuals classified as underweight or obese had lower physical health compared to normal, while the differences were less pronounced for mental health. No differences in mental health existed between rural/urban status. A BMI * rural interaction was significant for physical but not mental health. Rural residents report lower self-reported physical health status compared to urban residents, particularly older adults who are obese or underweight. No interaction was observed between BMI and rural status. © 2017 National Rural Health Association.
Homenko, Daria R.; Morin, Philip C.; Eimicke, Joseph P.; Teresi, Jeanne A.; Weinstock, Ruth S.
Objective: To evaluate differences between rural older adults with diabetes reporting the presence or absence of food insecurity with respect to meal planning, preparation, shopping, obesity, and glycemic control after receiving nutrition counseling through telemedicine. Methods: Food insecurity data were obtained by telephone survey (n = 74).…
Full Text Available Introduction : Obesity has reached epidemic proportions globally with more than 1 billion overweight, Atleast 300 million of them are clinically obese and is a major contributor to the global burden of chronic disease and disability (1. Long considered a buy product of modern life in rich, developed contries, obesity is spreading to developing contries as well. Two critical factors that have influenced this explosion are changes in dietary patterns and levels of physical activity. The latest list of morbidity associated with obesity includes about forty diseases. Though, prevalence of co-morbidities of obesity is quite high among adults in India yet there are relatively less reliable and representative data available. Hence, this study was carried out. Material & Methods : It was a community based, cross sectional study conducted in field practice areas at Rural Health Centre (RHC, Pohir and Urban Health Centre (UHC, Kirti Nagar attached to the department of Community Medicine, DMC & Hospital Ludhiana. Field practice area of RHC is composed of 10 villages serving a total population of 20,450. The Urban health Centre covers ten colonies having a total populaation of 20.645.
Wang, Shibin; Kou, Changgui; Liu, Yawen; Li, Bo; Tao, Yuchun; D'Arcy, Carl; Shi, Jieping; Wu, Yanhua; Liu, Jianwei; Zhu, Yingli; Yu, Yaqin
Rural-urban differences in the prevalence of chronic diseases in the adult population of northeast China are examined. The Jilin Provincial Chronic Disease Survey used personal interviews and physical measures to research the presence of a range of chronic diseases among a large sample of rural and urban provincial residents aged 18 to 79 years (N = 21 435). Logistic regression analyses were used. After adjusting for age and gender, rural residents had higher prevalence of hypertension, chronic ischemic heart disease, cerebrovascular disease, chronic low back pain, arthritis, chronic gastroenteritis/peptic ulcer, chronic cholecystitis/gallstones, and chronic lower respiratory disease. Low education, low income, and smoking increased the risk of chronic diseases in rural areas. Reducing rural-urban differences in chronic disease presents a formidable public health challenge for China. The solution requires focusing attention on issues endemic to rural areas such as poverty, lack of chronic disease knowledge, and the inequality in access to primary care. © 2014 APJPH.
Maruf, Fatai Adesina; Muonwe, Chidile; Odetunde, Marufat
Reports on social risk factors for falls are scarce. This study explored the associations of selected sociodemographic and health variables with falls among rural Nigerian community-dwelling older adults. The present cross-sectional study involved 131 community-dwelling older adults (84 women and 47 men) recruited at an outreach center. Demographic (age, sex and marital status), social (frequency of visiting relations and friends, and number of consistent informal carers) and health (number of comorbid conditions) variables were recorded. Having fewer than two informal carers (0.26, 95% CI 0.10-0.68) was independently associated with reduced risk for falls. Visiting relations and friends less than twice per week was independently associated with greater risks for falls (3.85, 95% CI 1.42-10.46) and recurrent falls (4.86, 95% CI 1.25-18.85). The number of informal carers and frequency of social visits are risk factors for falls in older adults, and need to be taken into consideration in any strategy for fall prevention in older adults. Geriatr Gerontol Int 2015; ●●: ●●-●●. © 2015 Japan Geriatrics Society.
O'Shea, T.J.; Ellison, L.E.; Stanley, T.R.
We studied adult survival and population growth at multiple maternity colonies of big brown bats (Eptesicus fuscus) in Fort Collins, Colorado. We investigated hypotheses about survival using information-theoretic methods and mark-recapture analyses based on passive detection of adult females tagged with passive integrated transponders. We constructed a 3-stage life-history matrix model to estimate population growth rate (??) and assessed the relative importance of adult survival and other life-history parameters to population growth through elasticity and sensitivity analysis. Annual adult survival at 5 maternity colonies monitored from 2001 to 2005 was estimated at 0.79 (95% confidence interval [95% CI] = 0.77-0.82). Adult survival varied by year and roost, with low survival during an extreme drought year, a finding with negative implications for bat populations because of the likelihood of increasing drought in western North America due to global climate change. Adult survival during winter was higher than in summer, and mean life expectancies calculated from survival estimates were lower than maximum longevity records. We modeled adult survival with recruitment parameter estimates from the same population. The study population was growing (?? = 1.096; 95% CI = 1.057-1.135). Adult survival was the most important demographic parameter for population growth. Growth clearly had the highest elasticity to adult survival, followed by juvenile survival and adult fecundity (approximately equivalent in rank). Elasticity was lowest for fecundity of yearlings. The relative importances of the various life-history parameters for population growth rate are similar to those of large mammals. ?? 2011 American Society of Mammalogists.
Full Text Available Research Question : - What is the magnitude of Diabetes mellitus in the urban and rural areas of Kanpur.Objectives:To study the prevalence of diabetes mellitus amongst high risk age group population in urban and rural areas of Kanpur.To compare the magnitude of problem of diabetes mellitus between urban and rural areas of Kanpur.To study the possible associates and socio-demographic variables related to diabetes mellitus.Study Design : Cross sectional study.Setting : The study was performed on three thousand population each in urban and rural areas of Kanpur.Participants : High risk age group population i.e. 45 years and above.Study variables : Age, Sex. impaired glucose tolerance. Body mass index, Education, Working status. Social class, family history of diabetes.Statistical analysis : Chi-square lest, percentagesResults From a total of 676 persons of high risk age group i.e. 45 years and above, the overall prevalence of diabetes mellitus in the study areas was observed lobe 7. l%with 9.94% in urban and 3.61% in rural areas, the maximum percetage of diabetes cases (41.66% was in the age group of 56-60 years. Higher prevalence of diabetes was observed in the obese (56.25% and sedentary (87.5% persons. The family history' of diabetes mellitus was present in (35.41% of diabetes mellitus cases.
Chen, Su-Hui; Huang, Yu-Ping; Shao, Jung-Hua
Nutritional health plays a crucial role in determining successful ageing and differs by different living area. Although nutritional interventions have long been advocated, little research has directly assessed the effectiveness of nutritional interventions on community-dwelling older adults in urban and rural areas and compared intervention effects on these two populations. To examine the effectiveness of a 12-week dietary self-management programme for salt-, fluid-, fat- and cholesterol-intake behaviours of community-dwelling older adults and to compare these effects in rural- and urban-dwelling older adults. For this quasi-experimental two-group study, older adults (≥65 years old) were recruited from two randomly selected public health centres in a rural north-eastern county and a northern city of Taiwan from January through December 2011. Outcomes included nutritional status, nutritional self-efficacy and health locus of control. Data were collected at baseline and 12 weeks later. To compare changes in outcome variables over time between the control (usual care) and intervention (nutritional programme) groups and between the urban- and rural-dwelling participants in the experimental group, we used generalised estimating equation analysis. Of the 129 participants, 120 completed this study (58 in the intervention group and 62 in the control group). After 12 weeks, the intervention group had significantly better nutritional status and higher internal health locus of control than the control group. Moreover, older rural participants who received the intervention tended towards higher nutritional self-efficacy and internal health locus of control than their urban counterparts. Our research findings support the positive effect of our nutritional self-management programme for community-dwelling older adults. The knowledge gained from this study can help stakeholders recognise the need for healthcare policy to establish effective strategies and sustainable
Full Text Available Cardiovascular diseases are the number one cause of death globally. They account for approximately 17 million deaths in the world each year (1.Of these deaths, complications of high blood pressure account for more than nine million, including about half of all deaths from heart disease and stroke(2.The number of adults with hypertension in 2025 was predicted to increase by about 60% to a total of 1•56 billion (1•54–1•58 billion(3. In India too, overall morbidity and mortality from non-communicable diseases (NCDs is rising rapidly which will have severe impact on the already frail economy (4. Many studies done in different settings in India have shown that the prevalence of hypertension ranges from as high as 20-50 percent in both rural and urban population (Table 1 (5. Contradictory to the earlier reports that the prevalence of hypertension is low in rural areas, the recent studies have shown that the rural-urban differences have largely disappeared and the hypertension and other risk factors for cardiovascular diseases are only equal or slightly greater in the rural population (6. A recent study done by the authors in a rural population in Tamilnadu found that 27.2% of adults between 18 to 60 years have hypertension (7. Also the studies show that more than 50% of the men and women above 60 years old are hypertensive in rural South India (8. This observation has major repercussion on India’s health system and health expenditure in the context of improved life expectancy and a significant increase in the proportion of people living in the age group of 60 years and above in India.
Abubakari, A R; Lauder, W; Jones, M C; Kirk, A; Agyemang, C; Bhopal, R S
To determine the prevalence and distribution of, and trends in, physical inactivity and diabetes in adult West African populations. Systematic review and meta-analysis. Literature searches were conducted using four electronic databases. Journal hand searches and examination of citations of relevant articles were also undertaken. To be included, studies had to be population based, use clearly defined criteria for measuring diabetes and physical inactivity, present data that allowed calculation of the prevalence of diabetes or physical inactivity, and sample adult participants. Studies retrieved were appraised critically. Meta-analysis was performed using the DerSimonian-Laird random effect model. Twenty-one reports were retrieved for diabetes and 15 reports were retrieved for physical in/activity. Most studies (10 for diabetes and six for physical activity) were conducted solely among urban populations. The prevalence of diabetes in West Africa was approximately 4.0% [95% confidence interval (CI) 2.0-9.0] in urban adults and 2.6% (95%CI 1.5-4.4) in rural adults, and was similar in men and women [prevalence ratio (PR) 1.36, 95%CI 0.96-1.92]. Cumulative time trend analyses suggested an increase in the prevalence of diabetes among adults in urban West Africa, from approximately 3.0% (95%CI 1.0-7.0) to 4.0% (95%CI 2.0-9.0) in the past 10 years. The prevalence of inactivity in West Africa was 13% (95%CI 9.0-18.0). An association was found between physical inactivity and being older (> or = 50 years) (PR 1.82, 95%CI 1.36-2.44), female gender (PR 1.62, 95%CI 1.41-1.87) and urban residence (PR 2.04, 95%CI 1.58-2.63). Diabetes and physical inactivity are important public health issues in urban West Africa, with similar prevalences to wealthy industrialized countries. There is an urgent need for policy makers, politicians and health promotion experts to put measures in place to encourage active lifestyles and control diabetes in urban West Africa.
Full Text Available Background: As China is going through a profound aging process, the mental health of the elderly is becoming an issue. As in many other societies, the elderly in China is a population at high risk of suicide; Methods: Data for the study were taken from the Sample Survey of the Aged Population in Urban/Rural China (SSAPUR accomplished in 2010 by the China Ministry of Civil Affairs. The valid sample for this study was composed of 18,683 individuals, including 9416 urban residents and 9267 rural residents both aged 60 or more years; Results: Logistic regression analyses showed that household income and expenditure, the number of children, chronic diseases, disability of daily living, depression, the frequency of visiting neighbors and having friends or relatives who can help or not had remarkable effects on the suicidal ideation among urban and rural old people. Gender, education, political affiliation, marital status and self-rated health status did not work on the dependent variable. However, some risk factors for suicidal ideation among the Chinese elderly were different between rural and urban regions; Conclusions: We should take different measures when facing the different groups of the elderly.
Cruz, Cassiano N.P. [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Eletrovento Ltda, Incubadora de Empresas de Base Tecnologica], e-mail: email@example.com; Mourad, Anna L. [Instituto de Tecnologia de Alimentos (ITAL) Campinas, SP (Brazil). Centro de Tecnologia de Embalagem], e-mail: firstname.lastname@example.org; Morinigo, Marcos A. [Comissao de Servicos Publicos de Energia do Estado de Sao Paulo (CSPE), SP (Brazil)], e-mail: email@example.com; Sanga, Godfrey [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Fac. de Engenharia Mecanica], e-mail: firstname.lastname@example.org
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
The study aim was to establish the prevalence and determinants of smokeless tobacco use in Nigerian adults' population. Across-sectional survey of 1776 adults inYola, North-East Nigeria was carried out in June 2007.A modified World Health Organization (WHO) tobacco survey questionnaire was used for interview and ...
Mette Lundsby Jensen
Full Text Available BACKGROUND: In urban Guinea-Bissau, adults with a vaccinia scar had better survival but also a higher prevalence of HIV-2 infection. We therefore investigated the association between vaccinia scar and survival and HIV infection in a rural area of Guinea-Bissau. METHODOLOGY/PRINCIPAL FINDINGS: In connection with a study of HIV in rural Guinea-Bissau, we assessed vaccinia and BCG scars in 193 HIV-1 or HIV-2 infected and 174 uninfected participants. Mortality was assessed after 2(1/2-3 years of follow-up. The analyses were adjusted for age, sex, village, and HIV status. The prevalence of vaccinia scar was associated with age, village, and HIV-2 status but not with sex and schooling. Compared with individuals without any scar, individuals with a vaccinia scar had better survival (mortality rate ratio (MR = 0.22 (95% CI 0.08-0.61, the MR being 0.19 (95% CI 0.06-0.57 for women and 0.40 (95% CI 0.04-3.74 for men. Estimates were similar for HIV-2 infected and HIV-1 and HIV-2 uninfected individuals. The HIV-2 prevalence was higher among individuals with a vaccinia scar compared to individuals without a vaccinia scar (RR = 1.57 (95% CI 1.02-2.36. CONCLUSION: The present study supports the hypothesis that vaccinia vaccination may have a non-specific beneficial effect on adult survival.
Cerutti, Bernard; Broers, Barbara; Masetsibi, Motlomelo; Faturiyele, Olatunbosun; Toti-Mokoteli, Likabelo; Motlatsi, Mokete; Bader, Joelle; Klimkait, Thomas; Labhardt, Niklaus D
Abstract Background Depression and alcohol use disorder have been shown to be associated with poor adherence to antiretroviral therapy (ART). Studies examining their association with viral suppression in rural Africa are, however, scarce. Methods This study reports prevalence of depressive symptoms and alcohol use disorder, and their potential association with adherence and viral suppression in adult patients on ART in ten clinics in rural Lesotho, Southern Africa. Results Among 1,388 adult p...
Penelope A Phillips-Howard
Full Text Available Targeted global efforts to improve survival of young adults need information on mortality trends; contributions from health and demographic surveillance system (HDSS are required.This study aimed to explore changing trends in deaths among adolescents (15-19 years and young adults (20-24 years, using census and verbal autopsy data in rural western Kenya using a HDSS. Mid-year population estimates were used to generate all-cause mortality rates per 100,000 population by age and gender, by communicable (CD and non-communicable disease (NCD causes. Linear trends from 2003 to 2009 were examined. In 2003, all-cause mortality rates of adolescents and young adults were 403 and 1,613 per 100,000 population, respectively, among females; and 217 and 716 per 100,000, respectively, among males. CD mortality rates among females and males 15-24 years were 500 and 191 per 100,000 (relative risk [RR] 2.6; 95% confidence intervals [CI] 1.7-4.0; p<0.001. NCD mortality rates in same aged females and males were similar (141 and 128 per 100,000, respectively; p = 0.76. By 2009, young adult female all-cause mortality rates fell 53% (χ(2 for linear trend 30.4; p<0.001 and 61.5% among adolescent females (χ(2 for linear trend 11.9; p<0.001. No significant CD mortality reductions occurred among males or for NCD mortality in either gender. By 2009, all-cause, CD, and NCD mortality rates were not significantly different between males and females, and among males, injuries equalled HIV as the top cause of death.This study found significant reductions in adolescent and young adult female mortality rates, evidencing the effects of targeted public health programmes, however, all-cause and CD mortality rates among females remain alarmingly high. These data underscore the need to strengthen programmes and target strategies to reach both males and females, and to promote NCD as well as CD initiatives to reduce the mortality burden amongst both gender.
Williams, Jill; Angotti, Nicole; Gómez-Olivé, Xavier
South Africa has the highest number of people living with HIV in the world (over 6 million) as well as a rapidly aging population, with 15% of the population aged 50 and over. High HIV prevalence in rural former apartheid homeland areas suggests substantial aging with HIV and acquisition of HIV at older ages. We develop a life course approach to HIV vulnerability, highlighting the rise and fall of risk and protection as people age, as well as the role of contextual density in shaping HIV vulnerability. Using this approach, we draw on an innovative multi-method data set collected within the Agincourt Health and Demographic Surveillance System in South Africa, combining survey data with 60 nested life history interviews and 9 community focus group interviews. We examine HIV risk and protective factors among adults aged 40–80, as well as how and why these vary among people at older ages. PMID:26364007
Pradeep R Deshmukh
Full Text Available Background and Objectives: Metabolic syndrome - a plausible precondition for type II diabetes and cardiovascular diseases is also on rise. To understand the mechanistic complexity of metabolic syndrome it is imperative to study the specific contribution of the determinants of metabolic syndrome. Such study can help to identify the most significant factor which may be of use in early detection as well as prevention efforts. Such information is scarcely available from India and especially from rural India. Hence, the present study was undertaken to explore for such factor which might be considered crucial for development of such pathogenesis particularly in rural population of Wardha. Methods: A cross-sectional study comprising of 300 subjects was carried out in rural area of Primary Health Center, attached to medical college with approximate 31,000 populations. The anthropometric parameters such as height, weight, waist circumference were measured. Overnight fasting samples were collected for lipid profile (total cholesterol, triglyceride, high density lipoproteins, low density lipoproteins, very low density lipoproteins and fasting blood glucose levels. The National Cholesterol Education Programme Adult Treatment Panel, ATP-III guidelines were used to categorize the study subjects. As many of the variables are highly intercorrelated, exploratory factor analysis was carried out to reduce the data to a smaller number of independent factors that accounts for the most of the variances in the data. Principal component analysis was used as a method of extraction. Results: For both sexes, three factors were extracted accounting for about 71% variance in the measured variables. An adiposity factor which accounted for highest explained variance (28%, was the initial factor extracted. It was loaded positively by waist circumference, triglyceride, and very low density lipoprotein and negatively loaded by high density lipoprotein. Second factor extracted
Aguilera Barciela, M [Secretariado Ejecutivo, Comision Nacional de Energia, La Habana(Cuba)
The development of electro energetic national system in Cuba has been directed to the following objectives: to brake the rural population's exodus toward the cities, electrification of dairy farm, interconnection to the system electro energetic of all the sugar central production, these improves the rural population's conditions life.
Sviatova, G S; Berezina, G M; Abil'dinova, G Zh
Rural populations neighboring the Semipalatinsk nuclear test site were used as a model to develop and test an integrated population-genetic approach to analysis of the medical genetic situation and environmental conditions in the areas studied. The contributions of individual factors of population dynamics into the formation of the genetic load were also assessed. The informative values of some genetic markers were estimated. Based on these estimates, a mathematical model was constructed that makes it possible to calculate numerical scores for analysis of the genetic loads in populations differing in environmental exposure.
Oramasionwu, Christine U; Daniels, Kelly R; Labreche, Matthew J; Frei, Christopher R
The Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) pandemic has caused far-reaching effects in sub-Saharan Africa. The pandemic has effectively diminished the workforce, increased poverty rates, reduced agricultural productivity, and transformed the structure of many rural households. HIV/AIDS further strains the already fragile relationship between livelihood and the natural and social environments of these regions. Therefore, the objective of this review is to characterize the impact of HIV/AIDS on the environment and the social infrastructure of rural sub-Saharan Africa. There are many aspects of rural life that contribute to disease transmission of HIV/AIDS and that pose unique challenges to the population dynamics in sub-Saharan Africa. Widespread AIDS-related mortality has caused a decrease in population growth for many African countries. In turn, these alterations in population dynamics have resulted in a decrease in the percentage of prime-age working adults, as well as a gender disparity, whereby, females carry a growing burden of household responsibilities. There is a rising proportion of older adults, often females, who assume the role of provider and caretaker for other dependent family members. These changing dynamics have caused many to exploit their natural surroundings, adopting less sustainable land use practices and utilizing protected resources as a primary means of generating revenue.
Kivett, Vira R.; Learner, R. Max
Results showed no significant difference in the morale scores of older rural adults living with children (N=97) and those in other arrangements (N=243) when health was controlled. However, more than twice as much variance in morale scores could be explained for parents in child-shared housing as for other parents. (Author)
Nahar, Papreen; Kannuri, Nanda Kishore; Mikkilineni, Sitamma; Murthy, G V S; Phillimore, Peter
This article examines challenges facing implementation of likely mHealth programmes in rural India. Based on fieldwork in Andhra Pradesh in 2014, and taking as exemplars two chronic medical 'conditions' - type 2 diabetes and depression - we look at ways in which people in one rural area currently access medical treatment; we also explore how adults there currently use mobile phones in daily life, to gauge the realistic likelihood of uptake for possible mHealth initiatives. We identify the very different pathways to care for these two medical conditions, and we highlight the importance to the rural population of healthcare outside the formal health system provided by those known as registered medical practitioners (RMP), who despite their title are neither registered nor trained. We also show how limited is the use currently made of very basic mobile phones by the majority of the older adult population in this rural context. Not only may this inhibit mHealth potential in the near future; just as importantly, our data suggest how difficult it may be to identify a clinical partner for patients or their carers for any mHealth application designed to assist the management of chronic ill-health in rural India. Finally, we examine how the promotion of patient 'self-management' may not be as readily translated to a country like India as proponents of mHealth might assume.
Full Text Available Unhealthy lifestyle characteristics such as low physical activity (PA and high plasma glucose levels (PGLs may lead to the development of type 2 diabetes mellitus in adulthood. The aim of this study was to investigate (i the level of physical activity; (ii the prevalence of pre-diabetes and (iii the relationship between PA and plasma glucose level in a rural Ellisras adult population aged 18 to 28 years. A total of 713 young adults (349 males and 364 females who took part in the Ellisras Longitudinal Study participated in the study. Fasting plasma glucose levels were analysed using Accutrend glucose meters. Physical activity data was collected using a validated questionnaire. Linear regression was used to assess the relationship between PA and pre-diabetes. The prevalence of pre-diabetes was between 45.7% and 50.2% and that of physical inactivity was 67.3% and 71.0% for males and females, respectively. There was no significant (p > 0.05 relationship between PA and pre-diabetes (beta = 1.016; 95% Confidence Interval from 0.352 to 2.777. The health benefits of PA increased with the increasing frequency, duration and intensity of exercise. The prevalence of pre-diabetes was found to be very high in this population. Our results suggest that greater physical activity is associated with low plasma glucose levels.
Gold, Paul B; Meisler, Neil; Santos, Alberto B; Carnemolla, Mark A; Williams, Olivia H; Keleher, Jennie
Urban-based randomized clinical trials of integrated supported employment (SE) and mental health services in the United States on average have doubled the employment rates of adults with severe mental illness (SMI) compared to traditional vocational rehabilitation. However, studies have not yet explored if the service integrative functions of SE will be effective in coordinating rural-based services that are limited, loosely linked, and geographically dispersed. In addition, SE's ability to replicate the work outcomes of urban programs in rural economies with scarce and less diverse job opportunities remains unknown. In a rural South Carolina county, we designed and implemented a program blending Assertive Community Treatment (ACT) with an SE model, Individual Placement and Support (IPS). The ACT-IPS program operated with ACT and IPS subteams that tightly integrated vocational with mental health services within each self-contained team. In a 24-month randomized clinical trial, we compared ACT-IPS to a traditional program providing parallel vocational and mental health services on competitive work outcomes for adults with SMI (N = 143; 69% schizophrenia, 77% African American). More ACT-IPS participants held competitive jobs (64 versus 26%; p < .001, effect size [ES] = 0.38) and earned more income (median [Mdn] = $549, interquartile range [IQR] = $0–$5,145, versus Mdn = $0, IQR = $0–$40; p < .001, ES = 0.70) than comparison participants. The competitive work outcomes of this rural ACT-IPS program closely resemble those of urban SE programs. However, achieving economic self-sufficiently and developing careers probably require increasing access to higher education and jobs imparting marketable technical skills. PMID:16177278
Gao, Langli; Jiang, Jiaojiao; Yang, Ming; Hao, Qiukui; Luo, Li; Dong, Birong
To compare the prevalence of sarcopenia in urban and rural Chinese elderly adults and to identify the risk factors related to sarcopenia. A cross-sectional study. Urban and rural communities in western China. A total of 887 community-dwelling elderly adults aged 60 years or older. Sarcopenia was defined according to the recommended algorithm of the Asian Working Group for Sarcopenia (AWGS). Cognitive function, depression, and nutrition status were assessed using the Chinese version of the Mini-Mental Status Examination (MMSE), the Chinese version of the 30-item Geriatric Depression Scale (GDS-30), and the revised Mini Nutritional Assessment short-form (MNA-SF), respectively. A total of 612 individuals aged 70.6 ± 6.7 years (range, 60-91 years) were included in this study. The prevalence of sarcopenia in the study population was 9.8% (women, 12.0%; men, 6.7%; P = .031). The prevalence of sarcopenia was 13.1% in rural elders and 7.0% in urban elders (P = .012). Age (odds ratio [OR] 1.22; 95% confidence interval [CI] 1.15-1.29), women (OR 1.71; 95% CI 1.20-5.65), malnutrition or at risk for malnutrition (OR 3.53; 95% CI 1.68-7.41), rural residence (OR 2.15; 95% CI 1.33-4.51), and the number of medications (OR 1.23; 95% CI 1.06-1.44) were independently associated with sarcopenia. Rural elders are more vulnerable to sarcopenia than urban elders in a sample of western China's elderly population. More attention should focus on rural populations in future sarcopenia studies. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
Kalichman, Seth; Katner, Harold; Banas, Ellen; Kalichman, Moira
AIDS stigmas delay HIV diagnosis, interfere with health care, and contribute to mental health problems among people living with HIV. While there are few studies of the geographical distribution of AIDS stigma, research suggests that AIDS stigmas are differentially experienced in rural and urban areas. We conducted computerized interviews with 696 men and women living with HIV in 113 different zip code areas that were classified as large-urban, small-urban, and rural areas in a southeast US state with high-HIV prevalence. Analyses conducted at the individual level (N = 696) accounting for clustering at the zip code level showed that internalized AIDS-related stigma (e.g., the sense of being inferior to others because of HIV) was experienced with greater magnitude in less densely populated communities. Multilevel models indicated that after adjusting for potential confounding factors, rural communities reported greater internalized AIDS-related stigma compared to large-urban areas and that small-urban areas indicated greater experiences of enacted stigma (e.g., discrimination) than large-urban areas. The associations between anticipated AIDS-related stigma (e.g., expecting discrimination) and population density at the community-level were not significant. Results suggest that people living in rural and small-urban settings experience greater AIDS-related internalized and enacted stigma than their counterparts living in large-urban centers. Research is needed to determine whether low-density population areas contribute to or are sought out by people who experienced greater AIDS-related stigma. Regardless of causal directions, interventions are needed to address AIDS-related stigma, especially among people in sparsely populated areas with limited resources.
MH Lotfi; M Shakiba; S Jafary-Nodushan
Introduction: Water is an essential nutrient for life. It comprises 75% of total body weight in infants,60% in adult males and 50% in adult females. Decrease in body water is commonly known as dehydration. Acute or chronic dehydration is a common condition in some population groups, especialy the elderly and those who participate in physical activity in warm enviroments. Potential consequences of dehydration include constipation,urinary tract and respiratory infection,urinary stone disease an...
Bartlett, Lynne M; Nowak, Madeleine J; Ho, Yikhong
In Australia, faecal incontinence, the involuntary loss of liquid or solid stool with or without a person's awareness, has been reported in 8% of the South Australian and 11% of the urban New South Wales community-dwelling populations. Studies conducted in 2004 and 2005 reported faecal incontinence in more than 20% of colorectal and urogynaecological clinic patients at Townsville Hospital (a referral centre serving rural North Queensland). This prompted concern regarding the level of faecal incontinence in the community. The aim of this study was to investigate the prevalence of faecal incontinence in the North and Far North Queensland urban and rural communities. The sample size was based on the New South Wales postal surveys (11% prevalence). Higher rates were expected in North/Far North Queensland, so prevalence there was estimated at 12.1% (confidence interval ± 2%, ie the true level to be between 10.1% and 14.1%). The sample for each of the Townsville, Cairns (in Far North Queensland) and rural/remote settings was calculated at 1022. The database for the present study was compiled using a systematic randomised process selecting two private names from each column on each page of the Cairns and Townsville White Pages® (Cairns: 1112 urban, 481 rural, 226 remote; Townsville: 1049 urban, 432 rural, 320 remote). The questionnaire covered personal demographics, health/risk factors, bowel habits, nutrition (fibre and fluid intake) and physical activity. Faecal incontinence was defined as accidental leakage of solid or liquid stool in the past 12 months that was not caused by a virus, medication or contaminated food. To improve the response rate a participation incentive of a chance to win a $250 voucher or one of ten $50 vouchers was offered in the initial mail-out. The initial survey was mailed out in July 2007; two follow-up surveys were mailed out to non-responders in September 2007 and January 2008. One hundred randomly selected non-responders were telephoned in
Le Thi Thanh, Xuan; Rheinländer, Thilde; Luu Ngoc, Hoat
-ethnic population of primary schoolchildren in northern rural Vietnam. Design: This study was implemented in two phases: a formative research project over 5 months (July-November 2008) and an action research project with a school-based HWWS intervention study in two rural communes during 5 months (May, September......-December 2010). Based upon knowledge from the formative research in 2008, schoolteachers from four selected schools in the study communes actively participated in designing and implementing a HWWS intervention. Qualitative data was collected during the intervention to evaluate the responses and reaction...
Chen, Xinguang; Stanton, Bonita; Kaljee, Linda M; Fang, Xiaoyi; Xiong, Qing; Lin, Danhua; Zhang, Liying; Li, Xiaoming
In this study, we examine migrant stigma and its effect on social capital reconstruction among rural migrants who possess legal rural residence but live and work in urban China. After a review of the concepts of stigma and social capital, we report data collected through in-depth interviews with 40 rural migrant workers and 38 urban residents recruited from Beijing, China. Findings from this study indicate that social stigma against rural migrants is common in urban China and is reinforced through media, social institutions and their representatives, and day-to-day interactions. As an important part of discrimination, stigma against migrant workers creates inequality, undermines trust, and reduces opportunities for interpersonal interactions between migrants and urban residents. Through these social processes, social stigma interferes with the reconstruction of social capital (including bonding, bridging and linking social capital) for individual rural migrants as well as for their communities. The interaction between stigma and social capital reconstruction may present as a mechanism by which migration leads to negative health consequences. Results from this study underscore the need for taking measures against migrant stigma and alternatively work toward social capital reconstruction for health promotion and disease prevention among this population.
Sreejith S. Nair
Full Text Available Background: Increasing life expectancy around the world, an outstanding achievement of our century, has brought with it new public health challenges. India is the second most populous country in the world, with over 72 million inhabitants above 60 years of age as of 2001. The life expectancy in India increased from 32 years in 1947 to over 66 years in 2010, with 8.0% of the population now reaching over 60 years of age. Few studies in India target the health, especially mental health, of this geriatric population. This study aims to estimate the current prevalence of psychiatric disorders in the geriatric population of the rural area of Singanodi,Karnataka, India.Methods: This cross sectional, epidemiological, community-based study was conducted in a rural health training area of Singanodi, Raichur District, Karnataka, India.The General Health Questionnaire-12, Mini Mental State Examination, and Geriatric Depression Scale were administered to 366 participants. Chi square tests with Yates correction were utilized for statistical analysis using SPSS 19.0 software.Results:We found that 33.9% of the geriatric population in the selected province were above the threshold for mental illness based on the GHQ-12 questionnaire. Females had a higher prevalence of mental disorder at 77.6% (152 out of 196 as compared to males who had a prevalence of 42.4% (72 out of 170. The most common psychiatric disorder was depression (21.9%, and generalized anxiety was present in 10.7% of the study population. Prevalence of cognitive impairment was 16.3%, with a significantly higher percentage of affected individuals in 80+ age group.Conclusion: Mental disorders are common among elderly people, but they are not well documented in rural India. The assessment of psychiatric disorder prevalence will help strengthen psycho-geriatric services and thus improve the quality of life of the elderly. A system that ensures comprehensive health care will have to be developed for
Nair, Sreejith S; Raghunath, Pooja; Nair, Sreekanth S
Increasing life expectancy around the world, an outstanding achievement of our century, has brought with it new public health challenges. India is the second most populous country in the world, with over 72 million inhabitants above 60 years of age as of 2001. The life expectancy in India increased from 32 years in 1947 to over 66 years in 2010, with 8.0% of the population now reaching over 60 years of age. Few studies in India target the health, especially mental health, of this geriatric population. This study aims to estimate the current prevalence of psychiatric disorders in the geriatric population of the rural area of Singanodi,Karnataka, India. This cross sectional, epidemiological, community-based study was conducted in a rural health training area of Singanodi, Raichur District, Karnataka, India.The General Health Questionnaire-12, Mini Mental State Examination, and Geriatric Depression Scale were administered to 366 participants. Chi square tests with Yates correction were utilized for statistical analysis using SPSS 19.0 software. We found that 33.9% of the geriatric population in the selected province were above the threshold for mental illness based on the GHQ-12 questionnaire. Females had a higher prevalence of mental disorder at 77.6% (152 out of 196) as compared to males who had a prevalence of 42.4% (72 out of 170). The most common psychiatric disorder was depression (21.9%), and generalized anxiety was present in 10.7% of the study population. Prevalence of cognitive impairment was 16.3%, with a significantly higher percentage of affected individuals in 80+ age group. Mental disorders are common among elderly people, but they are not well documented in rural India. The assessment of psychiatric disorder prevalence will help strengthen psycho-geriatric services and thus improve the quality of life of the elderly. A system that ensures comprehensive health care will have to be developed for this purpose as part of our future efforts.
Samuel T. Ntuli
Full Text Available Background: Hypertension is problem already faced by urban populations of South Africa, but little is known about its prevalence and risk factors in rural areas. Aim: To assess the prevalence of and risk factors associated with hypertension amongst adults in a rural community in South Africa. Setting: Dikgale Health and Demographic Surveillance Site, Limpopo Province, South Africa. Methods: A community-based cross-sectional survey was carried out at this site where individuals aged 15 years and older were screened using a locally adapted version of the World Health Organization STEPwise questionnaire. Demographics, anthropometry and three independent blood pressure (BP readings were taken. The average of the three BP measurements was used in analysis, and hypertension taken as systolic and diastolic BP of ≥ 140 or ≥ 90 mmHg respectively, or at least a two-week history of antihypertensive treatment. Analysis included the Chi-square test and statistical significance was set at p ≤ 0.05. Results: A total of 1407 individuals were interviewed, of whom 1281 had complete BP, weight and height measurements taken. The mean age of participants was 44.2 ± 2 0.9 years (range 15–98 years, 63% were female, 55% were single and 90% were unemployed, whilst 13% were tobacco smokers and 20% reported drinking alcohol. Overall prevalence of hypertension was 41% and this was significantly associated with age and marital status. Conclusion: The prevalence of hypertension was found to be high. Prevention strategies are urgently needed to address this life-threatening and important risk factor for cardiovascular disease in rural Limpopo Province.
Akhter, Rahena; Hannan, MA; Okhubo, R; Morita, M
Objectives: Several studies conducted in Western countries have shown significant associations between stress factors and periodontal disease. However, there have been only a few studies conducted in Asian countries. The present study was designed to identify possible relationship between stress and periodontal disease in residents of a rural area in Japan. Material and Methods: Data were collected from 1,089 adults with at least six natural teeth in a typical farming district of Japan. S...
Lo, Brian K; Morgan, Emily H; Folta, Sara C; Graham, Meredith L; Paul, Lynn C; Nelson, Miriam E; Jew, Nicolette V; Moffat, Laurel F; Seguin, Rebecca A
Rural populations in the United States have lower physical activity levels and are at a higher risk of being overweight and suffering from obesity than their urban counterparts. This paper aimed to understand the environmental factors that influence physical activity among rural adults in Montana. Eight built environment audits, 15 resident focus groups, and 24 key informant interviews were conducted between August and December 2014. Themes were triangulated and summarized into five categories of environmental factors: built, social, organizational, policy, and natural environments. Although the existence of active living features was documented by environmental audits, residents and key informants agreed that additional indoor recreation facilities and more well-maintained and conveniently located options were needed. Residents and key informants also agreed on the importance of age-specific, well-promoted, and structured physical activity programs, offered in socially supportive environments, as facilitators to physical activity. Key informants, however, noted that funding constraints and limited political will were barriers to developing these opportunities. Since building new recreational facilities and structures to support active transportation pose resource challenges, especially for rural communities, our results suggest that enhancing existing features, making small improvements, and involving stakeholders in the city planning process would be more fruitful to build momentum towards larger changes.
Brian K. Lo
Full Text Available Rural populations in the United States have lower physical activity levels and are at a higher risk of being overweight and suffering from obesity than their urban counterparts. This paper aimed to understand the environmental factors that influence physical activity among rural adults in Montana. Eight built environment audits, 15 resident focus groups, and 24 key informant interviews were conducted between August and December 2014. Themes were triangulated and summarized into five categories of environmental factors: built, social, organizational, policy, and natural environments. Although the existence of active living features was documented by environmental audits, residents and key informants agreed that additional indoor recreation facilities and more well-maintained and conveniently located options were needed. Residents and key informants also agreed on the importance of age-specific, well-promoted, and structured physical activity programs, offered in socially supportive environments, as facilitators to physical activity. Key informants, however, noted that funding constraints and limited political will were barriers to developing these opportunities. Since building new recreational facilities and structures to support active transportation pose resource challenges, especially for rural communities, our results suggest that enhancing existing features, making small improvements, and involving stakeholders in the city planning process would be more fruitful to build momentum towards larger changes.
Yen, Chia-Feng; Chiu, Tzu-Ying; Liou, Tsan-Hon; Chi, Wen-Chou; Liao, Hua-Fang; Liang, Chung-Chao; Escorpizo, Reuben
Based on the International Classification of Functioning, Disability, and Health (ICF) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), The Functioning Disability Evaluation Scale-Adult version (FUNDES-Adult) began development in 2011. The FUNDES-Adult was designed to assess the difficulty level of an individual's activities and participation in daily life. There is a lack of research regarding the profile of activity and participation for the general adult population. The purposes of this study were to establish activity and participation norms for the general adult population in Taiwan and to describe, discuss, and compare the activity and participation profile with other population. A population-based survey was administered in 2013 using a computer-assisted telephone interviewing system (CATI system). Using probability proportional to size (PPS) sampling and systematic sampling with random digit dialing (RDD), 1500 adults from Taiwan's general population were selected to participate in the survey. The FUNDES-Adult with six domains and two dimensions (performance and capability) was used to obtain data on activities and participation levels. A higher domain score indicated higher participation restriction. Approximately 50% of the respondents were male, and the average age of the respondents was 45.23 years. There were no significant differences in the demographic features between the sample and the population. Among the six domains, the self-care domain score was the lowest (least restriction) and the participation domain score was the highest (most restriction). Approximately 90% of the sample scored were less than 15, and only 0.1% scored more than 80. This is the first cross-national population-based survey to assess norms of activity and participation relevant to the general population of Taiwan. As such, the results of this survey can be used as a reference for comparing the activity and participation (AP) functioning of
Moutinho, Paulo Rufalco; Gil, Luis Herman Soares; Cruz, Rafael Bastos; Ribolla, Paulo Eduardo Martins
Anopheles darlingi is the major vector of malaria in South America, and its behavior and distribution has epidemiological importance to biomedical research. In Brazil, An. darlingi is found in the northern area of the Amazon basin, where 99.5% of the disease is reported. The study area, known as Ramal do Granada, is a rural settlement inside the Amazon basin in the state of Acre. Population variations and density have been analysed by species behaviour, and molecular analysis has been measured by ND4 mitochondrial gene sequencing. The results show higher density in collections near a recent settlement, suggesting that a high level of colonization decreases the vector presence. The biting activity showed higher activity at twilight and major numbers of mosquitos in the remaining hours of the night in months of high density. From a sample of 110 individual mosquitoes, 18 different haplotypes were presented with a diversity index of 0.895, which is higher than that found in other Anopheles studies. An. darlingi depends on forested regions for their larval and adult survival. In months with higher population density, the presence of mosquitoes persisted in the second part of the night, increasing the vector capacity of the species. Despite the intra-population variation in the transition to rainy season, the seasonal distribution of haplotypes shows no change in the structure population of An. darlingi.
Dhanoa, Amreeta; Hassan, Sharifah Syed; Jahan, Nowrozy Kamar; Reidpath, Daniel D; Fatt, Quek Kia; Ahmad, Mohtar Pungut; Meng, Cheong Yuet; Ming, Lau Wee; Zain, Anuar Zaini; Phipps, Maude Elvira; Othman, Iekhsan; Rabu, Aman Bin; Sirajudeen, Rowther; Fatan, Ahmad Abdul Basitz Ahmad; Ghafar, Faidzal Adlee; Ahmad, Hamdan Bin; Allotey, Pascale
The frequency and magnitude of dengue epidemics continue to increase exponentially in Malaysia, with a shift in the age range predominance toward adults and an expansion to rural areas. Despite this, information pertaining to the extent of transmission of dengue virus (DENV) in the rural community is lacking. This community-based pilot study was conducted to establish DENV seroprevalence amongst healthy adults in a rural district in Southern Malaysia, and to identify influencing factors. In this study undertaken between April and May 2015, a total of 277 adult participants were recruited from households across three localities in the Sungai Segamat subdistrict in Segamat district. Sera were tested for immunoglobulin G (IgG) (Panbio® Dengue Indirect IgG ELISA/high-titer capture) and immunoglobulin M (IgM) (Panbio®) antibodies. The plaque reduction neutralization test (PRNT) was conducted on random samples of IgG-positive sera for further confirmation. Medical history and a recall of previous history of dengue were collected through interviews, whereas sociodemographic information was obtained from an existing database. The overall seroprevalence for DENV infection was 86.6% (240/277) (95% CI: 83-91%). Serological evidence of recent infection (IgM/high-titer capture IgG) was noted in 11.2% (31/277) of participants, whereas there was evidence of past infection in 75.5% (209/277) of participants (indirect IgG minus recent infections). The PRNT assay showed that the detected antibodies were indeed specific to DENV. The multivariate analysis showed that the older age group was significantly associated with past DENV infections. Seropositivity increased with age; 48.5% in the age group of 45 years (P people. The majority of infections did not give rise to recognizable disease (either asymptomatic or nonspecific symptoms) as only 12.9% of participants (31/240) recalled having dengue in the past. The predominantly rural community under study had a very high previous
Full Text Available Abstract Introduction Equity in access to and utilization of health services is a common goal of policy-makers in most countries. The current study aimed to evaluate the distribution of need and access to health care services among Iran's rural population between 2006 and 2009. Methods Census data on population's characteristics in each province were obtained from the Statistical Centre of Iran and National Organization for civil registration. Data about the Rural Health Houses (RHHs were obtained from the Ministry of Health. The Health Houses-to-rural population ratio (RHP, crude birth rate (CBR and crude mortality rate (CMR in rural population were calculated in order to compare their distribution among the provinces. Lorenz curves of RHHs, CMR and CBR were plotted and their decile ratio, Gini Index and Index of Dissimilarity were calculated. Moreover, Spearman rank-order correlation was used to examine the relation between RHHs and CMR and CBR. Results There were substantial differences in RHHs, CMR and CBR across the provinces. CMR and CBR experienced changes toward more equal distributions between 2006 and 2009, while inverse trend was seen for RHHs. Excluding three provinces with markedly changes in data between 2006 and 2009 as outliers, did not change observed trends. Moreover; there was a significant positive relationship between CMR and RHP in 2009 and a significant negative association between CBR and RHP in 2006 and 2009. When three provinces with outliers were excluded, these significant associations were disappeared. Conclusion Results showed that there were significant variations in the distribution of RHHs, CMR and CBR across the country. Moreover, the distribution of RHHs did not reflect the needs for health care in terms of CMR and CBR in the study period.
Gansefort, Dirk; Brand, Tilman; Princk, Christina; Zeeb, Hajo
Communities can play an important role in delivering public health programs to older adults, but they differ in the provision of local structures and resources. The community readiness (CR) approach applies a stage model of change to the community level and analyzes structures and the degree of willingness to take action on a health issue. This study compared the CR regarding the promotion of physical activity as part of healthy ageing for older adults among urban and rural communities in North-West Germany. A cross-sectional CR assessment with key respondents in 23 municipalities (11 urban and 12 rural communities) was conducted using a semi-structured interview. Interviews were scored across the five CR dimensions and global CR score was calculated (scores between 1 = no awareness and 9 = professionalization). Wilcoxon rank-sum test and hierarchical regression models were used to compare urban and rural communities. In total, 118 interviews were conducted (response rate 69.8%). On average, the communities showed moderate CR scores (4.9 ± 0.3; Range: 4.3-5.4; preplanning or preparation phase). The global CR score was slightly higher in rural than in urban communities (regression coefficient = 0.29, 95% confidence interval (CI): -0.02-0.59). The rural communities showed significantly higher CR scores in the 'Knowledge of efforts' dimension (0.70, 95% CI: 0.26-1.14) and in the 'Knowledge of the issue' (0.37, 95% CI: 0.04-0.70). Rural communities display a slightly higher CR level than urban communities. In the next step, targeted capacity building activities will be initiated among communities with low CR levels.
Khan, A K
This population based cross-sectional study was conducted on 8283 persons of all ages in five districts, selected conveniently, to assess the magnitude of ocular injuries, their causes and consequences in rural Bangladesh. Six Upazilas from five districts and from each Upazila one Union was selected randomly. One village, the ultimate cluster, was then selected conveniently from each Union. All people (n = 8283) in the 8 villages were then surveyed. Out of 8283 population (ranging from 1-120 years) surveyed, 167(2%) had history and/or evidence of past ocular trauma with a yearly incidence of 6.2 per 1000 per year. Study demonstrated a female predominance with male to female ratio being roughly 4:5. Majority (82%) had at least one episode of trauma in their life-time with mean age at 1st trauma being 20 years. Nearly 40% of the traumas were caused by blunt objects followed by penetrating object (22.3%) and sharp instrument (18.1%) with home being the primary place of occurrence (55.1%). Evidence of ocular trauma was found on eye-lid (15%), conjunctiva (11.4%) and cornea (10.2%) as scars. The older participants (≥ 30 years), females, illiterates, agriculture labors, housewives and household workers were more likely to receive trauma. Majority (86.8%) of the subjects received treatment following injury. The median time lapsed between injuries and receiving first treatment was 5 days and that between injury and visiting an eye-specialist was 18 days. Self-treatment and treatment from over-the-counter comprised 45% and 42.1% respectively followed by eye-specialists (25.5%), village quack (22.8%), graduate doctors (19.3%) and traditional healers (6.9%). About 87% received conservative management, with 12.4% needing hospitalization. Most of the injured (92.8%) and non-injured (95.2%) eyes had normal vision before trauma as informed by the respondents. Following trauma, 18% had impaired, 10.7% severely impaired vision and about 6% were blind. Job abstinence due to trauma
Vihotogbe-Sossa, Carole N A; Akissoe, Noël H; Anihouvi, Victor B; Ahohuendo, Bonaventure C; Ahanchede, Adam; Sanni, Ambaliou; Hounhouigan, D Joseph
Leafy vegetables are sources of diet diversification and could contribute to food and nutritional security in African rural areas. However, in some places, little is known about if, how, and why leafy vegetables are consumed. Processing and preservation methods, food forms, and consumption determinants of four leafy vegetables (Sesamum radiatum, Ceratotheca sesamoïdes, Acmella uliginosa and Justicia tenella), known to contribute to the diet of rural populations in the Center and Northern parts of Benin, were investigated. Three hundred randomly selected households were investigated, using rapid appraisal and quantitative survey methods, descriptive statistics and correspondence analysis. Processing methods to prepare sauces varied depending on sociocultural groups. Cooking of fresh leaves predominated, while sun drying was the usual practice of preserving these leafy vegetables. Consumption frequencies were associated with sociocultural groups, food habits, and availability in living areas.
Connell, Braydon; Warner, Grace; Weeks, Lori E
Background/Question: Volunteers are important in the support of frail older adults requiring palliative care, especially in rural areas. However, there are challenges associated with volunteer supports related to training, management and capacity to work in partnership with healthcare providers (HCP). This review addresses the question: What is the feasibility of a volunteer-HCP partnership to support frail older adults residing in rural areas, as they require palliative care? This integrative review identified ten articles that met the identified search criteria. Articles were appraised using the Critical Appraisal Skills Programme (CASP) checklists, designed for use across a range of quantitative and qualitative studies. Studies were drawn from international sources to understand how volunteer roles vary by culture and organization; the majority of studies were conducted in North America. Studies varied in methodology, including quantitative, qualitative and educational commentary. Identified factors that were crucial to the feasibility of volunteer-HCP partnerships in rural areas included volunteer training dynamics, relationships between volunteers and HCP, and rural environmental factors. Preliminary evidence indicates that a volunteer-HCP palliative partnership is feasible. However, training policies/procedures, volunteer-HCP relationships, and rural specific designs impact the feasibility of this partnership. Additional research is needed to further establish the feasibility of implementing these partnerships in rural settings.
Full Text Available Introduction: The Mini-Cog is a simple and short test that identifies cognitive impairment. Its detection helps provide an early dementia diagnosis, rapid access to treatments, and even delay or reversion. Materials and Methods: This multicenter, observational, descriptive, and cross-sectional study included 214 patients. Patients enrolled in this study were community dwellers aged ≥55-year-old, without prior diagnosis of cognitive impairment or dementia, with adequate hearing and vision functions. It was conducted in primary care health centers localized in rural communities of Ecuador. Results: Ages ranged from 50 to 98 years and there was predominance of female gender: 66% versus 33%. The percentage of illiteracy was 26.4% (CI: 25.32–27.48, and 63% (CI: 62.1–63.94 of patients had complete primary educational level. The overall prevalence of cognitive impairment was 50.9% (95% CI: 48.5–53.3 and 47.2% (95% CI: 45.2–49.2 in patients with risk factors. We found several established risk factors associated with cognitive impairment onset, including social factors, physiological factors, and comorbidities. Conclusion: This is the first epidemiological research of CI in rural populations in this country using the Mini-Cog as a screening tool. Adopting public health measures for the prevention and control of those modifiable risk factors could reduce the prevalence of cognitive impairment and even its progression to dementia.
Luo, Liqun; Ding, Rui; Gao, Xiali; Sun, Jingjing; Zhao, Wei
According to the logic of the Trivers-Willard hypothesis, in a human population, if socioeconomic status is transmitted across generations to some extent, and if sons of high-status parents tend to have higher reproductive success than daughters, while daughters of low-status parents tend to have higher reproductive success than sons, then we should expect that offspring sex ratio is positively associated with socioeconomic status. This study examines whether the assumptions and prediction of this hypothesis apply to a rural population in northern China. Results show that (1) current family socioeconomic status is positively related to family head's father's socioeconomic status in around 1950, (2) low-status family heads have more grandchildren through their daughters than their sons, whereas high- or middle-status family heads have more grandchildren through sons, and (3) as family heads' status increases, they tend to produce a higher offspring sex ratio. Therefore, the assumptions and prediction of the hypothesis are met in the study population. These results are discussed in reference to past studies on sex ratio manipulation among humans.
Johnston, Natalie E
A comparison of the timing, rates and characteristics of electroconvulsive therapy use between urban and rural populations. The medical records of patients who received an acute course of electroconvulsive therapy at two rural and two urban psychiatric hospitals in New South Wales (NSW), Australia, in 2010 were reviewed retrospectively. Main outcome measures were the time from symptom onset, diagnosis and admission to commencing electroconvulsive therapy. Rates of use of electroconvulsive therapy were also compared between rural and urban hospitals using NSW statewide data. There was a significant delay in the time it took for rural patients to receive electroconvulsive therapy compared with urban patients when measured both from the time of symptom onset and from when they received a diagnosis. There were corresponding delays in the time taken for rural patients to be admitted to hospital compared with urban patients. There was no difference in the time it took to commence electroconvulsive therapy once a patient was admitted to hospital. NSW statewide urban-rural comparisons showed rates of electroconvulsive therapy treatment were significantly higher in urban hospitals. Patients in rural areas receive electroconvulsive therapy later in their acute illness due to delays in being admitted to hospital. The rate of use of electroconvulsive therapy also differs geographically. © The Royal Australian and New Zealand College of Psychiatrists 2015.
Heuman, Amy N; Scholl, Juliann C; Wilkinson, Kenton
Type II diabetes affects Hispanic populations disproportionately and is the fifth leading cause of death for Hispanic people in the United States ( Smith & Barnett, 2005 ). Risk of diabetes is of great concern throughout the United States and is clearly of epidemic proportions for regions such as the Southwest and Texas where the primary minority populations are Mexican American. We conducted four focus groups with a total of 49 Hispanic participants (23 adults and 26 adolescents) from rural West Texas communities to gain insights about participants' eating habits, knowledge of diabetes, and potential barriers to preventive care. From the data, we identified a three-tiered predisposition or vulnerability to diabetes-heredity; preferences for unhealthy, culturally based food; and temptations from U.S. mainstream fast food culture. These vulnerabilities added to the sociocultural concerns that participants identified-importance of parental and familial modeling; challenges to healthy eating based on a culturally based diet and mainstream fast food culture; and a lack of support from the larger sociocultural networks such as teachers, community leaders, and the media. From these data, we have a better understanding of familial and sociocultural factors that need to be addressed in the development of preventive public awareness and educational plans. We outline implications for practitioners and educators from an integrated cultural biomedical approach.
Khalid M. Khan
Full Text Available Abstract Background Hearing loss remains a neglected public health issue in the rural and agricultural communities in the United States and therefore, promotion of a low-cost hearing screening may be important for these underserved populations. The major objectives of our study were to assess feasibility of a low-cost telephone-administered hearing test in rural Indiana and to identify the challenges, barriers and viable implementation strategies associated with this test. Also, we evaluated whether a focus group session could change the hearing health attitude of rural residents. Methods We recruited 126 adults from six rural Indiana counties who participated in study activities in the following order: 1 a pre-focus group demographic, knowledge and attitude survey, 2 a focus group for discussing the feasibility of a telephone-administered hearing screening, 3 a post focus group attitude survey and 4 hearing was screened using an audiometer and self-assessment scale. These activities generated both qualitative and quantitative data, which were subsequently analyzed. Results Hearing impairment was perceived as an important public health issue. Many participants expressed interests to try the low-cost National Hearing Test (NHT. However, participants recommended NHT to be facilitated by community organizations to provide access to landline phones. The focus group turned out to be an excellent awareness building activity producing significant improvement in hearing health attitudes. Comparison of self and audiometric evaluations indicated underestimation of hearing handicap in our rural study population. Conclusions The study results underscore the urgent need for an effective strategy to promote low-cost hearing screening in rural US communities.
Full Text Available In rural Kazakhstan, the credit and insurance services are limited and the state support is weak. Therefore, households’ saving is crucial to provide an insurance against the economic and social shocks. The main goal of this study is to contribute to the literature on financial literacy in emerging economies, namely, the effect of financial literacy on saving rates of rural population. Being well educated not always means to be financial literate and make efficient decisions regarding one’s own finance. People with a lower formal education level but with better experience in consuming financial products could be better prepared for making financial decisions including those related to savings. In this paper other socio-economic determinants of saving rates were taken into account, such as an income level, family size and an employment status. This research was carried out in Pavlodar region of Kazakhstan, and the data collection took place in spring 2014. In total, 405 households were surveyed. Results of the analysis show that if a respondent gives at least one correct answer, it positively affects the saving rates as well as one can observe that the higher the financial literacy level, the higher are the saving rates. Availability of state supported financial education programs for rural people will significantly contribute to the financial literacy improvement. At the same time, providing various and appropriate financial products in rural areas will motivate rural people to search for new knowledge and require authorities to intensify activities in this field.
Akhtar, T.; Hussain, I.; Ahmad, I.
Background: In Pakistan, approximately 8 million people have diabetes mellitus, making it the fourth leading country in the list of world diabetic patients. Objectives: To measure the prevalence of diabetes mellitus and its associated risk factors in a rural community of Peshawar. Study type, settings: A cross-sectional study conducted in PMRC model research community village of Budhni. Subjects and Methods: All adults over the age of 40 years residing in the specific village were selected for the study. During door to door visit, consent was taken from all the subjects and they were informed that a fasting blood sugar level would be checked a day or two later. All those who consented were interviewed according to pre-designed proforma and their height, weight and blood pressure were recorded using standard methods. Fasting blood samples were drawn the next day and sent to PMRC research laboratory where they were checked using Microlab 200 Merck. Data was analyzed using Epi Info version 6.0. According to American Diabetic Association criteria, fasting blood sugar level of >126 mg/dl was diagnosed. Results: Estimated population of adults > 40 years in the village is 1249 individuals. Nine hundred nine (72.7%) consented to participate in the study. A total of 345 subjects were screened for diabetes using fasting blood sugar as the proxy indicator. Eighty one (23.4%) had blood sugar over 126 mg/dl and were therefore, diagnosed to be diabetic. Of these 81 cases 46(56.8%) were known diabetics while, 35(43.2%) were newly diagnosed. Majority (39) were between 51-60 years, followed by 29 between 40-50 years and remaining 13 subjects were above 60 years of age. Among the 46 known diabetics, 42(91.3%) were non insulin dependent and only 4(8.7%) were insulin dependent. The duration of diabetes was between 1-5 years in 26(57%) cases who were known diabetic's. Those individuals who were not sure about their exact duration of diabetes were 9(19%). Cases with a family history of
Su, Tin Tin; Goh, Jun Yan; Tan, Jackson; Muhaimah, Abdul Rahim; Pigeneswaren, Yoganathan; Khairun, Nasirin Sallamun; Normazidah, Abdul Wahab; Tharisini, Devi Kunasekaran; Majid, Hazreen Abd
This paper presents the level of colorectal cancer awareness among multi-ethnic rural population in Malaysia. A rural-based cross sectional survey was carried out in Perak state in Peninsular Malaysia in March 2011. The survey recruited a population-representative sample using multistage sampling. Altogether 2379 participants were included in this study. Validated bowel/colorectal cancer awareness measure questionnaire was used to assess the level of colorectal cancer awareness among study population. Analysis of variance (ANOVA) was done to identify socio-demographic variance of knowledge score on warning signs and risk factors of colorectal cancer. Among respondents, 38% and 32% had zero knowledge score for warning signs and risk factors respectively. Mean knowledge score for warning signs and risk factors were 2.89 (SD 2.96) and 3.49 (SD 3.17) respectively. There was a significant positive correlation between the knowledge score of warning signs and level of confidence in detecting a warning sign. Socio-demographic characteristics and having cancer in family and friends play important role in level of awareness. Level of awareness on colorectal cancer warning signs and risk factors in the rural population of Malaysia is very low. Therefore, it warrants an extensive health education campaign on colorectal cancer awareness as it is one of the commonest cancer in Malaysia. Health education campaign is urgently needed because respondents would seek medical attention sooner if they are aware of this problem.
Su, Tin Tin; Goh, Jun Yan; Tan, Jackson; Muhaimah, Abdul Rahim; Pigeneswaren, Yoganathan; Khairun, Nasirin Sallamun; Normazidah, Abdul Wahab; Tharisini, Devi Kunasekaran; Majid, Hazreen Abd
This paper presents the level of colorectal cancer awareness among multi-ethnic rural population in Malaysia. A rural-based cross sectional survey was carried out in Perak state in Peninsular Malaysia in March 2011. The survey recruited a population-representative sample using multistage sampling. Altogether 2379 participants were included in this study. Validated bowel/colorectal cancer awareness measure questionnaire was used to assess the level of colorectal cancer awareness among study population. Analysis of variance (ANOVA) was done to identify socio-demographic variance of knowledge score on warning signs and risk factors of colorectal cancer. Among respondents, 38% and 32% had zero knowledge score for warning signs and risk factors respectively. Mean knowledge score for warning signs and risk factors were 2.89 (SD 2.96) and 3.49 (SD 3.17) respectively. There was a significant positive correlation between the knowledge score of warning signs and level of confidence in detecting a warning sign. Socio-demographic characteristics and having cancer in family and friends play important role in level of awareness. Level of awareness on colorectal cancer warning signs and risk factors in the rural population of Malaysia is very low. Therefore, it warrants an extensive health education campaign on colorectal cancer awareness as it is one of the commonest cancer in Malaysia. Health education campaign is urgently needed because respondents would seek medical attention sooner if they are aware of this problem
Kinlen, L J; Bramald, S
In a national Scottish study of 809 cases of leukaemia and non-Hodgkins lymphoma diagnosed in 1950-89 among children aged 0-4 years who were born in Scotland, together with 2363 matched population controls, we investigated one aspect of the infective hypothesis. This concerns whether in rural areas (where the prevalence of susceptible individuals is likely to be higher) the risk is greater among the young children of men whose work involves contacts with many different people, particularly children, as noted in certain childhood infections. A positive trend was found in rural areas across 3 levels of increasing paternal occupational contact (as recorded at birth) by each of 2 previously defined classifications; no such effect was found in urban areas. The rural trend was more marked in that part of the study period with greater population mixing, but the difference from the period with less mixing was not itself significant, leaving open whether these rural findings reflect the extreme isolation of much of rural Scotland, or the effects in such areas of a degree of population mixing. In marked contrast, among the 850 cases and 2492 controls aged 5-14, those in rural areas in the higher population mixing period showed a significantly decreasing trend with increasing paternal occupational contact level. This would be consistent with immunity produced either by earlier infection at ages 0-4 years, or directly by low doses of the infective agent that were largely immunizing at these older ages. The findings overall provide further support for infection underlying childhood leukaemia and for the role of adults. Copyright 2001 Cancer Research Campaign http://www.bjcancer.com.
He, Ping; Luo, Yanan; Hu, Xiangyang; Gong, Rui; Wen, Xu; Zheng, Xiaoying
Hearing loss is the most common sensory impairment, but limited studies focused on the association of socioeconomic status (SES) with hearing loss among adults of working age. This paper aimed to fill this gap among Chinese adults. We obtained data from Ear and Hearing Disorder Survey conducted in four provinces of China in 2014-2015. The survey was based on WHO Ear and Hearing Disorders Survey Protocol and 25,860 adults aged 25 to 59 years were selected in this study. Trained local examiners performed pure tone audiometry to screen people with hearing loss, and those who were screened positively for hearing loss were referred to audiologists to make final diagnosis. SES was measured by occupation, education and income. Results show after adjusting for SES measures and covariates, in urban areas, compared with white-collar workers, blue-collar workers and the unemployed were more likely to have hearing loss, with an odds ratio of 1.2 (95%CI: 1.0, 1.3) and 1.2 (95%CI: 1.0, 1.4), respectively. Compared with people with education of senior high school or above, those with junior high school, primary school and illiteracy had 1.6 (95%CI: 1.4, 1.8), 2.1(95%CI: 1.7, 2.5) and 2.6 (95%CI: 1.9, 3.7) times as likely to have hearing loss, respectively. In rural areas, the unemployed had 1.5 (95%CI: 1.0, 2.3) times the risk of hearing loss compared with white-collar workers, and illiterates had 1.6 (95%CI: 1.6, 2.1) times the risk of hearing loss compared with people with education of senior high school or above, after SES variables and covariates were taken into considerations. Income was not significantly associated with hearing loss in urban and rural areas. In conclusion, SES, in the form of occupation and education, was associated with hearing loss among working-aged population, and further studies are needed to explore the mechanism of such association.
Full Text Available Objective: To estimate the prevalence of metabolic syndrome (MetS and its separate components in the adult population of the district of Tetovo. Methods: Total of 630 subjects aged over 18 years were selected at random, from the primary healthcare register, to constitute a representative sample of a population in the district of Tetovo, adjusted for age and sex. MetS is defined according to the definition of the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII. Results: The prevalence of MetS in the district of Tetovo was 28.25%. It was significantly higher in women than in men (34.06% versus 22.26%, p=0.004. The largest number of people with MetS living in rural areas (31.32% versus 23.60%, p=0.002. Of the particular components of MetS, 52.06% of the population had increased arterial blood pressure, 46.35% reduced values of high-density lipoprotein cholesterol (HDL-C and 43.17% abdominal adiposity (AA. In women population, more dominated was abdominal adiposity (59.38% and 26.54%, p=0.000, in men more dominated was increased arterial blood pressure (53.44% and 50.65%, p=0.48. Conclusion: The prevalence of MetS in our population is high, particularly in women. The prevalence rates for arterial hypertension and abdominal obesity are among the highest reported for the region. Advice on diet and change in lifestyles, in addition to the pharmacological treatment of this category, would contribute to the prevention of cardiovascular disease, type II diabetes and complications from these diseases.
Pesut, B; Hooper, B P; Robinson, C A; Bottorff, J L; Sawatzky, R; Dalhuisen, M
Healthcare models for the delivery of palliative care to rural populations encounter common challenges: service gaps, the cost of the service in relation to the population, sustainability, and difficulty in demonstrating improvements in outcomes. Although it is widely agreed that a community capacity-building approach to rural palliative care is essential, how that approach can be achieved, evaluated and sustained remains in question. The purpose of this community-based research project is to test the feasibility and identify potential outcomes of implementing a rural palliative supportive service (RPaSS) for older adults living with life-limiting chronic illness and their family caregiver in the community. This paper reports on the feasibility aspects of the study. RPaSS is being conducted in two co-located rural communities with populations of approximately 10 000 and no specialized palliative services. Participants living with life-limiting chronic illness and their family caregivers are visited bi-weekly in the home by a nurse coordinator who facilitates symptom management, teaching, referrals, psychosocial and spiritual support, advance care planning, community support for practical tasks, and telephone-based support for individuals who must commute outside of the rural community for care. Mixed-method collection strategies are used to collect data on visit patterns; healthcare utilization; family caregiver needs; and participant needs, functional performance and quality of life. A community-based advisory committee worked with the investigative team over a 1-year period to plan RPaSS, negotiating the best fit between research methods and the needs of the community. Recruitment took longer than anticipated with service capacity being reached at 8 months. Estimated service capacity of one nurse coordinator, based on bi-weekly visits, is 25 participants and their family caregivers. A total of 393 in-person visits and 53 telephone visits were conducted between
Olatunji, Victoria A; Adepoju, Feyi G; Owoeye, Joshua F A
To determine the perception and attitudes of a rural community regarding the etiology, prevention, and treatment of blindness in adults. A cross-sectional, descriptive study was performed in a rural community in Kwara State, Nigeria using semi-structured questionnaire. All adults aged 40 years or older who were residents for a minimum of 6 months in the community were included. Data were collected on patient demographics, knowledge, attitude, perception, and use of the eye care facility. A total of 290 participants were interviewed. The male-to-female ratio was 1:2. Consumption of certain types of food was an important cause of blindness as perceived by 57.9% of the respondents, followed by supernatural forces (41.7%) and aging (19%). Sixty percent of respondents thought blindness could be prevented. Age (P = 0.04) and level of education (P =0.003) significantly affected the beliefs on the prevention of blindness. Most respondents (79.3%) preferred orthodox eye care, but only 65% would accept surgical intervention if required. The level of education significantly affected the acceptance of surgery (P = 0.04). Reasons for refusing surgery were, fear (64%), previous poor outcomes in acquaintances (31%), belief that surgery is not required (3%), and cost (2%). About 65% used one form of traditional eye medication or the other. Over half (56.6%) believed that spectacles could cure all causes of blindness. Of those who had ocular complaints, 57.1% used orthodox care without combining with either traditional or spiritual remedies. This rural Nigerian community had some beliefs that were consistent with modern knowledge. However, the overall knowledge, attitude, and perceptions of this community need to be redirected to favor the eradication of avoidable blindness. Although an eye care facility was available, use by the community was suboptimal. Age and the level of education affected their overall perception and attitudes.
Shrivastava, Saurabh RamBihariLal; Ghorpade, Arun Gangadhar
We aimed to assess the prevalence of type-2 diabetes in rural Pondicherry and to study the determinants of Diabetes Mellitus (DM) in the rural population of Pondicherry, south Induia. It was a cross-sectional community-based study conducted from November 2010 to January 2012 in two of the field practice villages affiliated to a Medical College in Pondicherry. Sample size was calculated using open source software, Open Epi Version 2.3.10. The sampling frame comprised individuals aged above 25 years and single stage cluster random sampling was carried out. After obtaining the verbal informed consent each of the study participants were interviewed face-to-face using a pre-tested structured questionnaire. Data were analyzed using the SPSS version 16. The age of the study participants ranged from 25 to 98 years with mean of 42.6 (±13.7) and majority of the study participants 339 (32.5%) from the age-group of 30-39 years. The prevalence of diabetes was 19.8% (60-69 years), 17.1% (40-49 years), 16.8% (50-59 years), and 13.6% (>69 years) among study subjects. In univariate analysis, higher age, being educated, unemployed and poor was associated with higher risk of diabetes mellitus (DM). Furthermore, a high triglyceride level was significantly associated with increase in the risk of DM (adjusted odds ratio: 3.01; 95% CI: 1.86, 4.86). Type-2 diabetes mellitus (T2DM) is an important public health problem in the adults of rural Pondicherry. Among non-modifiable factors, higher age, better socio-educational background and positive family history of diabetes was significantly associated with T2DM.
Full Text Available Background: In Ghana, the older adult population is projected to increase from 5.3% of the total population in 2015 to 8.9% by 2050. National and local governments will need information about non-communicable diseases (NCDs in this population in order to allocate health system resources and respond to the health needs of older adults. Design: The 2007/08 Study on global AGEing and adult health (SAGE Wave 1 in Ghana used face-to-face interviews in a nationally representative sample of persons aged 50-plus years. Individual respondents were asked about their overall health, diagnosis of 10 chronic non-communicable conditions, and common health risk factors. A number of anthropometric and health measurements were also taken in all respondents, including height, weight, waist and hip circumferences, and blood pressure (BP. Results: This paper includes 4,724 adults aged 50-plus years. The highest prevalence of self-reported chronic conditions was for hypertension [14.2% (95% CI 12.8–15.6] and osteoarthritis [13.8%, (95% CI 11.7–15.9]. The figure for hypertension reached 51.1% (95% CI 48.9–53.4 when based on BP measurement. The prevalence of current smokers was 8.1% (95% CI 7.0–9.2, while 2.0 (95% CI 1.5–2.5 were infrequent/frequent heavy drinkers, 67.9% (95% CI 65.2–70.5 consume insufficient fruits and vegetables, and 25.7% (95% CI 23.1–28.3 had a low level of physical activity. Almost 10% (95% CI 8.3–11.1 of adults were obese and 77.6% (95% CI 76.0–79.2 had a high-risk waist-to-hip ratio (WHR. Risks from tobacco and alcohol consumption continued into older age, while insufficient fruit and vegetable intake, low physical activity and obesity increased with increasing age. The patterns of risk factors varied by income quintile, with higher prevalence of obesity and low physical activity in wealthier respondents, and higher prevalence of insufficient fruit and vegetable intake and smoking in lower-income respondents. The multivariate
Ezz al Arab, G; Tawfik, N; El Gendy, R; Anwar, W; Courtright, P
Evidence of widespread distribution of trachoma in Egypt had not been clarified as previous surveys were limited to individual communities which may not have been representative of the general population. The Nile Delta of Egypt presents a unique environment for trachoma to persist. Economic improvements in the past decade have affected even the poorest rural environments; availability of electricity is now found in many rural communities. Availability of water in Nile Delta has always been good but poor hygienic conditions have been the primary factor in trachoma transmission. A survey of trachoma was undertaken in Menofiya governorate to determine if Egypt should be identified as trachoma endemic and targeted for trachoma control efforts. A multistage random cluster study design was used with the target population defined as adults aged 50 and over and children aged 2-6 years from throughout the governorate. Among preschool children only trachoma was graded while among adults presenting visual acuity and cause of vision loss or blindness were also recorded. Adults were interviewed regarding past trichiasis surgery; those currently with trichiasis or a history of trichiasis surgery were also interviewed regarding outcome of surgery. A total of 3272 children aged 2-6 and 3322 adults age 50+ were enumerated. Among the children 81.3% were examined and among the adults 73.0% were examined. Active trachoma (follicles (TF) and/or intense inflammation (TI)) was found among 36.5% (95% confidence interval (CI) 34.7-38.3%) of the children. TI was 1.89 (95% CI 1.22-2.94) times more common in rural children compared to urban children. The prevalence of trichiasis (TT) in adults was 6.5%; women had an age adjusted odds of trichiasis of 1.68 (95% CI 1.18-2.39) compared to men. Trichiasis was 2.11 times (95% CI 1.33-3.37) more common in rural Menofiya compared to urban Menofiya. TT accounts for blindness (presenting vision vision loss. These findings would suggest that continued
Bernabé-Ortiz, Antonio; Miranda, J. Jaime; Rey de Castro, Jorge
Background. Sleep duration, either short or long, has been associated with diseases such as obesity, type-2 diabetes and cardiovascular diseases. Characterizing the prevalence and patterns of sleep duration at the population-level, especially in resource-constrained settings, will provide informative evidence on a potentially modifiable risk factor. The aim of this study was to explore the patterns of sleep duration in the Peruvian adult and adolescent population, together with its socio-demographic profile. Material and Methods. A total of 12,424 subjects, mean age 35.8 years (SD ±17.7), 50.6% males, were included in the analysis. This is a cross-sectional study, secondary analysis of the Use of Time National Survey conducted in 2010. We used weighted means and proportions to describe sleep duration according to socio-demographic variables (area and region; sex; age; education attainment; asset index; martial and job status). We used Poisson regressions, taking into account the multistage sampling design of the survey, to calculate crude and adjusted prevalence ratios (PR) and 95% confidence intervals (95% CI). Main outcomes were short- (Peruvians slept 7.7 h (95% CI [7.4–8.0]) on weekdays and 8.0 h (95% CI [7.8–8.1]) during weekends. The proportions of short- and long-sleep, during weekdays, were 4.3% (95% CI [2.9%–6.3%]) and 22.4% (95% CI [14.9%–32.1%]), respectively. Regarding urban and rural areas, a much higher proportion of short-sleep was observed in the former (92.0% vs. 8.0%); both for weekdays and weekends. On the multivariable analysis, compared to regular-sleepers (≥ 6 to educational status, and 50% more likely to be currently employed. Similarly, relative to regular-sleep, long-sleepers were more likely to have a lower socioeconomic status as per educational attainment. Conclusions. In this nationally representative sample, the sociodemographic profile of short-sleep contrasts the long-sleep. These scenarios in Peru, as depicted by sleeping
Full Text Available Introduction: Consumption of tobacco in any form is one of the leading causes of preventable mortality. The World Health Organization recommends that it should be monitored regularly. This study was designed to estimate the prevalence of tobacco use among the rural adult population in Sarawak and factors associated with it.Methods: This was a cross-sectional study conducted among the adult population in Sarawak. Data were collected from ten villages in Kota Samarahan and Kuching Division by face to face interview using modified Global Adult Tobacco Survey questionnaire. Non-probability sampling method was adopted to select the villages. All the households of the villages were visited and an adult member was selected randomly from each house irrespective of the sex. After missing value imputation, 1000 data were analysed using statistical software SPSS 19.0 version.Results: Analysis showed that 30.9% of the respondents were current tobacco users and 11% were past tobacco users. The mean age (SD at starting tobacco was 18.1 (6.48 years. The frequency of tobacco use was 14 times per day. Hierarchical Logistic regression analysis revealed that age with male sex (OR=1. 064, 95% CI: 1.052, 1.076, secondary education (OR=-2.712; 95% CI: 1.122, 6.555, higher secondary and above (OR=3. 571; 95% CI: 1.641,7.774, occupation as business (OR=3. 152; 95% CI: 1.732, 5.735 and environmental exposure such as smoking at working place (OR=2. 754;95% CI: 1.895,4.002, coffee house (OR=2. 274;95% CI: 1.32,3.919 and at home (OR=1. 827;95% CI: 1.242,2.687 appeared to be important predictors of tobacco use (p<0.05.Conclusion: A large proportion of males use tobacco products. Though tobacco use was negligible among females, but they would be potential users. Environmental exposure to tobacco appeared to be important predictors. Tobacco control campaigns should target banning of tobacco use in closed and open areas and also to intensify the monitoring of all forms
Gaber, Amal; Galarneau, Chantal; Feine, Jocelyne S; Emami, Elham
The objective of this population-based cross-sectional study was to estimate rural-urban disparity in the oral health-related quality of life (OHRQoL) of the Quebec adult population. A 2-stage sampling design was used to collect data from the 1788 parents/caregivers of schoolchildren living in the 8 regions of the province of Quebec in Canada. Andersen's behavioural model for health services utilization was used as a conceptual framework. Place of residency was defined according to the Statistics Canada Census Metropolitan Area and Census Agglomeration Influenced Zone classification. The outcome of interest was OHRQoL measured using the Oral Health Impact Profile (OHIP)-14 validated questionnaire. Data weighting was applied, and the prevalence, extent and severity of negative oral health impacts were calculated. Statistical analyses included descriptive statistics, bivariate analyses and binary logistic regression. The prevalence of poor oral health-related quality life (OHRQoL) was statistically higher in rural areas than in urban zones (P = .02). Rural residents reported a significantly higher prevalence of negative daily-life impacts in pain, psychological discomfort and social disability OHIP domains (P < .05). Additionally, the rural population showed a greater number of negative oral health impacts (P = .03). There was no significant rural-urban difference in the severity of poor oral health. Logistic regression indicated that the prevalence of poor OHRQoL was significantly related to place of residency (OR = 1.6; 95% CI = 1.1-2.5; P = .022), perceived oral health (OR = 9.4; 95% CI = 5.7-15.5; P < .001), dental treatment needs factors (perceived need for dental treatment, pain, dental care seeking) (OR = 8.7; 95% CI = 4.8-15.6; P < .001) and education (OR = 2.7; 95% CI = 1.8-3.9; P < .001). The results of this study suggest a potential difference in OHRQoL of Quebec rural and urban populations, and a need to develop strategies to promote oral health outcomes
Tringler, Matías; Rodriguez, Edgardo M; Aguera, Darío; Molina, John D; Canziani, Gabriela A; Diaz, Alejandro
Many studies have shown that high blood pressure and overweight begins in childhood. Consequently, it is useful to know blood pressure and body mass index (BMI) values from an early age. There are few data about blood pressure control in children and adolescents from rural populations in South America. The objective of this study was to determine the prevalence of high blood pressure and its association with sedentary habits and overweight/obesity in scholars from a rural population in Argentina. The study population for this cross-sectional study was composed of rural children and adolescent scholars from Maria Ignacia Vela. Pre-hypertension and hypertension were defined on the basis of percentiles from the average of three blood pressure measurements taken on a single occasion. In patients with three blood pressure measurements above the 90th percentile, ambulatory blood pressure monitoring was performed to confirm hypertension or pre-hypertension. BMI was categorized by using the 2000 Centers for Disease Control and Prevention growth charts. We studied 334 scholars (aged 5-18 years). Mean age was 11.4 years. In 70% of the subjects, blood pressure had never been measured. The prevalence of high blood pressure was 4.4%. Students with sedentary habits were 3.67-fold more likely to develop high blood pressure than their physically active counterparts (odds ratio [OR] 3.67; 95% CI 1.08, 12.46; p = 0.037). Obese students were more likely to develop hypertension than the students with normal weight (OR = 5.17; 95% CI 1.52, 17.60; p = 0.02). Male students had a 3.4-fold higher risk of developing high blood pressure than females. In our rural population, the evaluation of blood pressure in children and adolescents is not a routine measure. Our data indicate a low prevalence of high blood pressure. These data could argue differences between rural and urban scholars. Our data demonstrate a close relationship between increased overweight, obesity and sedentary lifestyle
Full Text Available Based on the International Classification of Functioning, Disability, and Health (ICF and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0, The Functioning Disability Evaluation Scale-Adult version (FUNDES-Adult began development in 2011. The FUNDES-Adult was designed to assess the difficulty level of an individual’s activities and participation in daily life. There is a lack of research regarding the profile of activity and participation for the general adult population. The purposes of this study were to establish activity and participation norms for the general adult population in Taiwan and to describe, discuss, and compare the activity and participation profile with other population. Method: A population-based survey was administered in 2013 using a computer-assisted telephone interviewing system (CATI system. Using probability proportional to size (PPS sampling and systematic sampling with random digit dialing (RDD, 1500 adults from Taiwan’s general population were selected to participate in the survey. The FUNDES-Adult with six domains and two dimensions (performance and capability was used to obtain data on activities and participation levels. A higher domain score indicated higher participation restriction. Results: Approximately 50% of the respondents were male, and the average age of the respondents was 45.23 years. There were no significant differences in the demographic features between the sample and the population. Among the six domains, the self-care domain score was the lowest (least restriction and the participation domain score was the highest (most restriction. Approximately 90% of the sample scored were less than 15, and only 0.1% scored more than 80. This is the first cross-national population-based survey to assess norms of activity and participation relevant to the general population of Taiwan. As such, the results of this survey can be used as a reference for comparing the activity and
Crosby, Richard A; Stradtman, Lindsay; Collins, Tom; Vanderpool, Robin
To determine the return rate of community-delivered fecal immunochemical test (FIT) kits in a rural population and to identify significant predictors of returning kits. Residents were recruited in 8 rural Kentucky counties to enroll in the study and receive an FIT kit. Of 345 recruited, 82.0% returned an FIT kit from the point of distribution. These participants were compared to the remainder relative to age, sex, marital status, having an annual income below $15,000, not graduating from high school, not having a regular health care provider, not having health care coverage, being a current smoker, indicating current overweight or obese status, and a scale measure of fatalism pertaining to colorectal cancer. Predictors achieving significance at the bivariate level were entered into a stepwise logistic regression model to calculate adjusted OR and 95% CI. The return rate was 82.0%. In adjusted analyses, those indicating an annual income of less than $15,000 were 2.85 times more likely to return their kits (95% CI: 1.56-5.24; P < .001). Also, those not perceiving themselves to be overweight/obese were 1.95 times more likely to return their kits (95% CI: 1.07-3.55; P = .029). An outreach-based colorectal cancer screening program in a rural population may yield high return rates. People with annual incomes below $15,000 and those not having perceptions of being overweight/obese may be particularly likely to return FIT kits. © 2016 National Rural Health Association.
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...
Yan, Z; Liang, Y; Shi, J; Cai, C; Jiang, H; Song, A; Qiu, C
The possible association between carotid stenosis and cognitive impairment in the Chinese population has been rarely investigated. The association between the severity of carotid stenosis and cognitive impairment amongst older Chinese people living in a rural area was assessed. This cross-sectional study included 1375 participants (age ≥60 years) from the Confucius Hometown Aging Project in Shandong. In 2010-2011, data were collected through interviews and clinical examinations. Carotid stenosis was assessed using ultrasonography. Cognitive impairment was defined according to the education-specific cutoff scores of the Mini-Mental State Examination. Data were analyzed using multinomial logistic models. The overall prevalence was 7.0% for moderate carotid stenosis, 2.0% for severe stenosis and 6.0% for cognitive impairment. The multi-adjusted odds ratio of cognitive impairment was 1.43 (95% confidence interval 0.63-3.22) for moderate carotid stenosis and 3.75 (1.24-11.40) for severe carotid stenosis (P(trend) = 0.023). Similar results were obtained in people without a history of cerebrovascular disease. Severe carotid stenosis, even asymptomatic, is associated with cognitive impairment independent of atherosclerotic risk factors and disorders amongst older Chinese people. © 2015 EAN.
McGrail, Matthew R; Wingrove, Peter M; Petterson, Stephen M; Humphreys, John S; Russell, Deborah J; Bazemore, Andrew W
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
Background Health inequality has been recognized as a problem all over the world. In China, the poor usually have less access to healthcare than the better-off, despite having higher levels of need. Since the proportion of the Chinese population living in urban areas increased tremendously with the urbanization movements, attention has been paid to the association between urban/rural residence and population health. It is important to understand the variation in health across income groups, and in particular to take into account the effects of urban/rural residence on the degree of income-related health inequalities. Methods This paper empirically assesses the magnitude of rural/urban disparities in income-related adult health status, i.e., self-assessed health (SAH) and physical activity limitation, using Concentration Indices. It then uses decomposition methods to unravel the causes of inequalities and their variations across urban and rural populations. Data from the China Health and Nutrition Survey (CHNS) 2006 are used. Results The study finds that the poor are less likely to report their health status as “excellent or good” and are more likely to have physical activity limitation. Such inequality is more pronounced for the urban population than for the rural population. Results from the decomposition analysis suggest that, for the urban population, 76.47 per cent to 79.07 per cent of inequalities are driven by non-demographic/socioeconomic-related factors, among which income, job status and educational level are the most important factors. For the rural population, 48.19 per cent to 77.78 per cent of inequalities are driven by non-demographic factors. Income and educational attainment appear to have a prominent influence on inequality. Conclusion The findings suggest that policy targeting the poor, especially the urban poor, is needed in order to reduce health inequality. PMID:22989200
Yang, Wei; Kanavos, Panos
Health inequality has been recognized as a problem all over the world. In China, the poor usually have less access to healthcare than the better-off, despite having higher levels of need. Since the proportion of the Chinese population living in urban areas increased tremendously with the urbanization movements, attention has been paid to the association between urban/rural residence and population health. It is important to understand the variation in health across income groups, and in particular to take into account the effects of urban/rural residence on the degree of income-related health inequalities. This paper empirically assesses the magnitude of rural/urban disparities in income-related adult health status, i.e., self-assessed health (SAH) and physical activity limitation, using Concentration Indices. It then uses decomposition methods to unravel the causes of inequalities and their variations across urban and rural populations. Data from the China Health and Nutrition Survey (CHNS) 2006 are used. The study finds that the poor are less likely to report their health status as "excellent or good" and are more likely to have physical activity limitation. Such inequality is more pronounced for the urban population than for the rural population. Results from the decomposition analysis suggest that, for the urban population, 76.47 per cent to 79.07 per cent of inequalities are driven by non-demographic/socioeconomic-related factors, among which income, job status and educational level are the most important factors. For the rural population, 48.19 per cent to 77.78 per cent of inequalities are driven by non-demographic factors. Income and educational attainment appear to have a prominent influence on inequality. The findings suggest that policy targeting the poor, especially the urban poor, is needed in order to reduce health inequality.
Full Text Available Abstract Background Health inequality has been recognized as a problem all over the world. In China, the poor usually have less access to healthcare than the better-off, despite having higher levels of need. Since the proportion of the Chinese population living in urban areas increased tremendously with the urbanization movements, attention has been paid to the association between urban/rural residence and population health. It is important to understand the variation in health across income groups, and in particular to take into account the effects of urban/rural residence on the degree of income-related health inequalities. Methods This paper empirically assesses the magnitude of rural/urban disparities in income-related adult health status, i.e., self-assessed health (SAH and physical activity limitation, using Concentration Indices. It then uses decomposition methods to unravel the causes of inequalities and their variations across urban and rural populations. Data from the China Health and Nutrition Survey (CHNS 2006 are used. Results The study finds that the poor are less likely to report their health status as “excellent or good” and are more likely to have physical activity limitation. Such inequality is more pronounced for the urban population than for the rural population. Results from the decomposition analysis suggest that, for the urban population, 76.47 per cent to 79.07 per cent of inequalities are driven by non-demographic/socioeconomic-related factors, among which income, job status and educational level are the most important factors. For the rural population, 48.19 per cent to 77.78 per cent of inequalities are driven by non-demographic factors. Income and educational attainment appear to have a prominent influence on inequality. Conclusion The findings suggest that policy targeting the poor, especially the urban poor, is needed in order to reduce health inequality.
Vijaya, Lingam; George, Ronnie; Baskaran, M; Arvind, Hemamalini; Raju, Prema; Ramesh, S Ve; Kumaramanickavel, Govindasamy; McCarty, Catherine
To estimate the prevalence and risk factors of primary open-angle glaucoma (POAG) in an urban population and compare the same with that of our published rural population data in southern India. Population-based cross-sectional study. Four thousand eight hundred subjects 40 years or older were selected using a multistage random cluster sampling procedure in Chennai city. Three thousand eight hundred fifty (80.2%) subjects underwent a complete ophthalmic examination, including applanation tonometry, gonioscopy, pachymetry, optic disc photography, and automated perimetry. Glaucoma was diagnosed using the International Society of Geographical and Epidemiological Ophthalmology Classification. The distribution of intraocular pressure (IOP) and vertical cup-to-disc ratio (VCDR) was obtained from the right eye of the 2532 subjects with normal suprathreshold visual fields. Mean IOP was 16.17+/-3.74 mmHg (97.5th and 99.5th percentiles, 24 mmHg and 30 mmHg). The mean VCDR was 0.43+/-0.17 (97.5th and 99.5th percentiles, 0.7 and 0.8). One hundred thirty-five (64 men, 71 women) subjects had POAG (3.51%; 95% confidence interval [CI], 3.04-4.0). Primary open-angle glaucoma subjects (58.4+/-11.3 years) were older (P or =40-year-old south Indian urban population was 3.51%, higher than that of the rural population. The prevalence increased with age, and >90% were not aware of the disease.
Mi, Te; Sun, Shangwen; Du, Yifeng; Guo, Shougang; Cong, Lin; Cao, Mingfeng; Sun, Qinjian; Sun, Yi; Qu, Chuanqiang
Considering the program of screening for risk factors of stroke in Eastern China, the aim of this study was to compare the distribution differences in risk factors for stroke among the high-risk population living in urban and rural areas. A total of 231,289 residents were screened and basic information collected. Risk factors for stroke among the high-risk population were compared between the urban and rural groups. A total of 117,776 high-risk residents from urban areas and 113,513 from rural areas were included in the analysis. The prevalence of hypertension was much higher in rural areas (73.3%) than that in urban areas (64.1%). Dyslipidemia (48.9% vs. 26.9%), sport lack (46.6% vs. 31.6%), diabetes mellitus (21.3% vs. 16.5%), and atrial fibrillation (18.7% vs. 9.8%) were more prevalent in the urban group, while smoking (26.5% vs. 28.8%), previous stroke (10.1% vs. 16.9%), and transient ischemic attack (20.9% vs. 24.6%) were less prevalent. Among the population at high risk of stroke, there were significant differences in the distribution of the following risk factors between the urban and rural groups: hypertension, atrial fibrillation, dyslipidemia, lack of physical exercise, and a previous stroke.
Full Text Available Objective: To determine the characteristics of the place of residence and the cardiovascular risk factors in a Peruvian jungle population in July 2014. Materials and methods: A descriptive cross-sectional study conducted in individuals between 30 and 74 years old without a diagnosis of or treatment for a cardiovascular disease in an urban and rural population of the district of Yantaló. The sample was obtained using the Power Analysis and Sample Size Software (PASS program, and consisted of 268 people (152 urban and 116 rural residents. The studied factors were hypertension (HBP, diabetes mellitus (DM, body mass index (BMI, waist-hip ratio (WHR and smoking. Results: The urban population had higher rates of hypertension (18.4%, while the other risk factors showed no significant differences between the two populations. Conclusions: The only risk factor that showed a significant association with the place of residence was hypertension. In contrast, the other risk factors of the study showed no differences between the two populations, which demonstrates that the district of Yantaló is involved in a process of epidemiological transition due to urbanization.
Oramasionwu, Christine U.; Daniels, Kelly R.; Labreche, Matthew J.; Frei, Christopher R.
The Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) pandemic has caused far-reaching effects in sub-Saharan Africa. The pandemic has effectively diminished the workforce, increased poverty rates, reduced agricultural productivity, and transformed the structure of many rural households. HIV/AIDS further strains the already fragile relationship between livelihood and the natural and social environments of these regions. Therefore, the objective of this review is to characterize the impact of HIV/AIDS on the environment and the social infrastructure of rural sub-Saharan Africa. There are many aspects of rural life that contribute to disease transmission of HIV/AIDS and that pose unique challenges to the population dynamics in sub-Saharan Africa. Widespread AIDS-related mortality has caused a decrease in population growth for many African countries. In turn, these alterations in population dynamics have resulted in a decrease in the percentage of prime-age working adults, as well as a gender disparity, whereby, females carry a growing burden of household responsibilities. There is a rising proportion of older adults, often females, who assume the role of provider and caretaker for other dependent family members. These changing dynamics have caused many to exploit their natural surroundings, adopting less sustainable land use practices and utilizing protected resources as a primary means of generating revenue. PMID:21845169
Christopher R. Frei
Full Text Available The Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS pandemic has caused far-reaching effects in sub-Saharan Africa. The pandemic has effectively diminished the workforce, increased poverty rates, reduced agricultural productivity, and transformed the structure of many rural households. HIV/AIDS further strains the already fragile relationship between livelihood and the natural and social environments of these regions. Therefore, the objective of this review is to characterize the impact of HIV/AIDS on the environment and the social infrastructure of rural sub-Saharan Africa. There are many aspects of rural life that contribute to disease transmission of HIV/AIDS and that pose unique challenges to the population dynamics in sub-Saharan Africa. Widespread AIDS-related mortality has caused a decrease in population growth for many African countries. In turn, these alterations in population dynamics have resulted in a decrease in the percentage of prime-age working adults, as well as a gender disparity, whereby, females carry a growing burden of household responsibilities. There is a rising proportion of older adults, often females, who assume the role of provider and caretaker for other dependent family members. These changing dynamics have caused many to exploit their natural surroundings, adopting less sustainable land use practices and utilizing protected resources as a primary means of generating revenue.
Dalbo, Vincent J; Czerepusko, James B; Tucker, Patrick S; Kingsley, Michael I; Moon, Jordan R; Young, Kaelin; Scanlan, Aaron T
The primary aim of this study was to determine the prevalence of current strength-based exercise in rural and regional populations of Central Queensland. The secondary aim was to examine the proportion of residents from various demographic groups who currently partake in strength-based exercise to allow for targeted strength training campaigns. A cross-sectional, survey-based experimental design was followed. Rural and regional Australia. Rural and regional community-dwelling individuals living in Central Queensland and aged 18 years and older. Survey data was collected in October and November 2010 as part of the Central Queensland University Social Survey. Strength-based exercise participation, gender, age, income, years of education, self-reported physical activity and perception of health. Participation in strength-based exercise was 13.2%. Women were less likely to partake in strength-based exercise than male, and ≥55 year old adults were less likely to partake in strength-based exercise than 18-34 year old adults. Participation in strength-based exercise was found to increase with years of education, self-reported physical activity and self-rated health. The prevalence of adults in rural and regional Central Queensland engaging in strength-based exercise is low. Exercise physiologists, clinicians and government officials must work together to ensure that this form of exercise is acknowledged as a vital component of health in rural and regional areas. © 2015 National Rural Health Alliance Inc.
Gaziano, Thomas A; Abrahams-Gessel, Shafika; Gomez-Olive, F Xavier; Wade, Alisha; Crowther, Nigel J; Alam, Sartaj; Manne-Goehler, Jennifer; Kabudula, Chodziwadziwa W; Wagner, Ryan; Rohr, Julia; Montana, Livia; Kahn, Kathleen; Bärnighausen, Till W; Berkman, Lisa F; Tollman, Stephen
A consequence of the widespread uptake of anti-retroviral therapy (ART) is that the older South African population will experience an increase in life expectancy, increasing their risk for cardiometabolic diseases (CMD), and its risk factors. The long-term interactions between HIV infection, treatment, and CMD remain to be elucidated in the African population. The HAALSI cohort was established to investigate the impact of these interactions on CMD morbidity and mortality among middle-aged and older adults. We recruited randomly selected adults aged 40 or older residing in the rural Agincourt sub-district in Mpumalanga Province. In-person interviews were conducted to collect baseline household and socioeconomic data, self-reported health, anthropometric measures, blood pressure, high-sensitivity C-reactive protein (hsCRP), HbA1c, HIV-status, and point-of-care glucose and lipid levels. Five thousand fifty nine persons (46.4% male) were enrolled with a mean age of 61.7 ± 13.06 years. Waist-to-hip ratio was high for men and women (0.92 ± 0.08 vs. 0.89 ± 0.08), with 70% of women and 44% of men being overweight or obese. Blood pressure was similar for men and women with a combined hypertension prevalence of 58.4% and statistically significant increases were observed with increasing age. High total cholesterol prevalence in women was twice that observed for men (8.5 vs. 4.1%). The prevalence of self-reported CMD conditions was higher among women, except for myocardial infarction, and women had a statistically significantly higher prevalence of angina (10.82 vs. 6.97%) using Rose Criteria. The HIV - persons were significantly more likely to have hypertension, diabetes, or be overweight or obese than HIV + persons. Approximately 56% of the cohort had at least 2 measured or self-reported clinical co-morbidities, with HIV + persons having a consistently lower prevalence of co-morbidities compared to those without HIV. Absolute 10-year risk cardiovascular risk
Zainol Abidin, Nurdiana; Brown, Wendy J; Clark, Bronwyn; Muhamed, Ahmad Munir Che; Singh, Rabindarjeet
We evaluated feasibility of physical activity measurement by accelerometry among older Malay adults living in semi-rural areas in Malaysia. Results showed that 95% of 146 participants (aged [SD] 67.6 [6.4] years) were compliant in wearing the accelerometer for at least five days. Fifteen participants were asked for re-wear the accelerometer because they did not have enough valid days during the first assessment. Participants wore the accelerometer an average of 15.3 hr in a 24-hr day, with 6.5 (1.2) valid wear days. No significant difference in valid wear day and time was found between men and women. Participants who are single provide more valid wear days compared with married participants (p < .05), and participants with higher levels of education provide longer periods of accelerometer wearing hours (p < .01). Eighty-seven percent of participants reported 'no issues' with wearing the meter. This study suggests that accelerometry is a feasible method to assess the physical activity level among older Malay adults living in semi-rural areas.
Esclassan, R; Grimoud, A M; Ruas, M P; Donat, R; Sevin, A; Astie, F; Lucas, S; Crubezy, E
The aims of the present work were to determine the frequency and distribution of caries and tooth wear on paired maxillae of a mediaeval sample from southwest France in which the sex of the remains had been established, and to make a relation with the diet of this population. The sample analysed consisted of the dental remains of 58 adult individuals (29 men and 29 women) excavated from the mediaeval cemetery of the archaeological site of Vilarnau d'Amont (southwest France). A total of 1395 teeth were examined. The frequency of ante-mortem tooth loss for the sample was 8.7% and the frequency of caries was 17.5%. The frequencies of carious lesions in adult men and women's dentition were 21.9% and 14.0%. The most frequent were occlusal (49.7% and 34.3%) and approximal caries (26.5% and 37.4%). Concerning tooth wear, all 58 individuals were affected by attrition (100%) and more than 90% of the teeth were concerned. Most of them showed the presence of dentin clusters. There was no significant difference between men and women for caries and tooth wear. These findings are similar to those of other studies on European populations of the same socio-economic status and confirm the predominance of tooth wear over carious lesions during this period. Both caries and tooth wear may be related to the regional diet of this rural population.
Norimah, A K; Safiah, M; Jamal, K; Haslinda, Siti; Zuhaida, H; Rohida, S; Fatimah, S; Norazlin, Siti; Poh, B K; Kandiah, M; Zalilah, M S; Wan Manan, W M; Fatimah, S; Azmi, M Y
This study reports the food consumption patterns of adults aged 18 to 59 years in the Malaysian Adults Nutrition Survey (MANS) carried out between October 2002 and December 2003. A total of 6,742 subjects comprising 3,274 men and 3,468 women representing the northern, central , southern and east coast of Peninsular Malaysia as well as Sabah and Sarawak were interviewed. A semiquantitative food frequency questionnaire (FFQ) which consisted of 126 food items was used to evaluate the food consumption pattern (habitual food intake) of the respondents during the previous one- year period. The results demonstrate that nasi putih (cooked rice) was consumed by 97% of the population twice daily (average 2½ plates per day). Other food items consumed daily were marine fish, (one medium fish per day), green leafy vegetables (one cup per day) and sweetened condensed milk (three teaspoons per day. The mean frequencies for daily intake of rice, leafy vegetables, marine fish, local kuih, anchovy (ikan bilis) and biscuits were significantly higher among the rural compared to the urban adults. In contrast, more urban dwellers consumed chicken and eggs more frequently than their rural counterparts. More men than women consumed chicken and eggs more frequently. Malaysian adults showed a satisfactory habit of drinking plain water, with 99% drinking at least six glasses of plain water daily. Other beverages such as tea (47%), coffee (28%), chocolate-based drinks (23%) and cordial syrup (11%) were also consumed on daily basis, however, in a smaller proportion of the population. There were differences in the prevalence of daily consumption of foods when comparing urban and rural population, and also between men and women. The prevalence of daily consumption of marine fish among rural and urban adults was 51% and 34% respectively. For sweetened condensed milk, men and women consumed 43% and 28% respectively; however, more women drank full cream milk than men. Between the age groups, 21
P. P. Turun
Full Text Available The article describes the dynamics of the rural population of the North Caucasus republics in 1989–2010 analyzes the differences of census data with the results of the current account of the population over two intercensal period. For obtaining the most accurate data in the rural population applies a correction factor the results of the census are considered critical, given the problems of its implementation.
Rolfe, Margaret I; Donoghue, Deborah Anne; Longman, Jo M; Pilcher, Jennifer; Kildea, Sue; Kruske, Sue; Kornelsen, Jude; Grzybowski, Stefan; Barclay, Lesley; Morgan, Geoffrey Gerard
Australia has a universal health care system and a comprehensive safety net. Despite this, outcomes for Australians living in rural and remote areas are worse than those living in cities. This study will examine the current state of equity of access to birthing services for women living in small communities in rural and remote Australia from a population perspective and investigates whether services are distributed according to need. Health facilities in Australia were identified and a service catchment was determined around each using a one-hour road travel time from that facility. Catchment exclusions: metropolitan areas, populations above 25,000 or below 1,000, and a non-birthing facility within the catchment of one with birthing. Catchments were attributed with population-based characteristics representing need: population size, births, demographic factors, socio-economic status, and a proxy for isolation - the time to the nearest facility providing a caesarean section (C-section). Facilities were dichotomised by service level - those providing birthing services (birthing) or not (no birthing). Birthing services were then divided by C-section provision (C-section vs no C-section birthing). Analysis used two-stage univariable and multivariable logistic regression. There were 259 health facilities identified after exclusions. Comparing services with birthing to no birthing, a population is more likely to have a birthing service if they have more births, (adjusted Odds Ratio (aOR): 1.50 for every 10 births, 95% Confidence Interval (CI) [1.33-1.69]), and a service offering C-sections 1 to 2 h drive away (aOR: 28.7, 95% CI [5.59-148]). Comparing the birthing services categorised by C-section vs no C-section, the likelihood of a facility having a C-section was again positively associated with increasing catchment births and with travel time to another service offering C-sections. Both models demonstrated significant associations with jurisdiction but not socio
Fernanda Fehlberg, M; dos Santos, I S; Tomasi, E
Epidemiological literature on occupational accidents among rural workers is scarce in Brazil. This population-based cross-sectional study was designed to investigate the characteristics of farming accidents occurring in the rural area of Pelotas, Southern Brazil. A multi-stage sampling scheme was used to select a representative sample of farms. From January to April 1996, a total of 258 rural families were visited, and all 580 rural workers identified in these families answered a standardized questionnaire. Sixty-three rural workers (11%) reported at least one work-related accident in the previous twelve months. There were 82 accidents during the study period, mainly related to the use of hand farm tools (29%) and handling farm animals (27%). The main types of injuries were cuts (50%), bruises (13%), and burns (9%). The body areas most frequently involved were hands (34%), feet (29%), and legs (18%). Among the injured rural workers, only 32% used health services to treat the resulting lesions (46% went to primary health care facilities and 36% to emergency services).
Said-Mohamed, Rihlat; Prioreschi, Alessandra; Nyati, Lukhanyo H; van Heerden, Alastair; Munthali, Richard J; Kahn, Kathleen; Tollman, Stephen M; Gómez-Olivé, Francesc Xavier; Houle, Brian; Dunger, David B; Norris, Shane A
The pre-pubertal socioeconomic environment may be an important determinant of age at menarche, adult height, body proportions and adiposity: traits closely linked to adolescent and adult health. This study explored differences in age at menarche, adult height, relative leg-length and waist circumference between rural and urban black South African young adult women, who are at different stages of the nutrition and epidemiologic transitions. We compared 18-23 year-old black South African women, 482 urban-dwelling from Soweto and 509 from the rural Mpumalanga province. Age at menarche, obstetric history and household socio-demographic and economic information were recorded using interview-administered questionnaires. Height, sitting-height, hip and waist circumference were measured using standardised techniques. Urban and rural black South African women differed in their age at menarche (at ages 12.7 and 14.5 years, respectively). In urban women, a one-year increase in age at menarche was associated with a 0.65 cm and 0.16% increase in height and relative leg-length ratio, respectively. In both settings, earlier age at menarche and shorter relative leg-length were independently associated with an increase in waist circumference. In black South African women, the earlier onset of puberty, and consequently an earlier growth cessation process, may lead to central fat mass accumulation in adulthood.
Trung, N.V.; Hoi, L.T.; Thuong, N.T.H.; Toan, T.K.; Huong, T.T.K.; Hoa, T.M.; Fox, A.; Kinh, N.V.; Doorn, H.R. van; Wertheim, H.F.L.; Bryant, J.E.; Nadjm, B.
AbstractRickettsial infections are recognized as important causes of fever throughout southeast Asia. Herein, we determined the seroprevalence to rickettsioses within rural and urban populations of northern Vietnam. Prevalence of individuals with evidence of prior rickettsial infections (IgG
The primary goals of the study were a critical analysis of the concepts associated with health from the perspective of sustainable development, and empirical analysis of health and health- related issues among the rural and urban residents of Eastern Poland in the context of the sustainable development of the region. The study was based on the following research methods: a systemic approach, selection and analysis of the literature and statistical data, developing a special questionnaire concerning socio-economic and health inequalities among the population in the studied area, field research with an interview questionnaire conducted on randomly-selected respondents (N=1,103) in randomly selected areas of the Lubelskie, Podkarpackie, Podlaskie and eastern part of Mazowieckie Provinces (with the division between provincial capital cities - county capital cities - other cities - rural areas). The results of statistical surveys in the studied area with the use of chi-square test and contingence quotients indicated a correlation between the state of health and the following independent variables: age, life quality, social position and financial situation (C-Pearson's coefficient over 0,300); a statistically significant yet weak correlation was recorded for gender, household size, place of residence and amount of free time. The conducted analysis proved the existence of a huge gap between state of health of the population in urban and rural areas. In order to eliminate unfavourable differences in the state iof health among the residents of Eastern Poland, and provide equal sustainable development in urban and rural areas of the examined areas, special preventive programmes aimed at the residents of peripheral, marginalized rural areas should be implemented. In these programmes, attention should be paid to preventive measures, early diagnosis of basic civilization and social diseases, and better accessibility to medical services for the residents.
Febrero, B; Almela, J; Ríos, A; Ros, I; Pérez-Sánchez, B; Martínez-Alarcón, L; Ruiz-Carreño, P; Ferreras, D; Ramírez, P; Parrilla, P
In rural areas it is common to find unfavorable attitudes toward organ donation, and therefore it is important to find out the attitude and profile of new generations for improving predisposition to organ donation in these areas. Our objective was to analyze the attitude toward organ donation and the related variables of teenagers in a rural area. Students in the final year of compulsory education (mostly 15-16 years of age) were selected from secondary schools in a rural area in southeastern Spain (n = 319; population density donating their organs, 30% (n = 90) were undecided, and 5% (n = 16) were against. Attitude toward the donation of one's own organs was related with sex (P = .015), previous experience of organ donation or transplantation (P = .046), comment on the topic of organ donation within the family (P = .003; odds ratio 2.155), knowing one's mother's opinion about the matter (P = .021), knowing the correct concept of brain death (P = .012; odds ratio 2.076), and religion (P = .014). A favorable attitude of teenagers in rural areas toward organ donation is slightly higher than in the adult population and is determined by many psychosocial variables, above all family discussion about organ donation and transplantation and correct knowledge of the brain death concept. Copyright © 2017 Elsevier Inc. All rights reserved.
Due to their limited resources, rural, older adults in the United States are at risk for poor diet-related health outcomes. Nutrition education is a key component in improving health outcomes in older adults. Cooking Healthy, Eating Smart (CHES) is a nine-lesson curriculum designed to teach rural, older adults culturally appropriate nutrition and food safety information. Funding to hire health professionals to deliver such a curriculum is limited, presenting the need to explore a less expensive mode of dissemination. In this community-based, participatory research study, a formative evaluation and feasibility study were conducted to examine the use of volunteers to deliver a nutrition and food safety curriculum to rural, older adults in South Carolina. Seven focus groups were conducted with members of the South Carolina Family and Community Leaders (SCFCL) and members of the American Association of Retired Persons (AARP) in the four regions of South Carolina to explore barriers and facilitators of volunteers delivering CHES (N=65 participants). The focus group findings informed the development of the volunteer training manual. A comparative case study method was used to examine the feasibility of a volunteer-based approach by observing and describing the delivery of CHES by two groups of volunteers in SC. The case study findings, including volunteer knowledge change, self-efficacy change, curriculum experience, program experience, and project team observations of volunteers indicated that using volunteers to deliver CHES is a plausible approach with the assistance of paid staff or project team members.
Ateba Ngoa, Ulysse; Schaumburg, Frieder; Adegnika, Ayola Akim; Kösters, Katrin; Möller, Tina; Fernandes, Jose Francisco; Alabi, Abraham; Issifou, Saadou; Becker, Karsten; Grobusch, Martin Peter; Kremsner, Peter Gottfried; Lell, Bertrand
Little data is available on the epidemiology of Staphylococcus aureus in Africa. In the present study we aim at characterizing the population structure of S. aureus in healthy subjects from a rural and a semi-urban area in Lambarene, Gabon as well as in hospital staff and inpatients. In total, 500
Montiel-Company, José M.; Manzanera-Pastor, David; Almerich-Silla, José M.
Objectives: Orthodontic treatment need has often been assessed in child populations, but few studies employing internationally-recognized indices have been conducted in adult or young adult populations. The aim of this study was to determine the orthodontic treatment need of a young adult population in Spain by means of the Dental Aesthetic Index (DAI), the Index of Orthodontic Treatment Need (IOTN) and the need perceived by the patients. Study design: A cross-sectional epidemiological study was conducted in a broad, representative sample of 671 adults aged between 35 and 44 years using health centers in the Valencia Region of Spain, following the recommendations of the World Health Organization (WHO). Results: Orthodontic treatment was required by 31.3% of the sample according to the DAI and 19.2% according to the IOTN (DHC). The orthodontic treatment need perceived by the patients was 21.1%. On relating treatment need to different variables, significant differences in patient perception were encountered by gender, as women perceived a greater need (23.9%) than men (14.4%). Significant differences in previous orthodontic treatment history were found between middle/high (15%) and low (9%) social class and between secondary/tertiary (14%) and primary (3.3%) education. Conclusions: There was no agreement between the treatment need assessed objectively by the indices and that perceived by the patient, or between the indices themselves. The decision to undergo orthodontic treatment can depend on socioeconomic and psychological factors and on values and principles that do not easily lend themselves to objective measurement. Key words:Orthodontics, epidemiology, adult, malocclusion. PMID:22322504
Jan 7, 2010 ... Prevalence of sleepwalking in an adult population. Celestine Okorome Mume*. Department of Mental Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Osun. State, Nigeria. Background: Sleepwalking consists of a series of behavioral activities that occur during sleep. These activities.
Abner, Erin L; Jicha, Gregory A; Christian, W Jay; Schreurs, Bernard G
Older adults living in rural areas may face barriers to obtaining a diagnosis of Alzheimer's disease and related disorders (ADRD). We sought to examine rural-urban differences in prevalence of ADRD among Medicare beneficiaries in Kentucky and West Virginia, 2 contiguous, geographically similar states with large rural areas and aged populations. We used Centers for Medicare and Medicaid Services Public Use Files data from 2007 to 2013 to assess prevalence of ADRD at the county level among all Medicare beneficiaries in each state. Rural-Urban Continuum Codes were used to classify counties as rural or urban. We used Poisson regression to estimate unadjusted and adjusted prevalence ratios. Primary analyses focused on 2013 data and were repeated for 2007 to 2012. This study was completely ecologic. After adjusting for state, average beneficiary age, percent of female beneficiaries, percent of beneficiaries eligible for Medicaid in each county, Central Appalachian county, percent of age-eligible residents enrolled in Medicare, and percent of residents under age 65 enrolled in Medicare in our adjusted models, we found that 2013 ADRD diagnostic prevalence was 11% lower in rural counties (95% CI: 9%-13%). Medicare beneficiaries in rural counties in Kentucky and West Virginia may be underdiagnosed with respect to ADRD. However, due to the ecologic design, and evidence of a younger, more heavily male beneficiary population in some rural areas, further studies using individual-level data are needed to confirm the results. © 2015 National Rural Health Association.
Abshire, Demetrius A; Lennie, Terry A; Chung, Misook L; Biddle, Martha J; Barbosa-Leiker, Celestina; Moser, Debra K
This study was conducted to (1) compare diet quality among depressed and nondepressed overweight and obese rural-dwelling adults and (2) determine whether body mass index (BMI) category moderates the relationship between depressive symptoms and overall diet quality. Rural adults in Kentucky (n = 907) completed the 9-item Patient Health Questionnaire (PHQ-9) that assessed depressive symptoms and a food frequency questionnaire that generated 2005 Healthy Eating Index (HEI) scores. Participants were grouped into overweight (BMI 25-29.9 kg/m 2 ) and obese (≥30 kg/m 2 ), and nondepressed (PHQ-9 category (overweight vs obese) moderated the association between depressive symptoms and overall diet quality. Overall diet quality was poorer in the obese depressed group than in the obese nondepressed group. Intake of fruit and dark green/orange vegetables and legumes was lower in the obese depressed group than in the overweight nondepressed group. Depressive symptoms predicted poor overall diet quality (B = -0.287, P category (coefficient of BMI category * depressive symptom interaction term = 0.355, P category and depressive symptom status. The relationship between depressive symptoms and diet quality is influenced by BMI category. © 2017 National Rural Health Association.
Bostic, Stephanie M; Sobal, Jeffery; Bisogni, Carole A; Monclova, Juliet M
To examine rural New York State consumers' cognitive scripts for fish and seafood provisioning. A cross-sectional design with in-depth, semistructured interviews. Three rural New York State counties. Adults (n = 31) with diverse fish-related experiences were purposefully recruited. Scripts describing fish and seafood acquisition, preparation, and eating out. Interview transcripts were coded for emergent themes using Atlas.ti. Diagrams of scripts for each participant were constructed. Five types of acquisition scripts included quality-oriented, price-oriented, routine, special occasion, and fresh catch. Frequently used preparation scripts included everyday cooking, fast meal, entertaining, and grilling. Scripts for eating out included fish as first choice, Friday outing, convenient meals, special event, and travel meals. Personal values and resources influenced script development. Individuals drew on a repertoire of scripts based on their goals and resources at that time and in that place. Script characteristics of scope, flexibility, and complexity varied widely. Scripts incorporated goals, values, and resources into routine food behaviors. Understanding the characteristics of scripts provided insights about fish provisioning and opportunities to reduce the gap between current intake and dietary guidelines in this rural setting. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Henderson, Sarah B; Wan, Victoria; Kosatsky, Tom
Temperature-mortality analyses are challenging in rural and remote communities with small populations, but this information is needed for climate change and emergency planning. The geographic health areas of British Columbia, Canada were aggregated into four ecoregions delineated by microclimatic conditions. Time series models were used to estimate the effect of maximum apparent temperature on daily non-traumatic mortality. The population of the coldest ecoregion was most sensitive to hot weather, while the population of the hottest ecoregion was least sensitive. The effects were consistently strongest in decedents aged less than 75 years. A province-wide total of 815 deaths was attributed to hot weather over the 25-year study period, with 735 deaths in the most populous ecoregion. The framework described could be adapted to other climatically variable regions with urban, rural, and remote populations. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.
Reif, Susan; Whetten, Kathryn; Ostermann, Jan; Raper, James L
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.
Pascual Velasco, F; Rodríguez Pérez, J C; Otero Ferrio, I; Borobio Enciso, M V
Q fever is an endemic zoonosis in the Canary Islands. In 1986, we detected, in a pilot study, residual antibodies of the infection in 3% of the population from Lanzarote. In 1989, we performed a new study in order to assess seroprevalence of Q fever among the adult native population from the island. We studied 390 human serums obtained from an statistically representative sample. Age ranged from 30 to 64 years. Out of 390 serums, 196 (50.25%) were obtained from men and 194 (49.74%) from women. The serological technique used was the fixation of complement using Coxiella burnetii antigens in phase II. Titres equal or higher than 1/8 were considered positive. No statistically significant differences were observed with regard to seroprevalence rates considering sex, age, nor living in or outside the island's capital city. However, when dividing the island's territory in three areas (north, centre and south), and assessing independently their respective seroprevalences, we observed relatively higher seroprevalences in the furthest areas (13.3% in the north and 13.5% in the south) than in the central area (4.7%), although only the higher seroprevalence in the south reached statistical significance when compared with the mean prevalence. Probably, these observations indicate that, although Q fever is extended all over the island, it is a more frequent infection in rural areas of Lanzarote, at the north and the south, than in the central area, where the main urban areas are located.
The radioecological model ECOSYS, developed in GSF-Institut fuer Strahlenschutz has been applied to calculate thyroid doses to the population due to I-131 exposures after the Chernobyl accident. The main contribution to the thyroid doses calculated is given by the consumption of milk and vegetables. Results are presented taking into account the different activity concentrations measured in milk of private family cows and mixed collective milk of a creamery in upper Bavaria, as well as different consumption behaviour of children and adults in rural and urban areas. Thyroid doses due to different milk consumption habits and a different milk origin in adults living in urban environments are estimated to be up to 12 times, in children up to 3 times lower than those estimated for rural environments. The dose contribution by vegetables, however, in any case exceeded the one by milk because of the high intake rates for the case investigated here. These values, however, may be overestimates for vegetables and have a very high uncertainty. For adults total thyroid dose by ingestion was higher in rural areas by a factor of 1.4, for children at the age of 10 years, total thyroid dose by ingestion was 1.5 times higher in urban environments for the conditions described here. (author)
Full Text Available Women live on average five years longer than men, and the sex difference in longevity is typically lower in populations with high mortality. South Africa-a high mortality population with a large sex disparity-is an exception, but the causes of death that contribute to this difference are not well understood.Using data from a demographic surveillance system in rural KwaZulu-Natal (2000-2014, we estimate differences between male and female adult life expectancy by HIV status. The contribution of causes of death to these life expectancy differences are computed with demographic decomposition techniques. Cause of death information comes from verbal autopsy interviews that are interpreted with the InSilicoVA tool.Adult women lived an average of 10.4 years (95% confidence Interval 9.0-11.6 longer than men. Sex differences in adult life expectancy were even larger when disaggregated by HIV status: 13.1 (95% confidence interval 10.7-15.3 and 11.2 (95% confidence interval 7.5-14.8 years among known HIV negatives and positives, respectively. Elevated male mortality from pulmonary tuberculosis (TB and external injuries were responsible for 43% and 31% of the sex difference in life expectancy among the HIV negative population, and 81% and 16% of the difference among people living with HIV.The sex differences in adult life expectancy in rural KwaZulu-Natal are exceptionally large, atypical for an African population, and largely driven by high male mortality from pulmonary TB and injuries. This is the case for both HIV positive and HIV negative men and women, signalling a need to improve the engagement of men with health services, irrespective of their HIV status.
Chang, Ye; Li, Yuan; Guo, Xiaofan; Guo, Liang; Sun, Yingxian
We aimed to determine the association of atherogenic index of plasma (AIP) with hyperuricemia (HUA) in the rural population of northeast China. This cross-sectional study was conducted in the rural areas of northeast China from January 2012 to August 2013, and the final analysis included data obtained form 5253 men and 6092 women. 1104 participants (9.7%) suffered from HUA. Spearman rank test showed that AIP was positively correlated with uric acid in both sexes (r = 0.310 for men and r = 0.347 for women, both p 0.21) risk. The prevalence of HUA increased with AIP. Multivariate logistic regression analysis showed that, compared to the low AIP group, participants in increased AIP group had a 2.536-fold risk for HUA (2.164-fold in male and 2.960-fold in female) after adjustment for covariates. Results of receiver operating characteristic curves showed that the area under the curve (95% confidence intervals) was 0.686 (0.665-0.707) for male and 0.730 (0.706-0.755) for female. We indicated that increased AIP was associated with higher serum uric acid levels and could be identified as an independent risk factor of HUA in the rural population of northeast China.
R. Vidya Bharathi
Major conclusions: Family history was found to have a strong association in incidence and manifestation of the disorder. Stress was found to set off the symptoms pertaining to PCOS. We also noticed that the awareness, among the rural population especially, was very minimum and thus they were not oblivious of diagnosis.
Crosby, Richard A; Collins, Tom
One largely unexplored barrier to colorectal cancer (CRC) screening is fatalistic beliefs about cancer. The purpose of this study was to identify correlates of ever having endoscopy screenings for CRC and to determine whether fatalism plays a unique role. Because evidence suggests that cancer-associated fatalistic beliefs may be particularly common among rural Americans, the study was conducted in a medically underserved area of rural Appalachia. METHODS: Rural residents (N = 260) between 51 and 75 years of age, from a medically underserved area of Appalachia, Kentucky, were recruited for a cross-sectional study. The outcome measure was assessed by a single item asking whether participants ever had a colonoscopy or flexible sigmoidoscopy. Demographic and health-related correlates of this outcome were selected based on past studies of rural populations. A single item assessed perceptions of fatalism regarding CRC. Age-adjusted analyses of correlates testing significant at the bivariate level were conducted. RESULTS: The analytic sample was limited to 135 rural residents indicating they had ever had CRC endoscopy and 107 indicating never having endoscopy. In age-adjusted analyses, only the measure of fatalism had a significant association with having endoscopy. Those endorsing the statement pertaining to fatalism were 2.3 times more likely (95% CI = 1.24-4.27, P = .008) than the remainder to indicate never having endoscopy. CONCLUSIONS: A community-based approach to the promotion of endoscopy for CRC screening could focus on overcoming CRC-associated fatalism, thereby potentially bringing more unscreened people to endoscopy clinics. © 2017 National Rural Health Association.
Silva, Hilton; Padez, Cristina
In many developing countries overweight, obesity and obesity-related morbidity are becoming a problem of increasing public health importance. The purpose of this study was to investigate differences in body size and body composition with age in adults of the Caboclo populations from the Brazilian Amazon as well as to examine the prevalence of overweight and obesity in adults aged 20-75 years, taking into account recent trends for the whole country. Caboclo are genetically and culturally admixed rural peasant groups that live along the Amazon River and its tributaries in Brazil, and there are few previous studies of their health and lifestyle. A total of 304 subjects (149 males and 155 females) from two socioecologically different areas were studied. Height, weight and skinfolds (tricipital, subscapular and suprailiac) were measured; international intervals (WHO) for overweight and obesity were used. Women showed significantly lower values than men for height, weight, upper arm circumference and fat-free mass and higher values for triceps, subscapular and suprailiac skinfolds and body fat (%). In the overall sample combined overweight and obesity was 47.8% in men and 50.8% in women. When compared to recent values published for the Northern region and for the whole of Brazil, 20.5% of Caboclo women aged 20-75 years were obese, which is higher than all other populations, including other rural samples. Caboclo men showed the highest rates of obesity (9.1%) and overweight (39.1%) of any rural population from the country, including Northern Brazil. The results suggest an effect of increased Western lifestyle influence on the body composition of these Caboclo populations. Considering that these are rural populations with limited access to education and health care, the high prevalence of overweight and obesity associated with low socio-economic status makes them a vulnerable group that deserves a higher level of attention by the country's public health authorities.
Horvath, Keith J; Iantaffi, Alex; Swinburne-Romine, Rebecca; Bockting, Walter
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.
Charu M Marya
Full Text Available Aim: The purpose of this study was to assess the self-perception of patients toward their dental appearance using the aesthetic component (AC of index of orthodontic treatment need (IOTN index and whether age and gender had any influence on it. Methods: A cross-sectional study was carried out to assess the perceived esthetic impact of malocclusion in 16-24 year-old subjects selected from the rural population of Faridabad, Haryana, India. The sample was divided into two groups, older adolescents and younger adults, and the AC of the IOTN index was applied. Results: The results showed that most subjects scored themselves as having an attractive dentition with no need for orthodontic treatment (60.91%. Gender-wise differences were not found to be statistically significant in relation to the perceived needs (P = 0.095, whereas age-wise differences were found to be statistically significant in relation to the perceived needs (P < 0.001. Conclusion: While the age seemed to have an impact on the perceived esthetic impact of malocclusion, the gender did not seemingly influence this self-perception.
Full Text Available Abstract Background During the post-communist transition period, political, economic, and social changes affected the lifestyles of the Lithuanian population, including their nutritional habits. However, people of lower socio-economic position were more vulnerable to these changes. The aim of the present study was to evaluate the trends in selected food habits of the Lithuanian adult population by their level of education and place of residence from 1994 to 2010. Methods The data were obtained from nine biannual cross-sectional postal surveys of Lithuanian health behaviours, beginning in 1994. Each survey used a randomly selected nationally representative sample of 3000 inhabitants aged 20-64 drawn from the population register. In total, 7358 men and 9796 women participated in these surveys. Questions about food consumption were included within all health behaviour questionnaires. Results During the transition period, use of vegetable oil in cooking and the frequency of consumption of fresh vegetables increased, use of butter on bread decreased, and the proportion of women drinking high-fat milk declined. Lithuanians with higher education reported more frequent use of vegetable oil in cooking as well as daily consumption of fresh vegetables than those with a lower level of education. Consumption of high-fat milk was inversely associated with educational background. In addition, the proportion of persons spreading butter on bread increased with higher education level. The greatest urban-rural difference was observed in high-fat milk consumption. The increase in the use of vegetable oil in cooking, and the reduction of spreading butter on bread was more evident among less educated and rural inhabitants. Meanwhile, a greater proportion of the rural population, compared to urban, reduced their use of butter on bread. Daily consumption of fresh vegetables increased most among highly educated Lithuanians. Conclusions The data from our study indicate
Michael G Kawooya
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.
Gurri, Francisco D
This paper attempts to link last century's disruption of local agricultural systems to today's presence of childhood under nutrition and adult overweight and obesity in the Yucatan Peninsula. It first compares Height for Age (H/A), Weight for Age (W/A) and Body Mass Index (BMI) of children from three rural populations in Yucatan and Campeche, Mexico whose subsistence strategy had been altered to different degrees since 1970. It then compares BMI in adults, in the same regions, born before and after the alteration of their environment in the 1970's. Children in the least disrupted zone were taller and had lower BMI than children in the other two, but were not heavier than children from the richest disrupted zone. Children in the poorest disrupted zone were shorter and lighter than the rest. BMI in adult men was higher in the two most disrupted zones only in those cohorts that grew up after the traditional agricultural regime was altered. It is concluded that disruptions of staple-based subsistence agriculture promoted a stockier phenotype in children and a tendency to accumulate body fat. Persistence of these conditions in the twenty first century has favored the coexistence of stunting during childhood with adults who easily become overweight.
HASHEMI, Hassan; REZVAN, Farhad; YEKTA, AbbasAli; OSTADIMOGHADDAM, Hadi; SOROUSH, Sara; DADBIN, Nooshin; KHABAZKHOOB, Mehdi
Background: Visual impairment is a very important public health problem. In Iran, reports of visual impairment and blindness have been published from the urban population while the prevalence of visual impairment in the rural population has not been reported. The purpose of this study to determine the prevalence and causes of visual impairment, in a rural population in district of based on age and sex Methods: In a cross-sectional population-based study, using random cluster sampling, 13 of the 83 villages of Khaf County in the north east of Iran were selected. Eye examinations were performed in a Mobile Eye Clinic (Nooravaran Salamat, 2011) and included optometric examinations such as measuring uncorrected and corrected visual acuity along with non-cycloplegic refraction. Results: The prevalence of visual impairment, low vision, and blindness was 6.3% (95% CI 5.3–7.3), 3.4% (95% CI 2.6–4.1), and 3.0% (95% CI 2.3–3.6), respectively. The prevalence of visual impairment ranged from 1.8% in the participant younger than 20 years of age to 28% in the subjects aged 60 and over (Pimpairment and low vision was significantly higher in women. The most prevalent causes of visual impairment were uncorrected refractory error (54.5%) and cataract (17.6%). Conclusion: The prevalence of visual impairment was significantly higher in the rural population of this study when compared to previous reports from Iran. It seems that provision of therapeutic facilities like cataract surgery and availability of eyeglasses in villages can considerably reduce the prevalence of visual impairment. PMID:26258099
Full Text Available Introduction: Water is an essential nutrient for life. It comprises 75% of total body weight in infants,60% in adult males and 50% in adult females. Decrease in body water is commonly known as dehydration. Acute or chronic dehydration is a common condition in some population groups, especialy the elderly and those who participate in physical activity in warm enviroments. Potential consequences of dehydration include constipation,urinary tract and respiratory infection,urinary stone disease and there might also be an association between a low habitual fluid intake and some carcinomas,cardiovascular disease and diabetes. Many indices have been investigated to establish their role as markers of dehydration status. Body mass changes,blood indices,urine indices and bioelectrical impedance analysis have been used most widely, but current evidence and opinion tend to favour urine indices as the most convenient and sensitive methods. Methods: This cross sectional study was done for estimating the prevalence of dehydration in adult population(students,nurses,officials,workersin Yazd. These persons were selected randomly. Urine samples of two hundred and thirty persons were obtained at 10-12 AM,and urine specific gravity measured by refractometer (all of the samplesand dip stick (some samples. Finding: According to this study,96.7% of our population had some degree of dehydration.69.7% of them were significantly dehydrated(urine SG>1020 and 4.8% of them were severely dehydrated (urine SG>1030 and the mean specific gravity was 1021±5/65. This study evaluated other factors that could probably indicate hydration status like urine colour, type of drink,frequency of urination and frequency of thirst per day. Conclusion: High percentage of our population were dehydrated which was not correlated to the type of drink but was correlated to urine colour, frequency of urination and frequency of thirst. So, regular monitoring of urine to keep if clear or light
Aguilera Barciela, M.
The development of electro energetic national system in Cuba has been directed to the following objectives: to brake the rural population's exodus toward the cities, electrification of dairy farm, interconnection to the system electro energetic of all the sugar central production, these improves the rural population's conditions life
Full Text Available BACKGROUND: Identification of high-risk populations for serious infection due to S. pneumoniae will permit appropriately targeted prevention programs. METHODS: We conducted prospective, population-based surveillance for invasive pneumococcal disease and laboratory confirmed pneumococcal pneumonia in homeless adults in Toronto, a Canadian city with a total population of 2.5 M, from January 1, 2002 to December 31, 2006. RESULTS: We identified 69 cases of invasive pneumococcal disease and 27 cases of laboratory confirmed pneumococcal pneumonia in an estimated population of 5050 homeless adults. The incidence of invasive pneumococcal disease in homeless adults was 273 infections per 100,000 persons per year, compared to 9 per 100,000 persons per year in the general adult population. Homeless persons with invasive pneumococcal disease were younger than other adults (median age 46 years vs 67 years, P<.001, and more likely than other adults to be smokers (95% vs. 31%, P<.001, to abuse alcohol (62% vs 15%, P<.001, and to use intravenous drugs (42% vs 4%, P<.001. Relative to age matched controls, they were more likely to have underlying lung disease (12/69, 17% vs 17/272, 6%, P = .006, but not more likely to be HIV infected (17/69, 25% vs 58/282, 21%, P = .73. The proportion of patients with recurrent disease was five fold higher for homeless than other adults (7/58, 12% vs. 24/943, 2.5%, P<.001. In homeless adults, 28 (32% of pneumococcal isolates were of serotypes included in the 7-valent conjugate vaccine, 42 (48% of serotypes included in the 13-valent conjugate vaccine, and 72 (83% of serotypes included in the 23-valent polysaccharide vaccine. Although no outbreaks of disease were identified in shelters, there was evidence of clustering of serotypes suggestive of transmission of pathogenic strains within the homeless population. CONCLUSIONS: Homeless persons are at high risk of serious pneumococcal infection. Vaccination, physical structure changes
Marleen E Hendriks
Full Text Available BACKGROUND: Cardiovascular disease (CVD is the leading cause of adult mortality in low-income countries but data on the prevalence of cardiovascular risk factors such as hypertension are scarce, especially in sub-Saharan Africa (SSA. This study aims to assess the prevalence of hypertension and determinants of blood pressure in four SSA populations in rural Nigeria and Kenya, and urban Namibia and Tanzania. METHODS AND FINDINGS: We performed four cross-sectional household surveys in Kwara State, Nigeria; Nandi district, Kenya; Dar es Salaam, Tanzania and Greater Windhoek, Namibia, between 2009-2011. Representative population-based samples were drawn in Nigeria and Namibia. The Kenya and Tanzania study populations consisted of specific target groups. Within a final sample size of 5,500 households, 9,857 non-pregnant adults were eligible for analysis on hypertension. Of those, 7,568 respondents ≥ 18 years were included. The primary outcome measure was the prevalence of hypertension in each of the populations under study. The age-standardized prevalence of hypertension was 19.3% (95%CI:17.3-21.3 in rural Nigeria, 21.4% (19.8-23.0 in rural Kenya, 23.7% (21.3-26.2 in urban Tanzania, and 38.0% (35.9-40.1 in urban Namibia. In individuals with hypertension, the proportion of grade 2 (≥ 160/100 mmHg or grade 3 hypertension (≥ 180/110 mmHg ranged from 29.2% (Namibia to 43.3% (Nigeria. Control of hypertension ranged from 2.6% in Kenya to 17.8% in Namibia. Obesity prevalence (BMI ≥ 30 ranged from 6.1% (Nigeria to 17.4% (Tanzania and together with age and gender, BMI independently predicted blood pressure level in all study populations. Diabetes prevalence ranged from 2.1% (Namibia to 3.7% (Tanzania. CONCLUSION: Hypertension was the most frequently observed risk factor for CVD in both urban and rural communities in SSA and will contribute to the growing burden of CVD in SSA. Low levels of control of hypertension are alarming. Strengthening of health
Huong, Le Thi Thanh; Long, Tran Khanh; Van Anh, Tran Thi; Tuyet-Hanh, Tran Thi; Giang, Kim Bao; Hai, Phan Thi; Huyen, Doan Thu; Khue, Luong Ngoc; Lam, Nguyen Tuan; Nga, Pham Quynh; Quan, Nguyen The; Linh, Tran Nu Quy; Ha, Nguyen Thanh; Van Minh, Hoang
The Law on Tobacco Control and the Law on Advertisement prohibit the advertising of any tobacco product in Vietnam. Tobacco promotion and marketing are alsostrictly prohibited. However, the violation of tobacco adverting and promotion is still common in Vietnam. This article aims at describing the exposure to tobacco advertising and promotion among the population aged 15+ years in Vietnam based on the data from the Global Adult Tobacco Survey 2015 from the view of the community, identifying any possible associations between the exposure to tobacco advertising and promotion and other individual factors, and discussing its possible public health implications. A cross-sectional study with the nationwide scale. Secondary data from the Global Adult Tobacco Survey 2015 was explored and analyzed. Chi-square test and multivariate logistic regressions were applied in the data analysis. The most common type of adults' exposure to tobacco advertising and promotion was points of sale (8.6%); 9.8% adults exposure to one source of tobacco advertising and 4.0% of them exposed to one source of tobacco promotion. Around 13.3% of Vietnamese adults were exposed to tobacco advertisement, while 2.0% were exposed to tobacco promotion, 5.3% were exposed to both tobacco advertising and promotion, and 16.6% were exposed to tobacco advertising or promotion. Gender, educational level, age, occupation, marital status, socioeconomic status, location (urban, rural), and current smoking status were associated with the exposure to tobacco advertising, tobacco promotion, tobacco advertising and promotion, and tobacco advertising or promotion. Although there are comprehensive bans on tobacco advertising and promotion in Vietnam, adults aged 15+ years still reported their exposure to tobacco advertising and promotion. There should be a strict enforcement of the ban on tobacco advertising and promotion in Vietnam.
Sebastian Martinuzzi; William A. Gould; Olga M. Ramos Gonzalez; Maya Quinones; Michael E. Jimenez
We have developed three land use regions for Puerto Rico: Urban, Suburban, and Rural (Gould et al. 2008; Martinuzzi et al. 2007). These three regions can also be considered urban, densely-populated rural, and sparsely-populated rural or as urban and wildland with a wildland-urban interface. The suburban use is the most dynamic in terms of population growth and land...
Amoah, Padmore Adusei; Edusei, Joseph; Amuzu, David
Communities and individuals in many sub-Saharan African countries often face limited access to healthcare. Hence, many rely on social networks to enhance their chances for adequate health care. While this knowledge is well-established, little is known about the nuances of how different population groups activate these networks to improve access to healthcare. This paper examines how rural and urban dwellers in the Ashanti Region in Ghana distinctively and systematically activate their social networks to enhance access to healthcare. It uses a qualitative cross-sectional design, with in-depth interviews of 79 primary participants (28 urban and 51 rural residents) in addition to the views of eight community leaders and eight health personnel. It was discovered that both intimate and distanced social networks for healthcare are activated at different periods by rural and urban residents. Four main stages of social networks activation, comprising different individuals and groups were observed among rural and urban dwellers. Among both groups, physical proximity, privacy, trust and sense of fairness, socio-cultural meaning attached to health problems, and perceived knowledge and other resources (mainly money) held in specific networks inherently influenced social network activation. The paper posits that a critical analysis of social networks may help to tailor policy contents to individuals and groups with limited access to healthcare.
Saw, S-M; Husain, R; Gazzard, G M; Koh, D; Widjaja, D; Tan, D T H
Aim: To determine the prevalence rates and major contributing causes of low vision and blindness in adults in a rural setting in Indonesia Methods: A population based prevalence survey of adults 21 years or older (n=989) was conducted in five rural villages and one provincial town in Sumatra, Indonesia. One stage household cluster sampling procedure was employed where 100 households were randomly selected from each village or town. Bilateral low vision was defined as habitual VA (measured using tumbling “E” logMAR charts) in the better eye worse than 6/18 and 3/60 or better, based on the WHO criteria. Bilateral blindness was defined as habitual VA worse than 3/60 in the better eye. The anterior segment and lens of subjects with low vision or blindness (both unilateral and bilateral) (n=66) were examined using a portable slit lamp and fundus examination was performed using indirect ophthalmoscopy. Results: The overall age adjusted (adjusted to the 1990 Indonesia census population) prevalence rate of bilateral low vision was 5.8% (95% confidence interval (CI) 4.2 to 7.4) and bilateral blindness was 2.2% (95% CI 1.1 to 3.2). The rates of low vision and blindness increased with age. The major contributing causes for bilateral low vision were cataract (61.3%), uncorrected refractive error (12.9%), and amblyopia (12.9%), and the major cause of bilateral blindness was cataract (62.5%). The major causes of unilateral low vision were cataract (48.0%) and uncorrected refractive error (12.0%), and major causes of unilateral blindness were amblyopia (50.0%) and trauma (50.0%). Conclusions: The rates of habitual low vision and blindness in provincial Sumatra, Indonesia, are similar to other developing rural countries in Asia. Blindness is largely preventable, as the major contributing causes (cataract and uncorrected refractive error) are amenable to treatment. PMID:12928268
Considered is the ration of rural population of arctic regions and Byelorussian-Ukrainian woodlands. The peculiarity of the nitrition structure of the population in the North is a relatively large contribution of deer meat in the ration. The main amount of 137 Cs contribution with other food stuffs and drinking water in the ration of population of this area does not exceed 10 %. The main supplier of 137 Cs in the ration of population of woodlands is milk which constitutes 70 %. The second place is taken by potatoes. The role and significance of separate food stuffs as 137 Cs suppliers in the ration in the zones with increased migration can be different; the leading role in this process is played by natural factors
Fernandez, J; Blanca, M; Soriano, V; Sanchez, J; Juarez, C
Systemic allergic reactions to Hymenoptera venom occur in a percentage that varies from 0.4 to 3.3%. Epidemiological studies indicate that from 15 to 25% of the general population can be sensitized to different Hymenoptera venom as well as the fact that the degree of exposure may be related to the prevalence found in those studies. The objective of this study was to evaluate the prevalence of insect sting allergy and the venom sensitization in a rural population to three Hymenoptera previously found in the area: Polistes dominulus (Pd), Vespula germanica (Vg) and honey bee (Hb). A rural community located in the south-east of Spain, close to the Mediterranean Sea, was selected since the stinging Hymenoptera having been previously identified. A random sample of 310 subjects from the village census was studied. A questionnaire and a serum sample were obtained from every patient. The evaluation was conducted by a family doctor, who focused on the reactions to Hymenoptera sting, age, sex, occupation, atopia, previous Hymenoptera sting, stinging insect, interval to last sting and average stings per year. RAST to Hymenoptera venoms were also determined. The prevalence of systemic reactions was 2.3% (57.6% of them had a positive RAST). Large local reactions were found in 26.4% (only 28.5% of them had a positive RAST). Asymptomatic sensitization (positive RAST) was observed in 16.4% of subjects without reaction. Only a weak correlation between subjects with less than 3 years' interval to last sting exposure and positive RAST results was noted, whether they presented with a clinical reaction or not (P < 0.05). The prevalence of systemic sting reactions in our rural community is higher than other general populations in the same Mediterranean area, and similar to other rural populations studied. The degree of exposure influences not only the prevalence found but also the detection of specific serum IgE.
Full Text Available Abstract Background Estimation of maternal mortality is difficult in developing countries without complete vital registration. The indirect sisterhood method represents an alternative in places where there is high fertility and mortality rates. The objective of the current study was to estimate maternal mortality indices using the sisterhood method in a rural district in south-west Ethiopia. Method We interviewed 8,870 adults, 15–49 years age, in 15 randomly selected rural villages of Bonke in Gamo Gofa. By constructing a retrospective cohort of women of reproductive age, we obtained sister units of risk exposure to maternal mortality, and calculated the lifetime risk of maternal mortality. Based on the total fertility for the rural Ethiopian population, the maternal mortality ratio was approximated. Results We analyzed 8503 of 8870 (96% respondents (5262 [62%] men and 3241 ([38%] women. The 8503 respondents reported 22,473 sisters (average = 2.6 sisters for each respondent who survived to reproductive age. Of the 2552 (11.4% sisters who had died, 819 (32% occurred during pregnancy and childbirth. This provided a lifetime risk of 10.2% from pregnancy and childbirth with a corresponding maternal mortality ratio of 1667 (95% CI: 1564–1769 per 100,000 live births. The time period for this estimate was in 1998. Separate analysis for male and female respondents provided similar estimates. Conclusion The impoverished rural area of Gamo Gofa had very high maternal mortality in 1998. This highlights the need for strengthening emergency obstetric care for the Bonke population and similar rural populations in Ethiopia.
Miller, Gregory E; Chen, Edith; Yu, Tianyi; Brody, Gene H
Some of the country's highest rates of morbidity and mortality from cardiovascular disease are found in lower-income black communities in the rural Southeast. Research suggests these disparities originate in the early decades of life, and partly reflect the influence of broader socioeconomic forces acting on behavioral and biological processes that accelerate cardiovascular disease progression. However, this hypothesis has not been tested explicitly. Here, we examine metabolic syndrome (MetS) in rural black young adults as a function of their family's economic conditions before and after the Great Recession. In an ongoing prospective study, we followed 328 black youth from rural Georgia, who were 16 to 17 years old when the Great Recession began. When youth were 25, we assessed MetS prevalence using the International Diabetes Federation's guidelines. The sample's overall MetS prevalence was 18.6%, but rates varied depending on family economic trajectory from before to after the Great Recession. MetS prevalence was lowest (10.4%) among youth whose families maintained stable low-income conditions across the Recession. It was intermediate (21.8%) among downwardly mobile youth (ie, those whose families were lower income before the Recession, but slipped into poverty). The highest MetS rates (27.5%) were among youth whose families began the Recession in poverty, and sank into more meager conditions afterwards. The same patterns were observed with 3 alternative MetS definitions. These patterns suggest that broader economic forces shape cardiometabolic risk in young blacks, and may exacerbate disparities already present in this community. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
Full Text Available Reformation of the economy of Ukraine today determines the necessity of development of the agrarian sector as a cornerstone of economic growth. Transformational processes contribute to the increase in gross output of agricultural production, export capacity building of the branch but, unfortunately, it has little effect on the socioeconomic development of rural areas and raising the level of well-being of the rural population. Underdevelopment of social infrastructure of rural areas especially significantly affects the quality of life in rural areas. Most of the Ukrainian villages are lacking preschool institutions, schools, medical outpatient clinics, emergency medical services, and other centres of social infrastructure. Living conditions in rural areas remain unfavourable. As a consequence, a need arises to search for a complex approach to the solution of problems of rural development, which is based on principles of sustainable development. The purpose of the article is to study the state of rural areas in Ukraine and Vinnytsia region based on the use of SWOT-analysis and to determine perspective tools for the further promotion of rural development. Methodology. When writing the article, the authors used a monographic method with the purpose of revealing cause-and-effect relations; an economic-statistical method for the analysis of a number of population; a graphical method for building schemes and diagrams; conclusions and recommendations are formulated by using abstract-logical method; methods of analysis and synthesis are used for conducting SWOTanalysis. Results. As a result of conducted research, approaches of foreign and domestic scientists to the definition of “rural areas” are studied and, on its basis, the authors present the main signs peculiar to rural areas and propose the author’s definition for a category of “rural areas.” Research of the modern state of rural areas on the basis of using SWOT-analysis is done
Full Text Available ABSTRACT Objective To analyse the nutritional status of the adult population in Esmeraldas by means of anthropometric measurements, the input of macro and micronutrients in the diet, and the adequacy estimation of nutrient intake by hispanic Dietary Reference Instakes along with the sex and the age influence. Methods Nutrient intake data were obtained by personal interview with the application of two 24 hour recalls (weekend and weekday. The anthropometric indicators analysed were body mass index, waist circumference and blood pressure. Nutriplato version 2.0 software was used for the two 24-hours food recall surveys data processing, and for the respective calculations of macronutrients, micronutrients and Dietary Reference Intakes. Means and standard deviations were calculated for anthropometry, nutrient intakes and Dietary Reference Instakes. The General Linear Model was applied to identify differences in relation to nutrient intakes considering sex, profession, body mass index, group, origin and day of the week as factors. Results Statistical analysis showed significant differences mainly in carbohydrates, fiber, calcium, phosphorus, iron, sodium, iodine, and vitamin E. Dietary intakes were compared with the Federación Española de Sociedades de Nutrición, Alimentación y Dietética Dietary Reference Intakes requirements and calcium, potassium, iodine, riboflavin, pantothenic acid, biotin, vitamin D, vitamin E, fiber, monounsaturated fatty acids and polyunsaturated fatty acids are below the Dietary Reference Instakes in all ages and gender subgroups. The anthropometric results obtained indicated that 67.0% of the population were overweight and obese, the 87.7% of the adults suffered from prehypertension and the waist circumference indicated that 73.0% of the subjects were established in the range of high risk of cardiovascular disease. Conclusion Priority nutrition actions and interventions are needed to be developed in Esmeraldas adult
Full Text Available The inspiration that drove us to this study is that conventional tourism in Albania is focused more on promoting seaside, cultural tourism, luxury resorts, etc. which has demonstrated a good trend. At the same time, specific parts of the country have been abandoned due to their underdeveloped situation. Given their assets as constructed and indigenous habitat, they progressively appear as regions for rural tourism development. It could provide good development opportunities in remote mountainous areas that every day more are abandoned by the population because they do not have enough employment opportunities. But as for other rural areas which have a great potential for development of rural tourism, they are not preferred by the population either to live because they do not have developed agriculture. They do not provide the opportunity to earn enough money to live on at the appropriate standard. So the development of rural tourism would help the population in such areas to diversify their activities and earn some extra income, motivating inhabitants to stay in their own areas. Overall, it would contribute to the balanced development of the regions of Albania.
Full Text Available Plasma homocysteine (Hcy is a modifiable, independent risk factor for cardiovascular disease (CVD and is affected by both environmental and genetic factors. This study aimed to describe the gender- and age-specific distribution of Hcy concentration for 1117 subjects aged 10–66 years, a subset of a community-based rural Chinese twin cohort. In addition, we examined environmental and genetic contributions to variances in Hcy concentration by gender and age groups. We found that the distribution pattern for Hcy varied by both age and gender. Males had higher Hcy than females across all ages. Elevated Hcy was found in 43% of male adults and 13% of female adults. Moreover, nearly one fifth of children had elevated Hcy. Genetic factors could explain 52%, 36% and 69% of the variation in Hcy concentration among children, male adults and female adults, respectively. The MTHFR C677T variant was significantly associated with Hcy concentrations. Smokers with the TT genotype had the highest Hcy levels. Overall, our results indicate that elevated Hcy is prevalent in the children and adults in this rural Chinese population. The early identification of elevated Hcy will offer a window of opportunity for the primary prevention of CVD and metabolic syndrome.
Full Text Available We aimed to determine the association of atherogenic index of plasma (AIP with hyperuricemia (HUA in the rural population of northeast China. This cross-sectional study was conducted in the rural areas of northeast China from January 2012 to August 2013, and the final analysis included data obtained form 5253 men and 6092 women. 1104 participants (9.7% suffered from HUA. Spearman rank test showed that AIP was positively correlated with uric acid in both sexes (r = 0.310 for men and r = 0.347 for women, both p < 0.001. AIP was classified into three groups: the low (<0.11, the intermediate (0.11–0.21 and the increased (>0.21 risk. The prevalence of HUA increased with AIP. Multivariate logistic regression analysis showed that, compared to the low AIP group, participants in increased AIP group had a 2.536-fold risk for HUA (2.164-fold in male and 2.960-fold in female after adjustment for covariates. Results of receiver operating characteristic curves showed that the area under the curve (95% confidence intervals was 0.686 (0.665–0.707 for male and 0.730 (0.706–0.755 for female. We indicated that increased AIP was associated with higher serum uric acid levels and could be identified as an independent risk factor of HUA in the rural population of northeast China.
Rodrigo M. Carrillo-Larco
Full Text Available Background. Sleep duration, either short or long, has been associated with diseases such as obesity, type-2 diabetes and cardiovascular diseases. Characterizing the prevalence and patterns of sleep duration at the population-level, especially in resource-constrained settings, will provide informative evidence on a potentially modifiable risk factor. The aim of this study was to explore the patterns of sleep duration in the Peruvian adult and adolescent population, together with its socio-demographic profile.Material and Methods. A total of 12,424 subjects, mean age 35.8 years (SD ±17.7, 50.6% males, were included in the analysis. This is a cross-sectional study, secondary analysis of the Use of Time National Survey conducted in 2010. We used weighted means and proportions to describe sleep duration according to socio-demographic variables (area and region; sex; age; education attainment; asset index; martial and job status. We used Poisson regressions, taking into account the multistage sampling design of the survey, to calculate crude and adjusted prevalence ratios (PR and 95% confidence intervals (95% CI. Main outcomes were short- (<6 h and long-sleep duration (≥ 9 h.Results. On average, Peruvians slept 7.7 h (95% CI [7.4–8.0] on weekdays and 8.0 h (95% CI [7.8–8.1] during weekends. The proportions of short- and long-sleep, during weekdays, were 4.3% (95% CI [2.9%–6.3%] and 22.4% (95% CI [14.9%–32.1%], respectively. Regarding urban and rural areas, a much higher proportion of short-sleep was observed in the former (92.0% vs. 8.0%; both for weekdays and weekends. On the multivariable analysis, compared to regular-sleepers (≥ 6 to <9 h, short-sleepers were twice more likely to be older and to have higher educational status, and 50% more likely to be currently employed. Similarly, relative to regular-sleep, long-sleepers were more likely to have a lower socioeconomic status as per educational attainment.Conclusions. In this
Full Text Available BACKGROUND: To improve HIV prevention and care programs, it is important to understand the uptake of HIV testing and to identify population segments in need of increased HIV testing. This is particularly crucial in countries with concentrated HIV epidemics, where HIV prevalence continues to rise in the general population. This study analyzes determinants of HIV testing in a rural Vietnamese population in order to identify potential access barriers and areas for promoting HIV testing services. METHODS: A population-based cross-sectional survey of 1874 randomly sampled adults was linked to pregnancy, migration and economic cohort data from a demographic surveillance site (DSS. Multivariate logistic regression analysis was used to determine which factors were associated with having tested for HIV. RESULTS: The age-adjusted prevalence of ever-testing for HIV was 7.6%; however 79% of those who reported feeling at-risk of contracting HIV had never tested. In multivariate analysis, younger age (aOR 1.85, 95% CI 1.14-3.01, higher economic status (aOR 3.4, 95% CI 2.21-5.22, and semi-urban residence (aOR 2.37, 95% CI 1.53-3.66 were associated with having been tested for HIV. HIV testing rates did not differ between women of reproductive age who had recently been pregnant and those who had not. CONCLUSIONS: We found low testing uptake (6% among pregnant women despite an existing prevention of mother-to-child HIV testing policy, and lower-than-expected testing among persons who felt that they were at-risk of HIV. Poverty and residence in a more geographically remote location were associated with less HIV testing. In addition to current HIV testing strategies focusing on high-risk groups, we recommend targeting HIV testing in concentrated HIV epidemic settings to focus on a scaled-up provision of antenatal testing. Additional recommendations include removing financial and geographic access barriers to client-initiated testing, and encouraging provider
Pharris, Anastasia; Nguyen, Thi Kim Chuc; Tishelman, Carol; Brugha, Ruairí; Nguyen, Phuong Hoa; Thorson, Anna
To improve HIV prevention and care programs, it is important to understand the uptake of HIV testing and to identify population segments in need of increased HIV testing. This is particularly crucial in countries with concentrated HIV epidemics, where HIV prevalence continues to rise in the general population. This study analyzes determinants of HIV testing in a rural Vietnamese population in order to identify potential access barriers and areas for promoting HIV testing services. A population-based cross-sectional survey of 1874 randomly sampled adults was linked to pregnancy, migration and economic cohort data from a demographic surveillance site (DSS). Multivariate logistic regression analysis was used to determine which factors were associated with having tested for HIV. The age-adjusted prevalence of ever-testing for HIV was 7.6%; however 79% of those who reported feeling at-risk of contracting HIV had never tested. In multivariate analysis, younger age (aOR 1.85, 95% CI 1.14-3.01), higher economic status (aOR 3.4, 95% CI 2.21-5.22), and semi-urban residence (aOR 2.37, 95% CI 1.53-3.66) were associated with having been tested for HIV. HIV testing rates did not differ between women of reproductive age who had recently been pregnant and those who had not. We found low testing uptake (6%) among pregnant women despite an existing prevention of mother-to-child HIV testing policy, and lower-than-expected testing among persons who felt that they were at-risk of HIV. Poverty and residence in a more geographically remote location were associated with less HIV testing. In addition to current HIV testing strategies focusing on high-risk groups, we recommend targeting HIV testing in concentrated HIV epidemic settings to focus on a scaled-up provision of antenatal testing. Additional recommendations include removing financial and geographic access barriers to client-initiated testing, and encouraging provider-initiated testing of those who believe that they are at-risk of
Lin, Elizabeth; Balogh, Robert; McGarry, Caitlin; Selick, Avra; Dobranowski, Kristin; Wilton, Andrew S; Lunsky, Yona
Describe the prevalence of substance-related and addictive disorders (SRAD) in adults with intellectual and developmental disabilities (IDD) and compare the sociodemographic and clinical characteristics of adults with IDD and SRAD to those with IDD or SRAD only. Population-based cohort study (the Health Care Access Research and Development Disabilities (H-CARDD) cohort). All legal residents of Ontario, Canada. 66 484 adults, aged 18-64, with IDD identified through linked provincial health and disability income benefits administrative data from fiscal year 2009. 96 589 adults, aged 18-64, with SRAD but without IDD drawn from the provincial health administrative data. Sociodemographic (age group, sex, neighbourhood income quintile, rurality) and clinical (psychiatric and chronic disease diagnoses, morbidity) characteristics. The prevalence of SRAD among adults with IDD was 6.4%, considerably higher than many previous reports and also higher than found for adults without IDD in Ontario (3.5%). Among those with both IDD and SRAD, the rate of psychiatric comorbidity was 78.8%, and the proportion with high or very high overall morbidity was 59.5%. The most common psychiatric comorbidities were anxiety disorders (67.6%), followed by affective (44.6%), psychotic (35.8%) and personality disorders (23.5%). These adults also tended to be younger and more likely to live in the poorest neighbourhoods compared with adults with IDD but no SRAD and adults with SRAD but no IDD. SRAD is a significant concern for adults with IDD. It is associated with high rates of psychiatric and other comorbidities, indicating that care coordination and system navigation may be important concerns. Attention should be paid to increasing the recognition of SRAD among individuals with IDD by both healthcare and social service providers and to improving staff skills in successfully engaging those with both IDD and SRAD. Published by the BMJ Publishing Group Limited. For permission to use (where not
Taype-Rondan, Alvaro; Bernabe-Ortiz, Antonio; Alvarado, Germán F; Gilman, Robert H; Smeeth, Liam; Miranda, J Jaime
Previous studies have found mixed results about cigarette and alcohol consumption patterns among rural-to-urban migrants. Moreover, there are limited longitudinal data about consumption patterns in this population. As such, this study aimed to compare the smoking and heavy drinking prevalence among rural, urban, and rural-to-urban migrants in Peru, as well as the smoking and heavy drinking incidence in a 5-year follow-up. We analyzed the PERU MIGRANT Study data from rural, urban, and rural-to-urban migrant populations in Peru. The baseline study was carried out in 2006-2007 and follow-up was performed five years later. For the baseline data analysis, the prevalence of lifetime smoking, current smokers, and heavy drinking was compared by population group using prevalence ratios (PR) and 95% confidence intervals (95% CI). For the longitudinal analysis, the incidence of smoking and heavy drinking was compared by population group with risk ratios (RR) and 95% CI. Poisson regression with robust variance was used to calculate both PRs and RRs. We analyzed data from 988 participants: 200 rural dwellers, 589 migrants, and 199 urban dwellers. Compared with migrants, lifetime smoking prevalence was higher in the urban group (PR = 2.29, 95% CI = 1.64-3.20), but lower in the rural group (PR = 0.55, 95% CI = 0.31-0.99). Compared with migrants, the urban group had a higher current smoking prevalence (PR = 2.29, 95% CI = 1.26-4.16), and a higher smoking incidence (RR = 2.75, 95% CI = 1.03-7.34). Current smoking prevalence and smoking incidence showed no significant difference between rural and migrant groups. The prevalence and incidence of heavy drinking was similar across the three population groups. Our results show a trend in lifetime smoking prevalence (urban > migrant > rural), while smoking incidence was similar between migrant and rural groups, but higher in the urban group. In addition, our results suggest that different
Full Text Available Abstract Background Previous studies have found mixed results about cigarette and alcohol consumption patterns among rural-to-urban migrants. Moreover, there are limited longitudinal data about consumption patterns in this population. As such, this study aimed to compare the smoking and heavy drinking prevalence among rural, urban, and rural-to-urban migrants in Peru, as well as the smoking and heavy drinking incidence in a 5-year follow-up. Methods We analyzed the PERU MIGRANT Study data from rural, urban, and rural-to-urban migrant populations in Peru. The baseline study was carried out in 2006–2007 and follow-up was performed five years later. For the baseline data analysis, the prevalence of lifetime smoking, current smokers, and heavy drinking was compared by population group using prevalence ratios (PR and 95% confidence intervals (95% CI. For the longitudinal analysis, the incidence of smoking and heavy drinking was compared by population group with risk ratios (RR and 95% CI. Poisson regression with robust variance was used to calculate both PRs and RRs. Results We analyzed data from 988 participants: 200 rural dwellers, 589 migrants, and 199 urban dwellers. Compared with migrants, lifetime smoking prevalence was higher in the urban group (PR = 2.29, 95% CI = 1.64–3.20, but lower in the rural group (PR = 0.55, 95% CI = 0.31–0.99. Compared with migrants, the urban group had a higher current smoking prevalence (PR = 2.29, 95% CI = 1.26–4.16, and a higher smoking incidence (RR = 2.75, 95% CI = 1.03–7.34. Current smoking prevalence and smoking incidence showed no significant difference between rural and migrant groups. The prevalence and incidence of heavy drinking was similar across the three population groups. Conclusions Our results show a trend in lifetime smoking prevalence (urban > migrant > rural, while smoking incidence was similar between migrant and rural groups, but higher in the
Hendriks, Marleen E; Wit, Ferdinand W N M; Akande, Tanimola M; Kramer, Berber; Osagbemi, Gordon K; Tanovic, Zlata; Gustafsson-Wright, Emily; Brewster, Lizzy M; Lange, Joep M A; Schultsz, Constance
IMPORTANCE Hypertension is a major public health problem in sub-Saharan Africa, but the lack of affordable treatment and the poor quality of health care compromise antihypertensive treatment coverage and outcomes. OBJECTIVE To report the effect of a community-based health insurance (CBHI) program on blood pressure in adults with hypertension in rural Nigeria. DESIGN, SETTING, AND PARTICIPANTS We compared changes in outcomes from baseline (2009) between the CBHI program area and a control area in 2011 through consecutive household surveys. Households were selected from a stratified random sample of geographic areas. Among 3023 community-dwelling adults, all nonpregnant adults (aged ≥18 years) with hypertension at baseline were eligible for this study. INTERVENTION Voluntary CBHI covering primary and secondary health care and quality improvement of health care facilities. MAIN OUTCOMES AND MEASURES The difference in change in blood pressure from baseline between the program and the control areas in 2011, which was estimated using difference-in-differences regression analysis. RESULTS Of 1500 eligible households, 1450 (96.7%) participated, including 564 adults with hypertension at baseline (313 in the program area and 251 in the control area). Longitudinal data were available for 413 adults (73.2%) (237 in the program area and 176 in the control area). Baseline blood pressure in respondents with hypertension who had incomplete data did not differ between areas. Insurance coverage in the hypertensive population increased from 0% to 40.1% in the program area (n = 237) and remained less than 1% in the control area (n = 176) from 2009 to 2011. Systolic blood pressure decreased by 10.41 (95% CI, -13.28 to -7.54) mm Hg in the program area, constituting a 5.24 (-9.46 to -1.02)-mm Hg greater reduction compared with the control area (P = .02), where systolic blood pressure decreased by 5.17 (-8.29 to -2.05) mm Hg. Diastolic blood pressure decreased by 4.27 (95
Full Text Available The burden of dyslipidaemia is rising in many low income countries. However, there are few data on the prevalence of, or risk factors for, dyslipidaemia in Africa.In 2011, we used the WHO Stepwise approach to collect cardiovascular risk data within a general population cohort in rural south-western Uganda. Dyslipidaemia was defined by high total cholesterol (TC ≥ 5.2 mmol/L or low high density lipoprotein cholesterol (HDL-C 6% (men aOR=3.00, 95%CI=1.37-6.59; women aOR=2.74, 95%CI=1.77-4.27. The odds of high TC was also higher among married men, and women with higher education or high BMI.Low HDL-C prevalence in this relatively young rural population is high whereas high TC prevalence is low. The consequences of dyslipidaemia in African populations remain unclear and prospective follow-up is required.
Thomas A. Gaziano
Full Text Available Abstract Background A consequence of the widespread uptake of anti-retroviral therapy (ART is that the older South African population will experience an increase in life expectancy, increasing their risk for cardiometabolic diseases (CMD, and its risk factors. The long-term interactions between HIV infection, treatment, and CMD remain to be elucidated in the African population. The HAALSI cohort was established to investigate the impact of these interactions on CMD morbidity and mortality among middle-aged and older adults. Methods We recruited randomly selected adults aged 40 or older residing in the rural Agincourt sub-district in Mpumalanga Province. In-person interviews were conducted to collect baseline household and socioeconomic data, self-reported health, anthropometric measures, blood pressure, high-sensitivity C-reactive protein (hsCRP, HbA1c, HIV-status, and point-of-care glucose and lipid levels. Results Five thousand fifty nine persons (46.4% male were enrolled with a mean age of 61.7 ± 13.06 years. Waist-to-hip ratio was high for men and women (0.92 ± 0.08 vs. 0.89 ± 0.08, with 70% of women and 44% of men being overweight or obese. Blood pressure was similar for men and women with a combined hypertension prevalence of 58.4% and statistically significant increases were observed with increasing age. High total cholesterol prevalence in women was twice that observed for men (8.5 vs. 4.1%. The prevalence of self-reported CMD conditions was higher among women, except for myocardial infarction, and women had a statistically significantly higher prevalence of angina (10.82 vs. 6.97% using Rose Criteria. The HIV− persons were significantly more likely to have hypertension, diabetes, or be overweight or obese than HIV+ persons. Approximately 56% of the cohort had at least 2 measured or self-reported clinical co-morbidities, with HIV+ persons having a consistently lower prevalence of co-morbidities compared to those without
Fenger, R V; Linneberg, A; Tvede, M
The incidence of Clostridium difficile-associated infections is increasing, but it remains to be defined whether any change in the seroprevalence of C. difficile has also occurred. In a population-based study of the general adult population, 734 subjects, aged 15-69 years, were examined on two...... occasions 8 years apart (1990 and 1998) for the presence of antibodies against C. difficile in serum. The overall seroprevalence of C. difficile increased significantly from 19% in 1990 to 27% in 1998 (P... was about four times higher in 1998 than in 1990. In conclusion, the observed increase in seroprevalence suggests a higher exposure to C. difficile in the general Danish adult population....
Full Text Available Abstract Background The home and neighborhood environments may be important in obesity prevention by virtue of food availability, food preparation, cues and opportunities for physical activity, and family support. To date, little research has examined how home and neighborhood environments in rural communities may support or hinder healthy eating and physical activity. This paper reports characteristics of rural homes and neighborhoods related to physical activity environments, availability of healthy foods, and family support for physical activity and maintaining an ideal body weight. Methods In-depth interviews were conducted with 60 African American and White adults over 50 years of age in two rural counties in Southwest Georgia. Interviews were transcribed verbatim and coded independently by two members of the research team using standard methods of qualitative analysis. Themes were then identified and data matrices were used to identify patterns by gender or race. Results Neighborhood features that supported physical activity were plenty of land, minimal traffic and living in a safe and friendly neighborhood. The major barrier was lack of recreational facilities. The majority of participants were not physically active with their family members due to schedule conflicts and lack of time. Family member-initiated efforts to encourage physical activity met with mixed results, with refusals, procrastination, and increased activity all reported. Participants generally reported it was easy to get healthy foods, although cost barriers and the need to drive to a larger town for a supermarket with good variety were noted as obstacles. Family conversations about weight had occurred for about half of the participants, with reactions ranging from agreement about the need to lose weight to frustration. Conclusion This study suggests that successful environmental change strategies to promote physical activity and healthy eating in rural neighborhoods may
Glasgow, Nina; Brown, David L.
This paper examines rural population ageing in the United States with a particular focus on the contrasting contexts in which older rural residents live. We compare the characteristics of the older population by rural versus urban residence, and explore challenges and opportunities associated with the ageing of rural baby boomers. The United…
Tay, T. T.; Low, Raymond; Loke, H. J.; Chua, Y. L.; Goh, Y. H.
The proliferation of robotic technologies in recent years brings robots closer to humanities. There are many researches on going at various stages of development to bring robots into our homes, schools, nurseries, elderly care centres, offices, hospitals and factories. With recently developed robots having tendency to have appearance which increasingly displaying similarities to household animals and humans, there is a need to study the existence of uncanny valley phenomenon. Generally, the acceptance of people toward robots increases as the robots acquire increasing similarities to human features until a stage where people feel very uncomfortable, eerie, fear and disgust when the robot appearance become almost human like but not yet human. This phenomenon called uncanny valley was first reported by Masahiro Mori. There are numerous researches conducted to measure the existence of uncanny valley in Japan and European countries. However, there is limited research reported on uncanny valley phenomenon in Malaysia so far. In view of the different cultural background and exposure of Malaysian population to robotics technology compared to European or East Asian populations, it is worth to study this phenomenon in Malaysian context. The main aim of this work is to conduct a preliminary study to determine the existence of uncanny valley phenomenon in Malaysian urban and rural populations. It is interesting to find if there are any differences in the acceptance of the two set of populations despite of their differences. Among others the urban and rural populations differ in term of the rate of urbanization and exposure to latest technologies. A set of four interactive robotic faces and an ideal human model representing the fifth robot are used in this study. The robots have features resembling a cute animal, cartoon character, typical robot and human-like. Questionnaire surveys are conducted on respondents from urban and rural populations. Survey data collected are
H. Ken Cordell; Vahé Heboyan; Florence Santos; John C. Bergstrom
Research has suggested that significant relationships exist between rural population change and natural amenities. Thus, understanding and predicting domestic migration trends as a function of changes in natural amenities is important for effective regional growth and development policies and strategies. In this study, we first estimated an econometric model which...
Sigurdardottir, Arun K; Arnadottir, Solveig Asa; Gunnarsdottir, Elín Díanna
To describe medication use among older community-dwelling Icelanders by collecting information on number of medicine, polypharmacy (>5 medications), and medications by ATC categories. Moreover, to explore the relationship between medication use and various influential factors emphasizing residency in urban and rural areas. Population-based, cross-sectional study. Participants were randomly selected from the National registry in one urban (n=118) and two rural (n=68) areas. 1) ≥ 65 years old, 2) community-dwelling, 3) able to communicate verbally. Information on medication use was obtained from each person's medication list and interviews. A questionnaire and five standardized instruments were used to assess the potential influencing factors. On average, participants used 3.9 medications and prevalence of polypharmacy was 41%. Men used 3.5 medications on average and women 4.4 (p=0.018). Compared to rural residents, urban residents had fewer medical diagnoses, better mobility, less pain, and fewer depressive symptoms. By controlling for the effects of these variables, more medications were associated with urban living (pbetter scores on health assessments.
Abshire, Demetrius A; Lennie, Terry A; Mudd-Martin, Gia T; Moser, Debra K
The prevalence of obesity is greater among adults living in rural compared to urban areas of the USA. Greater obesity risk among rural adults persists after adjusting for obesity-related behaviors and sociodemographic factors. With the rural-urban obesity disparity greatest among younger adults, it is important to examine the complexity of factors that may increase the risk for excess body weight in this population so that effective preventive interventions can be implemented. College students residing in economically deprived rural areas such as rural Appalachia may be particularly at risk for excess body weight from exposure to both rural and college obesogenic environments. The purpose of this study was to determine if living in economically distressed rural Appalachia is independently associated with excess body weight among college students. College students aged 18-25 years who were lifetime residents of either rural Eastern Appalachian Kentucky (n=55) or urban Central Kentucky (n=54) participated in this cross-sectional study. Students completed questionnaires on sociodemographics, depressive symptoms, and health behaviors including smoking, f