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Sample records for rural chiropractic practice

  1. Danish Chiropractic Practice

    DEFF Research Database (Denmark)

    Myburgh, Cornelius; Boyle, Eleanor; Christensen, Henrik Wulff

    Objectives: To develop a contemporary, patient-oriented perspective of chiropractic private practice, as reflected by the setting, practice models and clinical interactions observable in Denmark. Methods: A qualitative point-of-view investigation was conducted making use of participant observation......, face-to-face interviews and video analysis. Data was analysed for content and thematic emergence. Results: A purposive sampling framework yielded 11 clinic sites, representative of prevalent practice models. Data collected over a 6-month period included interviews with 60 patients, 22 health care...... value competence and professionalism in their clinical encounter with their chiropractor. Conclusion: Danish chiropractic practice is strongly influenced by modern consumer behaviour and team-oriented practice trends. Furthermore, the administrative hub plays an important role in operationalizing...

  2. Chiropractic Use by Urban and Rural Residents with Insurance Coverage

    Science.gov (United States)

    Lind, Bonnie K.; Diehr, Paula K.; Grembowski, David E.; Lafferty, William E.

    2009-01-01

    Purpose: To describe the use of chiropractic care by urban and rural residents in Washington state with musculoskeletal diagnoses, all of whom have insurance coverage for this care. The analyses investigate whether restricting the analyses to insured individuals attenuates previously reported differences in the prevalence of chiropractic use…

  3. Contemporary chiropractic practice in the UK: a field study of a chiropractor and his patients in a suburban chiropractic clinic

    OpenAIRE

    Hennius, Bjorn J

    2013-01-01

    Background Two recent surveys of chiropractors in Great Britain suggest that there are discrepancies between chiropractic practice as defined in regulatory guidelines and day-to-day chiropractic clinical practice and there is in general a paucity of information regarding the characteristics of contemporary chiropractic practice in the United Kingdom. This field study describes the daily practice of a contemporary British UK-trained chiropractor. Methods The fieldwork took place during the spr...

  4. The use of diagnostic coding in chiropractic practice

    DEFF Research Database (Denmark)

    Testern, Cecilie D; Hestbæk, Lise; French, Simon D

    2015-01-01

    of chiropractors about diagnostic coding and explore the use of it in a chiropractic setting. A secondary aim was to compare the diagnostic coding undertaken by chiropractors and an independent coder. METHOD: A codin exercise based on the International Classification of Primary Care version 2, PLUS extension (ICPC...... of agreement between the chiropractors and the coder was determined and Cohen's Kappa was used to determine the agreement beyond that expected by chance. RESULTS: From the interviews the three emerging themes were: 1) Advantages and disadvantages of using a clinical coding system in chiropractic practice, 2......) ICPC-2 PLUS terminology issues for chiropractic practice and 3) Implementation of a coding system into chiropractic practice. The participating chiropractors did not uniformly support or condemn the idea of using diagnostic coding. However there was a strong agreement that the terminology in ICPC-2...

  5. Prevalence of hip osteoarthritis in chiropractic practice in denmark

    DEFF Research Database (Denmark)

    Poulsen, Erik; Christensen, Henrik W; Overgaard, Søren

    2012-01-01

    The purposes of this study were to measure the prevalence of clinical and radiographic hip osteoarthritis (OA) and first-time diagnosis of hip OA in consecutive patients presenting to chiropractic practices in Denmark and to report the components of the initial treatment rendered by the chiroprac......The purposes of this study were to measure the prevalence of clinical and radiographic hip osteoarthritis (OA) and first-time diagnosis of hip OA in consecutive patients presenting to chiropractic practices in Denmark and to report the components of the initial treatment rendered...

  6. The perceptions, attitudes and knowledge of physiotherapy and chiropractic students regarding each others’ professional practice

    Directory of Open Access Journals (Sweden)

    N. Naidoo

    2009-02-01

    Full Text Available Introduction: The roles of physiotherapists and chiropractors demon-strate some overlap. Both are members of a multidisciplinary team and contributeto the holistic care of patients. Good understanding of each others’ professionalpractice may lead to good working relationships with effective referrals, inter -disciplinary and multidisciplinary management of patients. Purpose: To investigate the perceptions, attitudes and knowledge of undergraduatephysiotherapy and chiropractic students about each others’ professional roles inclinical practice. Methodology: Data was obtained using a questionnaire with closed and open-ended questions. First and final-yearphysiotherapy (n = 72 and chiropractic students (n = 49 participated. Results: First and final year physiotherapy students scored 58% and 62% respectively in the “test” on chiropractic;chiropractic students scored 52% and 68% respectively in the test on physiotherapy. Seventy percent of the chiropractic and 14% of the physiotherapy students had visited the practice of other profession. Sixty seven percent of the chiropractic and 38% of the physiotherapy students found it was effective. Forty seven percent chiropractic and 80% physiotherapy students considered physiotherapy and chiropractic to be in direct competition. Sixty six percentof the chiropractic students and 49% of the physiotherapy students expressed the intention of working together withthe other profession.  Discussion: The reason for the possible feelings of competitiveness could be because in South A frica there is vastoverlap of practice in both professions; Physiotherapists and chiropractors are seen to use modalities that are similar.This may be viewed as an indication of the importance in defining the roles, scope and characteristics of both physio-therapy and chiropractic.Conclusion: The knowledge of the physiotherapy and chiropractic students is equal, however, chiropractic studentshave more positive perceptions

  7. A description of children and adolescents in Danish chiropractic practice: results from a nationwide survey

    DEFF Research Database (Denmark)

    Hestbaek, Lise; Jørgensen, Anette; Hartvigsen, Jan

    2009-01-01

    OBJECTIVE: The purpose of this study was to describe Danish chiropractic patients younger than 18 years. METHODS: Questionnaires were mailed to all chiropractic clinics in Denmark during a randomly assigned month between September 2007 and September 2008. All patients younger than 18 years....... CONCLUSIONS: Babies made up most of the Danish chiropractic patients younger than 18 years. Among the older children and the adolescents, musculoskeletal complaints were most common and mostly of a chronic nature. The large number of pediatric patients in chiropractic practices and the paucity of evidence...

  8. Chiropractic Health Care: A National Study of Cost of Education, Service Utilization, Number of Practicing Doctors of Chiropractic, and Other Key Policy Issues. Volumes I-II.

    Science.gov (United States)

    von Kuster, Thomas, Jr.

    Results from the first federally sponsored study of the chiropractic health care profession are presented, and a broad range of facts and issues of concern to policy-makers, the profession, and the public are described. The two-year project included three national surveys of: service providers (doctors of chiropractic in practice more than two…

  9. Self-reported recognition of undiagnosed life threatening conditions in chiropractic practice: a random survey

    Directory of Open Access Journals (Sweden)

    Daniel Dwain M

    2012-07-01

    Full Text Available Abstract Background The purpose of this study was to identify the type and frequency of previously undiagnosed life threatening conditions (LTC, based on self-reports of chiropractic physicians, which were first recognized by the chiropractic physician. Additionally this information may have a preliminary role in determining whether chiropractic education provides the knowledge necessary to recognize these events. Methods The study design was a postal, cross-sectional, epidemiological self-administered survey. Two thousand Doctors of Chiropractic in the US were randomly selected from a list of 57878. The survey asked respondents to state the number of cases from the list where they were the first physician to recognize the condition over the course of their practice careers. Space was provided for unlisted conditions. Results The response rate was 29.9%. Respondents represented 11442 years in practice and included 3861 patients with a reported undiagnosed LTC. The most commonly presenting conditions were in rank order: carcinoma, abdominal aneurysm, deep vein thrombosis, stroke, myocardial infarction, subdural hematoma and a large group of other diagnoses. The occurrence of a previously undiagnosed LTC can be expected to present to the chiropractic physician every 2.5 years based on the responding doctors reports. Conclusion Based on this survey chiropractic physicians report encountering undiagnosed LTC’s in the normal course of practice. The findings of this study are of importance to the chiropractic profession and chiropractic education. Increased awareness and emphasis on recognition of LTC is a critical part of the education process and practice life.

  10. Historical influence on the practice of chiropractic radiology: part II - thematic analysis on the opinions of diplomates of the American Chiropractic College of Radiology about the future.

    Science.gov (United States)

    Young, Kenneth J

    2017-01-01

    Over the past 20 years, various authors have addressed the question of the future of chiropractic. Most were positive about the future, with some advocating evidence-based practice and integration with mainstream healthcare, some advocating continued separation with an emphasis on subluxation-based care or the traditional/historical paradigm of chiropractic, and some calling for tolerance and unity. No papers were found specifically inquiring about the future of chiropractic radiology. The study population consisted of all current members of the American Chiropractic College of Radiology (ACCR), estimated at 190 people, known as chiropractic radiologists or Diplomates of the American Chiropractic Board of Radiology (DACBRs). An internet-based, anonymous survey using SurveyMonkey was implemented, supplemented by hard copies distributed at a conference. The main point of interest for this paper is the final item of the overall questionnaire. This item inquired about the future of chiropractic radiology. Thematic analysis was used on the responses, coded in both constructionist and inductive ways to extract both a general outlook and more specific themes. The inductive themes were also assigned secondarily to a SWOT (strengths, weaknesses, opportunities, and threats) analysis. The overall response rate to the survey was 38% (73/190); within the group of respondents, 71 of 73 (98%) answered the item that is the subject of this paper. Opinions on the outlook for chiropractic radiology in the future were more negative than positive, with 14 respondents giving a positive outlook, 26 negative, and 14 non-committal. 28 respondents advocated integration with the wider healthcare community, 11 recommended emphasising separateness or a focus on working within chiropractic, and 15 did not express an opinion on this issue. Ten strengths were noted, 11 weaknesses, 57 opportunities, and 30 threats. The increasing necessity of demonstrating evidence for diagnostic and therapeutic

  11. Who uses Australian chiropractic services?

    Science.gov (United States)

    French, Simon D; Densley, Konstancja; Charity, Melanie J; Gunn, Jane

    2013-09-26

    The use of chiropractic services is widespread, however, little is known about the characteristics of people who seek chiropractic care in Australia. This study compared the characteristics of users and non-users of chiropractic services from a cohort of patients sourced from general medical practice in Victoria, Australia. This is a secondary analysis of baseline screening data from a prospective adult cohort study beginning in 2005. Thirty randomly selected Australian general medical practices mailed out surveys to 17,780 of their patients. Differences were examined between chiropractic users and others, and between chiropractic users who reported a back problem to those who did not. Of 7,519 respondents, 15% indicated they had visited a chiropractor in the last 12 months. Chiropractic users were more likely to have their GP located in a rural location and to be born in Australia; they were less likely to be in the older age group (55-76), to be unemployed or to have a pension/benefit as their main source of income. Chiropractic users were more likely to: have a back problem; use complementary or alternative medication; visit another type of complementary health practitioner or a physiotherapist. They were less likely to take medication for certain health problems (e.g. for high blood pressure, high cholesterol or asthma). No important differences were seen between chiropractic users and non-users for other health problems. People who visited a chiropractor and reported a back problem were more likely to: be a current smoker; have a number of other chronic conditions, including arthritis, hypertension, chronic sinusitis, asthma, dermatitis, depression and anxiety; report taking medications, including antidepressants, analgesics (painkillers and arthritis medication) and complementary or alternative medications. This large cross-sectional study of general medical practice attendees suggests that chiropractors are the most commonly consulted complementary health

  12. Chiropractic: a critical evaluation.

    Science.gov (United States)

    Ernst, Edzard

    2008-05-01

    Chiropractic was defined by D.D. Palmer as "a science of healing without drugs." About 60,000 chiropractors currently practice in North America, and, worldwide, billions are spent each year for their services. This article attempts to critically evaluate chiropractic. The specific topics include the history of chiropractic; the internal conflicts within the profession; the concepts of chiropractic, particularly those of subluxation and spinal manipulation; chiropractic practice and research; and the efficacy, safety, and cost of chiropractic. A narrative review of selected articles from the published chiropractic literature was performed. For the assessment of efficacy, safety, and cost, the evaluation relied on previously published systematic reviews. Chiropractic is rooted in mystical concepts. This led to an internal conflict within the chiropractic profession, which continues today. Currently, there are two types of chiropractors: those religiously adhering to the gospel of its founding fathers and those open to change. The core concepts of chiropractic, subluxation and spinal manipulation, are not based on sound science. Back and neck pain are the domains of chiropractic but many chiropractors treat conditions other than musculoskeletal problems. With the possible exception of back pain, chiropractic spinal manipulation has not been shown to be effective for any medical condition. Manipulation is associated with frequent mild adverse effects and with serious complications of unknown incidence. Its cost-effectiveness has not been demonstrated beyond reasonable doubt. The concepts of chiropractic are not based on solid science and its therapeutic value has not been demonstrated beyond reasonable doubt.

  13. Chiropractic practice in the Danish public health care sector

    DEFF Research Database (Denmark)

    Myburgh, Corrie

    2009-01-01

    and defined. Furthermore, a contextually relevant definition of an integral health care service is presented; and the professional importance for chiropractic in providing such services is also discussed. Finally, salient questions requiring empirical investigation in this context are posed; and selected...

  14. Practice analysis of chiropractic radiology: identifying items for part I of the clinical competency examination.

    Science.gov (United States)

    Smith, Sara Dawn; Beran, Tanya N

    2012-01-01

    The purpose of this study was to describe the current scope of practice of chiropractic radiologists by identifying frequent tasks conducted as well as those conditions most often seen and those that present the greatest risk of harm to patients. A mixed-methods approach was used. An online survey was conducted with 91 diplomates listed with the American Chiropractic Board of Radiology. Participants rated the frequency of tasks they perform and conditions they see on a 5-point scale from "never" to "daily." They also rated the level of risk each condition presents to patients on a 5-point scale from "no risk" to "severe risk." Frequency and risk ratings were then presented in rank order to 22 subject matter experts at 3 focus groups. The most frequent task reported was writing radiology reports (mean [SD], 4.29 [1.58]). Ratings of the frequency of conditions seen in practice and the risk they present to patients were ranked from the highest to lowest for frequency and risk separately. The most frequent conditions seen were reportedly those with structural or joint derangement; the highest risk conditions seen are those that are systemic. Focus group members recommended that some conditions receive higher rankings and that certain conditions be recategorized for future practice analyses. This study helps to define the current scope of practice of chiropractic radiologists and identify frequent tasks and conditions. These results inform the development of a new test outline for Part I of the chiropractic radiology certification examination to ensure that examinees are tested on the most important conditions chiropractic radiologists see in practice. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  15. Health Promotion Practices in Two Chiropractic Teaching Clinics

    Science.gov (United States)

    Ndetan, Harrison; Evans, Marion Willard; Lo, Kaming; Walters, David; Ramcharan, Michael; Brandon, Patricia; Evans, Cathy; Rupert, Ronald

    2010-01-01

    Purpose: To retrospectively review patient files in two teaching clinics in the United States and to assess the documented attempts to deliver health promotion messages when a chart indicated a need for health promotion or a red-flag condition that could be helped with positive behavioral changes. Methods: Approximately 100 patient files were randomly selected from each of two separate chiropractic teaching clinics, for patients seen after January 2007. Files were assessed for pertinent family history of diseases, personal medical history, and red-flag conditions of patients that would warrant intervention with health promotion. Results: Health promotion advice on at least one occasion was noted in 108 (53.7%) patient charts. Only 7 of 98 overweight or obese patients and none of those with family history of obesity were advised on weight management. Among 23 hypertensive patients, only 5 were advised and 17 of the 97 patients with risk of cardiovascular disease were advised. Conclusion: Chiropractic teaching clinics should assess what they are doing to help Americans reach their health goals. There is an opportunity to shape future practitioners so they include primary prevention as a part of what they do if the profession cares to move in that direction. Future research should look at mechanisms of delivery for health promotion, including better tracking of patients who need it and how staff doctors are trained to deliver oversight to interns in the area of primary prevention. PMID:21048878

  16. Chiropractic Handbook.

    Science.gov (United States)

    New York State Education Dept., Albany. Office of the Professions.

    This reference guide contains laws, regulations, and licensing requirements and procedures governing chiropractic practice in New York State. Following a general introduction to professional regulation in New York State, licensure requirements are spelled out in detail, including general requirements, education requirements, examination…

  17. Sport Concussion Knowledge and Clinical Practices: A Survey of Doctors of Chiropractic With Sports Certification.

    Science.gov (United States)

    Moreau, William J; Nabhan, Dustin C; Walden, Taylor

    2015-09-01

    The purpose of this study is to describe the knowledge base and clinical practices regarding concussion by sports-certified doctors of chiropractic. A 21-item survey was distributed to the 312 attendees of the 2014 American Chiropractic Board of Sports Physicians Sports Sciences Symposium. Results were measured by frequency analysis and descriptive statistics for all surveys completed by sports-certified chiropractors. Seventy-six surveys were returned by sports-certified doctors of chiropractic. All (N = 76) 100% of respondents believe that the evaluation of concussion should be performed by a health care provider with training in concussion. The respondents actively assess and manage concussion in adults (96%), adolescents (95%), and children (75%). A majority (79%) of respondents believe that the Sideline Concussion Assessment Tool-3 represents a current standard of care for the sideline evaluation of the athlete who possibly has sustained a sport concussion. Most respondents agreed or strongly agreed that manual therapies may be appropriate in certain circumstances in adults (80%) and minors (80%). This cross section of certified sports chiropractors strongly believes that the evaluation of concussion should be performed by a health care provider with specific training in concussion. A high percentage of the sports-certified chiropractors who responded assess and manage sport concussion in their practice, and many of them endorse the use of the Sideline Concussion Assessment Tool-3 as a sideline assessment tool.

  18. Health care encounters in Danish chiropractic practice from a consumer perspectives - a mixed methods investigation.

    Science.gov (United States)

    Myburgh, Corrie; Boyle, Eleanor; Larsen, Johanne Brinch; Christensen, Henrik Wulff

    2016-01-01

    Perceived value is the key ingredient to carving and maintaining a competitive business niche. The opportunities to interact with consumers to understand and enhance perceived value are termed 'touch points'. Due to the out-of-pocket expense incurred by patients, Danish chiropractors are subject to consumer trends and behaviors. The purpose of this investigation was to explore and describe consumer touch points relevant to perceived value through healthcare journeys in chiropractic practices. We designed a convergent parallel, mixed methods study. Our purposive sampling framework identified 11 chiropractic clinics from which we collected observational field notes, video recordings and face-to-face interviews. Data was collected between April 14(th) and June 26(th) 2014. We described the exteriors and interiors of all participant clinics, interviewed 32 staff members, 12 new patients and 36 follow-up patients and finally video recorded 11 new and 24 follow-up consultations. Categorization and analysis led to the emergence six consumer touch point themes: 'the internet', 'the physical environment', 'practice models', 'administrative staff', 'the consultation sequence and timing' and 'a consultation that adds value'. The Internet functions as a tool when choosing/confirming a clinic as appropriate, developing and initial image and managing appointments. The administrative hub appears integral to the shaping of positive consumer experiences outside of the consultation. Clinic location, practice model and interior design may contribute to context effects and thus may influence value perception during the clinical encounter. The duration of hands-on treatment received from the chiropractor is not an apparent consumer focus point. Rather, through a seven stage clinical procedure patients value consultations with clinicians who demonstrate professional competence by effective communication diagnosis/management and facilitating satisfactory treatment outcomes. At least six

  19. Clinical decision-making to facilitate appropriate patient management in chiropractic practice: 'the 3-questions model'

    Directory of Open Access Journals (Sweden)

    Amorin-Woods Lyndon G

    2012-03-01

    Full Text Available Abstract Background A definitive diagnosis in chiropractic clinical practice is frequently elusive, yet decisions around management are still necessary. Often, a clinical impression is made after the exclusion of serious illness or injury, and care provided within the context of diagnostic uncertainty. Rather than focussing on labelling the condition, the clinician may choose to develop a defendable management plan since the response to treatment often clarifies the diagnosis. Discussion This paper explores the concept and elements of defensive problem-solving practice, with a view to developing a model of agile, pragmatic decision-making amenable to real-world application. A theoretical framework that reflects the elements of this approach will be offered in order to validate the potential of a so called '3-Questions Model'; Summary Clinical decision-making is considered to be a key characteristic of any modern healthcare practitioner. It is, thus, prudent for chiropractors to re-visit the concept of defensible practice with a view to facilitate capable clinical decision-making and competent patient examination skills. In turn, the perception of competence and trustworthiness of chiropractors within the wider healthcare community helps integration of chiropractic services into broader healthcare settings.

  20. Clinical decision-making to facilitate appropriate patient management in chiropractic practice: 'the 3-questions model'.

    Science.gov (United States)

    Amorin-Woods, Lyndon G; Parkin-Smith, Gregory F

    2012-03-14

    A definitive diagnosis in chiropractic clinical practice is frequently elusive, yet decisions around management are still necessary. Often, a clinical impression is made after the exclusion of serious illness or injury, and care provided within the context of diagnostic uncertainty. Rather than focussing on labelling the condition, the clinician may choose to develop a defendable management plan since the response to treatment often clarifies the diagnosis. This paper explores the concept and elements of defensive problem-solving practice, with a view to developing a model of agile, pragmatic decision-making amenable to real-world application. A theoretical framework that reflects the elements of this approach will be offered in order to validate the potential of a so called '3-Questions Model'; Clinical decision-making is considered to be a key characteristic of any modern healthcare practitioner. It is, thus, prudent for chiropractors to re-visit the concept of defensible practice with a view to facilitate capable clinical decision-making and competent patient examination skills. In turn, the perception of competence and trustworthiness of chiropractors within the wider healthcare community helps integration of chiropractic services into broader healthcare settings.

  1. A narrative review of medical, chiropractic, and alternative health practices in the treatment of primary dysmenorrhea.

    Science.gov (United States)

    Spears, Lolita G

    2005-01-01

    Primary dysmenorrhea and related issues are discussed as they influence the gynecological and social health of females during adolescence, adulthood, and senior maturity. Health practitioners are exposed to multiple approaches towards the management of menstrual pain. Clinical and social viewpoints target the causation, development, diagnosis, manifestation and management of primary dysmenorrhea. This narrative review includes the topic of the doctor-patient relationship in efforts of cultivating effectively communicative health practitioners. Controversial topics related to primary dysmenorrhea and the quality of life for women are addressed. A search for literature reviews, case studies, laboratory research, and clinical trials from 1985-2004 was performed using the MEDLINE database. Sources of additional information included textbooks, national organizational literature and contemporary articles. Menstrual pain is a prevalent experience yet it is socially taboo for conversation; as such, it poses a hindrance to its management. The communication between the doctor and patient is a critical barrier point between establishing a diagnosis and determining an appropriate treatment plan. A multi-disciple treatment plan varies as much as patients themselves vary in personal experiences, needs, and preferences. Medicinal prophylactics, physical therapeutics, non-acidic diets, herbal supplements, eastern therapies and the chiropractic manual adjustments of the spine are effective methods for the management of primary dysmenorrhea. The non-invasive management of primary dysmenorrhea includes the chiropractic adjustment with complimentary modalities, and other alternative health care practices. Medicinal prophylactics are invasive and pose a higher risk to long-term chemical exposure, side effects or irreversible conditions.

  2. Chiropractic Adjustment

    Science.gov (United States)

    ... syndrome) A certain type of stroke (vertebral artery dissection) after neck manipulation Don't seek chiropractic adjustment ... Chiropractic treatment. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015. Shekelle P, et al. Spinal ...

  3. An audit of health products advertised for sale on chiropractic Web sites in Canada and consideration of these practices in the context of Canadian chiropractic codes of ethics and conduct.

    Science.gov (United States)

    Page, Stacey A; Grod, Jaroslaw P

    2009-01-01

    This study describes the extent to which chiropractors with Web sites practicing in Canada advertise health products for sale and considers this practice in the context of chiropractic codes of ethics and conduct. Chiropractic Web sites in Canada were identified using a public online business directory (Canada 411). The Web sites were searched, and an inventory of the health products for sale was taken. The influences of type of practice and province of practice on the sale of health product were assessed. Textual comments about health product marketing were summarized. National and provincial codes of ethics were reviewed, and the content on health product advertising was summarized. Two hundred eighty-seven Web sites were reviewed. Just more than half of the Web sites contained information on health products for sale (n = 158, 54%). Orthotics were advertised most often (n = 136 practices, 47%), followed by vitamins/nutritional supplements (n = 53, 18%), pillows and supports (n = 40, 14%), and exercise/rehabilitation products (n = 20, 7%). Chiropractors in solo or group chiropractic practices were less likely to advertise health products than those in multidisciplinary practice (P ethics and conduct varied in their guidelines regarding health product sales. Variations in codes of ethics and in the proportions of practitioners advertising health products for sales across the country suggest that opinions may be divided on the acceptability of health product sales. Such practices raise questions and considerations for the chiropractic profession.

  4. The efficacy of the homoeopathic similimum on musculoskeletal pain in UJ chiropractic students as a result of practicing adjustments

    OpenAIRE

    2013-01-01

    M.Tech. (Homeopathy) Students of Chiropractic, attending the University of Johannesburg (UJ), start the practical component of their training from their third year of study (Bunge & Tyranes, 2007). Each student must be proficient in 250 adjustments (200 of which must be spinal) by the end of their fifth year of study (Fletcher et al., 2005). As these manual manipulations are complex psychomotor skills, they require a good deal of practice to master (Bunge & Tyranes, 2007). Due to the pract...

  5. A narrative review of medical, chiropractic, and alternative health practices in the treatment of primary dysmenorrhea

    Science.gov (United States)

    Spears, Lolita G.

    2005-01-01

    Abstract Objective Primary dysmenorrhea and related issues are discussed as they influence the gynecological and social health of females during adolescence, adulthood, and senior maturity. Health practitioners are exposed to multiple approaches towards the management of menstrual pain. Clinical and social viewpoints target the causation, development, diagnosis, manifestation and management of primary dysmenorrhea. This narrative review includes the topic of the doctor-patient relationship in efforts of cultivating effectively communicative health practitioners. Controversial topics related to primary dysmenorrhea and the quality of life for women are addressed. Data Sources A search for literature reviews, case studies, laboratory research, and clinical trials from 1985–2004 was performed using the MEDLINE database. Sources of additional information included textbooks, national organizational literature and contemporary articles. Discussion Menstrual pain is a prevalent experience yet it is socially taboo for conversation; as such, it poses a hindrance to its management. The communication between the doctor and patient is a critical barrier point between establishing a diagnosis and determining an appropriate treatment plan. A multi-disciple treatment plan varies as much as patients themselves vary in personal experiences, needs, and preferences. Conclusions Medicinal prophylactics, physical therapeutics, non-acidic diets, herbal supplements, eastern therapies and the chiropractic manual adjustments of the spine are effective methods for the management of primary dysmenorrhea. The non-invasive management of primary dysmenorrhea includes the chiropractic adjustment with complimentary modalities, and other alternative health care practices. Medicinal prophylactics are invasive and pose a higher risk to long-term chemical exposure, side effects or irreversible conditions. PMID:19674650

  6. A workforce survey of Australian chiropractic: the profile and practice features of a nationally representative sample of 2,005 chiropractors.

    Science.gov (United States)

    Adams, Jon; Lauche, Romy; Peng, Wenbo; Steel, Amie; Moore, Craig; Amorin-Woods, Lyndon G; Sibbritt, David

    2017-01-05

    This paper reports the profile of the Australian chiropractic workforce and characteristics of chiropractic care from a large nationally-representative sample of practitioners. A 21-item questionnaire examining practitioner, practice and clinical management characteristics was distributed to all registered chiropractors (n = 4,684) in Australia in 2015 via both online and hard copy mail out. The survey attracted a response rate of 43% (n = 2,005), and the sample is largely representative of the national chiropractic workforce on a number of key indicators. The average age of the chiropractors was 42.1 years, nearly two-thirds are male, and the vast majority hold a bachelor degree or higher qualification. Australian chiropractors are focused upon treating people across a wide age range who mainly present with musculoskeletal conditions. Australian chiropractors have referral relationships with a range of conventional, allied health and complementary medicine (CAM) providers. The chiropractic profession represents a substantial component of the contemporary Australian health care system with chiropractors managing an estimated 21.3 million patient visits per year. While the Australian chiropractic workforce is well educated, research engagement and research capacity remains sub-optimal and there is much room for further capacity building to help chiropractic reach full potential as a key integrated profession within an evidence-based health care system. Further rich, in-depth research is warranted to improve our understanding of the role of chiropractic within the Australian health care system.

  7. Medication prescription: a pilot survey of Bernese doctors of chiropractic practicing in Switzerland.

    Science.gov (United States)

    Wangler, Martin; Zaugg, Beatrice; Faigaux, Eric

    2010-01-01

    The purpose of this survey was to assess the use of and the attitude toward prescribing medication among doctors of chiropractic in 1 of 26 Swiss cantons. A Likert scale electronic questionnaire was sent to licensed doctors of chiropractic of the canton of Berne (n = 47). Percentages, mean values, and standard deviations were calculated. A follow-up survey was used to assess comments from the main survey. A probability value of P Bernese doctors of chiropractic perceived medications as a necessary component of their treatment, mainly using them to help patients who cannot sleep because of pain and to speed up recovery. When asked if they would be allowed to prescribe medications of the "B-list," the majority would want structured continuing education. Limited medication prescription was judged as an advantage for the chiropractic profession by this group of survey participants. Copyright 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  8. Chiropractic. State of the Art.

    Science.gov (United States)

    Schafer, R. C., Ed.

    The review covers: (1) the discipline (description, scientific theories and principles, its practice, contributions to the health field, and history); (2) the profession (a doctor profile, patients, students, and the American Chiropractic Association); (3) chiropractic education (colleges, career opportunities, standard basic curriculum,…

  9. The interrater reliability of an objective structured practical examination in measuring the clinical reasoning ability of chiropractic students.

    Science.gov (United States)

    Rose, Kevin A; Babajanian, Jesika

    2016-10-01

    The objective structured practical examination (OSPE) is a case-based assessment that can be used to assess the clinical reasoning ability of students. The reliability of using an OSPE for this purpose has not been reported in the literature. The objective of this study was to determine the interrater reliability of the OSPE in measuring the clinical reasoning ability of chiropractic students. Two examiners tested each student simultaneously when enough were available as a check for interrater reliability. The scores for students over 4 exam administrations were compiled, and we calculated an intraclass correlation coefficient (ICC) using 1-way random single measures. Paired scores were available for 133 students. The ICC was .685, showing a fair-to-good level of agreement for faculty in assessing the clinical reasoning ability of chiropractic students using an OSPE. The OSPE can be a valuable tool for testing clinical reasoning abilities because it can simulate the decision-making process that needs to be implemented in clinical practice. Faculty members at our chiropractic college were able to achieve an acceptable level of reliability in measuring the clinical reasoning abilities of students using an OSPE. Other health professional programs may consider using this tool for assessing the clinical reasoning skills of their students.

  10. Chiropractic manipulation for the foot: Diversified chiropractic techniques.

    Science.gov (United States)

    Lawrence, D J

    2001-05-01

    There has been increasing acceptance and development of manual methods in providing for the needs of patients with musculoskeletal dysfunction. Several professions have helped fuel this growth, including the chiropractic profession. To date, there has been only a small amount of collaboration between chiropractors and physical therapists. This paper provides a base foundation for one small part of general chiropractic practice, i.e. procedures used for manipulating the foot. Information is provided about the specific diagnostic procedures used by the chiropractic profession in assessing the joints and soft tissues of the foot, followed by descriptions of a number of chiropractic manipulative techniques drawn from the form of chiropractic in widest usage, Diversified technique. For each technique, information is provided on indications for use, patient position, therapist position, hand placements and procedure. In addition, a short discussion on the genesis of Diversified technique is provided.

  11. An Investigation into the Faculty Development Practices in Chiropractic Education Programs

    Science.gov (United States)

    Scaringe, John G.

    2010-01-01

    A descriptive case study design using a cross-sectional quantitative survey method was used to investigate the impact of faculty development programs on teaching effectiveness perceived by faculty teaching at chiropractic colleges in the United States. The availability of faculty development programs related to teaching and student learning was…

  12. Texas Chiropractic College Practice Management Education: The Patient's Point of View.

    Science.gov (United States)

    Waigandt, Alex; And Others

    A survey was conducted to determine the patient's perception of treatment received from clinicians at the Texas Chiropractic College Clinic in Pasadena, Texas. A questionnaire designed to assess various aspects of the school's clinical and dispensary services was administered to 79 patients who had completed their treatment prescriptions. The…

  13. Pregnant Students in the Gross Anatomy Laboratory: Policies and Practices at Chiropractic Colleges

    Science.gov (United States)

    Duray, Stephen M.; Mekow, Craig L.

    2011-01-01

    Chiropractic and medical colleges have experienced a significant increase in the number of female applicants in recent years, a percentage of whom are pregnant or become pregnant following admission. It is therefore important to ask the question: How do institutions that educate future health care providers address the issue of pregnancy and the…

  14. Chiropractic. New York State.

    Science.gov (United States)

    New York State Education Dept., Albany. Office of the Professions.

    A reference guide to laws, rules, and regulations that govern the chiropractic practice in New York State is presented. After an overview of professional regulation in the state, licensing requirements/procedures for chiropractors are described. Provisions of Title VIII, Articles 130 and 132, of the Education Law are also covered, along with…

  15. Chiropractic intern attitudes, beliefs, and future practice intentions with regard to health promotion, wellness, and preventive services.

    Science.gov (United States)

    Grand, Stephen; Morehouse-Grand, Kenice; Carter, Shane

    2016-10-01

    This pilot study explored the attitudes, beliefs, and intentions of a group of chiropractic interns concerning health promotion, wellness, and preventive services before and after a series of brief educational interventions. Interns completed a survey before (n = 37) and after (n = 22) the interventions. The survey included 12 Likert scale questions about attitudes and intentions toward wellness and health promotion models. The interventions consisted of classroom lectures, clinical training, and online information pertaining to health promotion and wellness. The interns initially favored wellness models, perceived a need for them, and felt partially prepared to administer them, with mean Likert scores 4 or greater on a 1 to 5 scale. Afterward, the average scores were higher and the interns reported some benefit from this short course of training. The initial survey demonstrated that interns had some understanding of wellness, health promotion, and preventive services, and favored utilization of these services. The follow-up survey suggested that a short educational intervention could have a positive impact on these attitudes and future utilization of wellness procedures in their practices.

  16. Chiropractic and children

    DEFF Research Database (Denmark)

    Leboeuf-Yde, Charlotte; Hestbæk, Lise

    2010-01-01

    briefly discuss how this should be handled in clinical practice is briefly discussed, using the concept of "traffic lights" (red, yellow, green). We explain how the combination of evidence and plausibility can be used to reach a decision as to whether a treatment or diagnostic procedure is suitable...... of problems were identified: the lack of research in general and the lack of research using the appropriate study designs and methodology in particular. Therefore, we discuss the meager research noted in the areas of chiropractic care in children and the clinical consequences this should have...

  17. Evidence-based practice in chiropractic practice: A survey of chiropractors' knowledge, skills, use of research literature and barriers to the use of research evidence.

    Science.gov (United States)

    Walker, B F; Stomski, N J; Hebert, J J; French, S D

    2014-04-01

    Scant research has been undertaken regarding chiropractors' skills and knowledge associated with evidence-based practice (EBP), and their perceived barriers to EBP. These issues appear to have been examined in only one small qualitative study and one small study of chiropractors holding orthopaedic diplomas. The lack of research in this area suggests that additional studies are warranted to develop a better understanding of factors that affect chiropractors' use of research evidence in clinical practice. We used a modified online questionnaire that captured information regarding EBP skills and knowledge, and barriers to EBP. Its adaption was informed by the use of a content validity panel. The questionnaire was disseminated through email by Australian chiropractic professional organisations and the Chiropractic Board of Australia. Logistic regression analyses were conducted to examine univariate associations between responses to items measuring knowledge and skills with items measuring: age; years since registration; reading research literature; and use of research literature in clinical decision-making. 584 respondents returned questionnaires. About half of the respondents stated they had learned the foundations of EBP (56.6%) during their undergraduate training. Slightly more than two thirds of the respondents were confident in their ability to critically review literature (69.5%) and find relevant research to answer clinical questions (72.6%). The most common factors involved with reading more research, and increased use of research literature in clinical decision-making, were confidence in critical appraisal skills and confidence in finding relevant research literature. Conclusion Educational interventions should be implemented to enhance Australian chiropractors' fundamental EBP skills. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Practice-based randomized controlled-comparison clinical trial of chiropractic adjustments and brief massage treatment at sites of subluxation in subjects with essential hypertension: pilot study.

    Science.gov (United States)

    Plaugher, Gregory; Long, Cynthia R; Alcantara, Joel; Silveus, Alyssa D; Wood, Herbert; Lotun, Kapildeo; Menke, J Michael; Meeker, William C; Rowe, Stephen H

    2002-05-01

    To determine the feasibility of conducting a randomized clinical trial in the private practice setting examining short- and long-term effects of chiropractic adjustments for subjects with essential hypertension compared with a brief soft tissue massage, as well as a nontreatment control group. Randomized controlled-comparison trial with 3 parallel groups. Private practice outpatient chiropractic clinic. Twenty-three subjects, aged 24 to 50 years with systolic or diastolic essential hypertension. Two months of full-spine chiropractic care (ie, Gonstead) consisting primarily of specific-contact, short-lever-arm adjustments delivered at motion segments exhibiting signs of subluxation. The massage group had a brief effleurage procedure delivered at localized regions of the spine believed to be exhibiting signs of subluxation. The nontreatment control group rested alone for a period of approximately 5 minutes in an adjustment room. Cost per enrolled subject, as well as systolic and diastolic blood pressure (BP) measured with a random-0 sphygmomanometer and patient reported health status (SF-36). Pilot study outcome measures also included an assessment of cooperation of subjects to randomization procedures and drop-out rates, recruitment effectiveness, analysis of temporal stability of BPs at the beginning of care, and the effects of inclusion/exclusion criteria on the subject pool. Thirty subjects enrolled, yielding a cost of $161 per enrolled subject. One subject was later determined to be ineligible, and 6 others dropped out. In both the chiropractic and massage therapy groups, all subjects were classified as either overweight or obese; in the control group there were only 2 classified as such. SF-36 profiles for the groups were similar to that of a normal population. The mean change in diastolic BP was -4 (95% confidence interval [CI]: -8.6, 0.5) in the chiropractic care group, 0.5 (95% CI: -3.5, 4.5) in the brief massage treatment group, and -4.9 (95% CI: -9.7, -0

  19. Health care encounters in Danish chiropractic practice from a consumer perspectives

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Boyle, Eleanor; Larsen, Johanne Brinch

    2016-01-01

    BACKGROUND: Perceived value is the key ingredient to carving and maintaining a competitive business niche. The opportunities to interact with consumers to understand and enhance perceived value are termed 'touch points'. Due to the out-of-pocket expense incurred by patients, Danish chiropractors...... patients and 36 follow-up patients and finally video recorded 11 new and 24 follow-up consultations. Categorization and analysis led to the emergence six consumer touch point themes: 'the internet', 'the physical environment', 'practice models', 'administrative staff', 'the consultation sequence and timing......' and 'a consultation that adds value'. The Internet functions as a tool when choosing/confirming a clinic as appropriate, developing and initial image and managing appointments. The administrative hub appears integral to the shaping of positive consumer experiences outside of the consultation. Clinic...

  20. Spine Care as a Framework for the Chiropractic Identity

    DEFF Research Database (Denmark)

    Schneider, Michael; Murphy, Donald; Hartvigsen, Jan

    2016-01-01

    OBJECTIVE: The purpose of this commentary is to provide an argument for the role and identity of chiropractors as spine care providers within the context of the greater health care system. DISCUSSION: Surveys of the general public and chiropractors indicate that the majority of patients seek...... globally. CONCLUSION: Although the chiropractic profession may debate internally about its professional identity, the chiropractic identity seems to have already been established by society, practice, legislation, and education as a profession of health care providers whose area of expertise is spine care....... chiropractic services for back and neck pain. Insurance company utilization data confirm these findings. Regulatory and legal language found in chiropractic practice acts reveals that most jurisdictions define the chiropractic scope of practice as based on a foundation of spine care. Educational accrediting...

  1. Educational Standards for Chiropractic Colleges.

    Science.gov (United States)

    Council on Chiropractic Education, Des Moines, IA.

    The policy of accreditation for the chiropractic profession and educational standards for chiropractic colleges are presented. The following types are historical development of chiropractic accreditation; the structure and function of the Council on Chiropractic Education; and eligibility, procedures, and classifications for status as an…

  2. A Chiropracticness Test

    Directory of Open Access Journals (Sweden)

    Charlton Keith H

    2005-11-01

    Full Text Available Abstract Background There is little homogeneity of opinion in the chiropractic profession about its essence and identity. Matters compromising the establishment of a coherent identity include the issue of vertebral subluxation, philosophy, mercantilism, poverty of qualifications in some chiropractic college faculty, and lack of intellectual productivity in some chiropractic college faculty. Discussion The Chiropractic profession has mislabeled rhetoric, supposition and cant as philosophy, whilst showing sparse evidence for the existence of more than a few chiropractors writing in philosophy as a discipline. There is no evidence for "Chiropractic Philosophy". I propose, however, that a better use of the discipline of philosophy can be of great use to the Chiropractic profession. Various thinkers throughout the ages have written about deduction, induction and falsificationism as methods to discover more reliably the nature of things in the world about us. Each method has strengths and frailties, but some of the latter are insurmountable for our purposes. Summary Using a contrivance of that method which seems most suited, sui generis, for the purpose, I propose a Chiropracticness Test as a tool to assist the search for essence and identity in Chiropractic.

  3. The concept of rural community practice (RCP).

    Science.gov (United States)

    Nielsen, N Ole; Evans, Brian; King, Lonnie J

    2006-01-01

    The need to devote more human resources to veterinary public practice to cope with escalating threats to biological security, public health, and economic prosperity, while also addressing societal value changes, has been widely recognized and supported. Most envisage increasing the numbers of veterinarians in government employment. Why not at least combine this initiative, wherever possible, with far greater involvement of rural practitioners to deliver contractual public-practice services and provide an enhanced community interface? This could make the difference between having a local practice in a community or none at all, as well as promising to be more cost effective. The concept of rural community practice (RCP) envisages combining traditional services provided in a "mixed-animal" veterinary practice with an expanded portfolio of public-practice and communication services that meet the emerging animal, public, and ecosystem health needs of the collective community, not just those of animal owners. These services could include those involving active sentinel surveillance programs for both domestic animal and wildlife diseases; on-farm food safety; bio-security; traceability and export certification and audit programs; disease investigation, including foreign animal diseases; surge capacity emergency response; managing for ecosystem health; and client and community education. An expanded practice team of animal-health professionals and technologists, led by veterinarians, would deliver these services. This RCP approach should have the potential to make rural practice more attractive from economic, lifestyle, and job-satisfaction perspectives; to enhance the visibility and recognition of the profession; and to respond to changing and new societal needs. It also promises to maintain a stable network of veterinary practices in rural communities. In addition, the recognition of veterinary medicine as a public good should provide for consideration of increased

  4. Chiropractic approach to the management of children

    Directory of Open Access Journals (Sweden)

    Miller Joyce

    2010-06-01

    Full Text Available Abstract Background Chiropractic (Greek: done by hand is a health care profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. There is an emphasis on manual techniques, including joint adjustment and/or manipulation, with a particular focus on joint subluxation (World Health Organization 2005 or mechanical lesion and restoring function. The chiropractor's role in wellness care, prevention and treatment of injury or illness is based on education in anatomy and physiology, nutrition, exercise and healthy lifestyle counseling as well as referral to other health practitioners. Depending on education, geographic location, scope of practice, as well as consumer preference, chiropractors may assume the role of primary care for families who are pursuing a more natural and holistic approach to health care for their families. Objective To present a perspective on current management of the paediatric patient by members of the chiropractic profession and to make recommendations as to how the profession can safely and effectively manage the paediatric patient. Discussion The chiropractic profession holds the responsibility of ethical and safe practice and requires the cultivation and mastery of both an academic foundation and clinical expertise that distinguishes chiropractic from other disciplines. Research into the effectiveness of chiropractic care for paediatric patients has lagged behind that of adult care, but this is being addressed through educational programs where research is now being incorporated into academic tracks to attain advanced chiropractic degrees. Conclusion Studies in the United States show that over the last several decades, chiropractors are the most common complementary and alternative medicine providers visited by children and adolescents. Chiropractors continue to seek integration with other healthcare providers to

  5. Patient characteristics in low back pain subgroups based on an existing classification system. A descriptive cohort study in chiropractic practice

    DEFF Research Database (Denmark)

    Eirikstoft, Heidi; Kongsted, Alice

    2014-01-01

    Sub-grouping of low back pain (LBP) is believed to improve prediction of prognosis and treatment effects. The objectives of this study were: (1) to examine whether chiropractic patients could be sub-grouped according to an existing pathoanatomically-based classification system, (2) to describe...... relevance of the classification system should be investigated by testing its value as a prognostic factor or a treatment effect modifier. It is recommended that this classification system be combined with psychological and social factors if it is to be useful....

  6. HEALTH PRACTICE AMONG RURAL TURKMANS

    Directory of Open Access Journals (Sweden)

    Z. Hooshvar

    1979-03-01

    Full Text Available The purpose of this study which has been conducted among 1864 heads of Turkmans households or their wives in the north-east of Iran in 1979 was to rind the type and frequency of health practices in a traditional society, and the relation between these practices and variables such as age sex, literacy use of mass media and spatial mobility. As the pilot study uncovered the scarcity of health installations such as hot bath, water supply, clinic, and hospital in the study area, therefore, two most common health practices-i.e. to take a bath and brush teeth-were studied in relation with aforementioned variables. Finding revealed that: 1 - Elders take more a bath and youths brush more their teeth, and in both groups males are at higher level than females. However, females brush their teeth more regular than males. 2- Both practices are being more performed by literates than illiterates. 3- Turkmans are in 1general fatalistic people. In this regard those who are more fatalistic usually take a bath once a year while in contrast less fatalistic individuals take it once a week. 4- In spite of very low level of health awareness among Turkmans, pains such as, headache and/or bellyache (pain in the stomach is a kind of illness from their point of view. However, such recognition did not affect their health practices. 5- Those who had some knowledge of pathogens (microbes, or supposed the fly is a diffuse of illness, were more concerned about their hygiene and took more care of it. 6- Use of mass media (radio was effective in introducing health practices among Turkmans. Radio listeners took a bath or brushed their teeth more regular than non-listeners.

  7. Health promotion practices in two chiropractic teaching clinics: does a review of patient files reflect advice on health promotion?

    Science.gov (United States)

    Ndetan, Harrison; Evans, Marion Willard; Lo, Kaming; Walters, David; Ramcharan, Michael; Brandon, Patricia; Evans, Cathy; Rupert, Ronald

    2010-01-01

    To retrospectively review patient files in two teaching clinics in the United States and to assess the documented attempts to deliver health promotion messages when a chart indicated a need for health promotion or a red-flag condition that could be helped with positive behavioral changes. Approximately 100 patient files were randomly selected from each of two separate chiropractic teaching clinics, for patients seen after January 2007. Files were assessed for pertinent family history of diseases, personal medical history, and red-flag conditions of patients that would warrant intervention with health promotion. Health promotion advice on at least one occasion was noted in 108 (53.7%) patient charts. Only 7 of 98 overweight or obese patients and none of those with family history of obesity were advised on weight management. Among 23 hypertensive patients, only 5 were advised and 17 of the 97 patients with risk of cardiovascular disease were advised. Chiropractic teaching clinics should assess what they are doing to help Americans reach their health goals. There is an opportunity to shape future practitioners so they include primary prevention as a part of what they do if the profession cares to move in that direction. Future research should look at mechanisms of delivery for health promotion, including better tracking of patients who need it and how staff doctors are trained to deliver oversight to interns in the area of primary prevention.

  8. Investigating Rural Teachers' Professional Development, Instructional Knowledge, and Classroom Practice

    Science.gov (United States)

    Glover, Todd A.; Nugent, Gwen C.; Chumney, Frances L.; Ihlo, Tanya; Shapiro, Edward S.; Guard, Kirra; Koziol, Natalie; Bovaird, Jim

    2016-01-01

    Teachers Speak was a national survey study designed to investigate the characteristics of rural elementary school teachers' existing professional development; differences in professional development practices between rural and non-rural settings; and the potential influence of professional development characteristics on rural teachers' knowledge,…

  9. Patient characteristics in low back pain subgroups based on an existing classification system. A descriptive cohort study in chiropractic practice

    DEFF Research Database (Denmark)

    Eirikstoft, Heidi; Kongsted, Alice

    2014-01-01

    reducible disc syndromes followed by facet joint pain, dysfunction and sacroiliac (SI)-joint pain. Classification was inconclusive in 5% of the patients. Differences in pain, activity limitation, and psychological factors were small across subgroups. Within 10 days, 82% were reported to belong to the same......Sub-grouping of low back pain (LBP) is believed to improve prediction of prognosis and treatment effects. The objectives of this study were: (1) to examine whether chiropractic patients could be sub-grouped according to an existing pathoanatomically-based classification system, (2) to describe...... patient characteristics within each subgroup, and (3) to determine the proportion of patients in whom clinicians considered the classification to be unchanged after approximately 10 days. A cohort of 923 LBP patients was included during their first consultation. Patients completed an extensive...

  10. The advanced registered nurse practitioner in rural practice.

    Science.gov (United States)

    Schmidt, L; Brandt, J; Norris, K

    1995-10-01

    Availability of health care to rural areas is limited. FNP's in rural practice have the ability to address rural needs and tailor interventions to the specific attributes of rural populations. The objective of this article is to define the role and the functions of the FNP and to support and defend this role in the rural setting. Much of the FNP research presented in the literature to date focuses on urban populations; therefore, the unique health care problems and needs of rural populations will first be defined as they relate to the FNP's scope of practice.

  11. Breastfeeding practices in urban and rural Vietnam

    Directory of Open Access Journals (Sweden)

    Thu Huong

    2012-11-01

    Full Text Available Abstract Background The aim of this study was to describe and compare breastfeeding practices in rural and urban areas of Vietnam and to study associations with possibly influencing person and household factors. This type of study has not been conducted in Vietnam before. Methods Totally 2,690 children, born from 1st March 2008 to 30th June 2010 in one rural and one urban Health and Demographic Surveillance Site, were followed from birth to the age of 12 months. Information about demography, economy and education for persons and households was obtained from household surveys. Standard statistical methods including survival and regression analyses were used. Results Initiation of breastfeeding during the first hour of life was more frequent in the urban area compared to the rural (boys 40% vs. 35%, girls 49% vs. 40%. High birth weight and living in households with large number of assets significantly increased the probability for early initiation of breastfeeding. Exclusive breastfeeding at three months of age was more commonly reported in the rural than in the urban area (boys 58% vs. 46%, girls 65% vs. 53%. The duration of exclusive breastfeeding as well as of any breastfeeding was longer in the rural area than in the urban area (medians for boys 97 days vs. 81 days, for girls 102 days vs. 91 days. The percentages of children with exclusive breastfeeding lasting at least 6 months, as recommended by WHO, were low in both areas. The duration of exclusive breastfeeding was significantly shorter for mothers with three or more antenatal care visits or Caesarean section in both areas. High education level of mothers was associated with longer duration of exclusive breastfeeding in the rural area. No significant associations were found between duration of exclusive breastfeeding and mother’s age, household economy indicators or household size. Conclusion Intervention programs with the aim to promote breastfeeding are needed. Mothers should

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

    Science.gov (United States)

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

    2016-12-07

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

  13. Patient characteristics in low back pain subgroups based on an existing classification system. A descriptive cohort study in chiropractic practice.

    Science.gov (United States)

    Eirikstoft, Heidi; Kongsted, Alice

    2014-02-01

    Sub-grouping of low back pain (LBP) is believed to improve prediction of prognosis and treatment effects. The objectives of this study were: (1) to examine whether chiropractic patients could be sub-grouped according to an existing pathoanatomically-based classification system, (2) to describe patient characteristics within each subgroup, and (3) to determine the proportion of patients in whom clinicians considered the classification to be unchanged after approximately 10 days. A cohort of 923 LBP patients was included during their first consultation. Patients completed an extensive questionnaire and were examined according to a standardised protocol. Based on the clinical examination, patients were classified into diagnostic subgroups. After approximately 10 days, chiropractors reported whether they considered the subgroup had changed. The most frequent subgroups were reducible and partly reducible disc syndromes followed by facet joint pain, dysfunction and sacroiliac (SI)-joint pain. Classification was inconclusive in 5% of the patients. Differences in pain, activity limitation, and psychological factors were small across subgroups. Within 10 days, 82% were reported to belong to the same subgroup as at the first visit. In conclusion, LBP patients could be classified according to a standardised protocol, and chiropractors considered most patient classifications to be unchanged within 10 days. Differences in patient characteristics between subgroups were very small, and the clinical relevance of the classification system should be investigated by testing its value as a prognostic factor or a treatment effect modifier. It is recommended that this classification system be combined with psychological and social factors if it is to be useful.

  14. Chiropractic and concussion in sport: a narrative review of the literature.

    Science.gov (United States)

    Johnson, Claire D; Green, Bart N; Nelson, Robert C; Moreau, Bill; Nabhan, Dustin

    2013-12-01

    Concussion is a common sporting injury that may be seen by doctors of chiropractic and should be managed following current practice guidelines. The purpose of this abstract is to present a literature review on chiropractic management of concussion in sport and to discuss current guidelines. A review of the literature was performed using the PubMed search engine. MeSH terms included chiropractic and concussion. Search dates were the beginning of the record through July 30, 2013. All languages and article types were included in the search. Articles found were retrieved and evaluated for the relevance of chiropractic management of concussion in sport. Five articles were found (1 prospective study, 1 survey, 3 literature reviews) ranging in publication years from 1993 to 2012. No articles reported a position statement, and none provided a review of current concussion management practices related to chiropractic practice. No articles reported adverse outcomes of chiropractic management of an athlete with concussion. Research related to the chiropractic management of concussion in sport is a nascent area of investigation. Although there are few published articles, the articles in this review showed that doctors of chiropractic encounter concussed athletes at events and in clinical practice. It is essential for doctors of chiropractic to understand the importance of using standardized concussion assessment tools and current concussion guidelines.

  15. Legislative approaches to the regulation of the chiropractic profession.

    Science.gov (United States)

    Chapman-Smith, D A

    1997-01-01

    Traditional and complementary health care services have a growing and significant role in both developed and developing countries. In the United Kingdom the British Medical Association (BMA) has identified five complementary approaches to health care that should now be regarded as "discrete clinical disciplines" because they have "established foundations of training and have the potential for greatest use alongside orthodox medical care". These are acupuncture, chiropractic, herbalism, homeopathy and osteopathy. The BMA recommended that there should be legislation to regulate these disciplines and the Chiropractors' Act enacted in the U.K in 1994. The chiropractic profession was founded in the United States in 1895, and the practice of chiropractic has been regulated in the United States and Canada since the 1920s, in Australia since the late 1940s, in New Zealand and South Africa since the 1960s, and more recently in Asia, Europe, Latin America and elsewhere. Figure 1 lists the countries which currently recognize and regulate the chiropractic profession. Many countries, such as Japan with approximately 10,000 chiropractors with different levels of education, and Trinidad & Tobago with 5 chiropractors who are graduates of accredited chiropractic colleges in North America, are considering legislation. Croatia, with 3 chiropractors, is preparing legislation. Cyprus, with 6 chiropractors, has legislation. Even in countries such as these, where the profession is small, there are compelling public interest arguments for regulation. This is especially true in the 1990s. One reason is the growing incentive for lay healers and others without formal training to use the title "chiropractor" as chiropractic practice gains increasing acceptance. The majority of chiropractic practice involves patients with non- specific or mechanical back and neck pain. The chiropractic approach to management, which includes spinal adjustment or manipulation, other physical treatments, postural

  16. Children and chiropractic care

    DEFF Research Database (Denmark)

    Hartvigsen, Jan; Hestbaek, Lise

    2009-01-01

    care profession has convincingly assumed the responsibility of spinal and musculoskeletal health for children. Considering the magnitude of the challenges ahead for both researchers and clinicians, this may be a good opportunity for doctors of chiropractic to take responsibility and engage...

  17. Training generalist doctors for rural practice in New Zealand.

    Science.gov (United States)

    Nixon, Garry; Blattner, Katharina; Williamson, Martyn; McHugh, Patrick; Reid, James

    2017-01-01

    Targeted postgraduate training increases the likelihood young doctors will take up careers in rural generalist medicine. This article describes the postgraduate pathways that have evolved for these doctors in New Zealand. The Cairns consensus statement 2014 defined rural medical generalism as a scope of practice that encompasses primary care, hospital or secondary care, emergency care, advanced skill sets and a population-based approach to the health needs of rural communities. Even as work goes on to define this role different jurisdictions have developed their own training pathways for these important members of the rural healthcare workforce. In 2002 the University of Otago developed a distance-taught postgraduate diploma aimed at the extended practice of rural general practitioners (GPs) and rural hospital medical officers. This qualification has evolved into a 4-year vocational training program in rural hospital medicine, with the university diploma retained as the academic component. The intentionally flexible and modular nature of the rural hospital training program and university diploma allow for a range of training options. The majority of trainees are taking advantage of this by combining general practice and rural hospital training. Although structured quite differently the components of this combined pathway looks similar to the Australian rural generalist pathways. There is evidence that the program has had a positive impact on the New Zealand rural hospital medical workforce.

  18. Newborn care practices in rural Bangladesh

    Directory of Open Access Journals (Sweden)

    Islam MT

    2015-07-01

    Full Text Available Mohammad Tajul Islam,1 Nazrul Islam,2 Yukie Yoshimura,1 Monjura Khatun Nisha,3 Nawzia Yasmin4 1Safe Motherhood Promotion Project, Japan International Cooperation Agency (JICA, Dhaka, Bangladesh; 2School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; 3International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b; 4Department of Public Health, State University of Bangladesh, Dhaka, Bangladesh Background: Neonatal mortality is high in Bangladesh. Most of the neonatal deaths are preventable through simple and cost-effective essential newborn care interventions. Studies to document the determinants of unhealthy newborn care practices are scarce. Objective: The objective of this study is to describe the pattern of neonatal care practices and their determinants in rural Bangladesh. Methodology: This study is based on baseline data of a community-based intervention to assess impact of limited postnatal care services on maternal and neonatal health-seeking behavior. Data from 510 women, who had a live birth at home 1 year prior to survey, of six randomly selected unions of an Upazila (subdistrict were analyzed. Results: Majority of the respondents were at an age group of 20–34 years. Only 6% had delivery by skilled providers. Immediate drying and wrapping, and giving colostrums to newborns were almost universal. Unhealthy practices, like unclean cord care (42%, delayed initiation of breastfeeding (60%, use of prelacteals (36%, and early bathing (71% were very common. Muslims were more likely to give early bath (adjusted odds ratio [OR]: 2.01; 95% confidence interval [CI]: 1.13–3.59; P=0.018 and delay in initiating breastfeeding (adjusted OR: 1.45; 95% CI: 1.18–1.78; P<0.001 to newborns. Practice of giving prelacteals was associated with teenage mothers (adjusted OR: 2.26; 95% CI: 1.19–4.28; P=0.013 and women’s lack of education (adjusted OR: 2.64; 95% CI: 1.46–4.77; P=0

  19. The Council on Chiropractic Education's New Wellness Standard: A call to action for the chiropractic profession

    Directory of Open Access Journals (Sweden)

    Rupert Ronald

    2006-10-01

    Full Text Available Abstract Background The chiropractic profession has long considered itself to be a preventive science. Recently the Council on Chiropractic Education (CCE has defined a set of standards that must be implemented at all US chiropractic colleges as of January of 2007. These are specific to wellness measures and health promoting efforts that should be performed by chiropractors. This will mandate traditional health promotion and prevention methods be taught to students at accredited colleges and to practicing chiropractors. Objective To present the idea of performing traditional health promotion and wellness-concepts in chiropractic practice as a call to action for clinicians and generate discussion on the topic. Discussion This manuscript discusses relevant topics of health promotion and prevention for chiropractors and other practicing clinicians that should be made priorities with patients in order to enhance both patient health and community and population health. Conclusion All practicing chiropractors, as well as other clinicians should take these new standards from the CCE as a call to action to begin helping patients address the removable causes of morbidity, disability and premature mortality where they exist, in addition to treating their painful spinal conditions.

  20. Rural general practice training: experience of a rural general practice team and a postgraduate year two registrar

    Directory of Open Access Journals (Sweden)

    Scott-Jones J

    2013-09-01

    Full Text Available INTRODUCTION: Undertaking training in rural areas is a recognised way of helping recruit staff to work in rural communities. Postgraduate year two medical doctors in New Zealand have been able to undertake a three-month placement in rural practice as part of their pre-vocational training experience since November 2010. AIM: To describe the experience of a rural general practice team providing training to a postgraduate year two medical trainee, and to describe the teaching experience and range of conditions seen by the trainee. METHODS: A pre- and post-placement interview with staff, and analysis of a logbook of cases and teaching undertaken in the practice. RESULTS: The practice team's experience of having the trainee was positive, and the trainee was exposed to a wide range of conditions over 418 clinical encounters. The trainee received 22.5 hours of formal training over the three-month placement. DISCUSSION: Rural general practice can provide a wide range of clinical experience to a postgraduate year two medical trainee. Rural practices in New Zealand should be encouraged to offer teaching placements at this training level. Exposure to rural practice at every level of training is important to encourage doctors to consider rural practice as a career.

  1. Well-being outcomes of chiropractic intervention for lower back pain: a systematic review.

    Science.gov (United States)

    Parkinson, Lynne; Sibbritt, David; Bolton, Philip; van Rotterdam, Joan; Villadsen, Inger

    2013-02-01

    The usefulness of chiropractic for treatment of low back pain is a contentious issue. Chiropractors advocate holism and general well-being as a key principle on which they base their clinical practice, yet the quality of life, lifestyle, health and economic impacts of chiropractic intervention for back pain in adults have rarely been investigated. This article provides an overview of chiropractic principles and practices, together with the results of a systematic review of peer-reviewed publications between 2000 and 2010 retrieved from MEDLINE, CINAHL, EMBASE, AMED and Cochrane Database of Systematic Reviews. This review sought to determine the benefits of chiropractic treatment and care to well-being, and to what extent chiropractic treatment and care improve quality of life. Of 1,165 articles, 12 articles were retained, representing six studies (four randomised controlled trial, two observational) of varying quality. There was a high degree of inconsistency and lack of standardisation in measurement instruments and outcome measures. Three studies reported reduced use of other/extra treatments as a positive outcome; two studies reported a positive effect of chiropractic intervention on pain, and two studies reported a positive effect on disability. The six studies reviewed concentrated on the impact of chiropractic care on physical health and disability, rather than the wider holistic view which was the focus of this study. It is difficult, therefore, to defend any conclusion about the impact of chiropractic intervention on the quality of life, lifestyle, health and economic impact on chiropractic patients presenting with back pain.

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

    Science.gov (United States)

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

    2015-01-01

    There is a paucity of research regarding veterinary students' attitudes toward the rural environment and rural veterinary practice and how these attitudes might change over the course of a veterinary medicine program that includes rural clinical experience. Using a 23-item questionnaire, attitudes toward rural lifestyle, rural work-life balance, opportunities for career and skill development in rural veterinary practice, and inter-professional teamwork in the rural environment were assessed at the beginning and completion of a four-year veterinary medicine program. Eighty-six students (74.4% female) were included in this Canadian study over a six-year period. Thirty-one participants (36.1%) were rural students. Overall, students' attitudes toward the rural lifestyle, rural work-life balance, and inter-professional teamwork in rural veterinary practice all significantly decreased (p<.001) over the course of the program. As compared to urban students, rural students had significantly higher rural lifestyle scores at both the beginning (p<.001) and end (p<.01) of the veterinary medicine program. A less positive attitude toward living and working in a rural environment could influence students to exclude rural veterinary practice as a career choice. Rural clinical experiences designed to sustain or increase veterinary student interest in rural practice may not be sufficient to support positive rural attitudes. Given the demand for rural veterinary services in developed countries, the implications of this study may extend beyond Canada.

  3. The economic impact of rural family physicians practicing obstetrics.

    Science.gov (United States)

    Avery, Daniel M; Hooper, Dwight E; McDonald, John T; Love, Michael W; Tucker, Melanie T; Parton, Jason M

    2014-01-01

    The economic impact of a family physician practicing family medicine in rural Alabama is $1,000,000 a year in economic benefit to the community. The economic benefit of those rural family physicians practicing obstetrics has not been studied. This study was designed to determine whether there was any added economic benefit of rural family physicians practicing obstetrics in rural, underserved Alabama. The Alabama Family Practice Rural Health Board has funded the University of Alabama Family Medicine Obstetrics Fellowship since its beginning in 1986. Family medicine obstetrics fellowship graduates who practice obstetrics in rural, underserved areas were sent questionnaires and asked to participate in the study. The questions included the most common types and average annual numbers of obstetrics/gynecological procedures they performed. Ten physicians, or 77% of the graduates asked to participate in the study, returned the questionnaire. Fourteen common obstetrics/gynecological procedures performed by the graduates were identified. A mean of 115 deliveries were performed. The full-time equivalent reduction in family medicine time to practice obstetrics was 20%. A family physician practicing obstetrics in a rural area adds an additional $488,560 in economic benefit to the community in addition to the $1,000,000 from practicing family medicine, producing a total annual benefit of $1,488,560. The investment of $616,385 from the Alabama Family Practice Rural Health Board resulted in a $399 benefit to the community for every dollar invested. The cumulative effect of fellowship graduates practicing both family medicine and obstetrics in rural, underserved areas over the 26 years studied was $246,047,120. © Copyright 2014 by the American Board of Family Medicine.

  4. Developmental issues in chiropractic: a South African practitioner and patient perspective

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Mouton, Johan

    2007-01-01

    of the 3 domains investigated. Issues such as the apparent lack of conceptual identity of chiropractic; the absence of a coherent, marketable model of chiropractic practice; and poor interprofessional relationships with mainstream health care stakeholders were observed. The issue of integrated public...

  5. Chiropractic & Osteopathy. A new journal

    Directory of Open Access Journals (Sweden)

    Walker Bruce F

    2005-04-01

    Full Text Available Abstract Both chiropractic and osteopathy are over a century old. They are now regarded as complementary health professions. There is an imperative for both professions to research the principles and claims that underpin them, and the new journal Chiropractic & Osteopathy provides a scientific forum for the publication of such research.

  6. Rural Media Literacy: Youth Documentary Videomaking as a Rural Literacy Practice

    Science.gov (United States)

    Pyles, Damiana Gibbons

    2016-01-01

    Through an analysis of a corpus of youth-produced documentary video data collected at a youth media arts organization in rural Appalachia, I explore how these rural youth engaged in media literacy practices through creating documentary videos about themselves and their community. Using a theoretical foundation in literacies research, especially…

  7. Rural Social Work - Theory and Practice.

    Science.gov (United States)

    Collier, Ken

    Because life styles, values, social institutions, and "survival activities" differ in undeveloped rural areas from those in industrial societies, the techniques and approaches used by rural social workers must be adjusted to meet the needs of the population being dealt with. In forager and agricultural societies, social workers and other…

  8. Chiropractic care and public health

    DEFF Research Database (Denmark)

    Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre

    2012-01-01

    through the lifespan, and effective participation in community health issues. The questions that are addressed include: Is spinal manipulative therapy for neck and low-back pain a public health problem? What is the role of chiropractic care in prevention or reduction of musculoskeletal injuries...... in children? What ways can doctors of chiropractic stay updated on evidence-based information about vaccines and immunization throughout the lifespan? Can smoking cessation be a prevention strategy for back pain? Does chiropractic have relevance within the VA Health Care System for chronic pain and comorbid...... of prevention and public health? What role do citizen-doctors of chiropractic have in organizing community action on health-related matters? How can our future chiropractic graduates become socially responsible agents of change?...

  9. Characteristics of Veterans Health Administration chiropractors and chiropractic clinics.

    Science.gov (United States)

    Lisi, Anthony J; Goertz, Christine; Lawrence, Dana J; Satyanarayana, Preeti

    2009-01-01

    Chiropractic services have been delivered on station at select Veterans Health Administration (VHA) medical facilities since late 2004. No published data describing the characteristics of VHA chiropractic physicians (chiropractors) and chiropractic clinics exist at a national level. This study was designed to examine elements of the structures of chiropractic services in VHA settings. Web-based survey methods were used to question all chiropractors in VHA facilities (N = 36). Data were obtained from 33 providers, yielding a 91.6% response rate. Most respondents were full-time VHA employees, while others were part-time employees or contractors. Differences were found in prior training, integrated practice, and academic or research experience. Of the respondents, 88% ranked low back pain as the most common patient complaint seen in practice and 79% ranked cervical pain the second most common complaint. Of the new patient consultations, 67.6% originated from primary care, 9.4% from pain management, and 6.2% from physiatry. Most respondents were similar in their reported use of diagnostic and therapeutic procedures, but their reported rates of participation in various facility activities were different. Further work is needed for researchers and policy makers to more fully understand the integration and delivery of chiropractic services in VHA settings.

  10. A framework for developing rural academic general practices: a qualitative case study in rural Victoria.

    Science.gov (United States)

    Brown, J B; Morrison, Tracy; Bryant, Melanie; Kassell, Lisa; Nestel, Debra

    2015-01-01

    There is increasing pressure for Australian rural general practices to engage in educational delivery as a means of addressing workforce issues and accommodating substantial increases in learners. For practices that have now developed a strong focus on education, there is the challenge to complement this by engaging in research activity. This study develops a rural academic general practice framework to assist rural practices in developing both comprehensive educational activity and a strong research focus thus moving towards functioning as mature academic units. A case study research design was used with the unit of analysis at the level of the rural general practice. Purposively sampled practices were recruited and individual interviews conducted with staff (supervisors, practice managers, nurses), learners (medical students, interns and registrars) and patients. Three practices hosted 'multi-level learners', two practices hosted one learner group and one had no learners. Forty-four individual interviews were conducted with staff, learners and patients. Audio recordings were transcribed for thematic analysis. After initial inductive coding, deductive analysis was undertaken with reference to recent literature and the expertise of the research team resulting in the rural academic general practice framework. Three key themes emerged with embedded subthemes. For the first theme, organisational considerations, subthemes were values/vision/culture, patient population and clinical services, staffing, physical infrastructure/equipment, funding streams and governance. For the second theme, educational considerations, subthemes were processes, clinical supervision, educational networks and learner presence. Third, for research considerations, there were the subthemes of attitude to research and research activity. The framework maps the development of a rural academic practice across these themes in four progressive stages: beginning, emerging, consolidating and

  11. Chiropractic at the crossroads or are we just going around in circles?

    Directory of Open Access Journals (Sweden)

    Reggars John W

    2011-05-01

    Full Text Available Abstract Background Chiropractic in Australia has seen many changes over the past 30 years. Some of these changes have advanced the professional status of chiropractic, improved undergraduate training and paved the way for a research culture. Unfortunately, other changes or lack of changes, have hindered the growth, public utilisation and professional standing of chiropractic in Australia. This article explores what influences have impacted on the credibility, advancement and public utilisation of chiropractic in Australia. Discussion The 1970's and 1980's saw a dramatic change within the chiropractic profession in Australia. With the advent of government regulation, came government funded teaching institutions, quality research and increased public acceptance and utilisation of chiropractic services. However, since that time the profession appears to have taken a backward step, which in the author's opinion, is directly linked to a shift by sections of the profession to the fundamentalist approach to chiropractic and the vertebral subluxation complex. The abandonment, by some groups, of a scientific and evidenced based approach to practice for one founded on ideological dogma is beginning to take its toll. Summary The future of chiropractic in Australia is at a crossroads. For the profession to move forward it must base its future on science and not ideological dogma. The push by some for it to become a unique and all encompassing alternative system of healthcare is both misguided and irrational.

  12. Characteristics and Clinical Practices of Rural Marriage and Family Therapists

    Science.gov (United States)

    Morris, James

    2007-01-01

    This report presents a subset of data collected from the American Association for Marriage and Family Therapy (AAMFT) Practice Research Network project conducted in 2002. A sample of 47 clinical members of AAMFT who indicated they practiced in a rural community provided descriptive information on demographic characteristics, training, clinical…

  13. Integration of Chiropractic Services in Military and Veteran Health Care Facilities: A Systematic Review of the Literature.

    Science.gov (United States)

    Green, Bart N; Johnson, Claire D; Daniels, Clinton J; Napuli, Jason G; Gliedt, Jordan A; Paris, David J

    2016-04-01

    This literature review examined studies that described practice, utilization, and policy of chiropractic services within military and veteran health care environments. A systematic search of Medline, CINAHL, and Index to Chiropractic Literature was performed from inception through April 2015. Thirty articles met inclusion criteria. Studies reporting utilization and policy show that chiropractic services are successfully implemented in various military and veteran health care settings and that integration varies by facility. Doctors of chiropractic that are integrated within military and veteran health care facilities manage common neurological, musculoskeletal, and other conditions; severe injuries obtained in combat; complex cases; and cases that include psychosocial factors. Chiropractors collaboratively manage patients with other providers and focus on reducing morbidity for veterans and rehabilitating military service members to full duty status. Patient satisfaction with chiropractic services is high. Preliminary findings show that chiropractic management of common conditions shows significant improvement.

  14. HYGIENE PRACTICES AMONG RURAL SCHOOL CHILDREN IN PUDUCHERRY”

    OpenAIRE

    Basanta Kumar; Saubhagya Kumar; Shakthipriya; Anugya Aparajita; Soumya

    2013-01-01

    ABSTRACT: AIM: To assess the hygiene practices among rural school children. SETTINGS AND DESIGN: This cross - sectional study was conducted at Government higher secondary school in rural ar ea of Puducherry. METHODS AND MATERIAL : Around 214 children studying in standard 6 th to 8 th were randomly selected for the study during June to August 2011. The study was explained to the school children and their assent was taken before the study. They an...

  15. [Chiropractic in general and in low back pain].

    Science.gov (United States)

    Myhrvold, K

    1999-05-30

    The practice of chiropractic was for many years regulated by "The Quack Act" in Norway, and the numbers of chiropractors decreased year by year. They are now authorized health care practitioners with academic training; most Norwegian students attending courses in chiropractic or clinical biomechanics go to European universities. An international council ensures reciprocity and a quality assured academic programme in all recognized colleges of chiropractic. Recent research have broadened our understanding of the biomechanical interrelationship between the nervous system, the musculature and the skeletal articulations. In the early 1990s, several studies documented favourable effect of chiropractic treatment of low back disorders. These studies are now substantiated by new studies, especially concerning cost-effectiveness. Several reports also give evidence that chiropractic manipulation is beneficial especially in combination with light exercise. There are conflicting results concerning the efficacy of varying types of exercise programmes. Patients may benefit from increased cooperation between medical doctors and chiropractors. Most acute low back syndromes should be assessed by the chiropractor in order to prevent chronic illness.

  16. Chiropractic care for back pain

    Science.gov (United States)

    ... gov/ency/patientinstructions/000416.htm Chiropractic care for back pain To use the sharing features on this page, ... for problems that might be adding to your back pain. Treatment begins at the first or second visit ...

  17. The Chiropractic Centennial Historic Exhibit: marking the ten decades of chiropractic history.

    Science.gov (United States)

    Belair, R S

    1995-12-01

    The Chiropractic Centennial Historic Display was exhibited at the Chiropractic Centennial celebrations in Washington, DC, July 6-9 and Davenport, IA September 14-17, and proved to be the visual centerpiece for the year's historic commemorations. The Association for the History of Chiropractic coordinated the display through the Chiropractic Centennial Foundation.

  18. Social Work Practice Behaviors and Beliefs: Rural-Urban Differences?

    Directory of Open Access Journals (Sweden)

    Tom A. Croxton

    2002-12-01

    Full Text Available There is continuing debate within the social work profession on whether there are significant differences in the practice behaviors and beliefs between rural and urban clinical social workers and whether different standards should be applied in defining ethical practices. This study measures those differences with regard to five practice behaviors: bartering,maintaining confidentiality, competent practice, dual relationships, and social relationships. Differences were found in beliefs regarding the appropriateness of professional behavior though such differences did not translate into practice behaviors.More significantly, the research suggests considerable confusion about the meanings of ethical standards and the utilization of intervention techniques without formal training across both urban and rural social workers.

  19. A focus group study of chiropractic students following international service learning experiences.

    Science.gov (United States)

    Boysen, James C; Salsbury, Stacie A; Derby, Dustin; Lawrence, Dana J

    2016-10-01

    One objective of chiropractic education is to cultivate clinical confidence in novice practitioners. The purpose of this qualitative study was to describe how participation in a short-term international service learning experience changed perceptions of clinical confidence in senior chiropractic students. Seventeen senior chiropractic students participated in 4 moderated focus group sessions within 4 months after a clinical educational opportunity held in international settings. Participants answered standard questions on how this educational experience may have changed their clinical confidence. Two investigators performed qualitative thematic analysis of the verbatim transcripts to identify core concepts and supporting themes. The core concept was transformation from an unsure student to a confident doctor. The service learning experience allowed students to deliver chiropractic treatment to patients in a real-world setting, engage in frequent repetitions of technical skills, perform clinical decision-making and care coordination, and communicate with patients and other health professionals. Students described increased clinical confidence in 9 competency areas organized within 3 domains: (1) chiropractic competencies including observation, palpation, and manipulation; (2) clinical competencies including problem solving, clinic flow, and decision-making; and (3) communication competencies, including patient communication, interprofessional communication, and doctor-patient relationship. Students recommended that future service learning programs include debriefing sessions similar to the experience offered by these focus groups to enhance student learning. Senior chiropractic students who participated in an international service learning program gained confidence and valuable practical experience in integrating their chiropractic, clinical, and communication skills for their future practices.

  20. A focus group study of chiropractic students following international service learning experiences

    Science.gov (United States)

    Boysen, James C.; Salsbury, Stacie A.; Derby, Dustin; Lawrence, Dana J.

    2016-01-01

    Objective: One objective of chiropractic education is to cultivate clinical confidence in novice practitioners. The purpose of this qualitative study was to describe how participation in a short-term international service learning experience changed perceptions of clinical confidence in senior chiropractic students. Methods: Seventeen senior chiropractic students participated in 4 moderated focus group sessions within 4 months after a clinical educational opportunity held in international settings. Participants answered standard questions on how this educational experience may have changed their clinical confidence. Two investigators performed qualitative thematic analysis of the verbatim transcripts to identify core concepts and supporting themes. Results: The core concept was transformation from an unsure student to a confident doctor. The service learning experience allowed students to deliver chiropractic treatment to patients in a real-world setting, engage in frequent repetitions of technical skills, perform clinical decision-making and care coordination, and communicate with patients and other health professionals. Students described increased clinical confidence in 9 competency areas organized within 3 domains: (1) chiropractic competencies including observation, palpation, and manipulation; (2) clinical competencies including problem solving, clinic flow, and decision-making; and (3) communication competencies, including patient communication, interprofessional communication, and doctor–patient relationship. Students recommended that future service learning programs include debriefing sessions similar to the experience offered by these focus groups to enhance student learning. Conclusion: Senior chiropractic students who participated in an international service learning program gained confidence and valuable practical experience in integrating their chiropractic, clinical, and communication skills for their future practices. PMID:27258817

  1. Chiropractic and children: Is more research enough?

    Directory of Open Access Journals (Sweden)

    Leboeuf-Yde Charlotte

    2010-06-01

    Full Text Available Abstract Many health science research and review articles end with the words: "More research is needed". However, when it comes to research, it is not as much a question of quantity as of quality. There are a number of important prerequisites before research should be initiated. The three pillars, relevance, quality and ethics should be respected but for a project to be meaningful, it must also be based on plausible rationale. In evidence-based (informed practice, one takes into account not only research-based evidence but also clinical expertise and the patients' perspectives. In this paper, we briefly discuss how this should be handled in clinical practice is briefly discussed, using the concept of "traffic lights" (red, yellow, green. We explain how the combination of evidence and plausibility can be used to reach a decision as to whether a treatment or diagnostic procedure is suitable, possible, or unsuitable. In this thematic series of Chiropractic & Osteopathy a number of reviews are presented, in which the research status of pediatric chiropractic is scrutinized and found wanting. Two important aspects were studied in these reviews: the effect of treatment and safety issues. Two types of problems were identified: the lack of research in general and the lack of research using the appropriate study designs and methodology in particular. Therefore, we discuss the meager research noted in the areas of chiropractic care in children and the clinical consequences this should have. The prerequisites for "more research" are scrutinized and an example given of suitable research programs. Finally, the important issue of implementation of research findings is covered, emphasizing the responsibility of all stakeholders involved at both the undergraduate and the postgraduate level, within professional associations, and on an individual level.

  2. Chiropractic and social justice: a view from the perspective of Beauchamp's principles.

    Science.gov (United States)

    Green, Bart N; Johnson, Claire

    2010-01-01

    Social justice in public health involves the process and product of a community acting to fairly distribute advantages and burdens to improve the health of its population and to reasonably take care of the disadvantaged. Although publications are available about chiropractic public health history, programs, and policy, the potential role of chiropractic in social justice has received little attention. This article discusses Beauchamp's 4 principles of social justice and suggests actions that the chiropractic profession may consider to participate in the practice of social justice in the field of public health.

  3. A longitudinal study of chiropractic use among older adults in the United States

    Directory of Open Access Journals (Sweden)

    Jones Michael P

    2010-12-01

    all types of providers, even more than family practice and internal medicine combined. Conclusion There is substantial heterogeneity in the patterns of use of chiropractic services among older adults. In spite of the variability of use patterns, however, there are not many characteristics that distinguish high volume users from lower volume users. While high volume users accounted for a significant portion of claims, the enforcement of a hard cap on annual visits by Medicare would not significantly decrease overall claim volume. Further research to understand the factors causing high volume chiropractic utilization among older Americans is warranted to discern between patterns of "need" and patterns of "health maintenance".

  4. An educational campaign to increase chiropractic intern advising roles on patient smoking cessation

    Directory of Open Access Journals (Sweden)

    Strasser Sheryl M

    2006-10-01

    Full Text Available Abstract Background Tobacco use, particularly smoking, is the most preventable cause of death in the United States. More than 400,000 premature deaths are associated with its use and the health care costs are in the billions. All health care provider groups should be concerned with patients who continue to smoke and use tobacco. The US Preventive Services Taskforce and Health People 2010 guidelines encourage providers to counsel smokers on cessation. Current studies, though limited regarding chiropractic advising practices indicate a low engagement rate when it comes to providing cessation information. Objective To test a campaign regarding initial impact aimed at increasing chiropractic interns advising on cessation and delivery of information to smokers on cessation. Discussion Chiropractic interns do engage patients on smoking status and can be encouraged to provide more cessation messages and information to patients. The initial impact assessment of this campaign increased the provision of information to patients by about 25%. The prevalence of smoking among chiropractic patients, particularly at teaching clinics may be lower than the national averages. Conclusion Chiropractic interns can and should be encouraged to advise smokers about cessation. A systematic method of intake information on smoking status is needed and a standardized education protocol for chiropractic colleges is needed. Chiropractic colleges should assess the adequacy of their advising roles and implement changes to increase cessation messages to their patients as soon as possible.

  5. HYGIENE PRACTICES AMONG RURAL SCHOOL CHILDREN IN PUDUCHERRY”

    Directory of Open Access Journals (Sweden)

    Basanta Kumar

    2013-06-01

    Full Text Available ABSTRACT: AIM: To assess the hygiene practices among rural school children. SETTINGS AND DESIGN: This cross - sectional study was conducted at Government higher secondary school in rural ar ea of Puducherry. METHODS AND MATERIAL : Around 214 children studying in standard 6 th to 8 th were randomly selected for the study during June to August 2011. The study was explained to the school children and their assent was taken before the study. They an swered the pre - designed questionnaires. Data was collected by face to face interview. STATISTICAL ANALYSIS: Statistical analysis was done by using EPI INFO 3. RESULTS: Hygiene practice of hand washing before eating was 95.33%. Only 81.31% students used sli ppers/chappals during use of toilet. Around 58.41% of students went to open field for defecation and 6.07% of students did not wash their hands after defecation. Regarding the frequency of hygiene practice, only 62.15% and 68.22% of students brushed their teeth and bathed every day respectively. The study finding also showed that only 68.69% students washed their face twice daily where as 3.27% students washed their face weekly. As regards to the materials used for hygiene practice, 93.86% of students used tooth brush & paste for brushing of teeth, 85.98% of students used soap while taking bath and 25.70% of students did not use soap for hand wash after defecation. CONCLUSION: Study findings suggest the need for more hygiene practice education in rural schoo ls. Such healthy practices may help to decrease the burden of communicable diseases in rural school settings.

  6. The new Australian after-hours general practice incentive payment mechanism: equity for rural general practice?

    Science.gov (United States)

    Neil, Amanda L; Nelson, Mark; Palmer, Andrew J

    2016-07-01

    In July 2015, a national scheme for after-hours incentive funding for general practices was re-introduced in Australia, 2-years after funding was transferred to regional primary health care organisations (Medicare Locals). The re-introduction was recommended in a 2014 review of after-hours primary care reflecting the "overwhelming desire" among general practice. Given the centrality of after-hours care provision in rural and remote practices identified in the review, we compare and contrast the current and historical after-hours incentive funding mechanisms focussing on fairness towards rural general practices. While there are similarities between the current and historical mechanisms, significant differences exist. The comparison is not straightforward. The major consistency is utilisation of practice standardised whole patient equivalents (SWPE) as the basis of funding, inherently favouring large urban general practices. This bias is expected to increase given a shift in focus from practices with no option but to provide 24/7 care to any practice providing 24/7 care; and an associated increased funding per SWPE. Differences primarily pertain to classification processes, in which the realities of rural service provision and recognition of regional support mechanisms are given minimal consideration. Rapid introduction of the new general practice after-hours incentive funding mechanism has led to inconsistencies and has exacerbated inherent biases, particularly inequity towards rural providers. Impact on morale and service provision in non-urban areas should be monitored.

  7. Chiropractic management of back pain.

    Science.gov (United States)

    Lall, M

    1983-05-01

    The vast majority of those with back pain respond extremely well to chiropractic spinal manipulation. There are several hundred procedures available to a well trained chiropractor, including high velocity manipulation, mobilisation, soft tissue techniques and pressure point therapy, which may be used to eliminate the need for manipulation under anaesthesia or surgery.

  8. Acute dizziness in rural practice: Proposal of a diagnostic procedure

    Directory of Open Access Journals (Sweden)

    Ehab Eid

    2015-01-01

    Full Text Available Acute dizziness is a frequent index symptom in the emergency department as well as in the rural practice office. Most acute dizziness, however, is not dangerous, but some types are highly dangerous. Clinical routine acute dizziness can be separated into frequent benign syndromes including benign paroxysmal positional vertigo (BPPV, vestibular neuritis, Meniθre′s disease or vestibular migraine, and what is here referred to as the "white shark" of dizziness, i.e. a stroke in the posterior circulation or more rarely a tumor in the posterior fossa. A practical concept is presented to clarify most frequent acute dizziness syndromes using clinical and low budget methods.

  9. Acute dizziness in rural practice: Proposal of a diagnostic procedure

    Science.gov (United States)

    Eid, Ehab; Dastan, Sajed; Heckmann, Josef G.

    2015-01-01

    Acute dizziness is a frequent index symptom in the emergency department as well as in the rural practice office. Most acute dizziness, however, is not dangerous, but some types are highly dangerous. Clinical routine acute dizziness can be separated into frequent benign syndromes including benign paroxysmal positional vertigo (BPPV), vestibular neuritis, Meniθre's disease or vestibular migraine, and what is here referred to as the “white shark” of dizziness, i.e. a stroke in the posterior circulation or more rarely a tumor in the posterior fossa. A practical concept is presented to clarify most frequent acute dizziness syndromes using clinical and low budget methods. PMID:25883501

  10. The chiropractic profession in Norway 2011

    DEFF Research Database (Denmark)

    Kvammen, O. C.; Leboeuf-Yde, C.

    2014-01-01

    BACKGROUND: The chiropractic profession in Norway has increased five-fold in the last two decades. As there is no academic graduate program in Norway, all chiropractors have been trained outside of Norway, in either Europe, America or Australia. This might have given Norwegian chiropractors...... in Norway. METHOD: Two surveys were distributed to all 530 registered chiropractors in Norway in 2011. One survey was for all chiropractors (Survey 1) and the other for clinic owners (Survey 2). Results have been reported as tables and as approximate percentages in the text for ease of reading. RESULT......: Response rates were 61% (Survey 1, N = 320) and 71% (Survey 2, N = 217). More than two-thirds of the chiropractors in Norway had been in practice for under a decade. Only one in four chiropractors worked in solo practice and the majority shared premises with at least one colleague, typically at least one...

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

    Directory of Open Access Journals (Sweden)

    Keith Brownlee

    2015-03-01

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

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

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    Tonya Arscott-Mills

    2016-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Tonya Arscott-Mills

    2016-03-01

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

  14. Oral hygiene status and practices among rural dwellers

    Directory of Open Access Journals (Sweden)

    Clement C Azodo

    2013-01-01

    Full Text Available Objectives: To determine the oral hygiene status and practices among rural dwellers in Delta and Edo States of Nigeria. Materials and Methods: One-hundred and fifty-four participants (45 males and 109 females between the ages of 5 and 88 years with mean age of 33.44΁2.34 years selected among individuals attending Children Evangelism Ministry Free Medical Outreach in five rural communities in both Delta and Edo State of Nigeria were studied. Data were collected through clinical examinations and the use of interviewer-administered questionnaires. Results: Of the 154 participants studied, 22.1% participants had one or more carious teeth, 11.7% participants had at least one missing tooth and 0.6% participants had fillings. Toothache (33.1% and gingival bleeding (27.3% were reported oral health problems among the participants. One third (33.8% of the participants had poor oral hygiene status. Oral hygiene status was significantly associated with age, gender, and educational status, but there was no significant variation among the various communities. Majority of the participants cleaned their teeth with toothbrush and toothpaste-133 (86.4%, indulged in once-daily tooth cleaning-115 (74.7%, and have never visited the dentist-145 (94.2%. There existed significant association between daily tooth cleaning frequency, age, gender, location and level of education. Conclusion: The oral hygiene and oral health practices among rural dwellers were suboptimal. There is need to develop and implement community-oriented oral health promotion programs targeting oral health practices to control preventable oral diseases among rural dweller.

  15. The Road Towards Sustainable Rural Development : Issues of Theory, Policy and Research Practice

    NARCIS (Netherlands)

    Marsden, T.; Banks, J.; Renting, H.; Ploeg, van der J.D.

    2001-01-01

    Developing a more widespread diffusion of sustainable agricultural practices as part of progressing rural sustainable development is being hampered by different modes of environmental social thought. This introduction to this special issue on Reconstituting of nature through rural development practi

  16. Risky health seeking practice among pregnant women in rural Congo

    DEFF Research Database (Denmark)

    Hørby, Laila

    2007-01-01

    delays, Culture, Field and Capital, Democratic Republic Congo (DRC). Title: Risky health seeking practice, among pregnant women in rural Congo (DRC). Background Statement: Worldwide more than half a million women still die each year of pregnancy and childbirth related reasons. Most of these women live...... about 60 % of the women have a professional help at birth, and even fewer delivers in a health centre, which is far from the Unicef and WHO goal trying to combat high Maternal Mortality Rate (MMR). In the southern and rural part of DRC, is a small well equipped and well staffed dispensary and maternity...... professional assistance for normal pregnancy and delivery; delay in reaching an adequate medical facility, which includes accessibility, availability and cost of transportation and conditions of roads; and delays in obtaining the care needed to manage the situation. Following that I have analysed...

  17. Exploring Leadership Practices in Rural Context of a Developing Country

    Directory of Open Access Journals (Sweden)

    Ali Nawab

    2011-10-01

    Full Text Available The success or failure of any institution has closely been linked with the leadership practices exercised in the institution. Whereas the number of private schools is rapidly increasing in the rural context of Pakistan, the leadership practices of these institutions are interesting and timely questions to ponder upon. Drawing upon the data of a qualitative case study, this paper discusses the leadership practices in a private school in rural Pakistan. It is found that the school leaders in this context have still traditional approach to leadership with little possibilities of shared or distributed leadership. Since the private schools are owned by the individuals and the teachers are hardly involved in decision making processes, they show less motivation towards school activities and thus, there remains a gap between the expectations of the principal and the performance of the teachers. It is suggested that the leadership of these private institutions should have maximum exposure to updated management and leadership theories and practices if they have to successfully run their schools in this challenging and competitive era.

  18. Destinations without regulations: Informal practices in Romanian rural tourism

    Directory of Open Access Journals (Sweden)

    Maria Miruna Rădan-Gorska

    2013-12-01

    Full Text Available This article is an ethnographic account of the informal practices I encountered during my fieldwork in three touristic destinations in the Romanian countryside. In these places, as in other parts of rural Romania, over half of the accommodation units are unregistered, making tourism ‘on the black’ [market] widespread. This research is focused on unregistered businesses, as well as on those that aim to be law-abiding, but sometimes engage in informal practices. A typology of informal practices is outlined, dividing them into intended, unintended, and contextual. These categories are illustrated with evidence from interview data and from mass media accounts. Informality is discussed in relation to the legislative framework and to the actions of those authorities responsible with enforcing regulations. Local sense-making strategies are taken into account in explaining informal practices, as well as the wider national and historical contexts. The positive and negative implications of informality are examined and the article concludes by making a number of suggestions that could help to develop more appropriate norms and policies regarding rural guesthouses.

  19. Caught in the crosshairs: identity and cultural authority within chiropractic.

    Science.gov (United States)

    Villanueva-Russell, Yvonne

    2011-06-01

    In this paper the discourse over identity and cultural authority within the profession of chiropractic in the United States has been analyzed using critical discourse analysis. As the profession struggles to construct one singular image, versions of self must be internally debated and also shaped in consideration of larger, external forces. The dilemma of remaining tied to a marginal professional status must be balanced against considerations of integration. Written texts from chiropractic journals and newspapers are analyzed in a multidimensional approach that considers the rhetorical devices and thematic issues of identity construction; the representation of various voices within the discourse (both heard and unheard); and the extent to which external pressures affect the projection of cultural authority for the profession. A heterogeneous discourse characterized by conflict was found, with discrepancies between everyday chiropractors in actual practice versus academic chiropractors and leaders particularly over the idea, practice and significance of science for the profession.

  20. Rural health care delivery amidst federal retrenchment: lessons from the Robert Wood Johnson Foundation's Rural Practice Project.

    Science.gov (United States)

    Moscovice, I S; Rosenblatt, R A

    1982-12-01

    This paper examines the experience of the Robert Wood Johnson Foundation's Rural Practice Project (RPP), a major non-governmental effort in the last decade concentrating on the direct delivery of rural health services. The nine RPP sites started prior to 1977 showed a slow but steady increase in their utilization levels and improvement in their financial status during their initial operational years. The tempo of their development was remarkably similar to that of federally sponsored practices in underserved rural areas. After four years of operation, all of the practices had completed their period of grant support; the practices survived in all cases, with almost all of the practices still retaining community sponsorship, salaried physicians, and a commitment to comprehensive care. Practices in sparsely populated rural areas and in areas with fewer hospital beds grew more slowly than those set in rural areas with higher population density and more ancillary resources. We conclude that the use of time-limited initial subsidies is an effective strategy in starting new rural practices in underserved areas and that those practices have a good chance of surviving their start-up phase.

  1. Integrated neuroscience program: an alternative approach to teaching neurosciences to chiropractic students.

    Science.gov (United States)

    He, Xiaohua; La Rose, James; Zhang, Niu

    2009-01-01

    Most chiropractic colleges do not offer independent neuroscience courses because of an already crowded curriculum. The Palmer College of Chiropractic Florida has developed and implemented an integrated neuroscience program that incorporates neurosciences into different courses. The goals of the program have been to bring neurosciences to students, excite students about the interrelationship of neuroscience and chiropractic, improve students' understanding of neuroscience, and help the students understand the mechanisms underpinning the chiropractic practice. This study provides a descriptive analysis on how the integrated neuroscience program is taught via students' attitudes toward neuroscience and the comparison of students' perceptions of neuroscience content knowledge at different points in the program. A questionnaire consisting of 58 questions regarding the neuroscience courses was conducted among 339 students. The questionnaire was developed by faculty members who were involved in teaching neuroscience and administered in the classroom by faculty members who were not involved in the study. Student perceptions of their neuroscience knowledge, self-confidence, learning strategies, and knowledge application increased considerably through the quarters, especially among the 2nd-year students. The integrated neuroscience program achieved several of its goals, including an increase in students' confidence, positive attitude, ability to learn, and perception of neuroscience content knowledge. The authors believe that such gains can expand student ability to interpret clinical cases and inspire students to become excited about chiropractic research. The survey provides valuable information for teaching faculty to make the course content more relevant to chiropractic students.

  2. Dr. Millie Cleveland: chiropractic achiever.

    Science.gov (United States)

    Nash, J

    1998-06-01

    Dr. Mildred Genoa Allison-Cleveland, affectionately known as "Dr. Millie," was an important part of life at Cleveland Chiropractic College for over thirty years, serving first as a clerical assistant, then instructor, administrative assistant, and trusted right hand of her husband, Dr. Carl Cleveland, Jr. Yet Mildred Cleveland, like many other women who have helped the profession grow and survive over the years, has never been the subject of an article in print. In this paper, the author will strive to outline Dr. Mildred Cleveland's accomplishments, as well as to give the reader as clear a picture as possible of the woman who was the wife of one chiropractic pioneer and mother of another.

  3. Knowledge, attitude and practice of contraception in rural kashmir.

    Science.gov (United States)

    Hayat, Humera; Khan, Parwez Sajad; Imtiyaz, Bhat; Hayat, Gazala; Hayat, Rehana

    2013-12-01

    Human fertility is determined by many factors such as customs, morals and habits of social groups with regard to marital obligation of life. Acceptance of family planning methods varies within and between societies and there are many factors which are responsible for such variation at community, family and individual level. Socioeconomic environment, culture and education are few of them that play a vital role. Jammu and Kashmir state in general and Kashmir valley in particular is a Muslim-dominated population with traditionally a conservative society. Apart from family customs and influence of the elders, religious background has always been behind the passive resistance, or at the best indifference towards contraception. This study makes an attempt to assess the knowledge, attitude and practice of contraception in rural Kashmir. To assess the knowledge, attitude and practice of contraception in rural Kashmir. Community-based Cross-Sectional study. December 2006 to May 2008. 1900 currently married women in the age group of 15-49 years of age. Rural households. 1900 currently married women, aged 15-49 years, selected by multi-stage random sampling technique from three districts of Kashmir valley who were interviewed at home using a pretested oral questionnaire. The assessment of various socioeconomic and other variables made as per the available standard procedures and scales. Percentage, Chi square test and Bivariate analysis. Knowledge of the contraceptive methods was fairly good especially for terminal methods i.e. female sterilization (97.7 %). Main source of information on contraception was obtained from mass media (60.4 %). Contraceptive practice was significantly related to number of living children, literacy, socioeconomic status and type of family. What is needed is to promote and stress contraceptive methods and their advantages using mass media approach and to explore more and more participation of private sector.

  4. Contraceptive knowledge, attitude and practice among rural women.

    Science.gov (United States)

    Mustafa, Rozina; Afreen, Uzma; Hashmi, Haleema A

    2008-09-01

    To assess the knowledge, attitude regarding family planning and the practice of contraceptives among rural women. A cross-sectional observational study. The gynaecological outpatient clinic of Fatima Hospital, Baqai Medical University, Karachi, from July to December 2005. One-hundred women between the ages 15-45, living with their husbands and coming from rural area (villages) were interviewed. Women who were pregnant, had a child younger than 2 years, or had any medical disorder were excluded. Their knowledge, attitude and practice on contraceptives were evaluated with the help of a predesigned questionnaire. The other variables used were the age of women, parity and educational status. Descriptive analysis was conducted to obtain percentages. Out of 100 interviewed women with mean age of 29.7 years, 81(81%) had some knowledge about family planning methods. The media provided information of contraceptives in 52 out of 81 (64%) women. Regarding the usage of contraceptive methods, only 53 (53%) of the respondents were using some sort of contraception. Barrier method (condoms) was in practice by 18 (33.9%) and 12 (22.6%) of women had already undergone tubal ligation. The women using injectables and intrauterine contraceptive devices were 10 (18.8%) and 7 (13.2%) respectively. Six were using oral contraceptive pills (11.3%). Positive attitude towards contraception was shown by 76 (76%) of them, while 41(41%) stated their husbands' positive attitude towards contraception. In the present study, there was a low contraceptive use among women of rural origin despite good knowledge. Motivation of couples through media and health personnel can help to achieve positive attitude of husbands for effective use of contraceptives.

  5. Teaching Practices and Teachers' Perceptions of Group Creative Practices in Inclusive Rural Schools

    Science.gov (United States)

    Arrazola, Begoña Vigo; Bozalongo, Juana Soriano

    2014-01-01

    The central purpose of this paper is to highlight the research in a context where inclusive education is recognised within current global challenges in education. We aim to present different teaching practices and perceptions of teachers from rural schools regarding attention to diversity, before and during a collaborative action that reinforces…

  6. Rural placements in Tasmania: do experiential placements and background influence undergraduate health science student's attitudes toward rural practice?

    Science.gov (United States)

    Dalton, Lisa M; Routley, Georgina K; Peek, Karla J

    2008-01-01

    Each year growing numbers of undergraduate health science students, from a variety of disciplines, participate in a University of Tasmania Department of Rural Health supported rural placement program in Tasmania. This study aimed to investigate the influence rural placement and rural background had on students' intentions to live and work in a rural or remote location after graduation. Between January 2005 and December 2006, 336 students participated in the placement program. Students were requested to complete a survey at the completion of their placement. A response rate of 239 was achieved (71%). The survey measured students' stated rural career intentions and rural background status according to location of primary and secondary school attendance. A demographic analysis of respondents was undertaken and results cross tabulated according to the rural, remote and metropolitan area (RRMA) classification system. Statistical analyses, including paired t-tests and a Wilcoxon signed rank test, were conducted to compare reported mean intention to practise rurally both prior to and after placement. The results from this survey show that rural placements in the undergraduate health science programs have a predominantly positive influence on students' intention to work in a rural community post-graduation. While these findings were significant for the disciplines of nursing, medicine and allied health, the results were not significant for pharmacy students. Students' average intention to practise rurally significantly increased after the placement for students from RRMA classifications 1 and 3-5. The value of rural placements as a method for increasing health science students' intentionality to take up rural practice as a positive and viable career option is considerable.

  7. Nature of association between rural background and practice location: A comparison of general practitioners and specialists

    Directory of Open Access Journals (Sweden)

    Humphreys John S

    2011-03-01

    Full Text Available Abstract Background Rural and remote areas are characterised by a shortage of medical practitioners. Rural background has been shown to be a significant factor associated with medical graduates' intentions and decisions to practise within a rural area, though most studies have only used simple definitions of rural background and not previously looked at specialists. This paper aims to investigate in detail the nature of the association between rural background and practice location of Australian general practitioners (GPs and specialists Methods Data for 3156 GPs and 2425 specialists were obtained from the Medicine in Australia: Balancing Employment and Life (MABEL study. Data on the number of childhood years resident in a rural location and population size of their rural childhood location were matched against current practice location. Logistic regression modelling was used to calculate adjusted associations between doctors in rural practice and rural background, sex and age. Results GPs with at least 6 years of their childhood spent in a rural area were significantly more likely than those with 0-5 years in a rural area to be practising in a rural location (OR 2.28, 95% CI 1.69-3.08, whilst only specialists with at least 11 years rural background were significantly more likely to be practising in a rural location (OR 2.27, 95% CI 1.77-2.91. However, for doctors with a rural background, the size of the community that they grew up in was not significantly associated with the size of the community in which they currently practise. Both female GPs and female specialists are similarly much less likely to be practising in a rural location compared with males (GPs: OR 0.53, 95% CI 0.45-0.62. Conclusions This study elucidates the association between rural background and rural practice for both GPs and specialists. It follows that increased take-up of rural practice by new graduates requires an increased selection of students with strong rural

  8. Literacy in Rural America: A Study of Current Needs and Practices.

    Science.gov (United States)

    Bailey, Gwen; And Others

    This report examines rural practice in adult literacy programs and estimates the extent and nature of rural illiteracy. Surveys were sent to 3,287 rural literacy programs; more than 700 program directors responded for a return rate of 22 percent. In addition, 150 program directors and key state literacy contacts were interviewed by telephone.…

  9. Pharmacist Staffing, Technology Use, and Implementation of Medication Safety Practices in Rural Hospitals

    Science.gov (United States)

    Casey, Michelle M.; Moscovice, Ira S.; Davidson, Gestur

    2006-01-01

    Context: Medication safety is clearly an important quality issue for rural hospitals. However, rural hospitals face special challenges implementing medication safety practices in terms of their staffing and financial and technical resources. Purpose: This study assessed the capacity of small rural hospitals to implement medication safety…

  10. Is a practice-based rural research network feasible in Europe?

    Science.gov (United States)

    Klemenc-Ketis, Zalika; Kurpas, Donata; Tsiligianni, Ioanna; Petrazzuoli, Ferdinando; Jacquet, Jean-Pierre; Buono, Nicola; Lopez-Abuin, Jose; Lionis, Christos

    2015-01-01

    Research in family medicine is a well-established entity nationally and internationally, covering all aspects of primary care including remote and isolated practices. However, due to limited capacity and resources in rural family medicine, its potential is not fully exploited yet. An idea to foster European rural primary care research by establishing a practice-based research network has been recently put forward by several members of the European Rural and Isolated Practitioners Association (EURIPA) and the European General Practice Research Network (EGPRN). Two workshops on why, and how to design a practice-based research network among rural family practices in Europe were conducted at two international meetings. This paper revisits the definition of practice-based research in family medicine, reflects on the current situation in Europe regarding the research in rural family practice, and discusses a rationale for practice-based research in rural family medicine. A SWOT analysis was used as the main tool to analyse the current situation in Europe regarding the research in rural family practice at both meetings. The key messages gained from these meetings may be employed by the Wonca Working Party on research, the International Federation of Primary Care Research Network and the EGPRN that seek to introduce a practice-based research approach. The cooperation and collaboration between EURIPA and EGPRN creates a fertile ground to discuss further the prospect of a European practice-based rural family medicine research network, and to draw on the joint experience.

  11. Medical student selection criteria as predictors of intended rural practice following graduation

    OpenAIRE

    Puddey, Ian B.; Mercer, Annette; Playford, Denese E; Pougnault, Sue; Riley, Geoffrey J

    2014-01-01

    Background Recruiting medical students from a rural background, together with offering them opportunities for prolonged immersion in rural clinical training environments, both lead to increased participation in the rural workforce after graduation. We have now assessed the extent to which medical students’ intentions to practice rurally may also be predicted by either medical school selection criteria and/or student socio-demographic profiles. Methods The study cohort included 538 secondary s...

  12. Factors affecting pharmacists' selection of rural or urban practice sites in Nebraska.

    Science.gov (United States)

    Scott, D M; Neary, T J; Thilliander, T; Ueda, C T

    1992-08-01

    A questionnaire was used to determine why pharmacists in Nebraska chose urban or rural practice sites and to help the University of Nebraska College of Pharmacy encourage students to consider rural practice. Questionnaires were mailed to 1427 Nebraska pharmacists to gather data about their practice, job satisfaction, location of rearing, location of spouse's rearing, and prepharmacy and clerkship training. Usable responses were sorted into those from urban pharmacists (residing in Omaha and Lincoln and their suburban areas) and those from rural pharmacists (all others). Of the 689 usable responses, 315 (45.7%) were from urban pharmacists and 374 (54.3%) were from rural pharmacists. Of the rural pharmacists, 93% [corrected] grew up in communities of fewer than 100,000 people and 60% grew up in communities of fewer than 5,000 people. Respondents cited income potential, desirability of practice site, influence of spouse and family, and quality of children's schools as factors that most influenced their choice of practice site. Based on the survey results, the University of Nebraska College of Pharmacy took actions to recruit students from rural communities and increase students' exposure to rural practice settings. Pharmacists who were reared or trained in rural areas were more likely to practice in rural Nebraska than pharmacists who had only urban experience.

  13. KNOWLEDGE, ATTITUDE AND PRACTICES OF INFANT FEEDING PRACTICES AMONG RURAL WOMEN IN EASTERN INDIA

    Directory of Open Access Journals (Sweden)

    Ratan

    2015-11-01

    Full Text Available Poor infant feeding practices and their consequences are one of the world's major problems and a serious obstacle to social and economic development. Breastfeeding is one of the most important determinants of child survival , birth spacing , and the prevent ion of childhood infections. The beneficial effects of breastfeeding depend on its initiation , duration , and the age at which the breastfed child is weaned. Breastfeeding practices vary among different regions and communities. AIMS AND OBJECTIVES : To assess the knowledge , attitude and practices of infant feeding and , to assess the prevalence of exclusive breastfeeding practices among women in rural area of West Bengal , India. MATERIALS AND METHODS: This cross - sectional study was conducted on mothers of childr en less than two year of age attending the outpatient department of Malda Medical College and Hospital , a rural medical college in Eastern India. A total of 200 mothers were interviewed who were randomly selected. A structured , pretested and predesigned qu estionnaire was used to collect information on the socio - demographic profile and infant feeding practice. RESULTS : Mothers of male children were 65% and female children were 35%. 44% were literate upto middle school and 28% with primary education. 14% mothe rs were illiterate. 52% of mothers had the knowledge about initiation of breast feeding within 1 hour of birth whereas only 28% practiced it. 80% mothers had the knowledge of exclusive breast feeding but only 60% practiced it. 24% of infants had received p relacteal feeds and only 2% breast fed upto 24 months. CONCLUSIONS : Despite higher rates of early initiation of breastfeeding and exclusive breastfeeding , awareness of the benefits of exclusive breastfeeding was low. Creating an awareness of the advantages of breastfeeding will strengthen and support this common practice in rural communities and avoid early introduction of complementary foods for socio - cultural

  14. Pharmacy practice in small and rural hospitals in Illinois--2011.

    Science.gov (United States)

    Schumock, Glen T; Ursan, Iulia D; Crawford, Stephanie Y; Walton, Surrey M; Donnelly, Andrew J

    2013-07-01

    The results of a 2011 survey evaluating pharmacy services at small and rural Illinois hospitals are presented and compared with data from similar surveys in 2001 and 1991. A questionnaire modeled on the previous survey instruments but updated to reflect contemporary pharmacy practice was mailed to pharmacy directors at 86 small hospitals (i.e., hospitals (i.e., located outside metropolitan areas). The response rate was 46.5%. The survey data indicated that 57.5% of hospitals represented in the 2011 survey had a centralized drug distribution system, 35.0% had a hybrid system, and 7.5% had a decentralized system. The most commonly reported form of technology was automated dispensing cabinets, which were in use at 75.0% of hospitals in 2011, compared with 34.8% of hospitals represented in the 2001 survey. Barcode verification of medication doses before dispensing and at the time of administration was performed at 50% and 70% of hospitals, respectively. While the provision of clinical pharmacy services has risen sharply since 1991, substantial changes were not observed between 2001 and 2011 except in the provision of compliance and drug histories (67.6% of hospitals in 2011 versus 46.8% in 2001) and pharmacist participation in medical emergency responses (54.0% versus 34.0%). A 2011 survey of pharmacy departments in small and rural Illinois hospitals provided information on the use of automation and health information technologies and showed changes in the provision of many clinical pharmacy services since 1991.

  15. Child feeding practices in a rural Western Kenya community

    Directory of Open Access Journals (Sweden)

    Grace M. Mbagaya

    2009-04-01

    Full Text Available Background: Breastfeeding is nearly universal in Kenya. However, supplementation of breast milk starts too early, thereby exposing the infants to diarrhoea and other infections. Despite the recommendation of the World Health Organization (WHO of exclusive breastfeeding (EB from birth to six months, EB is rare and poorly timed and complementary feeding (CF practices are still common. The study describes feeding practices of children aged 0 to 24 months in the Mumias Division of the Kakamega district in Kenya. Method: Using a cross-sectional study, 180 mothers of infants/children were interviewed using a structured questionnaire. Data on socio-demographic characteristics, feeding practices and sources of information on the same were obtained from the mothers.Results: Whereas 92.1% of the children were breastfed, only 12.2% of the mothers practiced EB up to 4 to 6 months. Mothers introduced liquids and complementary foods at a mean age of 2.7 months and by the fourth month, more than one-third (34.5% of the mothers had initiated CF. Apart from water, fresh milk, tea, commercial juices, maize-meal/millet porridge, mashed potatoes, bananas and fruits were also introduced. The perceived reasons for introducing these foods included the child being old enough (33.8%, another pregnancy (25%, insufficient milk (20.3%, sickness of the mother or child (10.5% and in order for the child to eat other foods (11.4%. Over half (53.3% of the mothers obtained information on BF and CF from friends, neighbours, media advertisements and health workers.Conclusion: Breastfeeding is common; however, mothers do not seem to practice the WHO recommendations. Mothers in this study area and other rural communities need to be empowered with information on the correct BF and CF practices through existing government health services, nongovernmental organisations and other community-based networks, especially in the light of the HIV/AIDS pandemic.

  16. Restrictive Factors of Vocational Education Development in Cultivation of Rural Practical Skilled Personnel and Countermeasures

    OpenAIRE

    2014-01-01

    Kunming City is accelerating the process of agricultural modernization, industrialization, informationization and ecological development. In this process, it needs speeding up building new high level and advanced rural practical skilled personnel team suitable for development demand. By empirical analysis method, this paper discussed the factors restricting vocational education in cultivation of rural practical skilled personnel. Then, it came up with countermeasures in cultivation objective ...

  17. A commentary on the implications of medication prescription rights for the chiropractic profession.

    Science.gov (United States)

    Emary, Peter C; Houweling, Taco A W; Wangler, Martin; Burnie, Stephen J; Hood, Katherine J; Erwin, W Mark

    2016-01-01

    There is a growing desire within the chiropractic profession to expand the scope of practice to include limited medication prescription rights for the treatment of spine-related and other musculoskeletal conditions. Such prescribing rights have been successfully incorporated into a number of chiropractic jurisdictions worldwide. If limited to a musculoskeletal scope, medication prescription rights have the potential to change the present role of chiropractors within the healthcare system by paving the way for practitioners to become comprehensive specialists in the conservative management of spine / musculoskeletal disorders. However, if the chiropractic profession wishes to lobby to expand the scope of practice to include limited prescriptive authority, several issues must first be addressed. These would include changes to chiropractic education and legislation, as well as consideration of how such privileges could impact the chiropractic profession on a more theoretical basis. In this commentary, we examine the arguments in favour of and against limited medication prescription rights for chiropractors and discuss the implications of such privileges for the profession.

  18. Chiropractic treatment of low back pain: a prospective survey.

    Science.gov (United States)

    Bronfort, G

    1986-06-01

    The clinical course of low back pain (LBP) during chiropractic treatment has not previously been reported on the basis of a prospective survey. The prospective survey is based on patient questionnaires filled in before treatment was started, as well as 1, 3, 6 and 12 months later. Clinical examination was performed at entry and also 1 month later. Two hundred ninety-eight patients with acute or chronic LBP from ten different chiropractic clinics were selected sequentially for this study. At the time of first contact between these patients and the clinics, the current episode of LBP had lasted less than 1 wk in 30% of the patients and for more than 4 wk in 51%. Sixty-five percent had radiating pain into the lower extremity, and 38% were unable to work. Fifty-three percent of the patients had consulted a medical doctor or had received other types of treatment due to the current episode. Nineteen percent were referred by a medical doctor to the chiropractor. After each period of registration, approximately 75% of the patients reported being free of symptoms or feeling much better. The present study was designed to be compared to a similar investigation carried out in a general medical practice. A clear indication of a more favorable outcome was found in those patients receiving chiropractic treatment when compared to those receiving medical treatment, especially concerning such factors as ability to work, bedrest and use of medication. Only a randomized controlled clinical trial is suited for a direct comparison of the effect and cost of chiropractic and medical treatment of LBP.

  19. Chiropractic and CAM Utilization: A Descriptive Review

    Directory of Open Access Journals (Sweden)

    Meeker William C

    2007-01-01

    Full Text Available Abstract Objective To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions Data Sources A literature of PubMed and MANTIS was performed using the key terms Chiropractic; Low Back Pain; Utilization Rate; Use Rate; Complementary and Alternative Medicine; and Health Services in various combinations. Data Selection A total of 137 papers were selected, based upon including information about chiropractic utilization, CAM utilization and low back pain and other conditions. Data Synthesis Information was extracted from each paper addressing use of chiropractic and CAM, and is summarized in tabular form. Results Thematic analysis of the paper topics indicated that there were 5 functional areas covered by the literature: back pain papers, general chiropractic papers, insurance-related papers, general CAM-related papers; and worker's compensation papers. Conclusion Studies looking at chiropractic utilization demonstrate that the rates vary, but generally fall into a range from around 6% to 12% of the population, most of whom seek chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself used by people suffering from a variety of conditions, though it is often used not as a primary intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs for comparable results compared to conventional medicine.

  20. 2016 World Federation of Chiropractic/Association of Chiropractic Colleges Education Conference proceedings

    Science.gov (United States)

    2016-01-01

    In October 2016, the World Federation of Chiropractic and Association of Chiropractic Colleges Education Conference was held in Montreal, Canada. This summary provides the titles of the contributed presentations. The full set of abstracts for this meeting are published online at www.journalchiroed.com as an exclusively electronic publication that is part of volume 30, issue 2 (October 2016) of the Journal of Chiropractic Education. PMID:27749117

  1. Assessment and risk reduction of infectious pathogens on chiropractic treatment tables

    Directory of Open Access Journals (Sweden)

    Husbands Chris

    2007-06-01

    Full Text Available Abstract Background To investigate the presence of pathogenic microbes on chiropractic treatment tables in one outpatient teaching clinic. Additional aims were to test inexpensive disinfectants on tables that may kill microbes and suggest infection control measures for chiropractic offices, clinics and classrooms. The aim of the study was to assess the presence of pathogenic microbes on treatment tables in one outpatient teaching clinic and determine a simple behavioral model for infection control including table disinfection and accepted hand washing and sanitizing protocols. Methods 10 treatment tables were selected and sampled for possible microbial flora on face and hand pieces. Samples were cultured on MacConky's agar and mannitol salt agar, labeled and incubated for up to 48 hours. Confirmatory testing of microbes to determine if drug resistant flora were present was performed. Among tables tested, 5 were selected to test disinfectants. One-half of the face piece and 1 hand piece were treated with two different wipes and then post-tested for microbes. Results Pathogenic microbes were present on chiropractic treatment tables including methicillin-resistant Staph aureus. Simple disinfectants neutralized the pathogens. A rudimentary disinfection procedure and infection control measures are suggested based on the findings. Conclusion Pathogenic microbes may be present on chiropractic treatment tables and can be effectively killed with proper disinfecting. Hand washing/sanitizing is an important measure in infection control as is table disinfecting. Rudimentary behavioral changes to improve chiropractic clinic infection control are needed. More comprehensive behavioral models are needed. All teaching clinics and private chiropractic offices should adopt infection control practices including routine table disinfecting and hand sanitizing. Effective measures can be put in place at minimal costs. Accrediting bodies of chiropractic institutions

  2. The prevalence of the term subluxation in North American English-Language Doctor of chiropractic programs

    Directory of Open Access Journals (Sweden)

    Mirtz Timothy A

    2011-06-01

    Full Text Available Abstract Background The subluxation construct has been a divisive term in the chiropractic profession. There is a paucity of evidence to document the subluxation. Some authors have questioned the propriety of continuing to use the term. Aim The purpose of this study is to examine current North American English language chiropractic college academic catalogs and determine the prevalence of the term subluxation in the respective chiropractic program curricula. Methods Sixteen current English-language North American chiropractic college academic catalogs were studied. The term subluxation was searched for in each of the catalogs. Categories were developed for the usage of the term. These included "total times mentioned", "subluxation mentioned in a course description", "subluxation mentioned in a course title", "subluxation mentioned in a technique course description", and "subluxation mentioned in a philosophy course description." The prevalence of the "subluxation mentioned in a course description" was compared to the total programmatic curriculum. Results Palmer College in Florida devoted 22.72% of its curriculum to courses mentioning the subluxation followed by Life University (Marietta, GA and Sherman College with 16.44% and 12.80% respectively. As per specific coursework or subjects, an average of 5.22 courses or subjects have descriptions mentioning the term subluxation. Three schools made no mention of the term subluxation in their academic catalogs; they were National University of Health Sciences, Canadian Memorial Chiropractic College, and Southern California University of Health Sciences. Conclusion Despite the controversies and paucity of evidence the term subluxation is still found often within the chiropractic curricula of most North American chiropractic programs. Future research should determine if changes in accreditation standards and research on evidence based practice will affect this prevalence.

  3. Enlightenment from ancient Chinese urban and rural stormwater management practices.

    Science.gov (United States)

    Wu, Che; Qiao, Mengxi; Wang, Sisi

    2013-01-01

    Hundreds of years ago, the ancient Chinese implemented several outstanding projects to cope with the changing climate and violent floods. Some of these projects are still in use today. These projects evolved from the experience and knowledge accumulated through the long coexistence of people with nature. The concepts behind these ancient stormwater management practices, such as low-impact development and sustainable drainage systems, are similar to the technology applied in modern stormwater management. This paper presents the cases of the Hani Terrace in Yunnan and the Fushou drainage system of Ganzhou in Jiangxi. The ancient Chinese knowledge behind these cases is seen in the design concepts and the features of these projects. These features help us to understand better their applications in the contemporary environment. In today's more complex environment, integrating traditional and advanced philosophy with modern technologies is extremely useful in building urban and rural stormwater management systems in China.

  4. Factors related to doctors' choice of rural pathway in general practice specialty training.

    Science.gov (United States)

    Sureshkumar, Premala; Roberts, Chris; Clark, Tyler; Jones, Michael; Hale, Robert; Grant, Marcia

    2017-06-01

    To investigate the factors eligible applicants consider in electing for a rural pathway into specialty training. Cohort study. Australia. Applicants to the Australian General Practice Training program. Applicants' initial preference of either a general or rural pathway to undertake specialty training. Of the 2,221 applicants, 45% were Australian Medical Graduates (AMGs), 27% Foreign Graduates of Accredited Medical Schools (FGAMS) and 29% International Medical Graduates (IMGs). Through government regulation, two thirds (70%) were eligible to train on both general and rural pathways and a third (30%) were required to train rurally. For applicants eligible for general pathway (n = 1552), those with rural background [Odds Ratio (OR) = 3.7, 95% CI 2.7-5.2] and rural clinical school experience (OR = 2.0, 95% CI 1.5-2.8) were more likely to choose the rural pathway. In addition, FGAMS who were eligible for the general pathway were less likely to choose a rural pathway when compared with IMGs (OR = 0.33, 95%CI 0.1 = 0.7). In applicants who changed their training pathway from their initial to revised preference, lower Multiple-Mini-Interview (OR = 0.54, 95% CI 0.43-0.66) and Situational Judgement Test z-scores (OR = 0.68, 95% CI 0.56-0.83) were associated with a higher probability of changing from a general to rural pathway preference. For those eligible for a general or rural pathway, rural background and rural clinical school experience are associated with the decision to elect for rural training. Targeted support for international and foreign graduates of Australia/New Zealand schools may influence them to train rurally. © 2016 National Rural Health Alliance Inc.

  5. Case management of chiropractic patients with cervical brachialgia

    DEFF Research Database (Denmark)

    Guenoun, Olivier; Debarle, Michel; Garnesson, Coralie;

    2011-01-01

    Not much is known about the French chiropractic profession on, for example, level of consensus on clinical issues.......Not much is known about the French chiropractic profession on, for example, level of consensus on clinical issues....

  6. Attitudes Toward Chiropractic: A Survey of Canadian Obstetricians.

    Science.gov (United States)

    Weis, Carol Ann; Stuber, Kent; Barrett, Jon; Greco, Alexandra; Kipershlak, Alexander; Glenn, Tierney; Desjardins, Ryan; Nash, Jennifer; Busse, Jason

    2016-04-01

    We assessed the attitudes of Canadian obstetricians toward chiropractic with a 38-item cross-sectional survey. Ninety-one obstetricians completed the survey, for a response rate of 14% (91 of 659). Overall, 30% of respondents held positive views toward chiropractic, 37% were neutral, and 33% reported negative views. Most (77%) reported that chiropractic care was effective for some musculoskeletal complaints, but 74% disagreed that chiropractic had a role in treatment of non-musculoskeletal conditions. Forty percent of respondents referred at least some patients for chiropractic care each year, and 56% were interested in learning more about chiropractic care. Written comments from respondents revealed concerns regarding safety of spinal manipulation and variability among chiropractors. Canadian obstetricians' attitudes toward chiropractic are diverse and referrals to chiropractic care for their patients who suffer from pregnancy-related low back pain are limited. Improved interprofessional relations may help optimize care of pregnant patients suffering from low back pain.

  7. Developing Integrated Rural Tourism: Actor Practices in the English/Welsh Border

    Science.gov (United States)

    Saxena, Gunjan; Ilbery, Brian

    2010-01-01

    This paper examines community attitudes and distinctive practices that shape local responses to integrated rural tourism (IRT) development in the lagging rural region of the English/Welsh border area. The focus is on how actors acquire attributes as a result of their relations with others and how these assumed identities are performed in, by and…

  8. People's practices: Exploring contestation, counter-development, and rural livelihoods. Cases from Muktinagar, Bangladesh

    NARCIS (Netherlands)

    Huq, H.

    2000-01-01

    People's Practices: Exploring contestation, Counter - development, and rural livelihoodsThe central problems explored in the thesis concern the vulnerability of disadvantaged local people, especially women, and their agency; development discourses and counter-development processes; livelihood strate

  9. The theory and practice of 100 pilot SHP-based rural electrification counties in China

    Energy Technology Data Exchange (ETDEWEB)

    Luo Gaorong [Organization of the United Nations, Beijing (China). International Centre of Small Hydroelectric Power Plants

    1995-07-01

    This document presents the theory and practice of 100 pilot small hydroelectric power plants (SHP) based rural electrification counties in China. The document reports the research contents, methodology and results, and the pilot benefit analysis and evaluation.

  10. The habitus and technological practices of rural students: a case study

    African Journals Online (AJOL)

    Keywords: Bourdieu; ethnography; higher education; practices; rural; South Africa; students; ... it became clear that it would be important to describe the challenges and adjustments students from ..... have to travel a distance to gain access.

  11. Chiropractic

    Science.gov (United States)

    ... care profession. Chiropractors perform adjustments (manipulations) to the spine or other parts of the body. The goal is to correct alignment problems, ease pain, and support the body's natural ...

  12. Rural hospital web-based, evidence-based practice professional development: challenges and opportunities.

    Science.gov (United States)

    Oman, Kathleen S; Fink, Regina M; Krugman, Mary; Goode, Colleen J; Traditi, Lisa K

    2013-01-01

    To provide quality patient care and achieve positive patient outcomes, it is widely recognized that organizations must develop a supportive environment that encourages individuals to practice from a research- and evidence-based framework. This article describes a Web-based professional educational program designed to teach principles of evidence-based practice to nurses in rural hospitals. Nurses working in staff development will find this useful for designing educational programs for staff in rural hospitals.

  13. QUALITY MANAGEMENT PRACTICES IN RURAL AND URBAN SMEs – A COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Rashmi Srinivas

    2013-12-01

    Full Text Available The level of awareness on Quality Management Practices (QMP has increased considerably over the last decade, but the literature findings reveal the lack of studies on QMP and its implementation in rural SMEs. The exploratory research focuses on identifying, analysing and comparing the level of QMP implementation in urban and rural Small and Medium Enterprises (SMEs in Bangalore. The research hypothesis is that, urban and rural SMEs would differ significantly in implementation of different quality practices. Data was collected through structured questionnaire and analyzed using F-test and chi-square test, as appropriate, to detect the statistical significance of QMP implementation in urban and rural SMEs. The research findings suggest that research, rural firms are performing at a higher level of sophistication and experience in QMP, further, TQM is the major drive for QMP implementation.

  14. Restrictive Factors of Vocational Education Development in Cultivation of Rural Practical Skilled Personnel and Countermeasures

    Institute of Scientific and Technical Information of China (English)

    Ning; WANG; Fang; LIU

    2014-01-01

    Kunming City is accelerating the process of agricultural modernization,industrialization,informationization and ecological development. In this process,it needs speeding up building new high level and advanced rural practical skilled personnel team suitable for development demand. By empirical analysis method,this paper discussed the factors restricting vocational education in cultivation of rural practical skilled personnel. Then,it came up with countermeasures in cultivation objective of rural vocational education,arrangement of specialized disciplines,key development tasks,and establishment of diversified investment system.

  15. Marketing of rural and remote pharmacy practice via the digital medium.

    Science.gov (United States)

    Peterson, G M; Fitzmaurice, K D; Rasiah, R L; Kruup, H

    2010-08-01

    The shortage of community and hospital pharmacists is particularly acute in rural and remote areas of Australia. Pharmacy students, in particular, as those who may be able to alleviate this shortage, need to be made more aware of the challenges and rewards of rural pharmacy practice. A marketing tool was developed to promote rural and remote pharmacy practice as a career option. A DVD was produced from interviews with health professionals working in rural and remote areas of Australia. This DVD will complement current rural practical placements, which have been incorporated into the curriculum of Australian schools of pharmacy. Interviews were conducted with healthcare professionals from areas in Tasmania, Northern Queensland and the Northern Territory. Interviewees included pharmacists, graduate pharmacists, pharmacy students, aboriginal health workers and a general practitioner. Each of the interviewees was able to provide personal accounts of experiences in rural and remote healthcare, and roles and opportunities for pharmacists. A final draft of the DVD was shown to University of Tasmania students to assess the impact and quality of the production. A number of common themes arose from interviewing and these were subsequently converted into five key chapters of the DVD - Lifestyle, Belonging, Diversity, Indigenous Health and 'Give it a go'. The final DVD, produced from over 15 h of footage, runs for 35 min. Students reported positive feedback on both the technical quality and the information contained within the DVD; 37% of students who viewed the DVD felt that it increased their awareness of what rural pharmacy has to offer. The rural pharmacy, 'Enjoy the Lifestyle' DVD can be used to increase awareness of rural and remote pharmacy practice to students and other pharmacists, and complements other pharmacy workforce strategies for rural and remote areas of Australia. It could also be a useful approach for adaptation in other countries.

  16. Chiropractic management of a hypertensive patient.

    Science.gov (United States)

    Plaugher, G; Bachman, T R

    1993-10-01

    Although many chiropractors may treat patients who have concomitant hypertensive disease, there is a paucity of literature on the nuances of case management for these patients. We report a patient who underwent a course of chiropractic care with a previous diagnosis of chronic essential hypertension. A 38-yr-old male presented for chiropractic care with complaints of hypertension, drug-related side effects and lower back pain. He was also receiving concurrent medical care for his hypertension. The patient received specific contact, short lever arm spinal adjustments as the primary mode of chiropractic care. During the course of chiropractic treatment, the patient's need for hypertensive medication was reduced. The patient's medical physician gradually withdrew the medication over 2 months. Specific contact short lever arm spinal adjustments may cause a hypotensive effect in a medicated hypertensive patient that may lead to complications (e.g., hypotension). Since a medicated hypertensive patient's blood pressure may fall below normal while he or she is undergoing chiropractic care, it is advised that the blood pressure be closely monitored and medications adjusted, if necessary, by the patient's medical physician.

  17. Parenting practice and children's well-being in rural China

    OpenAIRE

    Chen, Mengtong; 陈孟彤.

    2016-01-01

    Parental absence is generally linked to poorer child well-being. In China, over 61 million rural children are left behind with other caregivers when one or both parents have to migrate to urban areas to work. A meta-analysis of 106 empirical studies reveals that left-behind children in rural China are generally more disadvantaged compared with non-left-behind children, in regard to psychological adjustment, behavioral health, school-related outcomes, child safety, and other protective outcome...

  18. Chiropractic management of fibromyalgia syndrome: a systematic review of the literature.

    Science.gov (United States)

    Schneider, Michael; Vernon, Howard; Ko, Gordon; Lawson, Gordon; Perera, Jerome

    2009-01-01

    Fibromyalgia syndrome (FMS) is one of the most commonly diagnosed nonarticular soft tissue conditions in all fields of musculoskeletal medicine, including chiropractic. The purpose of this study was to perform a comprehensive review of the literature for the most commonly used treatment procedures in chiropractic for FMS and to provide evidence ratings for these procedures. The emphasis of this literature review was on conservative and nonpharmaceutical therapies. The Scientific Commission of the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) was charged with developing literature syntheses, organized by anatomical region, to evaluate and report on the evidence base for chiropractic care. This article is the outcome of this charge. As part of the CCGPP process, preliminary drafts of these articles were posted on the CCGPP Web site www.ccgpp.org (2006-8) to allow for an open process and the broadest possible mechanism for stakeholder input. Online comprehensive literature searches were performed of the following databases: Cochrane Database of Systematic Reviews; National Guidelines Clearinghouse; Cochrane Central Register of Controlled Trials; Manual, Alternative, and Natural Therapy Index System; Index to Chiropractic Literature, Cumulative Index to Nursing and Allied Health Literature; Allied and Complementary Medicine; and PubMed up to June 2006. Our search yielded the following results: 8 systematic reviews, 3 meta-analyses, 5 published guidelines, and 1 consensus document. Our direct search of the databases for additional randomized trials did not find any chiropractic randomized clinical trials that were not already included in one or more of the systematic reviews/guidelines. The review of the Manual, Alternative, and Natural Therapy Index System and Index to Chiropractic Literature databases yielded an additional 38 articles regarding various nonpharmacologic therapies such as chiropractic, acupuncture, nutritional/herbal supplements

  19. Utilizing doctors' attitudes toward staff training to inform a chiropractic technology curriculum.

    Science.gov (United States)

    Eberhart, Catherine A; Martel, Stacie S

    2015-03-01

    The purpose of this study is to determine attitudes of doctors of chiropractic regarding the importance of staff training in specific skill areas to inform the curriculum management process of a chiropractic technology program. A survey was distributed to registrants of a chiropractic homecoming event. On a 5-point Likert scale, respondents were asked to rate the degree of importance that staff members be trained in specific skills. Descriptive statistics were derived, and a 1-way analysis of variance (ANOVA) was used to test differences between groups based on years in practice and level of staff training. Doctors place a high level of importance on oral communication skills and low importance on nutrition and physical examinations. Comparing groups based on years in practice revealed differences in the areas of passive physiotherapies (F = 3.61, p = .015), legal issues/regulations (F = 3.01, p = .032), occupational safety and health regulation (F = 4.27, p = .006), and marketing (F = 2.67, p = .049). Comparing groups based on level of staff training revealed differences in the areas of occupational safety and health regulations (F = 4.56, p = .005) and cardiopulmonary resuscitation (F = 4.91, p = .003). With regard to their assistants, doctors of chiropractic tend to place high importance on office skills requiring effective communication and place less importance on clinical skills such as physical examinations and physiotherapy.

  20. Chiropractic as spine care: a model for the profession

    Directory of Open Access Journals (Sweden)

    Metz R Douglas

    2005-07-01

    Full Text Available Abstract Background More than 100 years after its inception the chiropractic profession has failed to define itself in a way that is understandable, credible and scientifically coherent. This failure has prevented the profession from establishing its cultural authority over any specific domain of health care. Objective To present a model for the chiropractic profession to establish cultural authority and increase market share of the public seeking chiropractic care. Discussion The continued failure by the chiropractic profession to remedy this state of affairs will pose a distinct threat to the future viability of the profession. Three specific characteristics of the profession are identified as impediments to the creation of a credible definition of chiropractic: Departures from accepted standards of professional ethics; reliance upon obsolete principles of chiropractic philosophy; and the promotion of chiropractors as primary care providers. A chiropractic professional identity should be based on spinal care as the defining clinical purpose of chiropractic, chiropractic as an integrated part of the healthcare mainstream, the rigorous implementation of accepted standards of professional ethics, chiropractors as portal-of-entry providers, the acceptance and promotion of evidence-based health care, and a conservative clinical approach. Conclusion This paper presents the spine care model as a means of developing chiropractic cultural authority and relevancy. The model is based on principles that would help integrate chiropractic care into the mainstream delivery system while still retaining self-identity for the profession.

  1. Determinants of an urban origin student choosing rural practice: a scoping review.

    Science.gov (United States)

    Myhre, Douglas L; Bajaj, Sameer; Jackson, Wesley

    2015-01-01

    The shortage of physicians in rural and remote communities is an ongoing problem. Many studies have shown that the rural background of a student (ie rural origin) is a primary factor in recruiting physicians for practice in rural communities. Scoping reviews are primarily done to gauge the extent of literature on the research question at hand, typically with an intent that future research in that area is a constructive addition to pre-existing knowledge. This scoping review focuses on factors that predispose urban-origin students to choose a carrier in rural medicine. The study used Arksey and O'Malley's guidelines for a scoping review of the literature, which, in contrast to a traditional systematic review, is brief yet comprehensive. Medline (Ovid) and PubMed databases were used to review literature published between 1 January 1970 and 30 November 2014. After removing duplicates, articles were screened based on inclusion and exclusion criteria set up by the research team. The literature search resulted in 435 articles, 418 of which were excluded, leaving 17 articles for comprehensive review. Out of these 17 studies, the following four factors that suggest why urban-origin medical students may choose rural practice were generated: geographic diffusion of physicians in response to economic forces such as debt repayment and financial incentives (five studies), scope of practice and personal satisfaction (five studies), undergraduate and postgraduate rural training (nine studies) and premedical school mindset to practice rurally (five studies). Urban-origin students may choose rural practice because of market forces as well as financial incentives. The participation in undergraduate and postgraduate rural training is reported to positively alter the attitude of urban-origin students. A small subset of these students has a predetermined mindset to practice rurally at the time of matriculation. Obstacles for choosing a rural carrier include, but are not limited to lack

  2. Chiropractic and the politics of health care.

    Science.gov (United States)

    O'Neill, A; Willis, E

    1994-09-01

    Musculoskeletal disorders remain a common disability suffered by Australians, but the question of who should treat them remains a contentious issue as the first centenary of the original chiropractic adjustment approaches. This paper, part of a longitudinal study of the role of chiropractic in the Australian health system, analyses this ongoing debate. Recent events are analysed here in this commentary on the politics of health care in this field. These include meta-analysis to evaluate the effectiveness of spinal manipulation for the treatment of lower back pain, recent legal action in the United States, and the recent epistle against Australian chiropractors published by the Australian Medical Association.

  3. Evolutionary Approach of Virtual Communities of Practice: A Reflection within a Network of Spanish Rural Schools

    Science.gov (United States)

    Frossard, Frédérique; Trifonova, Anna; Barajas Frutos, Mario

    The isolation of rural communities creates special necessities for teachers and students in rural schools. The present article describes "Rural Virtual School", a Virtual Community of Practice (VCoP) in which Spanish teachers of rural schools share learning resources and teaching methodologies through social software applications. The article arrives to an evolutionary model, in which the use of the social software tools evolves together with the needs and the activities of the VCoP through the different stages of its lifetime. Currently, the community has reached a high level of maturity and, in order to keep its momentum, the members intentionally use appropriate technologies specially designed to enhance rich innovative educational approaches, through which they collaboratively generate creative practices.

  4. Time Trends in the Association of a Rural or Urban Background with Practice Location.

    Science.gov (United States)

    Becker, Phillip; And Others

    1979-01-01

    The association of rural or urban background with choice of medical practice location was investigated in two time periods, 1950-1955 and 1963-1968, using the alumni of the Medical College of Wisconsin. High school location, place of birth, and place of internship were found to be significantly associated with practice location. (Author/JMD)

  5. Individual and population doses in Manitoba from chiropractic x-ray procedures

    Energy Technology Data Exchange (ETDEWEB)

    Huda, W.; Sourkes, A.M. (Manitoba Cancer Treatment and Research Foundation, Winnipeg, MB (Canada))

    1989-12-01

    Manitoba (population of 1.0 million) has 37 chiropractors who perform x-rays on behalf of 100 practising chiropractors. In 1987 these specialists performed approximately 33 300 spinal x-ray studies. Cervical spine examinations contribute the lowest patient dose (average H{sub E} of 26 {mu}Sv); thoracic and lumbar spine examinations show considerably higher patient dose (H{sub E} in the range 24-410 {mu}Sv) Average patient H{sub E} was determined to be 220 {mu}Sv. Lumbar spine examinations account for 45% of all chiropractic x-ray examinations (84% of the collective dose). Cervical spine examinations also account for 45% of chiropractic x-ray examinations, but contribute only 5% of the collective dose with thoracic spine examinations contributing the 11% balance of the collective dose. Patients undergoing chiropractic procedures involving exposure to x-rays account for about 3.6% of all diagnostic x-ray procedures. The per caput dose contribution from chiropractic practice was calculated to be 7.3 {mu}Sv (1.2% of total population dose from diagnostic procedures employing ionising radiation). (author).

  6. Intercultural Awareness in Rural Title 1 Elementary School Teaching Practices

    Science.gov (United States)

    Leventhal, Mary Wilson

    2012-01-01

    The purpose of the study was to examine cultural dissonance between teachers and students with its implications for student achievement in a rural Title 1 elementary school. Most U.S. teachers share a White, monolingual, middle-class, female teaching culture that is a mismatch with their increasingly multicultural student population. That problem…

  7. Integrative studies on rural landscapes: policy expectations and research practice

    NARCIS (Netherlands)

    Tress, B.; Tress, G.; Fry, G.

    2005-01-01

    During the 1990s, integrative (interdisciplinary and transdisciplinary) approaches gained increasing importance for rural landscape studies and numbers of such projects rose. However, it is not clear, what funding agencies expect from integrative projects, how researchers make them operational and w

  8. The Clan Problem in Rural Grassroots Governance and Democratic Practice

    Institute of Scientific and Technical Information of China (English)

    XiaoTangbiao; ZhuShida; DavidKelly

    2004-01-01

    The role of patrilineal clans in rural grassroots governance and democracy is conspicuously stratified. On the one hand, there is variation between village and township levels of governance: clan influence is greater in the former than in the latter. This is linked to the difference in size and area of village and township organizations.

  9. Chiropractic Colleges Seek Legitimacy amid Financial Woes

    Science.gov (United States)

    Fuller, Andrea

    2012-01-01

    Many of the nation's chiropractic colleges, like other small colleges that rely heavily on tuition, are struggling to stay in business. At the same time that they are working to improve their stature in higher education and broadening their missions to increase their appeal, a number of the colleges are seeing enrollments plummet--and revenues are…

  10. A qualitative study of naturopathy in rural practice: A focus upon naturopaths' experiences and perceptions of rural patients and demands for their services

    Directory of Open Access Journals (Sweden)

    Wardle Jon L

    2010-06-01

    Full Text Available Abstract Background Complementary and alternative medicine (CAM use - of which naturopathy constitutes a significant proportion - accounts for approximately half of all health consultations and half of out-of-pocket expenditure in Australia. Data also suggest CAM use is highest amongst rural Australians. Unfortunately little is known about the grass-roots reality of naturopathy or other CAM use in rural regions. Methods Semi-structured interviews were conducted with 20 naturopaths practising in the Darling Downs region of South-East Queensland to assess their perceptions and experiences of rural patients and demand for their services. Results Naturopaths described strong demand in rural areas for their services and perceived much of this demand as attributable to cultural traits in rural communities that served as pull factors for their naturopathic services. Such perceived traits included a cultural affinity for holistic approaches to health and disease and the preventive philosophy of naturopathy and an appreciation of the core tenet of naturopathic practice to develop closer therapeutic relationships. However, cost and a rural culture of self-reliance were seen as major barriers to naturopathic practice in rural areas. Conclusions Demand for naturopathic services in rural areas may have strong underlying cultural and social drivers. Given the apparent affinity for and increasingly large role played by CAM services, including naturopathic medicine, in rural areas it is imperative that naturopathic medicine and the CAM sector more broadly become a core focus of rural health research.

  11. A qualitative study of naturopathy in rural practice: a focus upon naturopaths' experiences and perceptions of rural patients and demands for their services.

    Science.gov (United States)

    Wardle, Jon L; Adams, Jon; Lui, Chi-Wai

    2010-06-28

    Complementary and alternative medicine (CAM) use--of which naturopathy constitutes a significant proportion--accounts for approximately half of all health consultations and half of out-of-pocket expenditure in Australia. Data also suggest CAM use is highest amongst rural Australians. Unfortunately little is known about the grass-roots reality of naturopathy or other CAM use in rural regions. Semi-structured interviews were conducted with 20 naturopaths practising in the Darling Downs region of South-East Queensland to assess their perceptions and experiences of rural patients and demand for their services. Naturopaths described strong demand in rural areas for their services and perceived much of this demand as attributable to cultural traits in rural communities that served as pull factors for their naturopathic services. Such perceived traits included a cultural affinity for holistic approaches to health and disease and the preventive philosophy of naturopathy and an appreciation of the core tenet of naturopathic practice to develop closer therapeutic relationships. However, cost and a rural culture of self-reliance were seen as major barriers to naturopathic practice in rural areas. Demand for naturopathic services in rural areas may have strong underlying cultural and social drivers. Given the apparent affinity for and increasingly large role played by CAM services, including naturopathic medicine, in rural areas it is imperative that naturopathic medicine and the CAM sector more broadly become a core focus of rural health research.

  12. Educating advanced practice nurses in using social media in rural health care.

    Science.gov (United States)

    Rutledge, Carolyn M; Renaud, Michelle; Shepherd, Laurel; Bordelon, Michele; Haney, Tina; Gregory, Donna; Ayers, Paula

    2011-10-03

    Health care in the United States is facing a crisis in providing access to quality care for those in underserved and rural regions. Advanced practice nurses are at the forefront of addressing such issues, through modalities such as health care technology. Many nursing education programs are seeking strategies for better educating students on technology utilization. Health care technology includes electronic health records, telemedicine, and clinical decision support systems. However, little focus has been placed on the role of social media in health care. This paper describes an educational workshop using standardized patients and hands-on experiences to introduce advanced practice nurses in a Doctor of Nursing Practice program to the role of social media in addressing issues inherent in the delivery of rural health care. The students explore innovative approaches for utilizing social media for patient and caregiver support as well as identify online resources that assist providers in a rural setting.

  13. Maternal care practices among the ultra poor households in rural Bangladesh: a qualitative exploratory study

    OpenAIRE

    Choudhury Nuzhat; Ahmed Syed M

    2011-01-01

    Abstract Background Although many studies have been carried out to learn about maternal care practices in rural areas and urban-slums of Bangladesh, none have focused on ultra poor women. Understanding the context in which women would be willing to accept new practices is essential for developing realistic and relevant behaviour change messages. This study sought to fill in this knowledge gap by exploring maternal care practices among women who participated in a grant-based livelihood program...

  14. Practical resources for critical science education in rural Appalachia

    Science.gov (United States)

    Kingsolver, Ann

    2017-03-01

    This article argues that there is no typical Appalachian experience or community. There is more cultural diversity and global interchange in this region of the U.S. than appears in popular representations of "isolated" Appalachians, which are ironic because of the region's having been so central to the global extractive economy for centuries. Some pedagogical resources are provided to encourage or contribute to a broader perspective on the possibilities and knowledge centered in rural communities, with Appalachian examples.

  15. Practical resources for critical science education in rural Appalachia

    Science.gov (United States)

    Kingsolver, Ann

    2016-08-01

    This article argues that there is no typical Appalachian experience or community. There is more cultural diversity and global interchange in this region of the U.S. than appears in popular representations of "isolated" Appalachians, which are ironic because of the region's having been so central to the global extractive economy for centuries. Some pedagogical resources are provided to encourage or contribute to a broader perspective on the possibilities and knowledge centered in rural communities, with Appalachian examples.

  16. Rural nurse specialists: clinical practice and the politics of care.

    Science.gov (United States)

    Fitzgerald, Ruth P

    2008-01-01

    Doctor flight from rural areas is an international phenomenon that places great pressure on primary health care delivery. In New Zealand, the response to these empty doctors' surgeries has been the introduction of nurse-led rural health clinics that have attracted controversy both in the media and from urban-based doctors over whether such nurse-led care is a direct substitution of medical care. This article analyzes the reflections of nurses working in some of these clinics who suggest that their situation is more complex than a direct substitution of labor. Although the nurses indicate some significant pressures moving them closer to the work of doctoring, they actively police this cross-boundary work and labor simultaneously to shore up their nursing identities. My own conclusions support their assertions. I argue that it is the maintenance of a holistic professional habitus that best secures their professional identity as nurses while they undertake the cross-boundary tasks of primary rural health care. There are clear professional benefits and disadvantages for the nurses in these situations, which make the positions highly politicized. These recurring divisions of labor within medical care giving and the elaboration of new types of care worker form an appropriate although neglected topic of study for anthropologists. The study of the social organization of clinical medicine is much enriched by paying closer attention to its interaction with allied health professions and their associated understandings of "good" care.

  17. The Utah Rural Residency Study: A Blueprint for Evaluating Potential Sites for Development of a 4-4-4 Family Practice Residency Program in a Rural Community.

    Science.gov (United States)

    Catinella, A. Peter; Magill, Michael K.; Thiese, Steven M.; Turner, Deborah; Elison, Gar T.; Baden, Daniel J.

    2003-01-01

    Criteria were developed for evaluating rural Utah communities as potential sites for rural family practice residencies. Criteria were concerned with community facilities, physicians, numbers of patients, and physician and hospital commitment to teaching residents. Two of the 10 communities evaluated were found to be potentially capable of…

  18. Pediatric Chiropractic Care: The Subluxation Question And Referral Risk.

    Science.gov (United States)

    Homola, Samuel

    2016-02-01

    Chiropractors commonly treat children for a variety of ailments by manipulating the spine to correct a 'vertebral subluxation' or a 'vertebral subluxation complex' alleged to be a cause of disease. Such treatment might begin soon after a child is born. Both major American chiropractic associations - the International Chiropractic Association and the American Chiropractic Association - support chiropractic care for children, which includes subluxation correction as a treatment or preventive measure. I do not know of any credible evidence to support chiropractic subluxation theory. Any attempt to manipulate the immature, cartilaginous spine of a neonate or a small child to correct a putative chiropractic subluxation should be regarded as dangerous and unnecessary. Referral of a child to a chiropractor for such treatment should not be considered lest a bad outcome harms the child or leads to a charge of negligence or malpractice.

  19. A Cross-Sectional Study on Child Rearing Practices in Rural Goa

    Directory of Open Access Journals (Sweden)

    Jagadish Cacodcar

    2015-10-01

    Full Text Available Aim: To assess the traditional child rearing practices among rural Goan mothers and the various socio demographic factors influencing these practices. Materials and Methods: A cross sectional study was conducted among 307 rural mothers with children < 2 years in two rural areas under rural health and training centre Mandur located 16 kilometres from Panaji Goa, through house to house visits and oral interviews. Analysis of collected data was done using Microsoft Excel and SPSS version. Chi-square test was applied in addition to proportions and percentages. Results: Rooming in was practiced by majority (86% of the mothers within 24 hours of birth. 46.25% of the mothers fed colustrum to their newborns while 73.62 % of the mothers breastfed within 24 hours. 37.59% of the mothers practiced exclusive breastfeeding (EBF for the first six months. The mean duration of breastfeeding was 11.015 th months. 90% of the women was educated 12 standard and above breastfed their babies up to 12 months. Bottle feeding was common (75%. Cereal based diet was the commonest complementary feeding administered by 23% of the mothers. Commonest traditional practices followed included oil massage (97.72% and use of amulets/talisman (97.72% in the study population. Conclusion: Beneficial infant feeding practices such as early initiation of breastfeeding and feeding of colustrum among rural Goan mothers was low despite accessible antenatal care and health care services. However, though some of the traditional children rearing practices followed such as oil massage, delivery at parents' home were as per the recommended norms, some of the beliefs/practices such as kajal application, bathing the newborn immediately after birth, need to be replaced by sound and scientific methods.

  20. Constructing a Practice-Oriented Education System of Urban-Rural Planning

    Institute of Scientific and Technical Information of China (English)

    Yin; Jie; Luo; Xiaolong; Zhang; Qingfei

    2015-01-01

    As China’s urbanization accelerates, there is an increasing demand for urban-rural planning at both national and local levels, making it become an independent fi rst-level discipline. Currently in China, the teaching and research system of urban-rural planning is facing some problems like the uneven education level among various universities, improper knowledge system that hardly meets the actual social demands, and insufficient theoretical research. This article argues that, in order to train qualif ied planners capable of satisfying socio-economic development and urbanrural construction, the teaching and research system of urban-rural planning should be practice-oriented and meet social needs. The healthy development of urban-rural planning discipline should be based on the mutual promotion of teaching and research system.

  1. Building a community of practice in rural medical education: growing our own together.

    Science.gov (United States)

    Longenecker, Randall L; Schmitz, David

    2017-01-01

    This article chronicles the rise, decline, and recent resurgence of rural training track residency programs (RTTs) in the USA over the past 30 years and the emergence of a healthy community of practice in rural medical education. This has occurred during a time in the USA when federal and state funding of graduate medical education has been relatively stagnant and the rules around finance and accreditation of rural programs have been challenging. Many of the early family residency programs developed in the 1970s included a curricular focus on rural practice. However, by the 1980s, these programs were not yet producing the desired numbers of rural physicians. In response, in 1986, Maudlin and others at the family medicine residency in Spokane developed the first 1-2 RTT in Colville, Washington. In the 1990s, and by 2000, early news of success led to a peak of 35 active programs. However, over the next decade these programs experienced significant hardship due to a lack of funding and a general decline in student interest in family medicine. By 2010, only 25 programs remained. In 2010, in an effort to sustain the 1-2 RTT as a national strategy in training physicians for rural practice, a federally funded consortium of individuals and programs established the RTT Technical Assistance program (RTT TA). Building on the pattern of peer support and collaboration set by earlier groups, the RTT TA consortium expanded the existing community of practice in rural medical education in support of RTTs. In-person meetings, peer consultation and visitation, coordinated efforts at student recruitment, and collaborative rural medical education research were all elements of the consortium's strategy. Rather than anchoring its efforts in medical schools or hospitals, this consortium engaged as partners a wider variety of stakeholders. This included physician educators still living and practicing in rural communities ('local experts'), rural medical educator peers, program directors

  2. Sports chiropractic management at the World Ice Hockey Championships

    Directory of Open Access Journals (Sweden)

    Vitiello Andrew L

    2010-12-01

    Full Text Available Abstract Background Ice hockey is an international sport. Injuries occur in a full body fashion, to a number of tissues, commonly through body contact. There is a lack of literature documenting the scope of sports chiropractic practice. Thus, it was the aim to document the type, scope and severity of conditions presenting to, and the treatment provided by, the New Zealand team chiropractor acting as a primary health provider for the duration of the 2007 World Ice Hockey Championships. Methods All conditions presenting were recorded. Diagnosis was recorded along with clinical parameters of injury: injury type, severity, mechanism and whether referral or advanced imaging was required. All treatment provided was continuously recorded, including information on the number of treatments required and the reason, duration, type and location of treatment. Results Players presented for diagnosis of injury 50 times. Muscle (34%, joint (24% and tendon injuries (18% were most common. Players presented with a new injury 76% of the time. Most injuries had been present for less than one week (84%, with 53% occurring through a contact mechanism. Injuries were common at training and match locations. Only two injuries required the player to stop playing or training, both of which were referred for advanced imaging. During the study, 134 treatment consultations were rendered to 45 player injuries. Eighty per-cent of injuries were managed with four or less treatments. Three quarters of treatment was provided at training locations with treatment duration predominantly being between 11-15 minutes (71% and 16-20 minutes (27%. Most treatment delivered was passive in nature (71% although combination active and passive care was provided (27%. Treatment typically involved joint (81% and soft tissue based therapies (81% and was delivered in a full body manner. Conclusions This study documented the injury profile of ice hockey at an international level of competition. It

  3. Rural primary care practices and meaningful use of electronic health records: the role of Regional Extension Centers.

    Science.gov (United States)

    Casey, Michelle M; Moscovice, Ira; McCullough, Jeffrey

    2014-01-01

    To examine the role of Regional Extension Centers (RECs) in helping rural physician practices adopt electronic health records (EHRs) and achieve meaningful use. Using data from the Office of the National Coordinator for Health Information Technology, we conducted a county-level regression analysis using ordinary least squares to better understand rural-urban differences in REC participation, EHR implementation, and meaningful use, controlling for counties' economic conditions. We prepared case studies of 2 RECs that are serving a large number of rural practices, based on interviews with key individuals at the RECs, their partner organizations, and rural primary care practices that received assistance from the RECs. RECs are largely achieving their objective of targeting providers in communities that face barriers to EHRs. REC participants are disproportionately rural and more likely to come from high poverty and low employment communities. The case study RECs had long-standing relationships with rural providers, as well as extensive staff expertise in quality improvement and EHR implementation, and employed a variety of strategies to successfully assist rural providers. Rural providers report that REC assistance was invaluable in helping them implement EHRs and achieve meaningful use status. Modifying the criteria for Medicare and Medicaid EHR incentives could help additional rural providers pay for EHRs. REC federal funding is scheduled to end in 2014, but practices that have not yet adopted EHRs may need significant, ongoing assistance to receive meaningful use. © 2013 National Rural Health Association.

  4. The journal 'chiropractic & osteopathy' changes its title to 'chiropractic & manual therapies'. a new name, a new era

    Directory of Open Access Journals (Sweden)

    Walker Bruce F

    2011-01-01

    Full Text Available Abstract Chiropractic & Osteopathy changes its title to Chiropractic & Manual Therapies in January 2011. This change reflects the expanding base of submissions from clinical scientists interested in the discipline of manual therapy. It is also in accord with the findings of a review of the journal content and a joint venture between the original parent organisation the Chiropractic and Osteopathic College of Australasia and a new partner the European Academy of Chiropractic, which is a subsidiary body of the European Chiropractors' Union. The title change should encourage submissions from all professionals interested in manual therapy including chiropractors, osteopaths, physiotherapists, medical doctors and scientists interested in this field.

  5. The journal 'chiropractic & osteopathy' changes its title to 'chiropractic & manual therapies'. a new name, a new era.

    Science.gov (United States)

    Walker, Bruce F; French, Simon D; Cameron, Melanie; Perle, Stephen M; Lebouef-Yde, Charlotte; Rubinstein, Sidney M

    2011-01-01

    Chiropractic & Osteopathy changes its title to Chiropractic & Manual Therapies in January 2011. This change reflects the expanding base of submissions from clinical scientists interested in the discipline of manual therapy. It is also in accord with the findings of a review of the journal content and a joint venture between the original parent organisation the Chiropractic and Osteopathic College of Australasia and a new partner the European Academy of Chiropractic, which is a subsidiary body of the European Chiropractors' Union. The title change should encourage submissions from all professionals interested in manual therapy including chiropractors, osteopaths, physiotherapists, medical doctors and scientists interested in this field.

  6. Core and Complementary Chiropractic: Lowering Barriers to Patient Utilization of Services.

    Science.gov (United States)

    Triano, John J; McGregor, Marion

    2016-12-01

    The use of chiropractic services has stalled while interest in accessing manipulation services is rising. The purpose of this paper is to consider this dilemma in the context of the dynamics of professional socialization, surveys of public attitudes, and a potential strategic action. This is a reflection work grounded in the literature on professional socialization and the attitudes held regarding chiropractic in modern society, to include its members, and in original data on training programs. Data were interpreted on the background of the authors' cross-cultural experiences spanning patient care, research, education, and interprofessional collaboration. Recommendation on a strategic action to counter barriers in patient referrals was synthesized. Professional socialization is the process by which society enables professional privilege. Illustration of typical and divergent professional socialization models emerged that explain cognitive dissonance toward the profession. Questions of trust are commensurate with the experiences during patient encounters rather than with a common identity for the profession. Diversity among encounters perpetuates the uncertainty that affects referral sources. Commonality as an anchor for consistent professional identity and socialization through the content of core chiropractic, defined by training and practice, offers a means to offset uncertainty. Complementary chiropractic, analogous to complementary medicine, provides an outlet under professional socialization for the interests to explore additional methods of care. The practice workplace is an effective lever for altering barriers to the use of services. Clarifying rhetoric through conceptualization of core and complementary practices simplifies the socialization dynamic. Further, it takes advantage of accepted cultural semantics in meaningful analogy while continuing to empower practical diversity in care delivery in response to evolving scientific evidence.

  7. Creating Opportunities: Good Practice in Small Business Training for Australian Rural Women.

    Science.gov (United States)

    Simpson, Lyn; Daws, Leonie; Wood, Leanne

    2002-01-01

    To overcome barriers to participation in small business training faced by rural Australian women, training needs and delivery issues were identified and a good practice matrix was developed with the following components: marketing, content, delivery, support, impact, and innovation. Underlying principles included unique needs, diversity, use of…

  8. "A'ole" Drugs! Cultural Practices and Drug Resistance of Rural Hawai'ian Youths

    Science.gov (United States)

    Po'A-Kekuawela, Ka'Ohinani; Okamoto, Scott K.; Nebre, La Risa H.; Helm, Susana; Chin, Coralee I. H.

    2009-01-01

    This qualitative study examined how Native Hawai'ian youths from rural communities utilized cultural practices to promote drug resistance and/or abstinence. Forty-seven students from five different middle schools participated in gender-specific focus groups that focused on the cultural and environmental contexts of drug use for Native Hawai'ian…

  9. Title VII Funding and Physician Practice in Rural or Low-Income Areas

    Science.gov (United States)

    Krist, Alex H.; Johnson, Robert E.; Callahan, David; Woolf, Steven H.; Marsland, David

    2005-01-01

    Whether Title VII funding enhances physician supply in underserved areas has not clearly been established. The purpose was to determine the relation between Title VII funding in medical school, residency, or both, and the number of family physicians practicing in rural or low-income communities. A retrospective cross sectional analysis was carried…

  10. The Importance of Context, Reflection, Interaction, and Consequence in Rural Music Education Practice

    Science.gov (United States)

    Prest, Anita

    2013-01-01

    In this paper, I argue that aesthetic music education philosophy, which undergirds many current music teacher education programs, textbooks, practices, and networks, fosters assumptions that are not applicable to rural settings. I outline and critique the main principles of this philosophy and demonstrate the ways in which music teachers' habits…

  11. Adoption and Impacts of Sustainable Agricultural Practices on Maize Yields and Incomes: Evidence from Rural Zambia

    NARCIS (Netherlands)

    Manda, J.; Alene, A.D.; Gardebroek, C.; Kassie, M.; Tembo, G.

    2016-01-01

    This paper uses a multinomial endogenous treatment effects model and data from a sample of over 800 households and 3,000 plots to assess the determinants and impacts of adoption of sustainable agricultural practices (SAPs) on maize yields and household incomes in rural Zambia. Results show that adop

  12. Women, microcredit and family planning practices: a case study from rural Ghana.

    Science.gov (United States)

    Norwood, Carolette

    2011-01-01

    This paper examines the influence of informal banking club participation on family planning practices in rural Ghana. Research from Asia suggests that family planning practices are improved by club participation. This study examines this thesis in an African context, using rural Ghana as a case study. A sample of 204 women (19 years and older) was drawn from Abokobi village, Ghana. Multivariate analyses of direct, mediating and moderating effects of women’s demographic background characteristics, membership status and length, and women’s empowerment status as predictors of family planning practices are assessed. Findings suggest that club membership and membership length is not associated with family planning practices; however, age, education level, number of children and empowerment status are.

  13. Chiropractic and CAM Utilization: A Descriptive Review

    OpenAIRE

    Meeker William C; Lawrence Dana J

    2007-01-01

    Abstract Objective To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions Data Sources A literature of PubMed and MANTIS was performed using the key terms Chiropractic; Low Back Pain; Utilization Rate; Use Rate; Complementary and Alternative Medicine; and Health Services in various combinations. Data Selection A total of 137 papers were selected, based upon including inform...

  14. Chiropractic approach to the management of children

    OpenAIRE

    2010-01-01

    Abstract Background Chiropractic (Greek: done by hand) is a health care profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. There is an emphasis on manual techniques, including joint adjustment and/or manipulation, with a particular focus on joint subluxation (World Health Organization 2005) or mechanical lesion and restoring function. The chiropractor's role in wellness care, p...

  15. BEST PRACTICES FOR SMALL BUSINESS IN RURAL AREAS

    Directory of Open Access Journals (Sweden)

    Aydinova A. T.

    2015-10-01

    Full Text Available The level and nature of the development of small agro-business in the modern Russian economy differs substantially depending on regional specifics. In this context, analysis and compilation of best practices is the development of farming will not only allow revealing the main factors of success, but will also give an opportunity both by farmers and the state authorities to effectively develop this sector. Russian experience in the development of small agro-business has not been well understood; in this context, the analysis of the practice of farming has both theoretical and practical interest. In the article, we present the analysis of management practices of small agricultural enterprises in the regions of Russia. Various forms of marketing of farm products, including the use of agro-franchise and with the use of IT-technologies have been shown

  16. The status of hygiene and sanitation practice among rural model ...

    African Journals Online (AJOL)

    2mikitser

    were involved in the study; comparison of hygiene and sanitation practices of a ... Qualitative data were also collected in June 2011 to complement the findings of the quantitative data from a purposively selected group of women and men ...

  17. Iowa Chiropractic Students Outlook for Practitioners and Need for State-Funded Assistance.

    Science.gov (United States)

    Greiner, Keith

    This state-mandated study examined the needs of Iowa chiropractic students and the Iowa demand for chiropractic health care in order to determine the feasibility of establishing a chiropractic forgivable loan program. The project used financial aid data and repayment rate data to evaluate the need for financial aid for chiropractic students;…

  18. Making space for wind farms: Practices of territorial stigmatisation in rural Denmark

    DEFF Research Database (Denmark)

    Rudolph, David Philipp; Kirkegaard, Julia Kirch

    of territorial stigmatisation are mobilised and aligned by developers and municipalities in order to make space for and legitimise large wind farm projects in rural areas. In doing so, the paper will illustrate how stigmatisation practices are embedded in discourses of rurality as ‘Outskirts......Whilst issues of siting wind farms have mostly revolved around their public acceptance resulting from an unequal distribution of local costs and benefits, the perceived fairness of the planning process and the disruption of places, the challenge of finding adequate locations and getting access...

  19. Sense of place and linguistic practice in a rural Danish community

    DEFF Research Database (Denmark)

    Skovse, Astrid Ravn

    This presentation sets out to explore the relationship between geographical orientation, everyday mobility and linguistic practice among young people in a rural area in Southern Denmark. The Danish speech community as a whole presents a case of rather extensive dialect levelling due to processes......” (cf. Johnstone 2010b). However, recent findings serve as a corrective to this general picture, as researchers from the project Language and Place in Urban and Rural Denmark have shown young people in Southern Jutland, more specifically in the village of Bylderup and surroundings, to speak the local...

  20. Development of a Survey to Assess the Acceptability of an Innovative Contraception Practice among Rural Pharmacists

    Directory of Open Access Journals (Sweden)

    Michael Wong

    2014-03-01

    Full Text Available Improved access to effective contraceptive methods is needed in Canada, particularly in rural areas, where unintended pregnancy rates are high and specific sexual health services may be further away. A rural pharmacist may be the most accessible health care professional. Pharmacy practice increasingly incorporates cognitive services. In Canada many provinces allow pharmacists to independently prescribe for some indications, but not for hormonal contraception. To assess the acceptability for the implementation of this innovative practice in Canada, we developed and piloted a survey instrument. We chose questions to address the components for adoption and change described in Rogers’ “diffusion of innovations” theory. The proposed instrument was iteratively reviewed by 12 experts, then focus group tested among eight pharmacists or students to improve the instrument for face validity, readability, consistency and relevancy to community pharmacists in the Canadian context. We then pilot tested the survey among urban and rural pharmacies. 4% of urban and 35% of rural pharmacies returned pilot surveys. Internal consistency on repeated re-phrased questions was high (Cronbach’s Alpha = 0.901. We present our process for the development of a survey instrument to assess the acceptability and feasibility among Canadian community pharmacists for the innovative practice of the independent prescribing of hormonal contraception.

  1. Breast feeding practices and newborn care in rural areas: A descriptive cross-sectional study

    Directory of Open Access Journals (Sweden)

    Madhu K

    2009-01-01

    Full Text Available Context: Breastfeeding practices play an important role in reducing child mortality and morbidity. This study was aimed to describe the breastfeeding practices prevalent in rural areas. Objectives: The primary objective of this study was to describe the breastfeeding and newborn care practices in rural areas and the secondary objective was to describe the factors affecting the initiation and duration of breastfeeding. Settings and Design: The study was conducted in primary health care center (PHC that is attached to a medical college in Kengeri, rural Bangalore, Karnataka. Materials and Methods: Mothers with children who were 9 months old who came to the PHC for measles vaccination were included in the study and data was collected using the pre-tested questionnaire on breastfeeding and newborn practices. Results: Our study shows 97% of the mothers initiated breastfeeding, 19% used pre lacteal feeds, 90% had hospital deliveries and 10% had home deliveries, and 50% used a house knife to cut the umbilical cord among home deliveries. Conclusions: This study emphasizes the need for breastfeeding intervention programs especially for the mother during antenatal and postnatal check-ups and practices like discarding the colostrum and early/late weaning are still widely prevalent and need to be addressed.

  2. Discovering the healthcare beliefs and practices of rural mestizo Ecuadorians. An ethnonursing study

    Directory of Open Access Journals (Sweden)

    Julie A Moss

    2014-07-01

    Full Text Available Objetive. To discover and understand the healthcare beliefs and practices of mestizo Ecuadorians within rural Ecuador. Methodology. An ethnonursing method developed by Leininger was used to guide this study and four phases of qualitative data analysis. 28 informants were interviewed in Tosagua, Ecuador. Results. Data analysis revealed four themes (a Spirituality and prayer necessary for health and well-being, (b Sharing life with people positively affects health and well-being, (c Incorporation of both traditional and modern medicine is essential to health (d Environmental context beyond the control of the people greatly affect health and well-being. Conclusion. The findings are consistent with the cultural life ways of rural mestizo Ecuadorians who live in community with one another. These results can be used to enable nurses and other healthcare workers to provide care that is acceptable, culturally congruent and promotes health in rural Ecuador.

  3. Social Representations and Citizenship Practices in a Rural Community: A Strategic Communication Contribution

    Directory of Open Access Journals (Sweden)

    Luciana Trimano

    2012-12-01

    Full Text Available The community of Las Calles, located in Traslasierra Valley, in the westof CórdobaProvince, Argentina, is characterised by a unique combination of rural and touristiclife anda largeurban to rural migration movement. In this sense, a diversity of cultural groups and identities coexist in thiscommunity. These cultural groups are part of “culture” as a strategic arena for the understanding of the tensions that tear apart and reconcile the “being together”continuum.This paper analyses social representations and interactions among actors from emergingand existing cultures (hippies and paisas, respectively in this rural community, as well as the emergence of newcodesand citizenshippractices. Citizenship interactions and practices demand the review and redesign of the “current” sociocultural integration and management policies. Here is where strategic communication can and must contribute to the promotion of this community’s territorial and local development.

  4. McTimoney chiropractic: a gentle way with back pain.

    Science.gov (United States)

    Cartlidge, S

    1997-10-01

    There are 1080 chiropractors in the UK today, and almost one-third of these are McTimoney chiropractors. This article outlines the development of McTimoney Chiropractic, which is a particular branch of the chiropractic profession in the UK, taught at the McTimoney Chiropractic College in Abingdon, near Oxford. The McTimoney method is distinguished by its gentle, whole body approach. It aims to correct the alignment of the bones of the spine and other joints of the body, to restore nerve function, to alleviate pain, and to promote natural health. The technique is suitable for the very young as well as the old and frail. In this paper, several nurses-turned-chiropractor offer their personal views. Reference is also made to the McTimoney-Corley technique, which is a similar chiropractic method taught at the Oxford School of Chiropractic, UK.

  5. Core Competencies of the Certified Pediatric Doctor of Chiropractic

    DEFF Research Database (Denmark)

    Hewitt, Elise; Hestbaek, Lise; Pohlman, Katherine A

    2016-01-01

    An outline of the minimum core competencies expected from a certified pediatric doctor of chiropractic was developed using a Delphi consensus process. The initial set of seed statements and substatements was modeled on competency documents used by organizations that oversee chiropractic and medical...... education. These statements were distributed to the Delphi panel, reaching consensus when 80% of the panelists approved each segment. The panel consisted of 23 specialists in chiropractic pediatrics (14 females) from across the broad spectrum of the chiropractic profession. Sixty-one percent of panelists...... had postgraduate pediatric certifications or degrees, 39% had additional graduate degrees, and 74% were faculty at a chiropractic institution and/or in a postgraduate pediatrics program. The panel were initially given 10 statements with related substatements formulated by the study's steering...

  6. A diachronic study of the language of chiropractic.

    Science.gov (United States)

    Budgell, Brian S; Kwong, Alice; Millar, Neil

    2013-03-01

    This study investigates how the language of chiropractic has changed over time. A collection of material, published up until approximately 1950 and consisting of textbooks, monographs and lecture notes from Canadian Memorial Chiropractic College, was analyzed to identify commonly occurring words and phrases. The results were compared to a corpus of recent articles from the Journal of the Canadian Chiropractic Association. This permitted the identification of words which were over-represented in the historical literature and therefore likely have become somewhat archaic or represent themes which are of less import in the modern chiropractic literature. Words which were over-represented in the historical literature often referred to anatomical, pathological and biomechanical concepts. Conversely, words which were comparatively over-represented in the modern chiropractic literature often referred to concepts of professionalism, the clinical interaction and evidence-based care. A detailed analysis is presented of trends in the use of the conceptually important terms subluxation and adjustment.

  7. Professional Identity at Los Angeles College of Chiropractic.

    Science.gov (United States)

    Kimura, Melissa Nagare; Russell, Robb; Scaringe, John

    2016-12-01

    The objective of this article is to describe chiropractic professional identity as espoused by the Los Angeles College of Chiropractic. Professional identity is a construct that begins formation prior to career selection, can be considered the backbone of health care education, and has been linked to career success. Los Angeles College of Chiropractic's professional identity is shaped by a philosophy of health care that is focused on vitalism, holism, naturalism, therapeutic conservatism, critical rationalism, phenomenology, humanism, and interprofessionalism. Other distinguishing aspects include portal-of-entry professionals with broad diagnostic skills; a focus on spine care; promotion of public-health; and delivery of manual treatments. The chiropractic professional identity at the Los Angeles College of Chiropractic focuses on serving the needs of the people who entrust their health to its graduates and will continue to evolve on the basis of many factors, such as politics, social perceptions, and economic conditions.

  8. Exercise prescription: perceptions and physical activity habits in chiropractic students at CMCC

    Science.gov (United States)

    Howitt, Scott; Ethridge, Eric; Nelson, Eric; Gotuaco, Mike; Demello, Louis

    2016-01-01

    Background: Health care practitioner’s physical activity (PA) habits are associated with their likelihood to recommend PA to their patients. The intent of this project is to better understand the Canadian Memorial Chiropractic College (CMCC) students’ perceptions and practices of PA and exercise prescription as this may predict exercise counselling they will provide to future patients. Methods: A 27-item survey was distributed to Canadian Memorial Chiropractic College (CMCC) students (N = 744). The survey determined the proportion of CMCC students that meet the (2012) Canadian Physical Activity Guidelines. Additionally the survey recorded students’ perceptions of PA counselling during patient visits and their own example of maintaining a healthy lifestyle. Results: The response rate for the survey was 46% (N = 343). By using average estimates, it was determined that 72% of the respondents meet the (2012) Canadian Physical Activity Guidelines. 86% of the respondents perceived PA counselling to be usually or always relevant during patient interactions, and approximately 73% believed that exercise counselling is highly relevant to chiropractic practice. Furthermore, at least 88% percent believed that chiropractors must adhere to a healthy lifestyle in order to effectively model a healthy lifestyle to their patients. Conclusions: A high proportion of CMCC students meet PA guidelines, and perceive PA counselling to be highly relevant and important to patient encounters. PMID:28065988

  9. Traditional Birth Attendants in Rural Northern Uganda: Policy, Practice, and Ethics.

    Science.gov (United States)

    Rudrum, Sarah

    2016-01-01

    The current emphasis on skilled attendants as a means to reduce maternal mortality contributes to a discouraging policy environment for traditional birth attendants (TBAs). They continue to attend a significant number of births, however, such that their role and the policies and practices affecting their work remain important to understanding maternity health care and maternal health in the global South. In this article, I examine the policies and practices governing community elders practicing as TBAs in rural northern Uganda. This discussion is relevant to health workers in developing countries and to scholars in fields such as women's studies, sociology, and public health.

  10. Hold that TIGER! A collaborative service-learning academic-practice partnership with rural healthcare facilities.

    Science.gov (United States)

    Fairchild, Roseanne Moody

    2012-01-01

    Observing a renewed focus on community engagement as part of our university's strategic plan and the experiential learning partnerships encouraged by the TIGER (Technology and Information Guiding Education Reform) Initiative in health information technology, an academic-practice partnership was initiated between a group of Midwestern rural hospitals and a university's advanced practice nursing students via the graduate online nursing informatics course. Using a service-learning approach, the course features an emphasis on the collaborative design and implementation of student- and healthcare provider team-driven projects to support rural hospital staff and administrators in meeting the broad spectrum of challenges they face every day. The author discusses the adaptable course outline of foundational and service-learning course activities, recent service-learning projects and outcomes, and results of a cumulative 2-year course evaluation by internal/external stakeholders.

  11. The nature of nursing practice in rural and remote areas of Greenland

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Jensen, A.B.; Præst Wilche, J.

    2013-01-01

    Background The Greenlandic Healthcare Reform (2010) required improved quality of services for health promotion, prevention of infectious and lifestyle diseases, family nursing and evidence-based clinical nursing. Aim To investigate current nursing practice in Greenland and to identify whether......, and subsequently interviewed. Interviews included in-depth questioning, based on emerging outcomes from observation. Interviews were recorded and transcribed; they were analysed within a phenomenological–hermeneutic approach. Results Nurses in rural and remote areas navigate their health promotion and preventive...... nursing, medical and social work. Conclusion The nature of nursing practice in rural and remote Greenland is characterised by a high degree of variability and complexity, with a requirement for a wide range of knowledge and skills. Nurses need to be better prepared with regard to acute medical care...

  12. Retainment incentives in three rural practice settings: variations in job satisfaction among staff registered nurses.

    Science.gov (United States)

    Stratton, T D; Dunkin, J W; Juhl, N; Geller, J M

    1995-05-01

    Researchers have demonstrated repeatedly the importance of the relationship linking job satisfaction to employee retention. In rural areas of the country, where a persistent maldistribution of nurses continues to hamper health care delivery, the potential benefits of bolstering retention via enhancements in job satisfaction are of utmost utility to administrators and providers alike. Data were gathered from a multistate survey of registered nurses (RNs) practicing in rural hospitals, skilled nursing facilities, and community/public health settings (N = 1,647; response rate = 40.3%). The investigators found that the use of tuition reimbursement corresponded significantly with increased levels of job satisfaction among nurses in all three practice environments, as did day care services for nurses in acute care settings. Also, among hospital-based RNs, level of nursing education was found to be a significant factor in the relationship between tuition reimbursement and job satisfaction, with the highest level occurring among diploma-prepared nurses.

  13. Outpatient prescription practices in rural township health centers in Sichuan Province, China

    Directory of Open Access Journals (Sweden)

    Jiang Qian

    2012-09-01

    Full Text Available Abstract Background Sichuan Province is an agricultural and economically developing province in western China. To understand practices of prescribing medications for outpatients in rural township health centers is important for the development of the rural medical and health services in this province and western China. Methods This is an observational study based on data from the 4th National Health Services Survey of China. A total of 3,059 prescriptions from 30 township health centers in Sichuan Province were collected and analyzed. Seven indicators were employed in the analyses to characterize the prescription practices. They are disease distribution, average cost per encounter, number of medications per encounter, percentage of encounters with antibiotics, percentage of encounters with glucocorticoids, percentage of encounters with combined glucocorticoids and antibiotics, and percentage of encounters with injections. Results The average medication cost per encounter was 16.30 Yuan ($2.59. About 60% of the prescriptions contained Chinese patent medicine (CPM, and almost all prescriptions (98.07% contained western medicine. 85.18% of the prescriptions contained antibiotics, of which, 24.98% contained two or more types of antibiotics; the percentage of prescriptions with glucocorticoids was 19.99%; the percentage of prescriptions with both glucocorticoids and antibiotics was 16.67%; 51.40% of the prescriptions included injections, of which, 39.90% included two or more injections. Conclusions The findings from this study demonstrated irrational medication uses of antibiotics, glucocorticoids and injections prescribed for outpatients in the rural township health centers in Sichuan Province. The reasons for irrational medication uses are not only solely due to the pursuit of maximizing benefits in the township health centers, but also more likely attributable to the lack of medical knowledge of rational medication uses among rural doctors and the

  14. [Childhood diarrhea in rural Nicaragua: beliefs and traditional health practices].

    Science.gov (United States)

    Gorter, A C; Sánchez, G; Pauw, J; Pérez, R M; Sandiford, P; Smith, G D

    1995-11-01

    In Nicaragua, the principal cause of infant mortality is diarrhea, which is responsible for 40% of these deaths annually. This statistic reflects the low usage of health services and oral rehydration therapy (ORT). In an effort to improve the situation, several studies were carried out in Villa Carlos Fonseca municipio. This report describes two of those studies, one ethnographic and the other epidemiologic (conducted in 1989 and 1990, respectively), to find out beliefs and traditional health practices and their influence on the way in which mothers responded to their children's diarrheal illness. The ethnographic study involved interviewing 70 mothers with an average age of 28 years who had children under 2 years of age. The children represented two groups: one at high risk for diarrhea and the other at low risk. The objectives were to learn the traditional names for diarrhea, the perception of risk, and the treatments that were used. The epidemiologic study included 391 mothers over 14 years of age with one or more children under age 5 years, of whom 215 had had diarrhea in the two weeks preceding the survey. The objectives were to describe local beliefs and health practices and to determine the incidence of diarrheas according to the diagnosis made by the mothers. At least 12 types of diarrhea were identified, for which terms such as "empacho" and "sol de vista" were used. In most cases, the mothers had more confidence in folkloric treatments that they themselves or the traditional healers (curanderos) applied than in the services offered at health centers. This attitude limited their use of health services and ORT, although it was observed that in certain cases traditional treatments were used in combination with those of western medicine. There was a direct but nonsignificant correlation between the level of schooling of the mothers and the frequency with which they visited the health center. The authors suggest the effects of massages, herbal baths, and other

  15. Development of a nurse practice arrangement in rural Appalachia: triumphs and challenges.

    Science.gov (United States)

    McDaniel, Janet; Strauss, Sarah S

    2006-01-01

    This article describes the development of a nurse practice arrangement for delivery of health services via a mobile health clinic to an underserved, rural Appalachian community in southwestern Virginia. Faculty, students, and staff worked with nontraditional community partners to develop case management strategies for diverse populations of Appalachian and Hispanic clients. The roles of students, faculty, and staff and the successes and obstacles in delivering health services through a university-based outreach program are discussed.

  16. Traditional birth attendants lack basic information on HIV and safe delivery practices in rural Mysore, India

    OpenAIRE

    Adamson Paul; Kumar Bhavana N; Madhivanan Purnima; Krupp Karl

    2010-01-01

    Abstract Background There is little research on HIV awareness and practices of traditional birth attendants (TBA) in India. This study investigated knowledge and attitudes among rural TBA in Karnataka as part of a project examining how traditional birth attendants could be integrated into prevention-of-mother-to-child transmission of HIV (PMTCT) programs in India. Methods A cross-sectional survey was conducted between March 2008 and January 2009 among TBA in 144 villages in Mysore Taluk, Karn...

  17. Farewell to Fiestas and Saints? Changing Catholic Practices in Contemporary Rural Oaxaca

    OpenAIRE

    Toomas Gross

    2009-01-01

    This article discusses recent changes in Catholic festivities, especially the system of fiestas in rural Mexico. The ethnographic focus of the discussion is on indigenous Zapotec communities of the State of Oaxaca. Collective religious practices in Mexican villages contribute to social cohesion. Fiestas commemorating patron saints of the villages play a particularly important role in (re)constructing communal identity and the feeling of collective belongingness. Various global processes like ...

  18. Procedural skills practice and training needs of doctors, nurses, midwives and paramedics in rural Victoria

    Directory of Open Access Journals (Sweden)

    Campbell D

    2015-03-01

    Full Text Available David Campbell,1 Irwyn Shepherd,2 Matthew McGrail,3 Lisa Kassell,4 Marnie Connolly,1,5 Brett Williams,6 Debra Nestel7 1East Gippsland Regional Clinical School, School of Rural Health, Monash University, Melbourne, VIC, 2Simconhealth Healthcare Simulation Consultancy Group, Linsfield, NSW, 3School of Rural Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, 4Southern General Practice Training, Churchill, 5Central Gippsland Health Service, Sale, 6Department of Community Emergency Health and Paramedic Practice, Faculty of Medicine, Nursing and Health Sciences, 7School of Rural Health and HealthPEER, Monash University, Melbourne, VIC, Australia Introduction: Procedural skills are a significant component of clinical practice. Doctors, nurses, midwives and paramedics are trained to use a variety of procedural skills. Rural clinicians in particular are often required to maintain competence in some procedural skills that are used infrequently, and which may require regular and repeated rehearsal. This paper reports on a research project conducted in Gippsland, Victoria, to ascertain the frequency of use, and relevance to clinical practice, of a range of skills in the fields of medicine, nursing, midwifery, and paramedic practice. The project also gathered data on the attitudes of clinicians regarding how frequently and by what means they thought they needed to practice these skills with a particular focus on the use of simulation as an educational method. Methods: The research was conducted following identification of a specific set of procedural skills for each professional group. Skills were identified by an expert steering committee. We developed online questionnaires that consisted of two parts: 1 demographic and professional characteristics, and 2 experience of procedural skills and perceived training needs. We sought to invite all practicing clinicians (doctors, nurses, midwives, paramedics working in Gippsland

  19. A treatise for a new philosophy of chiropractic medicine.

    Science.gov (United States)

    Mirtz, Timothy A

    2017-01-01

    The philosophy of chiropractic has been a much debated entity throughout the existence of the chiropractic profession. Much criticism has been passed upon the historical philosophy of chiropractic and propagated by contemporary adherents. To date, a new philosophy has not been detailed nor presented that demonstrates principles by which to follow. The purpose of this paper is to expand upon the work of Russell Kirk (b.1918, d. 1994), an American political theorist, as a basis for principles to guide the formation of a philosophy of chiropractic medicine (PCM). Each of Kirk's principles will be explained and expounded upon as applicable to a PCM. The addition of the term "medicine" to chiropractic is indicative of a new direction for the profession. The ten principles that provide a foundation for a PCM include: (a) moral order, (b) custom, convention and continuity, (c) prescription, (d) prudence, (e) variety, (f) imperfectability, (g) freedom and property linkage, (h) voluntary community and involuntary collectivism, (i) prudent restraints upon power and human passions, and (j) permanence and change. Each of these principles offers not a dogmatic approach but provides insight into the application of chiropractic medicine to the entire station of the patient and society at large especially that of the economic, social and political. These principles provide direction in not only the approach to the doctor-patient encounter but can be used to visualize the wider world and its potential impact. Instead, these principles examine many tangential issues worthy of discussion that may impact health, social, political, and economic policy and how the chiropractic profession can approach these issues. This paper provides the initial steps in formulating a PCM using principles from a sociological, political and economic standpoint which may impact on how chiropractic medicine approaches the patient and society in totality. In addition, these principles provide the necessary

  20. Isolated rural general practice as the focus for teaching core clinical rotations to pre-registration medical students

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    Davies Llewellyn M

    2005-06-01

    Full Text Available Abstract Background Earlier studies have successfully demonstrated that medical students can achieve success in core clinical rotations with long term attachments in small groups to rural general / family practices. Methods In this study, three students from a class of 226 volunteered for this 1-year pilot program, conducted by the University of Queensland in 2004, for medical students in the 3rd year of a 4-year graduate entry medical course. Each student was based with a private solo general practitioner in a different rural town between 170 and 270 km from the nearest teaching hospital. Each was in a relatively isolated rural setting, rated 5 or 6 on the RRMA scale (Rural, Remote, Metropolitan Classification: capital city = 1, other metropolitan = 2, large regional city = 3, most remote community = 7. The rural towns had populations respectively of 500, 2000 and 10,000. One practice also had a General Practice registrar. Only one of the locations had doctors in the same town but outside the teaching practice, while all had other doctors within the same area. All 3 supervisors had hospital admitting rights to a hospital within their town. The core clinical rotations of medicine, surgery, mental health, general practice and rural health were primarily conducted within these rural communities, with the student based in their own consulting room at the general practitioner (GP supervisor's surgery. The primary teacher was the GP supervisor, with additional learning opportunities provided by visiting specialists, teleconferences and university websites. At times, especially during medicine and surgery terms, each student would return to the teaching hospital for additional learning opportunities. Results All students successfully completed the year. There were no statistical differences in marks at summative assessment in each of the five core rotations between the students in this pilot and their peers at the metropolitan or rural hospital based

  1. Reflex control of the spine and posture: a review of the literature from a chiropractic perspective

    Science.gov (United States)

    Morningstar, Mark W; Pettibon, Burl R; Schlappi, Heidi; Schlappi, Mark; Ireland, Trevor V

    2005-01-01

    Objective This review details the anatomy and interactions of the postural and somatosensory reflexes. We attempt to identify the important role the nervous system plays in maintaining reflex control of the spine and posture. We also review, illustrate, and discuss how the human vertebral column develops, functions, and adapts to Earth's gravity in an upright position. We identify functional characteristics of the postural reflexes by reporting previous observations of subjects during periods of microgravity or weightlessness. Background Historically, chiropractic has centered around the concept that the nervous system controls and regulates all other bodily systems; and that disruption to normal nervous system function can contribute to a wide variety of common ailments. Surprisingly, the chiropractic literature has paid relatively little attention to the importance of neurological regulation of static upright human posture. With so much information available on how posture may affect health and function, we felt it important to review the neuroanatomical structures and pathways responsible for maintaining the spine and posture. Maintenance of static upright posture is regulated by the nervous system through the various postural reflexes. Hence, from a chiropractic standpoint, it is clinically beneficial to understand how the individual postural reflexes work, as it may explain some of the clinical presentations seen in chiropractic practice. Method We performed a manual search for available relevant textbooks, and a computer search of the MEDLINE, MANTIS, and Index to Chiropractic Literature databases from 1970 to present, using the following key words and phrases: "posture," "ocular," "vestibular," "cervical facet joint," "afferent," "vestibulocollic," "cervicocollic," "postural reflexes," "spaceflight," "microgravity," "weightlessness," "gravity," "posture," and "postural." Studies were selected if they specifically tested any or all of the postural reflexes

  2. Reflex control of the spine and posture: a review of the literature from a chiropractic perspective

    Directory of Open Access Journals (Sweden)

    Schlappi Mark

    2005-08-01

    Full Text Available Abstract Objective This review details the anatomy and interactions of the postural and somatosensory reflexes. We attempt to identify the important role the nervous system plays in maintaining reflex control of the spine and posture. We also review, illustrate, and discuss how the human vertebral column develops, functions, and adapts to Earth's gravity in an upright position. We identify functional characteristics of the postural reflexes by reporting previous observations of subjects during periods of microgravity or weightlessness. Background Historically, chiropractic has centered around the concept that the nervous system controls and regulates all other bodily systems; and that disruption to normal nervous system function can contribute to a wide variety of common ailments. Surprisingly, the chiropractic literature has paid relatively little attention to the importance of neurological regulation of static upright human posture. With so much information available on how posture may affect health and function, we felt it important to review the neuroanatomical structures and pathways responsible for maintaining the spine and posture. Maintenance of static upright posture is regulated by the nervous system through the various postural reflexes. Hence, from a chiropractic standpoint, it is clinically beneficial to understand how the individual postural reflexes work, as it may explain some of the clinical presentations seen in chiropractic practice. Method We performed a manual search for available relevant textbooks, and a computer search of the MEDLINE, MANTIS, and Index to Chiropractic Literature databases from 1970 to present, using the following key words and phrases: "posture," "ocular," "vestibular," "cervical facet joint," "afferent," "vestibulocollic," "cervicocollic," "postural reflexes," "spaceflight," "microgravity," "weightlessness," "gravity," "posture," and "postural." Studies were selected if they specifically tested any or

  3. An independent review of NCCAM-funded studies of chiropractic.

    Science.gov (United States)

    Ernst, Edzard; Posadzki, Paul

    2011-05-01

    To promote an independent and critical evaluation of 11 randomised clinical trials (RCTs) of chiropractic funded by the National Centre for Complementary and Alternative Medicine (NCCAM). Electronic searches were conducted to identify all relevant RCTs. Key data were extracted and the risk of bias of each study was determined. Ten RCTs were included, mostly related to chiropractic spinal manipulation for musculoskeletal problems. Their quality was frequently questionable. Several RCTs failed to report adverse effects and the majority was not described in sufficient detail to allow replication. The criticism repeatedly aimed at NCCAM seems justified, as far as their RCTs of chiropractic is concerned. It seems questionable whether such research is worthwhile.

  4. Stakeholders' Recommendations to Improve Patient-centered "LGBTQ" Primary Care in Rural and Multicultural Practices.

    Science.gov (United States)

    Kano, Miria; Silva-Bañuelos, Alma Rosa; Sturm, Robert; Willging, Cathleen E

    2016-01-01

    Individuals among gender/sexual minorities share experiences of stigma and discrimination, yet have distinctive health care needs influenced by ethnic/racial minority and rural realities. We collected qualitative data from lesbian/gay/bisexual/transgender (LGBT) and queer persons across the largely rural, multicultural state of New Mexico, particularly those from understudied ethnic groups, regarding factors facilitating or impeding patient-centered primary care. The themes identified formed the basis for a statewide summit on LGBT health care guidelines and strategies for decreasing treatment gaps. Three to 15 individuals, ages 18 to 75 years, volunteered for 1 of 4 town hall dialogues (n = 32), and 175 people took part in the summit. Participants acknowledged health care gaps pertinent to LGBT youth, elders, American Indians, and Latinos/Latinas, expressing specific concern for rural residents. This preliminary research emphasizes the need to improve primary care practices that treat rural and ethnic-minority LGBT people and offers patient-driven recommendations to enhance care delivery while clinic-level transformations are implemented. © Copyright 2016 by the American Board of Family Medicine.

  5. Socio Demographic Determinants of Delivery Practice in Rural Women of Bangladesh

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    Meherunnessa Begum

    2013-07-01

    Full Text Available Background: Every year, world wide, 200 million women become pregnant. The development of urban areas allowed women to receive more care and treatment. However, in rural areas such measures are not available to every woman. Data on delivery practice of rural woman may help the social and public health planners and decision makers to minimize and prevent maternal mortality and morbidity ensuring safe motherhood.Objective: The aim of the study was to observe the delivery practice of rural women of Bangladesh.Materials and method: A cross-sectional study was conducted and data were collected from Dhamrai upazila, Dhaka, Bangladesh in April 2008. Total 159 women of reproductive age group at least having one child were selected purposively to elicit information on various demographic, socioeconomic, cultural and selected programmatic variables including maternal health care and delivery practices.Results: Among the respondents about 55% were literate. Majority (80% of the respondents delivered at home and most of the them (71% felt that home delivery was comfortable where as about 29% of the respondents were compelled to deliver at home due to family decision and financial constraint. Among the deliveries about 82% occurred normally and 18.2% were by cesarean section. A considerable percentage of deliveries (49% were attended by traditional birth attendants. Blade was used for cutting umbilical cord in majority of the cases (74% who delivered at home. Most of the respondents (90% took ante natal check up and about 74% were vaccinated by tetanus toxoid.Conclusion: The results of the study suggest that a lot of work is still to do for the policy makers and health planners to target, plan, develop and deliver maternal health services to the rural women of Bangladesh.

  6. Assessment of prescribing practices among urban and rural general practitioners in Tamil Nadu

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    Sekharan Gopalakrishnan

    2013-01-01

    Full Text Available Background: Studying drug use pattern among medical practitioners is of vital importance in the present scenario where irrational drug use and development of drug resistance is becoming rampant. Objective: To assess, the pattern of prescribing practices among the general practitioners in a defined rural and urban area of Tamil Nadu. Materials and Methods: A community based descriptive study was conducted to collect 600 prescriptions from the catchment areas of rural and urban health training centers of a medical college using prescribing indicators as per the WHO "How to investigate drug use in health facilities" tool. Results: This prescription study revealed that multivitamins (19.5%, antibiotics (19.3%, drugs for gastro-intestinal tract (GIT (18%, analgesic non-steroidal anti-inflammatory drugs/ (NSAID′s (15.1%, and antihistaminic (12.5% were prescribed frequently. Among the antibiotics, amoxicillin (49.2% was the most commonly prescribed followed by gentamicin (31.7%. Percentage of prescriptions with an antibiotic was 55% and nearly 62% of the practitioners prescribed drugs by their generic names. As a practice of poly-pharmacy, it was observed that the average number of drugs prescribed in urban and rural area was nearly 5 and 4, respectively. Nearly 80% of the urban and rural practitioners were prescribing at least one injection. Study of the quality of prescriptions revealed that there was poor legibility, high usage of abbreviations, inadequate details of the drugs, and absence of signature by practitioners in the prescriptions. Conclusion: This study clearly highlights the practice of poly-pharmacy, low usage of generic drugs, injudicious usage of antibiotics and injections and low usage of drugs prescribed from essential drugs list.

  7. [The cultural aspects of the practice of Community Health Agents in rural areas].

    Science.gov (United States)

    Lara, Maristela Oliveira; Brito, Maria José Menezes; Rezende, Lilian Cristina

    2012-06-01

    The daily practice of Community Health Agents (CHAs) is permeated with educational interventions aimed at preventive care and health promotion. The sociocultural universe of these professionals can affect the dynamics of their practice within the community, particularly in rural areas, where there is evidence that the population expects to obtain information relative to their health and/or disease by means of cultural rites. Based on a case study, we sought to analyze the influence of the cultural practices of the agents working in a rural area in the interior of the state of Minas Gerais. The analysis revealed the presence of a strong connection between the culture and their activities. Religious beliefs and knowledge developed from the fusion of biomedical information and values based on family tradition regarding the health-disease process have a direct effect on their practices. It is emphasized that they have an important role as facilitators in the practice of health care, with a positive effect stemming from the similarity of their life experiences and inherited cultures with those of the clients, thus making it possible to develop effective interventions.

  8. The impact of extensive loss of telecommunications on general practice: A case study in rural Victoria.

    Science.gov (United States)

    Tran, Nancy H; Pedler, Daryl

    2017-04-01

    To describe the impact of major loss of telecommunications on general practice in a rural region of Australia. A multi-stage qualitative study. Purposively selected participants were invited to contribute to initial data collection using an online survey, followed by interviews with selected participants. Thematic analysis of the data was performed by both research team members. South-western Victoria, Australia. Individuals from organisations involved in Telstra recovery efforts, disaster management, health care and general practice staff. The survey collected freeform responses from participants. Semi-structured interviews further explored a variety of experiences from purposively selected participants. Organisations and practices in the region were prepared for major disasters, but not for the unusual and 'limited' disaster of losing telecommunications, including lack of Internet access and loss of telephone services. Although alternative measures were found for telecommunications, there was still a significant impact on many health-care-related activities and general practice functionality during the outage period. In particular, there was an increase in duties for administrative staff to compensate for loss of telecommunications. Patient traffic for many services decreased due to uncertainty about availability and continuation of business. The Warrnambool outage could be used as a case study illustrating the dramatic impact of communication loss. Major impacts include changes in patient traffic, increased administrative duties and slowing of patient care. When developing or assessing disaster management plans, general practices should consider the impact of telecommunication loss on functionality and prepare appropriate alternative, accessible and reliable measures. © 2016 National Rural Health Alliance Inc.

  9. An Investigation of Science Teaching Practices in Indonesian Rural Secondary Schools

    Science.gov (United States)

    Wahyudi; Treagust, David F.

    2004-08-01

    This study reports on teaching practices in science classrooms of Indonesian lower secondary schools in rural areas. Using six schools from three districts in the province of Kalimantan Selatan as the sample, this study found that most teaching practices in science classrooms in rural schools were teacher-centred with students copying notes. However, the study also found unique teaching practices of an exemplary science teacher whose teaching style can be described as both student-centred and teacher-centred, with students encouraged to be active learners. Four features of exemplary teaching practices were identified: The teacher managed the classroom effectively; used a variety of questioning techniques; employed various teaching approaches instead of traditional methods; and created a favourable learning environment. Data from classroom observations, interviews with teachers, and students responses to a questionnaire were used to compare the exemplary teacher and his colleagues. This study identified internal factors that may affect teaching practices such as a teachers content knowledge and beliefs about teaching. Compared to the other teachers, the exemplary teacher possessed more content knowledge and had a relatively stronger belief in his ability to teach.

  10. Ebola hemorrhagic fever under scope, view of knowledge, attitude and practice from rural Sudan in 2015.

    Science.gov (United States)

    Mohamed, Mohamed M G; Shwaib, Hussam M; Fahim, Monica M; Ahmed, Elhamy A; Omer, Mawadda K; Monier, Islam A; Balla, Siham A

    Ebola hemorrhagic fever (EHF) is an emerging threat to public health. The last epidemic in West Africa had a great effect on the affected communities. Timely and effective interventions were necessary in addition to community participation to control the epidemic. The knowledge, attitude and practices of vulnerable communities remain unknown, particularly in Sudan. The aim of this study was to explore the knowledge, attitude and practices of rural residents in Sudan regarding Ebola hemorrhagic fever. We conducted a cross sectional, community-based large-scale study in Al Gaziera state in rural Sudan in eight localities. In total, 1500 random adult participants were selected. The participants were assessed by a predesigned pretested questionnaire regarding their knowledge, attitude and practices regarding Ebola. Their sources of information were determined, and we assessed demographic factors as predictors of knowledge. We found poor knowledge, a fair attitude and suboptimal practices among the participants. The main sources of information were the press and media. Education was the only predictor of knowledge regarding Ebola. A lack of knowledge and suboptimal preventive practices mandates orientation and education programs to raise public awareness. Health care providers are advised to engage more in educating the community. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  11. Rural domestic waste management in Zhejiang Province, China: Characteristics, current practices, and an improved strategy.

    Science.gov (United States)

    Guan, Yidong; Zhang, Yuan; Zhao, Dongye; Huang, Xiaofeng; Li, Haini

    2015-06-01

    Lack of access to adequate sanitation facilities has serious health implications for rural dwellers and can degrade the ecosystems. This study offers a systemantic and quantitative overview of historical data on rural domestic waste (RDW) production and past and current management practices in a prototype region in China, where rural areas are undergoing rapid urbanization and are confronted with great environmental challenges associated with poor RDW management practices. The results indicate that RDW is characterized with a large fraction of kitchen waste (42.9%) and high water content (53.4%). The RDW generation (RDWG) per capita between 2012 and 2020 is estimated to increase from 0.68 to 1.01 kg/d-cap. The Hill 1 model is able to adequately simulate/project the population growth in a rural area from 1993 to 2020. The annual RDWG in the region is estimated to double from 6,033,000 tons/year in 2008 to 12,030,000 tons/year by 2020. By comparing three RDW management scenarios based on the life-cycle inventory approach and cost-benefit analysis, it is strongly recommended that the present Scenario 2 (sanitary landfill treatment) be upgraded to Scenario 3 (source separation followed by composting and landfill of RDW) to significantly reduce the ecological footprint and to improve the cost-effectiveness and long-term sustainability. Rural domestic waste (RDW) is affecting 720 million people in China and more than 3221 million people worldwide. Consequently, handling and disposal of RDW have serious health implications to rural dwellers and the ecosystems. This study offers a systemantic and quantitative overview and analysis of historical data on RDW production and management practices in a prototype region in China, which is confronted with great environmental challenges associated with RDW. Then we predict future production of RDW and propose a sustainable RDW management strategy, which holds the promise of greatly mitigating the mounting environmental pressure

  12. Evidence-based rural general practice: barriers and solutions in South Australia.

    Science.gov (United States)

    Taylor, J; Wilkinson, D; Blue, I A; Dollard, J T

    2002-01-01

    This paper reports on research to ascertain the views of general practitioners (GPs) practising in rural and remote areas of South Australia, on evidence-based medicine (EBM). It follows our previous paper that identified, through a literature search, the key issues in moving towards EBM in general practice in these areas1. The objective of the paper was to identify perceived barriers and potential solutions to evidence-based general practice in rural and remote South Australia. An interview survey was conducted in the year 2000 at 89 of 104 GPs' (86%) surgeries in three rural Divisions of General Practice in South Australia. EBM was viewed positively by 85%, and 94% reported practising EBM. However, barriers to EBM were identified by 84% and four key themes were identified. GP-related barriers identified by 60% included difficulty finding, appraising and applying evidence and lack of time to read, reflect and update practice. Patient related barriers (23%) included an apparent conflict between some patients' expectations and evidence. Environmental barriers (43%) related to remoteness included high workload, limited information and poor resources for continued medical education. Resource related barriers included a lack of computer hardware and software and slow, unreliable and expensive Internet access (14%). Potential solutions were suggested by 82%. The most frequent was improved hardware, software and Internet access (41%). Only 19% suggested formal training for GPs, while 26% suggested improved clinical practice guidelines and 23% suggested non-Internet based dissemination of information including a service to provide evidence-based answers to clinical problems. EBM was viewed positively by the surveyed GPs and many believed they already practised it. Most identified barriers to full and effective use of EBM but also suggested solutions.

  13. Informal allopathic provider knowledge and practice regarding hypertension in urban and rural Bangladesh.

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    John Parr

    Full Text Available OBJECTIVES: Describe informal allopathic practitioner (IAP knowledge and practice about management of hypertension and identify gaps in IAP knowledge and practice amenable to interventions. METHODS: A cross sectional descriptive survey of 642 IAPs in Kamalapur (urban and Mirsarai (rural Bangladesh was conducted from March to April, 2011. Using a structured, pre-tested questionnaire sociodemographic, training, knowledge and practice data about management of hypertension was collected. Comparative statistics were preformed to show differences between urban and rural practitioners using SAS 8.0. FINDINGS: 99.4% of IAPs were male, mean age was 37.5 (12.5 SD years. Greater than 65% correctly identified the upper limit of normal blood pressure. 50.2% underestimated lower limit of systolic hypertension. 79.8% allowed age to affect their treatment approach. As blood pressure increased, willingness to treat with medication decreased and tendency to refer increased. Sedative/sleeping pills, antidepressants, and beta blockers were the most commonly prescribed medications for prehypertension (58.7%, 50.3% and 53.7% respectively, stage I hypertension (55.0%, 38.6%, 49.8% respectively and stage II hypertension (42.4%, 23.7%, and 28.8% respectively. Rural IAPs were more likely than urban IAPs to treat (84.7% vs 77.7%, order tests (27.1% vs 6.0% and write prescriptions (60.4% vs 18.7%. CONCLUSION: While IAPs are crucial to Bangladesh's pluralistic healthcare system, gaps in knowledge and practice could cause unnecessary harm. To include IAPs in the public sector's fight against the chronic disease epidemic, interventions aimed at standardizing IAPs knowledge and practice will be essential. Successfully utilizing IAPs will have beneficial implications not only for Bangladesh, but for all developing countries.

  14. Rural and remote Australian general practice nurses' sources of evidence for knowledge translation: a cross-sectional survey.

    Science.gov (United States)

    Mills, Jane; Field, John; Cant, Robyn

    2011-09-01

    This paper explores nurses' sources of knowledge for evidence-based practice, comparing rural/remote, urban and regional participants. A cross-sectional survey of practice nurses in the state of Victoria was conducted in 2008. The instrument used was the Developing Evidence-based Practice Questionnaire - Au, distributed to a convenience sample of nurses with response of 590 (33%). Survey data were stratified by geographical location for this exploratory report. The sample was representative of practice nurses, with half employed in either regional or rural and remote areas. Rural and remote nurses were less qualified in nursing than urban nurses. However, rural, remote and regional nurses were significantly less likely to apply experiential knowledge as evidence and were more likely to source knowledge from clinical nurse specialists or nurse practitioners, local audit reports or articles in research and medical journals. Nurses in each work category reported in-service training, conferences and information shared by colleagues as important in developing their knowledge for practice. According to participants, evidence-based practice would be promoted by allocation of work time, education and training in research skills, and improved access to resources. Rural and remote practice nurses prioritised the development of their skills in sourcing and appraising evidence for practice as a strategy to facilitate knowledge translation at the point of care. © 2011 The Authors. International Journal of Evidence-Based Healthcare © 2011 The Joanna Briggs Institute.

  15. Feeding Practices among Infants in a Rural Community in Bangladesh: A Cross-Sectional Study

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    Rajat Das Gupta

    2015-10-01

    Full Text Available Background: Proper feeding practices during infancy are necessary for the growth and development of infants and to prevent malnutrition. This study was conducted to describe the feeding practice among infants in a rural area in Bangladesh. Methods: A cross-sectional study was conducted between February and June 2013. Data was collected through face-to-face interviews of 212 mothers using a pretested questionnaire. Results: Exclusive breast feeding and complementary feeding rates were 40.6% and 97.3%, respectively. One third of the mothers practiced prelactal feeding, and honey was the most common item. Maternal illness (72.7% was the most common reason for not giving breast milk. Infant formula was used as an alternative food in majority of the cases (72.7%. Conclusion: Percentage of exclusive breast feeding was not satisfactory. Encouragement of female education is recommended to improve feeding practices and infant care.

  16. Knowledge, Attitude and Practice About Salt Intake in Croatian Continental Rural Population

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    Ksenija Vitale

    2012-09-01

    Full Text Available High salt intake is important risk factor for hypertension, cardiovascular and cerebrovascular diseases. The aim of this study was to investigate knowledge, attitude and practice regarding salt intake in rural population in continental Croatia. Data were obtained by standardized questionnaire in 928 adult subjects (586 women and 342 men. Results have shown low level of awareness (~60% of salt risk. Women were more aware about the harmful effects of salt and could identify some food with higher concentration of salt. Participants were not aware through which food is the highest salt intake. Our results urge the need for national projects and public health campaigns that would raise the awareness of salt intake, need for health education particularly for rural population. Food industry and nutritionists should become partners in this initiative.

  17. Cultural health beliefs in a rural family practice: a Malaysian perspective.

    Science.gov (United States)

    Ariff, Kamil M; Beng, Khoo S

    2006-02-01

    Understanding the sociocultural dimension of a patient's health beliefs is critical to a successful clinical encounter. Malaysia with its multi-ethnic population of Malay, Chinese and Indian still uses many forms of traditional health care in spite of a remarkably modern rural health service. The objective of this paper is discuss traditional health care in the context of some of the cultural aspects of health beliefs, perceptions and practices in the different ethnic groups of the author's rural family practices. This helps to promote communication and cooperation between doctors and patients, improves clinical diagnosis and management, avoids cultural blind spots and unnecessary medical testing and leads to better adherence to treatment by patients. Includes traditional practices of 'hot and cold', notions of Yin-Yang and Ayurveda, cultural healing, alternative medicine, cultural perception of body structures and cultural practices in the context of women's health. Modern and traditional medical systems are potentially complementary rather than antagonistic. Ethnic and cultural considerations can be integrated further into the modern health delivery system to improve care and health outcomes.

  18. A COMMUNITY BASED STUDY ON INFANT AND YOUNG FEEDING PRACTICES IN A RURAL AREA OF KARNATAKA

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    Sharvanan Udayar

    2012-09-01

    Full Text Available ABSTRACT: BACKGROUND: Adequate nutrition during infancy and early childho od is critical to the development of children’s full human potential . OBJECTIVE : The main objective was to assess the Infant and Young Child Feeding (IYCF pra ctices and associated socio demographic variables among children aged less than two years i n rural areas METHODS: A community based, cross sectional descriptive study was done du ring Sept 09-Aug 2010 which is the rural field practice area of Shri. B. M. Patil Medical Col lege SBMPMC. The data was computed and analyzed using SPSS statistical package (version 13. 0. RESULTS: During the study period 264 mothers of infants and young children interviewed w ith the questionnaire and 159 out of 264 had received prelacteal feeds (males 64 % and female s56.3 %. Illiterate mothers (69.7% practiced more prelacteal feeding than the literate m others (54.6%. 36% received exclusive breast feeding for a period six months. Majority of the illiterate mothers were practicing early (31.4% and delayed weaning (32.5%.Poor socioecono mic status, illiteracy, birth spacing and cultural beliefs had significant effect on infant a nd young children feeding practices. CONCLUSIONS: The study re-emphasized the need for conducting con tinued infant and child feeding intervention programmes especially for the mo ther during antenatal and postnatal checkups.

  19. Chiropractic wellness on the web: the content and quality of information related to wellness and primary prevention on the Internet

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    Evans Marion

    2011-02-01

    Full Text Available Abstract Background The Internet has become a common source of information for patients wishing to learn about health information. Previous studies found information related to back pain poor and often contradictory to current guidelines. Wellness has become a common topic in the field of chiropractic and accrediting agencies have standards on delivery of wellness-based content in college curricula as well as directives for clinical applications. The purpose of this study was to evaluate the quality of the information on the Internet using the terms "chiropractic wellness," or "wellness chiropractic". Methods Five commonly used search engines were selected and the first 10 sites found using the strategy above were evaluated by two raters. Demographic assessments of the sites were made along with whether they were Health on the Net Foundation (HON certified, contained standard wellness content, mentioned any Healthy People Focus Areas, and other chiropractic topics. Kappa statistics compared inter-rater agreement. Results Potential patients appeared to be the audience 87% of the time and a private doctor of chiropractic appeared to be the typical site owner. The sites usually promoted the provider. No sites displayed HON certification logo nor did any appear to meet the HON certification criteria. Twenty-six sites (55% promoted regular physical activity in some manner and 18 (38% had information on health risks of tobacco. Four (9% had mental health or stress-reduction content but none had information supportive of vaccination. Some had information contradictory to common public health measures. Conclusions Patients searching the Internet for chiropractic wellness information will often find useless information that will not help them maintain health or become well. Most simply market the chiropractic practice or allow for a patients to provide personal information in exchange for more 'wellness' information. More research should be done on how

  20. Chiropractic management of chronic idiopathic meralgia paresthetica: a case study.

    Science.gov (United States)

    Houle, Sébastien

    2012-03-01

    This report describes the case of a patient with chronic idiopathic meralgia paresthetica associated with bilateral sacroiliac joint dysfunction who was managed with chiropractic care. A 35-year-old white woman presented to a private chiropractic clinic with a complaint of numbness in the right anterolateral thigh region. Neurological assessment revealed a diminution of sensibility and discrimination on the right lateral femoral cutaneous nerve territory. Pain was rated as 8.5 on a numeric pain scale of 0 to 10. Musculoskeletal examination of the pelvic region disclosed bilateral sacroiliac joint dysfunction. Chiropractic management included pelvic mobilizations, myofascial therapy, transverse friction massage, and stretching exercises. After 3 visits (2 weeks later), result of neurological evaluation was normal, with no residual numbness over the lateral thigh. In the present case, chiropractic management with standard and applied kinesiology techniques resulted in recovery of meralgia paresthetica symptoms for this patient.

  1. The role of chiropractic care in older adults

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    Dougherty Paul E

    2012-02-01

    Full Text Available Abstract There are a rising number of older adults; in the US alone nearly 20% of the population will be 65 or older by 2030. Chiropractic is one of the most frequently utilized types of complementary and alternative care by older adults, used by an estimated 5% of older adults in the U.S. annually. Chiropractic care involves many different types of interventions, including preventive strategies. This commentary by experts in the field of geriatrics, discusses the evidence for the use of spinal manipulative therapy, acupuncture, nutritional counseling and fall prevention strategies as delivered by doctors of chiropractic. Given the utilization of chiropractic services by the older adult, it is imperative that providers be familiar with the evidence for and the prudent use of different management strategies for older adults.

  2. Raising Backyard Poultry in Rural Bangladesh: Financial and Nutritional Benefits, but Persistent Risky Practices.

    Science.gov (United States)

    Shanta, I S; Hasnat, Md A; Zeidner, N; Gurley, E S; Azziz-Baumgartner, E; Sharker, M A Y; Hossain, K; Khan, S U; Haider, N; Bhuyan, A A; Hossain, Md A; Luby, S P

    2017-10-01

    Poultry is commonly raised by households in rural Bangladesh. In 2007, the Government of Bangladesh began a mass media campaign to disseminate 10 recommended precautions to prevent transmission of H5N1 from poultry to humans. This longitudinal study explored the contribution of backyard poultry on household economy and nutrition and compared poultry-raising practices to government recommendations. From 2009 to 2012, we enrolled a nationally representative sample of 2489 primary backyard poultry raisers from 115 rural villages selected by probability proportional to population size. Researchers interviewed the raisers to collect data on poultry-raising practices. They followed the raisers for 2-12 months to collect data on household income and nutrition from poultry. Income from backyard poultry flocks accounted for 2.8% of monthly household income. Return on annual investment (ROI) per flock was 480%. Yearly, median family consumption of eggs was one-fifth of the total produced eggs and three poultry from their own flock. Respondents' reported practices conflicted with government recommendations. Sixty per cent of raisers had never heard of avian influenza or 'bird flu'. Among the respondents, 85% handled sick poultry or poultry that died due to illness, and 49% slaughtered or defeathered sick poultry. In 37% of households, children touched poultry. Fifty-eight per cent never washed their hands with soap after handling poultry, while <1% covered their nose and mouth with a cloth when handling poultry. Only 3% reported poultry illness and deaths to local authorities. These reported practices did not improve during the study period. Raising backyard poultry in rural Bangladesh provides important income and nutrition with an excellent ROI. Government recommendations to reduce the risk of avian influenza transmission did not impact the behaviour of poultry producers. Further research should prioritize developing interventions that simultaneously reduce the risk of

  3. Evaluation of Nutrition and Physical Activity Policies and Practices in Child Care Centers within Rural Communities.

    Science.gov (United States)

    Foster, Jaime S; Contreras, Dawn; Gold, Abby; Keim, Ann; Oscarson, Renee; Peters, Paula; Procter, Sandra; Remig, Valentina; Smathers, Carol; Mobley, Amy R

    2015-10-01

    Although some researchers have examined nutrition and physical activity policies within urban child care centers, little is known about the potentially unique needs of rural communities. Child care centers serving preschool children located within low-income rural communities (n = 29) from seven states (Indiana, Kansas, Michigan, North Dakota, Ohio, South Dakota, and Wisconsin) were assessed to determine current nutrition and physical activity (PA) practices and policies. As part of a large-scale childhood obesity prevention project, the Community Healthy Living Index's previously validated Early Childhood Program Assessment Tool was used to collect data. Descriptive statistical analysis was conducted to identify high-priority areas. Healthy People 2020 and the Academy of Nutrition and Dietetics' recommendations for nutrition and PA policies in child care centers were used as benchmarks. Reports of not fully implementing (nutrition-related policies or practices within rural early child care centers were identified. Centers not consistently serving a variety of fruits (48%), vegetables (45%), whole grains (41%), limiting saturated fat intake (31%), implementing healthy celebration guidelines (41%), involving children in mealtime (62%), and referring families to nutrition assistance programs (24%) were identified. More than one third of centers also had limited structured PA opportunities. Although eligible, only 48% of the centers participated in the Child and Adult Care Food Program. Overall, centers lacked parental outreach, staff training, and funding/resources to support nutrition and PA. These results provide insight into where child care centers within low-income, rural communities may need assistance to help prevent childhood obesity.

  4. Creating European guidelines for Chiropractic Incident Reporting and Learning Systems (CIRLS: relevance and structure

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    Wangler Martin

    2011-04-01

    Full Text Available Abstract Background In 2009, the heads of the Executive Council of the European Chiropractors' Union (ECU and the European Academy of Chiropractic (EAC involved in the European Committee for Standardization (CEN process for the chiropractic profession, set out to establish European guidelines for the reporting of adverse reactions to chiropractic treatment. There were a number of reasons for this: first, to improve the overall quality of patient care by aiming to reduce the application of potentially harmful interventions and to facilitate the treatment of patients within the context of achieving maximum benefit with a minimum risk of harm; second, to inform the training objectives for the Graduate Education and Continuing Professional Development programmes of all 19 ECU member nations, regarding knowledge and skills to be acquired for maximising patient safety; and third, to develop a guideline on patient safety incident reporting as it is likely to be part of future CEN standards for ECU member nations. Objective To introduce patient safety incident reporting within the context of chiropractic practice in Europe and to help individual countries and their national professional associations to develop or improve reporting and learning systems. Discussion Providing health care of any kind, including the provision of chiropractic treatment, can be a complex and, at times, a risky activity. Safety in healthcare cannot be guaranteed, it can only be improved. One of the most important aspects of any learning and reporting system lies in the appropriate use of the data and information it gathers. Reporting should not just be seen as a vehicle for obtaining information on patient safety issues, but also be utilised as a tool to facilitate learning, advance quality improvement and to ultimately minimise the rate of the occurrence of errors linked to patient care. Conclusions Before a reporting and learning system can be established it has to be clear

  5. Evaluation of urban-rural differences in pharmacy practice needs in Maine with the MaPPNA

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    Martin SL

    2015-12-01

    Full Text Available Background: Maine is a rural state with an aging population located in the northeastern United States. Pharmacists play an important role in serving the public’s health as they are often the most available point-of-contact within a community. Objective: To assess the current pharmacy practice needs as viewed by licensed pharmacists across our rural state, and to distinguish issues that are unique to rural pharmacy practice. Methods: An online survey was sent to all licensed pharmacists in the state in the fall of 2014 (n=1,262 to assess their pharmacy practice needs, and specify an rural-specific needs, within the categories of (1 opioid misuse, abuse, and diversion, (2 challenges associated with access to healthcare, (3 poly-pharmacy use, (4 meeting the needs of special populations, (5 lack of antibiotic stewardship, and (6 resources, such as staffing. Results: The response rate was 22.1 % (n=279. We found the most agreed upon issue facing pharmacists’ in Maine is opioid use, misuse and diversion, followed closely by shortages in staffing. We also learned that pharmacists’ view pharmaceutical care for older adults, those with low health literacy, and those with mental disabilities more time-consuming. Some urban-rural differences were discovered in with regard to the pharmacists’ views; such as the magnitude of the distance barrier, and limited transportation options available to rural residents. Issues related to polypharmacy were viewed as more problematic by pharmacists practicing in urban versus rural sites. Conclusions: Pharmaceutical care in Maine must focus on meeting the needs of the elderly, those with disabilities, and those with limited health literacy. As with the rest of the nation, opioids challenge pharmacy practice in a variety of ways. These findings clarify areas that present opportunities for pharmacists to focus more specifically on Maine’s largely rural population.

  6. Do Organisational Characteristics Explain The Differences Between Drivers of ICT Adoption in Rural and Urban General Practices in Australia?

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    Robert C. MacGregor

    2009-08-01

    Full Text Available A number of studies have compared general medical practices in rural locations with those in urban locations. Some of these studies have concentrated on the reasons why a GP might choose to work in a rural or urban setting. Others have examined the type of work required to be undertaken by medical professionals. Increasing use of information and communications technology (ICT in medical practices has led to some studies examining their use in rural as well as urban settings. However, little if any research has examined whether ICT adoption drivers differ between rural and urban GPs based on their organisational characteristics. This paper presents a study of 198 GPs (122 rural, 76 urban in Australia. The results show that organisational characteristics are associated with the importance of the drivers for ICT adoption and that these characteristics differ between rural and urban GPs. These findings have important practical and theoretical contributions because it shows that ICT adoption decisions must be contextualised and that it is unlikely that universal adoption drivers will apply to all general practices.

  7. Family Planning Practice Among Rural Reproductive-Age Married Women in Myanmar.

    Science.gov (United States)

    Jirapongsuwan, Ann; Latt, Kyaw Thu; Siri, Sukhontha; Munsawaengsub, Chokchai

    2016-05-01

    A cross-sectional study was undertaken to investigate family planning (FP) practices and associated factors among reproductive-age married women. Data were collected by interviewing the 300 married women living in a rural area of Myanmar. The questionnaire had reliability coefficients ranging from .8 to .9. Results indicated that 73.3% of women performed FP, and contraceptive injection was the most common method. Significant associations were found with age 21 to 35 years (adjusted odds ratio [adj OR] = 3.748, 95% CI = 2.179-6.445), adequacy of income (adj OR = 2.520, 95% CI = 1.477-4.290), good attitude toward FP (adj OR = 0.386, 95% CI = 0.228-0.656), good support from health care providers (adj OR = 0.129, 95% CI = 0.054-0.313), good support from family (adj OR = 0.304, 95% CI = 0.163-0.565), good support from friends (adj OR = 0.344, 95% CI = 0.193-0.613), and FP practice. It is recommended that designing FP programs with peers and family involvement could increase the practice of FP among rural Myanmar women. © 2016 APJPH.

  8. Anemia and Feeding Practices among Infants in Rural Shaanxi Province in China

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    Renfu Luo

    2014-12-01

    Full Text Available Anemia is one of the most prevalent public health problems among infants and iron deficiency anemia has been related to many adverse consequences. The overall goal of this study is to examine the prevalence of anemia among infants in poor rural China and to identify correlates of anemia. In April 2013, we randomly sampled 948 infants aged 6–11 months living in 351 villages across 174 townships in nationally-designated poverty counties in rural areas of southern Shaanxi Province, China. Infants were administered a finger prick blood test for hemoglobin (Hb. Anthropometric measurement and household survey of demographic characteristics and feeding practices were conducted in the survey. We found that 54.3% of 6–11 month old infants in poor rural China are anemic, and 24.3% of sample infants suffer from moderate or severe anemia. We find that children still breastfed over 6 months of age had lower Hb concentrations and higher anemia prevalence than their non-breastfeeding counterparts (p < 0.01, and that children who had ever been formula-fed had significantly higher Hb concentrations and lower anemia prevalence than their non-formula-fed counterparts (p < 0.01. The results suggest the importance of iron supplementation or home fortification while breastfeeding.

  9. Assessment of Knowledge and Practices towards Swine flu: A cross-sectional study among rural housewives

    OpenAIRE

    Rashmi Kumari; Rajiv Kumar Gupta; Bhavna Langer; Aruna Verma

    2016-01-01

    Background: Swine flu is an emerging public health problem in various countries including India and was declared a “Phase 6 Pandemic” by WHO in 2009. India ranks as 3rd most affected country for cases and deaths of swine flu globally.Objectives: To assess the level of knowledge and practices regarding Swine flu among rural housewives of Jammu and to find out the association between the two.Methods: A cross-sectional study was conducted during the month of April 2015 using a pre-tested and sem...

  10. The evidence base for chiropractic treatment of musculoskeletal conditions in children and adolescents: The emperor's new suit?

    OpenAIRE

    Stochkendahl Mette; Hestbaek Lise

    2010-01-01

    Abstract Five to ten percent of chiropractic patients are children and adolescents. Most of these consult because of spinal pain, or other musculoskeletal complaints. These musculoskeletal disorders in early life not only affect the quality of children's lives, but also seem to have an impact on adult musculoskeletal health. Thus, this is an important part of the chiropractors' scope of practice, and the objective of this review is to assess the evidence base for manual treatment of musculosk...

  11. Women Literacy and Infant Feeding Practices in Rural Integrated Child Development Scheme (ICDS Block of Delhi

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    Davey Sanjeev , Davey Anuradha

    2012-09-01

    Full Text Available Background: Infant feeding practices have significant effect on the child nutrition, which largely dependent upon the mothers correct knowledge and awareness for the same. Objective: To find out effect of rural women empowerment through literacy on infant feeding practices in an ICDS block. Material and Methodology: Interview of the mothers of registered children up to 6 years in the rural ICDS block for the feeding practices and recording of the weight of those registered children by the salter weighing scale for their nutritional status. Results: Three fourth of the children had received ceremonial feed in the form of honey or gutti and 40 percent of the mothers in our study has discarded colostrums, considering it as ‘bad milk’. Exclusive breast feeding was received by 34.6% children. As literacy level of mothers increased the nutritional status of children was better. This could be because most of the women who are middle school passed or above are non working, so are able to give more time for care and feeding practices. The Severe malnutrition (grade III and IV was evident only in illiterate category of mothers, where 58.7% women were working in unskilled or semiskilled job outside home. Conclusion: Women living in chronic hunger are forced to unskilled jobs for income generation for the family, thereby influencing the feeding practices of their children. In such scenario AWCs and AWWs can be a unique opportunity with their focused approach to take care of severe and moderate malnutrition.

  12. Knowledge and practice of handwashing among mothers of under five children in rural coastal South India

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    SS Datta

    2011-01-01

    Full Text Available Objectives: To study the knowledge and practice of handwashing after critical moments among mothers of under five children and to recommend measures for improvement of handwashing practices based on the study findings Methods: A community based cross-sectional study was undertaken during February 2010 covering 28 villages around coastal South India. The EPI 30-cluster sampling method was used and 1898 mothers of under five children were interviewed about their knowledge and practice regarding handwashing after critical moments. Results: 83.41% mothers stated handwashing was important for prevention of communicable diseases. 77.82% opined that washing hands with only water was sufficient. 38.88% and 24.92% stated handwashing could prevent diarrhoea and ARI respectively. 80.08% mothers thought handwashing was crucial before eating meals; 56.90%, 41.73% and 40.73% respectively felt that it was important to wash hands after defeacation, before preparing food and feeding child. 73.18% mothers washed hands with soap and water after defeacation and 63.91% after cleaning the child who had defeacated. Majority wash their hands with only water before preparing food (71.86% and feeding the child (67.39%. Mothers with per capita monthly family income of Rs.1001-2000 and more, education of 5-7 standard and above, belonging to a joint family and Christian background had better handwashing practices. However, daily labourer mothers were at highest risk of not washing hands at all critical moments. Conclusion: Knowledge and practice of handwashing is low among rural mothers. Hence there is a need to spread importance of proper and regular handwashing in rural areas through available evidence based BCC strategies and multiple dissemination channels.

  13. Neonatal care in rural Karnataka: healthy and harmful practices, the potential for change

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    Cleland John

    2009-05-01

    Full Text Available Abstract Background Every year four million babies die in the first month of life and a quarter of these take place in India. A package of essential newborn care practices exists, which has a proven impact on reducing mortality, and can be implemented in low resource settings. However, childbirth and the neonatal period are culturally important times, during which there is strong adherence to traditional practices. Successful implementation of the package therefore requires in-depth knowledge of the local context and tailored behaviour change communication. Methods This study was carried out in rural Karnataka, India. It uses quantitative data from a prospective survey following mothers through their experience of pregnancy and the postnatal period; and qualitative data from in depth interviews and focus group discussions conducted with mothers, grandmothers and birth attendants. It explores local newborn care practices and beliefs, analyses their harmful or beneficial characteristics and elucidates areas of potential resistance to behaviour change and implementation of the essential newborn care package. Results Findings show that many potentially harmful newborn care practices are being carried out in the study area, such as unhygienic cord cutting, delayed breastfeeding and early bathing. Some are more amenable to change than others, depending on the strength of the underlying beliefs, and acceptability of alternative care. However, movement away from traditional practices is already taking place, particularly amongst the more educated and better off, and there is a clear opportunity to broaden, direct and accelerate this process. Conclusion Community education should be a focus of the National Rural Health Mission (NRHM and Integrated Management of Neonatal and Childhood Illness (IMNCI program being implemented in Karnataka. The added capacity of the new Accredited Social Health Activists (ASHAs could enable more women to be reached. With

  14. Traditional birth attendants in rural Nepal: knowledge, attitudes and practices about maternal and newborn health.

    Science.gov (United States)

    Thatte, N; Mullany, L C; Khatry, S K; Katz, J; Tielsch, J M; Darmstadt, G L

    2009-01-01

    Efforts to formalise the role of traditional birth attendants (TBAs) in maternal and neonatal health programmes have had limited success. TBAs' continued attendance at home deliveries suggests the potential to influence maternal and neonatal outcomes. The objective of this qualitative study was to identify and understand the knowledge, attitudes and practices of TBAs in rural Nepal. Twenty-one trained and untrained TBAs participated in focus groups and in-depth interviews about antenatal care, delivery practices, maternal complications and newborn care. Antenatal care included advice about nutrition and tetanus toxoid (TT) immunisation, but did not include planning ahead for transport in cases of complications. Clean delivery practices were observed by most TBAs, though hand-washing practices differed by training status. There was no standard practice to identify maternal complications, such as excessive bleeding, prolonged labour, or retained placenta, and most referred outside in the event of such complications. Newborn care practices included breastfeeding with supplemental feeds, thermal care after bathing, and mustard seed oil massage. TBAs reported high job satisfaction and desire to improve their skills. Despite uncertainty regarding the role of TBAs to manage maternal complications, TBAs may be strategically placed to make potential contributions to newborn survival.

  15. A pilot study of a chiropractic intervention for management of chronic myofascial temporomandibular disorder

    DEFF Research Database (Denmark)

    DeVocht, James W; Goertz, Christine M; Hondras, Maria

    2013-01-01

    BACKGROUND: Temporomandibular pain has multiple etiologies and a range of therapeutic options. In this pilot study, the authors assessed the feasibility of conducting a larger trial to evaluate chiropractic treatment of temporomandibular disorders (TMDs). METHODS: The authors assigned 80...... the study design and methodology to be manageable. They gained substantial knowledge to aid in conducting a larger study. AMCT, RIST and self-care should be evaluated in a future comparative effectiveness study. PRACTICAL IMPLICATIONS: This pilot study was a necessary step to prepare for a larger study...

  16. KNOWLEDGE, ATTITUDE AND PRACTICES OF INFANT FEEDING PRACTICES AMONG RURAL WOMEN IN EASTERN INDIA

    OpenAIRE

    Ratan; Amitava

    2015-01-01

    Poor infant feeding practices and their consequences are one of the world's major problems and a serious obstacle to social and economic development. Breastfeeding is one of the most important determinants of child survival , birth spacing , and the prevent ion of childhood infections. The beneficial effects of breastfeeding depend on its initiation , duration , and the age at which the breastfed child is weaned. Breastfeeding practices vary among differ...

  17. The interface with naturopathy in rural primary health care: a survey of referral practices of general practitioners in rural and regional New South Wales, Australia.

    Science.gov (United States)

    Wardle, Jon L; Sibbritt, David W; Adams, Jon

    2014-07-11

    Naturopathy forms an increasingly significant part of the Australian healthcare setting, with high utilisation of naturopaths by the Australian public and a large therapeutic footprint in rural and regional Australia. However, despite these circumstances, there has been little exploration of the interface between naturopathy providers and conventional primary health care practitioners in rural and regional Australia. The study reported here examined the referral practices and factors that underlie referral to naturopaths amongst a sample of rural and regional Australian general practitioners (GPs). A 27-item questionnaire was sent to all 1,486 GPs currently practising in rural and regional Divisions of General Practice in New South Wales, Australia. A total of 585 GPs responded to the questionnaire, with 49 questionnaires returned as "no longer at this address" (response rate: 40.7%). One-quarter of GPs (25.8%) referred to a naturopath at least a few times per year while nearly half (48.8%) stated that they would not refer to a naturopath under any circumstances. GPs were more likely to refer to a naturopath if the GP: was not initially from a rural area (OR=1.78; 95% CI: 0.95, 3.33); believes in the efficacy of naturopathy (OR=5.62; 95% CI: 2.42, 11.36); has seen positive results from naturopathy previously (OR=2.61; 95% CI: 1.35, 5.05); perceives a lack of other treatment options for their patient (OR=5.25; 95% CI: 2.42; 11.36); uses peer-reviewed literature as their major source of CAM information (OR=3.03; 95% CI: 1.65, 5.55); uses CAM practitioners as a major source of CAM information (OR=6.09; 95% CI: 2.91, 12.72); and does not have an existing relationship with any CAM provider (OR=3.03; 95% CI: 1.53, 6.25). There is little interaction (both via referrals as well as the development of professional relationships) between the naturopathic and GP communities in rural and regional Australia, with significant levels of both support and opposition for naturopathic

  18. A pilot study evaluating alternative approaches of academic detailing in rural family practice clinics

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    Hartung Daniel M

    2012-12-01

    Full Text Available Abstract Background Academic detailing is an interactive, convenient, and user-friendly approach to delivering non-commercial education to healthcare clinicians. While evidence suggests academic detailing is associated with improvements in prescribing behavior, uncertainty exists about generalizability and scalability in diverse settings. Our study evaluates different models of delivering academic detailing in a rural family medicine setting. Methods We conducted a pilot project to assess the feasibility, effectiveness, and satisfaction with academic detailing delivered face-to-face as compared to a modified approach using distance-learning technology. The recipients were four family medicine clinics within the Oregon Rural Practice-based Research Network (ORPRN. Two clinics were allocated to receive face-to-face detailing and two received outreach through video conferencing or asynchronous web-based outreach. Surveys at midpoint and completion were used to assess effectiveness and satisfaction. Results Each clinic received four outreach visits over an eight month period. Topics included treatment-resistant depression, management of atypical antipsychotics, drugs for insomnia, and benzodiazepine tapering. Overall, 90% of participating clinicians were satisfied with the program. Respondents who received in person detailing reported a higher likelihood of changing their behavior compared to respondents in the distance detailing group for five of seven content areas. While 90%-100% of respondents indicated they would continue to participate if the program were continued, the likelihood of participation declined if only distance approaches were offered. Conclusions We found strong support and satisfaction for the program among participating clinicians. Participants favored in-person approaches to distance interactions. Future efforts will be directed at quantitative methods for evaluating the economic and clinical effectiveness of detailing in rural

  19. Knowledge, attitudes and practices (KAP relating to avian influenza in urban and rural areas of China

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    Cheng Xiaowen

    2010-02-01

    Full Text Available Abstract Background Studies have revealed that visiting poultry markets and direct contact with sick or dead poultry are significant risk factors for H5N1 infection, the practices of which could possibly be influenced by people's knowledge, attitudes and practices (KAPs associated with avian influenza (AI. To determine the KAPs associated with AI among the Chinese general population, a cross-sectional survey was conducted in China. Methods We used standardized, structured questionnaires distributed in both an urban area (Shenzhen, Guangdong Province; n = 1,826 and a rural area (Xiuning, Anhui Province; n = 2,572 using the probability proportional to size (PPS sampling technique. Results Approximately three-quarters of participants in both groups requested more information about AI. The preferred source of information for both groups was television. Almost three-quarters of all participants were aware of AI as an infectious disease; the urban group was more aware that it could be transmitted through poultry, that it could be prevented, and was more familiar with the relationship between AI and human infection. The villagers in Xiuning were more concerned than Shenzhen residents about human AI viral infection. Regarding preventative measures, a higher percentage of the urban group used soap for hand washing whereas the rural group preferred water only. Almost half of the participants in both groups had continued to eat poultry after being informed about the disease. Conclusions Our study shows a high degree of awareness of human AI in both urban and rural populations, and could provide scientific support to assist the Chinese government in developing strategies and health-education campaigns to prevent AI infection among the general population.

  20. Qualitative study exploring healthy eating practices and physical activity among adolescent girls in rural South Africa.

    Science.gov (United States)

    Sedibe, Heather M; Kahn, Kathleen; Edin, Kerstin; Gitau, Tabitha; Ivarsson, Anneli; Norris, Shane A

    2014-08-26

    Dietary behaviours and physical activity are modifiable risk factors to address increasing levels of obesity among children and adolescents, and consequently to reduce later cardiovascular and metabolic disease. This paper explores perceptions, attitudes, barriers, and facilitators related to healthy eating and physical activity among adolescent girls in rural South Africa. A qualitative study was conducted in the rural Agincourt subdistrict, covered by a health and sociodemographic surveillance system, in Mpumalanga province, South Africa. Semistructured "duo-interviews" were carried out with 11 pairs of adolescent female friends aged 16 to 19 years. Thematic content analysis was used. The majority of participants considered locally grown and traditional foods, especially fruits and vegetables, to be healthy. Their consumption was limited by availability, and these foods were often sourced from family or neighbourhood gardens. Female caregivers and school meal programmes facilitated healthy eating practices. Most participants believed in the importance of breakfast, even though for the majority, limited food within the household was a barrier to eating breakfast before going to school. The majority cited limited accessibility as a major barrier to healthy eating, and noted the increasing intake of "convenient and less healthy foods". Girls were aware of the benefits of physical activity and engaged in various physical activities within the home, community, and schools, including household chores, walking long distances to school, traditional dancing, and extramural activities such as netball and soccer. The findings show widespread knowledge about healthy eating and the benefits of consuming locally grown and traditional food items in a population that is undergoing nutrition transition. Limited access and food availability are strong barriers to healthy eating practices. School meal programmes are an important facilitator of healthy eating, and breakfast

  1. An investigation into the demographics and motivations of students studying for a chiropractic degree.

    Science.gov (United States)

    Yalden, Philip; Cunliffe, Christina; Hunnisett, Adrian

    2013-01-01

    Objective : This research aimed to investigate motivations for studying chiropractic, and to determine what students look for in a course/college and potential barriers to studying chiropractic. Methods : The study design was a cross-sectional survey. Following IRB/Ethical approval, a paper-based questionnaire was distributed to students at McTimoney College of Chiropractic. Demographic data were compared to another chiropractic college in the United Kingdom. Results : The questionnaire response rate was 70.8% (n = 121). Motivating factors for studying chiropractic included a desire to help others (54.5%, n = 66), with 44.6% (n = 54) attracted by chiropractic's holistic, drugless approach to health. Previous help from chiropractic influenced 55.4% (n = 67) and 22.3% (n = 27) felt chiropractic had "changed their life." Just over half of the respondents (55.4%, n = 67) viewed the ability to work while studying as extremely important and 73.6% (n = 89) said they could not have studied chiropractic without this. Conclusion : Previous help from chiropractic care was a common motivation for studying chiropractic. The ability to work while studying was seen as vital by many students and, without it, the vast majority felt they could not have studied chiropractic.

  2. The Effects of Chiropractic Treatment on Students With Learning and Behavioral Impairments Due to Neurological Dysfunction.

    Science.gov (United States)

    Walton, E. V.; Brzozowski, Walter T.

    The effects of chiropractic treatment on children with learning and behavioral problems was investigated with 24 elementary and secondary level students, 12 receiving regular chiropractic treatment and 12 receiving medication. Results indicated that chiropractic treatment was more effective for the wide range symptoms common in the neurological…

  3. Menstruation in rural Igbo women of south east Nigeria: attitudes, beliefs and practices.

    Science.gov (United States)

    Umeora, O U J; Egwuatu, V E

    2008-04-01

    Many cultures hold on to different beliefs and retain community-defined restrictions for menstruating women. The Igbo society of southeast Nigeria is rich in culture, myths and superstitions but, surprisingly no documentation exists on menstrual beliefs and practices among the population. This questionnaire-based cross sectional study supplemented with in-depth interviews evaluated the beliefs, myths and traditional practices associated with menstruation within rural Igbo communities. It revealed that the menstrual egress is of great significance in Igbo culture and must be disposed of carefully to avoid exposure to witchcraft and rituals. Some respondents observed self-imposed restrictions on exercises, food items, visits and sex in order to maintain physical and spiritual cleanliness, lessen discomfort and avoid embarrassment. Gynaecologists working in this region should utilize the opportunities of clinical consultations to discuss menstrual health issues with their female patients and educate them on the physiology and significance of menstruation.

  4. The garden dying: Commoditization of agriculture and changes in practices of self-consumption among rural families of southern gaucho

    Directory of Open Access Journals (Sweden)

    Flávio Sacco dos Anjos

    2009-12-01

    Full Text Available The article is based on qualitative research carried out in the southern extreme of the Rio Grande do Sul state and explores the transformations on the practices of self-consumption production in the context of familiar agriculture, essentially, under the impacts of the process of commoditization of agriculture and the rural life. The self-consumption practices present a cultural matrix among rural families, in spite of the symbolic value attributed to products generated within the very rural establishment, as compared to the ones which are acquired externally in usual commerce or from other units of production. The field-work was performed within thirty family agricultural establishments whose main commercial activity lies on the milk, peach and tobacco production. The authors discuss the impacts of the commoditization of agriculture on the practical of self-consumption production.

  5. Training rural practical talents and expanding rural employment%培养农村实用型人才,扩大农村劳动力就业

    Institute of Scientific and Technical Information of China (English)

    刘玲

    2012-01-01

    农民脱贫致富的长效机制在于提高农村劳动力就业竞争力,并通过政策措施扩大农村劳动力就业规模.因此要大力培养农村实用型人才,提高自身素质;建立城乡统筹就业机制,促进农村劳动力在城乡、区域间的有序流动和合理配置;规范劳务服务管理,提高农村劳动力就业组织化程度;加强信息化建设,完善农村劳动力供求信息系统;打造劳务输出品牌,建设农村劳动力转移和输出的绿色通道;加强政策激励,引导农民工自主创业.%As a large agricultural country, China must pay attention to the development of agriculture if China wants to enhance the comprehensive national strength. The long-term mechanism, for farmers to shake off poverty is to improve the competitiveness of rural labor employment, and expand the scale of rural labor employment by the policy measures. Therefore, the rural practical talents should be powerfully trained, and their quality should be improved. Coordinated employment mechanism for the whole urban-rural area should be set up, and the orderly flow and reasonable configuration of rural labor force in urban and rural should be promoted. The management of the labor service should be regulated, and the organizable degree of rural labor force should be improved. The construction of informationization should be strengthened, and the supply and demand information system should be perfected for the rural labor. The export of labor services brand should be made, and a green channel for the transfer and output of rural labor should be built. The policy incentives should be reinforced, and the peasant workers who start their own businesses should be guided.

  6. Teacher professional development outside the lecture room: Voices of professionally unqualified practicing teachers in rural Zimbabwe secondary schools

    Directory of Open Access Journals (Sweden)

    Tabitha Grace Mukeredzi

    2016-11-01

    Full Text Available Attempts to address global pressure to achieve Education for All have been hampered by two fundamental challenges in developing countries, namely an acute shortage of teachers and large rural populations in these countries. In addition there is a trend for qualified competent teachers to shun working in rural settings. While recruitment of professionally unqualified graduate teachers into the teaching profession has become internationally acclaimed to address in particular rural school postings and Education for All commitments, there remain outstanding questions regarding how such teachers professionally learn and grow in these rural contexts outside the Teacher Education Institution lecture room. An understanding of how they develop professionally is crucial. The study explored professional development experiences of professionally unqualified practicing teachers in rural secondary schools. A qualitative design was adopted and three-interview series complimented by photo elicitations were employed to explore the teachers’ professional development experiences. Data were transcribed and manually analysed inductively utilizing open coding. Findings suggest that professional development experiences for these teachers occurred in four sites: school structures, wider professional sites, planned and unplanned gatherings, and the classroom. Drawing on concepts around professional development to describe, analyse and understand data, I illustrate that professionally unqualified practicing teachers in rural secondary schools experience professional development outside Teacher Education Institutions in interaction, through domains of formality and experience: non formal, informal and experiential.

  7. Skilled care at birth among rural women in Nepal: practice and challenges.

    Science.gov (United States)

    Dhakal, Sulochana; van Teijlingen, Edwin; Raja, Edwin Amalraj; Dhakal, Keshar Bahadur

    2011-08-01

    In Nepal, most births take place at home, and many, particularly in rural areas, are not attended by a skilled birth attendant. The main objectives of the study were to assess the use of skilled delivery care and barriers to access such care in a rural community and to assess health problems during delivery and seeking care. This cross-sectional study was carried out in two Village Development Committees in Nepal in 2006. In total, 150 women who had a live birth in the 24 months preceding the survey were interviewed using a structured questionnaire. The sample population included married women aged 15-49 years. Forty-six (31%) women delivered their babies at hospital, and 104 (69%) delivered at home. The cost of delivery at hospital was significantly (p access skilled delivery care were: distance to hospital, lack of transportation, lack of awareness on delivery care, and cost. The main reasons for seeking intrapartum care were long labour, retained placenta, and excessive bleeding. Only a quarter of women sought care immediately after problems occurred. The main reasons seeking care late were: the woman or her family not perceiving that there was a serious problem, distance to health facility, and lack of transport. The use of skilled birth attendants at delivery among rural women in Nepal is very poor. Home delivery by unskilled birth attendants is still a common practice among them. Many associated factors relating to the use of skilled delivery care that were identified included age, education and occupation of women, and education and occupation of husbands. Therefore, the availability of skilled delivery care services at the community, initiation of a primary health centre with skilled staff for delivery, and increasing awareness among women to seek skilled delivery care are the best solution.

  8. Assessment of the Rural Teacher’s Profile from the Perspective of the Training Process and the Educational Practice

    Directory of Open Access Journals (Sweden)

    Andrea Ramírez-González

    2015-09-01

    Full Text Available This paper presents the results of an evaluation of the profile of rural teachers from the perspective of the teaching practice. The literary sources show different profile approaches that are based on the functions, characteristics, traits, and skills and where the essential aspects of the profile such as skills, abilities, knowledge, attitudes, and values are determined. Consequently, the teaching practice is the ideal context to assess the aspects that shape the rural teacher performance since it allows us to compare the various profile approaches. For the research process, a qualitative methodology was applied, through participant observation techniques and an in-depth interview, to six teachers with university studies in rural education of schools classified as single-teacher and administration 1, located in rural areas of Costa Rica. To retrieve the necessary information to assess the profile of the participants, this research examined the pedagogical-community characteristics of the educational practice, which, at the same time, allow the teacher insertion in alternative work spaces in the rural areas.

  9. Soil ingestion rate determination in a rural population of Alberta, Canada practicing a wilderness lifestyle.

    Science.gov (United States)

    Irvine, G; Doyle, J R; White, P A; Blais, J M

    2014-02-01

    The inadvertent ingestion of contaminated soil can be a major pathway for chemical exposure to humans. Few studies to date have quantified soil ingestion rates to develop exposure estimates for human health risk assessments (HHRA), and almost all of those were for children in suburban/urban environments. Here we employed a quantitative mass balance tracer approach on a rural population practicing outdoor activities to estimate inadvertent soil ingestion. This study followed 9 subjects over a 13 day period in Cold Lake, Alberta, near the largest in situ thermal heavy oil (bitumen) extraction operation in the world. The mean soil ingestion rate in this study using Al Ce, La, and Si tracers was 32 mg d(-1), with a 90th percentile of 152 mg d(-1) and median soil ingestion rate of 18 mg d(-1). These soil ingestion values are greater than the standard recommended soil ingestion rates for HHRA from Health Canada, and are similar to soil ingestion estimates found in the only other study on a rural population. © 2013. Published by Elsevier B.V. All rights reserved.

  10. Attitudes towards chiropractic: an analysis of written comments from a survey of north american orthopaedic surgeons

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    Busse Jason W

    2011-10-01

    Full Text Available Abstract Background There is increasing interest by chiropractors in North America regarding integration into mainstream healthcare; however, there is limited information about attitudes towards the profession among conventional healthcare providers, including orthopaedic surgeons. Methods We administered a 43-item cross-sectional survey to 1000 Canadian and American orthopaedic surgeons that inquired about demographic variables and their attitudes towards chiropractic. Our survey included an option for respondants to include written comments, and our present analysis is restricted to these comments. Two reviewers, independantly and in duplicate, coded all written comments using thematic analysis. Results 487 surgeons completed the survey (response rate 49%, and 174 provided written comments. Our analysis revealed 8 themes and 24 sub-themes represented in surgeons' comments. Reported themes were: variability amongst chiropractors (n = 55; concerns with chiropractic treatment (n = 54; areas where chiropractic is perceived as effective (n = 43; unethical behavior (n = 43; patient interaction (n = 36; the scientific basis of chiropractic (n = 26; personal experiences with chiropractic (n = 21; and chiropractic training (n = 18. Common sub-themes endorsed by surgeon's were diversity within the chiropractic profession as a barrier to increased interprofessional collaboration, endorsement for chiropractic treatment of musculoskeletal complaints, criticism for treatment of non-musculoskeletal complaints, and concern over whether chiropractic care was evidence-based. Conclusions Our analysis identified a number of issues that will have to be considered by the chiropractic profession as part of its efforts to further integrate chiropractic into mainstream healthcare.

  11. Practices of rural Egyptian birth attendants during the antenatal, intrapartum and early neonatal periods.

    Science.gov (United States)

    Darmstadt, Gary L; Hussein, Mohamed Hassan; Winch, Peter J; Haws, Rachel A; Gipson, Reginald; Santosham, Mathuram

    2008-03-01

    Neonatal deaths account for almost two-thirds of infant mortality worldwide; most deaths are preventable. Two-thirds of neonatal deaths occur during the first week of life, usually at home. While previous Egyptian studies have identified provider practices contributing to maternal mortality, none has focused on neonatal care. A survey of reported practices of birth attendants was administered. Chi-square tests were used for measuring the statistical significance of inter-regional differences. In total, 217 recently-delivered mothers in rural areas of three governorates were interviewed about antenatal, intrapartum and postnatal care they received. This study identified antenatal advice of birth attendants to mothers about neonatal care and routine intrapartum and postpartum practices. While mothers usually received antenatal care from physicians, traditional birth attendants (dayas) conducted most deliveries. Advice was rare, except for breastfeeding. Routine practices included hand-washing by attendants, sterile cord-cutting, prompt wrapping of newborns, and postnatal home visits. Suboptimal practices included lack of disinfection of delivery instruments, unhygienic cord care, lack of weighing of newborns, and lack of administration of eye prophylaxis or vitamin K. One-third of complicated deliveries occurred at home, commonly attended by relatives, and the umbilical cord was frequently pulled to hasten delivery of the placenta. In facilities, mothers reported frequent use of forceps, and asphyxiated neonates were often hung upside-down during resuscitation. Consequently, high rates of birth injuries were reported. Priority areas for behaviour change and future research to improve neonatal health outcomes were identified, specific to type of provider (physician, nurse, or daya) and regional variations in practices.

  12. The first research agenda for the chiropractic profession in Europe

    DEFF Research Database (Denmark)

    Rubinstein, Sidney M; Bolton, Jenni; Webb, Alexandra L;

    2014-01-01

    BACKGROUND: Research involving chiropractors is evolving and expanding in Europe while resources are limited. Therefore, we considered it timely to initiate a research agenda for the chiropractic profession in Europe. The aim was to identify and suggest priorities for future research in order...... to best channel the available resources and facilitate advancement of the profession. METHODS: In total, 60 academics and clinicians working in a chiropractic setting, and who had attended any of the annual European Chiropractors' Union/European Academy of Chiropractic (ECU/EAC) Researchers' Day meetings...... thought to be most important: 1) cost-effectiveness/economic evaluations, 2) identification of subgroups likely to respond to treatment, and 3) initiation and promotion of collaborative research activities. CONCLUSIONS: This is the first formal and systematic attempt to develop a research agenda...

  13. The chiropractic profession in Denmark 2010-2014

    DEFF Research Database (Denmark)

    Nielsen, Orla Lund; Kongsted, Alice; Christensen, Henrik Wulff

    2015-01-01

    BACKGROUND: The chiropractic profession has been well established in Denmark for several decades with state authorization, partial reimbursement by the state and a formal academic education. Biennial systematic data collections among all chiropractors and clinics have been performed since 2010...... in order to provide exact information on the profession to The Danish Chiropractic Association (DCA). It is the aim of this study to outline the major characteristics and developments of the chiropractic profession in Denmark to make this information accessible to other stakeholders, domestic as well...... as foreign. METHODS: Using contact information from the DCA, two questionnaires were distributed electronically to all individual members of the association actively working as chiropractors and all clinics respectively in 2010, 2012 and 2014. The questions asked were developed for this specific survey...

  14. Procedural skills practice and training needs of doctors, nurses, midwives and paramedics in rural Victoria

    Science.gov (United States)

    Campbell, David; Shepherd, Irwyn; McGrail, Matthew; Kassell, Lisa; Connolly, Marnie; Williams, Brett; Nestel, Debra

    2015-01-01

    Introduction Procedural skills are a significant component of clinical practice. Doctors, nurses, midwives and paramedics are trained to use a variety of procedural skills. Rural clinicians in particular are often required to maintain competence in some procedural skills that are used infrequently, and which may require regular and repeated rehearsal. This paper reports on a research project conducted in Gippsland, Victoria, to ascertain the frequency of use, and relevance to clinical practice, of a range of skills in the fields of medicine, nursing, midwifery, and paramedic practice. The project also gathered data on the attitudes of clinicians regarding how frequently and by what means they thought they needed to practice these skills with a particular focus on the use of simulation as an educational method. Methods The research was conducted following identification of a specific set of procedural skills for each professional group. Skills were identified by an expert steering committee. We developed online questionnaires that consisted of two parts: 1) demographic and professional characteristics, and 2) experience of procedural skills and perceived training needs. We sought to invite all practicing clinicians (doctors, nurses, midwives, paramedics) working in Gippsland. Online surveys were distributed between November 2011 and April 2012 with three follow-up attempts. The Monash University Human Research Ethics Committee approved the study. Results Valid responses were received from 58 doctors, 94 nurses, 46 midwives, and 30 paramedics, whom we estimate to represent not more than 20% of current clinicians within these professions. This response rate reflected some of the difficulties experienced in the conduct of the research. Results were tabulated for each professional group across the range of skills. There was significant correlation between the frequency of certain skills and confidence with maintenance of these skills. This did not necessarily correlate

  15. Study of knowledge, attitude and practices regarding dengue in the urban and rural field practice area of a tertiary care teaching hospital in Pune, India

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    Samir Singru

    2013-01-01

    Full Text Available Context: Dengue is the most common disease among all the arthropod-borne viral diseases. There is no specific treatment or vaccine available for dengue. The sole method of prevention and control is the knowledge attitude and practices (KAP for the same. Although, dengue is considered an urban- and semi-urban disease, in recent years, due to water storage practices and large-scale development activities in rural areas, dengue has become endemic in rural areas of India as well. Aims: To assess the KAP regarding dengue. Settings and Design: Urban and rural field practice area of a Tertiary Care Teaching Hospital in Pune, India. Materials and Methods: A pre-tested, semi-structured questionnaire was used to study the knowledge, attitude, and practices regarding dengue. Stratified random sampling technique was used. A modified B. G. Prasad criterion was used for socio-economic classification. Statistical Analysis Used: KAP represented as proportion (%. Chi-square test was used as a test of significance. P value < 0.05 was considered as statistically significant. Results: 68.4% in urban areas and 40.4% in rural area knew that dengue is transmitted by mosquito. 62.6% in urban areas and 48% in rural areas respectively stated fever as a symptom of dengue. The use of anti-adult mosquito measures was 48.05% and 51.42% in urban and rural area respectively Conclusions: There is a definite need to increase the information education communication activities for dengue in the study area.

  16. Healthcare-Seeking Practices of African and Rural-to-Urban Migrants in Guangzhou

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    Tabea Bork-Hüffer

    2015-01-01

    Full Text Available Taking the examples of Chinese rural-to-urban migrant and African migrant businesspeople in Guangzhou, this article inquires into the commonalities and differences in the health status and healthcare-seeking practices of both groups. While both populations of migrants are diverse and heterogeneous, there are many commonalities with regard to the challenges they face compared to the Chinese local population. Mixed-methods research frameworks and qualitative and quantitative methods were applied. While existing publications emphasise lacking financial access to healthcare, further individual and social factors account for migrants’ healthcare choices. Their access to healthcare can be improved only by introducing insurance schemes with portable benefits, providing localised and culturally adequate health services adapted to migrants’ specific needs and health risks, and enhancing patient orientation and responsiveness by health professionals.

  17. Farewell to Fiestas and Saints? Changing Catholic Practices in Contemporary Rural Oaxaca

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    Toomas Gross

    2009-08-01

    Full Text Available This article discusses recent changes in Catholic festivities, especially the system of fiestas in rural Mexico. The ethnographic focus of the discussion is on indigenous Zapotec communities of the State of Oaxaca. Collective religious practices in Mexican villages contribute to social cohesion. Fiestas commemorating patron saints of the villages play a particularly important role in (reconstructing communal identity and the feeling of collective belongingness. Various global processes like secularisation, integration of local economies into the capitalist market system, increasing out-migration from villages, and the rise of Protestantism have undermined the position of the Catholic Church in the region. The article scrutinises the changing organisation and role of fiestas in the communities, concluding that the impact of secularisation, migration and Protestantism in particular is not simple and always negative – these changes can actually invigorate certain dimensions of the fiestas.

  18. Nutritional Deficiencies, the Absence of Information and Caregiver Shortcomings: A Qualitative Analysis of Infant Feeding Practices in Rural China.

    Science.gov (United States)

    Yue, Ai; Marsh, Lauren; Zhou, Huan; Medina, Alexis; Luo, Renfu; Shi, Yaojiang; Zhang, Linxiu; Kenny, Kaleigh; Rozelle, Scott

    2016-01-01

    Development during the first two years of life is critical and has a lasting impact on a child's health. Poor infant and child nutrition can lead to deficiencies in essential micronutrients, which may cause a weakened immune system and lasting effects on children's growth and development. Recent studies in rural Shaanxi Province found an anemia prevalence of 54.3% among rural children aged six to twelve months. While new large-scale, quantitative research has begun to catalogue the extent of child malnutrition and anemia, no effort has yet been made to look more closely at the potential reasons for rural children's nutritional deficiencies through qualitative analysis. This study aims to elucidate some of the fundamental causes of poor complementary feeding practices that may lead to anemia among children in rural Shaanxi Province, China. We interviewed sixty caregivers participating in a large survey on child health and nutrition. We conducted three waves of interviews with children's primary caregivers in seventeen rural villages within four nationally-designated poverty counties in the southern part of Shaanxi Province. The qualitative analysis reveals that poor complementary feeding practices are common across our sample. Information gathered from our interviews suggests that complementary feeding practices are impeded by two constraints: absence of understanding topics related to infant health and nutrition under caregivers, as well as inadequate sources of information on these topics. Poverty does not appear to constrain child feeding practices. Our results uncover lack of proper knowledge on infant and child nutrition among rural caregivers in China. This situation causes them to fail incorporating micronutrient rich foods in their children's diet. Age-appropriate complementary feeding can stimulate children's physical and cognitive development, but in its absence it leads to iron-deficiency anemia. We suggest that steps be taken to educate caregivers to

  19. Prevalence of exclusive breastfeeding practices among rural women in Tamil Nadu

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    Shankar Radhakrishnan

    2012-01-01

    Full Text Available Background: Poor infant feeding practices and their consequences are one of the world′s major problems and a serious obstacle to social and economic development. Various studies have shown that infant feeding could be influenced by socioeconomic status, maternal education, place of living and many other factors. Hence a prevalence study on exclusive breastfeeding was conducted in rural Tamil Nadu. Aim and Objective: To assess the prevalence of exclusive breastfeeding practices and the factors influencing them among women in a rural area in Tamil Nadu. Materials and Methods: It is a cross-sectional study conducted in Attyampatti Panchyat Union, Salem district, Tamil Nadu, from March 2011-June 2011. All the 291 children in the age group of six months to two years in Attyampatti Panchayat Union were included in the study, irrespective of any sample. The data was analyzed using SPSS package. Results: Among the study population 52.6% were male children and 47.4% were females. Only 99 (34% children were exclusively breastfed for six months. The majority of women (60.5% initiated breastfeeding within half an hour after delivery. Various demographic factors like the education of the mother, type of delivery, type of family, occupation, number of children, monthly income, family size, age at marriage and religion had a direct influence on exclusive breastfeeding, which in turn influenced the weight of the baby and immune status of the child. Most of the mothers (44.7% inferred that the main reason for giving bottle feed is because of inadequate breast milk secretion. Conclusion: The prevalence of exclusive breastfeeding is low in this particular area. Hence promotion of exclusive breastfeeding and focus on the factors affecting them is highly warranted in this area.

  20. Differences in Sexual Practices, Sexual Behavior and HIV Risk Profile between Adolescents and Young Persons in Rural and Urban Nigeria.

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    Morenike Oluwatoyin Folayan

    Full Text Available We aimed to determine differences in sexual practices, HIV sexual risk behaviors, and HIV risk profile of adolescents and young persons' in rural and urban Nigeria.We recruited 772 participants 15 to 24 years old from urban and rural townships in Nigeria through a household survey. Information on participants' socio-demographic profile (age sex, residential area, number of meals taken per day, sexual practices (vagina, oral and anal sex; heterosexual and homosexual sex; sex with spouse, casual acquaintances, boy/girlfriend and commercial sex workers, sexual behavior (age of sexual debut, use of condom, multiple sex partners, transactional sex and age of sexual partner, and other HIV risk factors (use of alcohol and psychoactive substances, reason for sexual debut, knowledge of HIV prevention and HIV transmission, report of STI symptoms were collected through an interviewer administered questionnaire. Differences in sexual behavior and sexual practices of adolescents and HIV risk profile of adolescents and young persons resident in urban and rural areas were determined.More than half (53.5% of the respondents were sexually active, with more residing in the rural than urban areas (64.9% vs 44.1%; p<0.001 and more resident in the rural area reporting having more than one sexual partner (29.5% vs 20.4%; p = 0.04. Also, 97.3% of sexually active respondents reported having vaginal sex, 8.7% reported oral sex and 1.9% reported anal sex. More male than female respondents in the urban area used condoms during the last vaginal sexual intercourse (69.1% vs 51.9%; p = 0.02, and reported sex with casual partners (7.0% vs 15.3%; p = 0.007. More female than male respondents residing in the rural area engaged in transactional sex (1.0% vs 6.7%; p = 0.005. More females than males in both rural (3.6% vs 10.2%; p = 0.04 and urban (4.7% vs 26.6%; p<0.001 areas self-reported a history of discharge. More females than males in both rural (1.4% vs 17.0%; p = 0.04 and

  1. Infant care practices in rural China and their relation to prenatal care utilisation.

    Science.gov (United States)

    Nwaru, B I; Wu, Z; Hemminki, E

    2011-01-01

    Studies describing postpartum childcare practices and the influence of prenatal care on infant care outcomes in rural China are scarce. This study looked at data for 1479 women who had given birth during the preceding 2 years (median age of the child was 8 months). Data were available from a Knowledge, Attitude and Perception cross-sectional survey collected from 2001 to 2003, after a prenatal care intervention in Anhui County, China, with a response rate of 97%. Prenatal care utilisation was categorised using the Adequacy of Prenatal Care Utilisation index. Logistic regression was used to study the association between prenatal care utilisation and infant care practices. Mothers' uptake of breastfeeding, introduction of milk formula, cereal/porridge, meat and uptake of any immunisation were found to be in accordance with national recommendations. Intermediate prenatal care uptake was positively associated with never breastfeeding and early introduction of cereal/porridge. Inadequate care was positively associated with never breastfeeding, early introduction of milk formula and cereal/porridge, and early start of work after delivery. Initiation to prenatal care after the third month was positively associated with early introduction of milk formula and cereal/porridge. Having no prenatal care was positively associated with never breastfeeding and early introduction of milk formula. Mothers' uptake of infant care practices in this population was largely in accordance with national recommendations. Women with less than adequate utilisation of prenatal care and those who had initiated prenatal care late were less likely to follow recommendations on infant care.

  2. The appropriation and dismembering of development intervention : policy, discourse and practice in the field of rural development in Benin

    NARCIS (Netherlands)

    Mongbo, R.L.

    1995-01-01

    This book concerns a Community Development Programme which provides a vehicle for a theoretical discussion of the reproduction of the discourse and practice of development intervention in general, and the concept of rural development as a field of social interaction in particular. The

  3. The appropriation and dismembering of development intervention: policy, discourse and practice in the field of rural development in Benin.

    NARCIS (Netherlands)

    Mongbo, R.L.

    1995-01-01

    This book concerns a Community Development Programme which provides a vehicle for a theoretical discussion of the reproduction of the discourse and practice of development intervention in general, and the concept of rural development as a field of social interaction in particular. The actions on whi

  4. The appropriation and dismembering of development intervention : policy, discourse and practice in the field of rural development in Benin

    NARCIS (Netherlands)

    Mongbo, R.L.

    1995-01-01

    This book concerns a Community Development Programme which provides a vehicle for a theoretical discussion of the reproduction of the discourse and practice of development intervention in general, and the concept of rural development as a field of social interaction in particular. The actio

  5. Determinants of income-earning strategies and adoption of conservation practices in hillside communities in rural Honduras

    NARCIS (Netherlands)

    Jansen, H.P.G.; Rodriguez, A.; Damon, A.; Pender, J.; Chenier, J.; Schipper, R.A.

    2006-01-01

    Based on the results of participatory diagnostic surveys conducted in 95 rural communities in the hillsides of Honduras, we determine income earning strategies at the community level; identify their main determinants; and analyze the adoption of of conservation practices. Eight income-earning strate

  6. Impact of social factors on health practices of the elderly: an analytical study in rural Surendranagar

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    Shashwat Nagar

    2013-04-01

    Full Text Available Introduction: Increased attention to health promotion and disease prevention are important for the appropriate care of the elderly. With the increasing life expectancy, a focus on preventive measures to decrease morbidity and improve quality of life in old age has also developed. To that end, health behavior and lifestyle have become important areas of concern over the last 20 years. Social factors lay a significant impact on the health practices. This study was therefore taken up to study the above factor and draw conclusions. Aims and objectives: 1. To study the various health practices of the elderly. 2. To find out association between the socio demographic features and the prevailing health practices. Methods: A Cross sectional analytical study was carried out. All the subjects were interviewed personally to know the details and were treated with due respect after a consent. Out of all the talukas in rural Surendranagar, Sayla was selected randomly after which Sayla village was selected in a similar manner from all the villages in the talukas. Results: The mean age of the subjects was 68±7.5. Majority of the subjects were unemployed and illiterate (58%. Social factors like Social class, staying with children and staying in joint family were significantly associated with good health practices. Conclusions: The Health practices of the elderly can be improved upon by large scale health education programmes which can be targeted on the age group. Patient compliance improvement can be achieved by explaining them about the disease and treatment protocol in detail at the time of their health visit. [Int J Res Med Sci 2013; 1(2.000: 116-122

  7. Lessons for Research Policy and Practice: The Case of Co-enquiry Research With Rural Communities

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    Emily Caruso

    2016-07-01

    Full Text Available This article explores the relationship between institutional funding for research and community-based or co-enquiry research practice. It examines the implementation of co-enquiry research in the COMBIOSERVE project, which was funded by the European Commission’s Seventh Framework Programme for research and innovation, between the years 2012 and 2015. Research partnerships between Latin American and European civil society organisations, research institutions, and Latin American rural communities are analysed. Challenges for effective collaboration in co-enquiry and lessons learned for research policy and practice are outlined. Based on our case study we suggest that: (1 the established values and practices of academia seem largely unfavourable towards alternative forms of research, such as co-enquiry; (2 the policies and administrative practices of this European Commission funding are unsuitable for adopting participatory forms of enquiry; and (3 the approach to research funding supports short engagements with communities whereas long-term collaborations are more desirable. Based on our case study, we propose more flexible funding models that support face-to-face meetings between researchers and communities from the time of proposal drafting, adaptation of research processes to local dynamics, adaptation of administrative processes to the capacities of all participants, and potential for long-term collaborations. Large-scale funding bodies such as European Commission research programmes are leaders in the evolution of research policy and practice. They have the power and the opportunity to publicly acknowledge the value of partnerships with civil society organisations and communities, actively support co-enquiry, and foment interest in innovative forms of research.

  8. The development and evaluation of a small ready-reference library collection for a rural practice: a case study.

    Science.gov (United States)

    Gotsick, P S; Friedman, R L; Stith, J B

    1979-04-01

    A demonstration core collection of twenty-four ready-reference sources and five journals was selected cooperatively by a solo practitioner in rural Menifee County, Kentucky, and the University of Kentucky Medical Center Library Field Librarian to fit the ready-reference and current awareness information needs of a primary care solo rural practice in eastern Kentucky. The collection selections were systematically assessed by the physician to determine their utility in filling the practitioner's information needs with regard to his particular situation in terms of medical experience and level of training, available library and educational resources, and the type of health problems seen in his practice. This assessment showed that the Rural Demonstration Library Collection completely filled the information needs of the physician 66% of the time materials were consulted and filled his immediate information needs either completely or partially 82% of the time the collection was searched. This demonstration has shown that, under a specific set of circumstances, a librarian and a solo rural practitioner can effectively work together in identifying health sciences materials which fit the information needs of a solo rural practitioner. It suggests that cooperation between a librarian and a physician is important in meeting information needs.

  9. The evidence base for chiropractic treatment of musculoskeletal conditions in children and adolescents: The emperor's new suit?

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    Stochkendahl Mette

    2010-06-01

    Full Text Available Abstract Five to ten percent of chiropractic patients are children and adolescents. Most of these consult because of spinal pain, or other musculoskeletal complaints. These musculoskeletal disorders in early life not only affect the quality of children's lives, but also seem to have an impact on adult musculoskeletal health. Thus, this is an important part of the chiropractors' scope of practice, and the objective of this review is to assess the evidence base for manual treatment of musculoskeletal disorders in children and adolescents. Randomized, quasi-randomized and non-randomized clinical studies were included if they investigated the effect of manual therapy on musculoskeletal disorders in children and/or adolescents. The MEDLINE and MANTIS databases were searched, and studies published in English, Danish, Swedish or Norwegian were included. Only three studies were identified that in some way attempted to look at the effectiveness of manual therapy for children or adolescents with spinal problems, and none of these was a randomized controlled clinical trial. As for the rest of the musculoskeletal system, only one study of temporomandibular disorder was identified. With this review, we have detected a paradox within the chiropractic profession: Although the major reason for pediatric patients to attend a chiropractor is spinal pain, no adequate studies have been performed in this area. It is time for the chiropractic profession to take responsibility and systematically investigate the efficiency of joint manipulation of problems relating to the developing musculoskeletal system.

  10. The evidence base for chiropractic treatment of musculoskeletal conditions in children and adolescents: The emperor's new suit?

    Science.gov (United States)

    Hestbaek, Lise; Stochkendahl, Mette Jensen

    2010-06-02

    Five to ten percent of chiropractic patients are children and adolescents. Most of these consult because of spinal pain, or other musculoskeletal complaints. These musculoskeletal disorders in early life not only affect the quality of children's lives, but also seem to have an impact on adult musculoskeletal health. Thus, this is an important part of the chiropractors' scope of practice, and the objective of this review is to assess the evidence base for manual treatment of musculoskeletal disorders in children and adolescents.Randomized, quasi-randomized and non-randomized clinical studies were included if they investigated the effect of manual therapy on musculoskeletal disorders in children and/or adolescents. The MEDLINE and MANTIS databases were searched, and studies published in English, Danish, Swedish or Norwegian were included.Only three studies were identified that in some way attempted to look at the effectiveness of manual therapy for children or adolescents with spinal problems, and none of these was a randomized controlled clinical trial. As for the rest of the musculoskeletal system, only one study of temporomandibular disorder was identified.With this review, we have detected a paradox within the chiropractic profession: Although the major reason for pediatric patients to attend a chiropractor is spinal pain, no adequate studies have been performed in this area. It is time for the chiropractic profession to take responsibility and systematically investigate the efficiency of joint manipulation of problems relating to the developing musculoskeletal system.

  11. Prácticas alimentarias de mujeres rurales: ¿una nueva percepción del cuerpo? Alimentary practices of rural women: a new body perception?

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    Sara Elena Pérez Gil-Romo

    2007-02-01

    Full Text Available OBJETIVO: Determinar cómo perciben su cuerpo las mujeres de una zona rural, a partir de los trastornos del comportamiento alimentario (sobrepeso, obesidad y "delgadez" y modifican sus prácticas. MATERIAL Y M[ÉTODOS: El estudio fue de tipo cualitativo. Se entrevistaron 37 mujeres, de las cuales se seleccionaron seis madres para ser entrevistadas a profundidad, en Huatecalco, Morelos, México. RESULTADOS: Se detectó una preocupación en algunas mujeres sobre el cuerpo: la obesidad es rechazada; ser delgada es sinónimo de "belleza" y la publicidad del "adelgazamiento" (vgr. dietas, alimentos y bebidas light y ejercicio, está modificando algunas prácticas alimentarias entre las mujeres. CONCLUSIONES: Se plantea la necesidad de investigar a mayor profundidad el origen de este fenómeno que puede convertirse en un problema de salud pública en las zonas rurales del país.OBJECTIVE: To determine how women in a rural area perceive their bodies and modify their practices, considering alimentary behavior disorders (overweight, obesity, and thinness. MATERIAL AND METHODS: The approach was qualitative. An initial survey of 37 women in Huatecalco, Morelos, Mexico was conducted, from which six mothers were selected for extensive interviews. RESULTS: Concern about their bodies was detected in some of these women. Obesity is rejected and thinness is equated with "beauty", and the publicity around losing weight (diets, "light" foods and drinks, exercise, etc. is modifying some of the alimentary practices among the women. CONCLUSION: It is suggested that the cause of this phenomenon needs to be more extensively investigated, since it could become a public health problem in rural areas of the country.

  12. Mixed-Methods Research in a Complex Multisite VA Health Services Study: Variations in the Implementation and Characteristics of Chiropractic Services in VA

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    Raheleh Khorsan

    2013-01-01

    Full Text Available Maximizing the quality and benefits of newly established chiropractic services represents an important policy and practice goal for the US Department of Veterans Affairs’ healthcare system. Understanding the implementation process and characteristics of new chiropractic clinics and the determinants and consequences of these processes and characteristics is a critical first step in guiding quality improvement. This paper reports insights and lessons learned regarding the successful application of mixed methods research approaches—insights derived from a study of chiropractic clinic implementation and characteristics, Variations in the Implementation and Characteristics of Chiropractic Services in VA (VICCS. Challenges and solutions are presented in areas ranging from selection and recruitment of sites and participants to the collection and analysis of varied data sources. The VICCS study illustrates the importance of several factors in successful mixed-methods approaches, including (1 the importance of a formal, fully developed logic model to identify and link data sources, variables, and outcomes of interest to the study’s analysis plan and its data collection instruments and codebook and (2 ensuring that data collection methods, including mixed-methods, match study aims. Overall, successful application of a mixed-methods approach requires careful planning, frequent trade-offs, and complex coding and analysis.

  13. Traditional birth attendants lack basic information on HIV and safe delivery practices in rural Mysore, India

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    Adamson Paul

    2010-09-01

    Full Text Available Abstract Background There is little research on HIV awareness and practices of traditional birth attendants (TBA in India. This study investigated knowledge and attitudes among rural TBA in Karnataka as part of a project examining how traditional birth attendants could be integrated into prevention-of-mother-to-child transmission of HIV (PMTCT programs in India. Methods A cross-sectional survey was conducted between March 2008 and January 2009 among TBA in 144 villages in Mysore Taluk, Karnataka. Following informed consent, TBA underwent an interviewer-administered questionnaire in the local language of Kannada on practices and knowledge around birthing and HIV/PMTCT. Results Of the 417 TBA surveyed, the median age was 52 years and 96% were Hindus. A majority (324, 77.7% had no formal schooling, 88 (21.1% had up to 7 years and 5 (1% had more than 7 yrs of education. Only 51 of the 417 TBA (12% reported hearing about HIV/AIDS. Of those who had heard about HIV/AIDS, only 36 (72% correctly reported that the virus could be spread from mother to child; 37 (74% identified unprotected sex as a mode of transmission; and 26 (51% correctly said healthy looking people could spread HIV. Just 22 (44% knew that infected mothers could lower the risk of transmitting the virus to their infants. An overwhelming majority of TBA (401, 96.2% did not provide antenatal care to their clients. Over half (254, 61% said they would refer the woman to a hospital if she bled before delivery, and only 53 (13% felt referral was necessary if excessive bleeding occurred after birth. Conclusions Traditional birth attendants will continue to play an important role in maternal child health in India for the foreseeable future. This study demonstrates that a majority of TBA lack basic information about HIV/AIDS and safe delivery practices. Given the ongoing shortage of skilled birth attendance in rural areas, more studies are needed to examine whether TBA should be trained and

  14. Traditional birth attendants lack basic information on HIV and safe delivery practices in rural Mysore, India.

    Science.gov (United States)

    Madhivanan, Purnima; Kumar, Bhavana N; Adamson, Paul; Krupp, Karl

    2010-09-22

    There is little research on HIV awareness and practices of traditional birth attendants (TBA) in India. This study investigated knowledge and attitudes among rural TBA in Karnataka as part of a project examining how traditional birth attendants could be integrated into prevention-of-mother-to-child transmission of HIV (PMTCT) programs in India. A cross-sectional survey was conducted between March 2008 and January 2009 among TBA in 144 villages in Mysore Taluk, Karnataka. Following informed consent, TBA underwent an interviewer-administered questionnaire in the local language of Kannada on practices and knowledge around birthing and HIV/PMTCT. Of the 417 TBA surveyed, the median age was 52 years and 96% were Hindus. A majority (324, 77.7%) had no formal schooling, 88 (21.1%) had up to 7 years and 5 (1%) had more than 7 yrs of education. Only 51 of the 417 TBA (12%) reported hearing about HIV/AIDS. Of those who had heard about HIV/AIDS, only 36 (72%) correctly reported that the virus could be spread from mother to child; 37 (74%) identified unprotected sex as a mode of transmission; and 26 (51%) correctly said healthy looking people could spread HIV. Just 22 (44%) knew that infected mothers could lower the risk of transmitting the virus to their infants. An overwhelming majority of TBA (401, 96.2%) did not provide antenatal care to their clients. Over half (254, 61%) said they would refer the woman to a hospital if she bled before delivery, and only 53 (13%) felt referral was necessary if excessive bleeding occurred after birth. Traditional birth attendants will continue to play an important role in maternal child health in India for the foreseeable future. This study demonstrates that a majority of TBA lack basic information about HIV/AIDS and safe delivery practices. Given the ongoing shortage of skilled birth attendance in rural areas, more studies are needed to examine whether TBA should be trained and integrated into PMTCT and maternal child health programs in

  15. Knowledge, attitudes and practices of mothers regarding diarrhoea among children in a Sudanese rural community.

    Science.gov (United States)

    Ahmed, I S; Eltom, A R; Karrar, Z A; Gibril, A R

    1994-11-01

    A survey of knowledge, attitudes and practices of mothers in the rural communities of two villages in Sudan regarding diarrhoeal diseases in children was conducted using a focus group research technique. Seven groups of literate mothers (87 mothers) and 13 groups of illiterate mothers (152 mothers) interviewed comprised 85% of mothers with children under 5 years of age in that community. The study showed that mothers can define and describe diarrhoea, however awareness about the aetiology and the importance of germs in its causation was low. The majority of mothers attributed diarrhoea to teething, milk of pregnant women, hot food and salty water. Less than 40% of mothers identify symptoms and signs of "dehydration" and the need for consultation. Only 10% could relate danger signs to severe dehydration. The ORS use rate was very low (2.1-4.3%). Although awareness about ORS was high (100%), only 25% prepared and used it correctly. However, home made fluids including rice water, custard, pap and tabaladi juice were used by 45% of the mothers. 45% of illiterate mothers stop breast feeding and food during diarrhoea compared to 30% of literate mothers. Harmful practices used in caring for children with diarrhoea included: fumigation (50%), cauterization and removal of teeth buds (45% illiterate mothers, 10% literate), withholding of breast feeding and indiscriminate use of drugs and herbs in 30%.

  16. Local bureaucrats as bricoleurs. The everyday implementation practices of county environment officers in rural Kenya

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    Mikkel Funder

    2015-03-01

    Full Text Available Bricolage in natural resource governance takes place through the interplay of a variety of actors. This article explores the practices of a group whose agency as bricoleurs has received little attention, namely the government officers who represent the state in the everyday management of water, land, forests and other resources across rural Africa. Specifically we examine how local Environment Officers in Taita Taveta County in Kenya go about implementing the national environmental law on the ground, and how they interact with communities in this process. As representatives of “the local state”, the Environment Officers occupy an ambiguous position in which they are expected to implement lofty laws and policies with limited means and in a complex local reality. In response to this they employ three key practices, namely (i working through personal networks, (ii tailoring informal agreements, and (iii delegating public functions and authority to civil society. As a result, the environmental law is to a large extent implemented through a blend of formal and informal rules and governance arrangements, produced through the interplay of the Environment Officers, communities and other local actors.

  17. Knowledge, attitudes and practices toward breast cancer screening in a rural South African community

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    Dorah U. Ramathuba

    2015-02-01

    Full Text Available Objectives: The study assessed the knowledge, attitudes and breast cancer screening practices amongst women aged 30–65 years residing in a rural South African community.Method: A quantitative, descriptive cross-sectional design was used and a systematic sampling technique was employed to select 150 participants. The questionnaire was pretested for validity and consistency. Ethical considerations were adhered to in protecting the rights of participants. Thereafter, data were collected and analysed descriptively using the Predictive Analytics Software program.Results: Findings revealed that the level of knowledge about breast cancer of women in Makwarani Community was relatively low. The attitude toward breast cancer was negative whereas the majority of women had never performed breast cancer diagnostic methods.Conclusion: Health education on breast cancer screening practices is lacking and the knowledge deficit can contribute negatively to early detection of breast cancer and compound late detection. Based on the findings, community-based intervention was recommended in order to bridge the knowledge gap

  18. Capitation combined with pay-for-performance improves antibiotic prescribing practices in rural China.

    Science.gov (United States)

    Yip, Winnie; Powell-Jackson, Timothy; Chen, Wen; Hu, Min; Fe, Eduardo; Hu, Mu; Jian, Weiyan; Lu, Ming; Han, Wei; Hsiao, William C

    2014-03-01

    Pay-for-performance in health care holds promise as a policy lever to improve the quality and efficiency of care. Although the approach has become increasingly popular in developing countries in recent years, most policy designs do not permit the rigorous evaluation of its impact. Thus, evidence of its effect is limited. In collaboration with the government of Ningxia Province, a predominantly rural area in northwest China, we conducted a matched-pair cluster-randomized experiment between 2009 and 2012 to evaluate the effects of capitation with pay-for-performance on primary care providers' antibiotic prescribing practices, health spending, outpatient visit volume, and patient satisfaction. We found that the intervention led to a reduction of approximately 15 percent in antibiotic prescriptions and a small reduction in total spending per visit to village posts-essentially, community health clinics. We found no effect on other outcomes. Our results suggest that capitation with pay-for-performance can improve drug prescribing practices by reducing overprescribing and inappropriate prescribing. Our study also shows that rigorous evaluations of health system interventions are feasible when conducted in close collaboration with the government.

  19. South Vietnamese Rural Mothers’ Knowledge, Attitude, and Practice in Child Health Care

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    Dinh Thac

    2016-01-01

    Full Text Available A study of 600 rural under-five mothers’ knowledge, attitude, and practice (KAP in child care was performed in 4 southern provinces of Vietnam. The mothers were randomly selected and interviewed about sociodemographic factors, health seeking behaviour, and practice of home care of children and neonates. 93.2% of the mothers were literate and well-educated, which has been shown to be important for child health care. 98.5% were married suggesting a stable family, which is also of importance for child health. Only 17.3% had more than 2 children in their family. The mother was the main caretaker in 77.7% of the families. Only 1% would use quacks as their first health contact, but 25.2% would use a private clinic, which therefore eases the burden on the government system. Nearly 69% had given birth in a hospital, 27% in a commune health station, and only 2.7% at home without qualified assistance. 89% were giving exclusive breast feeding at 6 months, much more frequent than in the cities. The majority of the mothers could follow IMCI guideline for home care, although 25.2% did not deal correctly with cough and 38.7% did not deal correctly with diarrhoea. Standard information about Integrated Management of Childhood Illnesses (IMCI based home care is still needed.

  20. The Early Years of Organized Chiropractic Orthopedics, 1954–1973: A Social History

    Science.gov (United States)

    Green, Bart N.; Johnson, Claire D.

    2009-01-01

    Objective: This paper presents the origins and development of the organized chiropractic orthopedics movement in the United States from 1954–1973. Methods: Hand searches of early periodicals were performed and information was organized chronologically to create a timeline. Context for the timeline was provided by extracting pertinent information from audio recordings of interviews. Relevant background information was located using the cumulative index of the journal Chiropractic History and searching the MANTIS database. Historical Features: After World War I, The advent of third party reimbursement for health care created a new environment for health care practitioners. For doctors of chiropractic, this event provided the impetus to begin the postgraduate chiropractic orthopedics program over 50 years ago. In 1954, Alvin A. Hancock, DC and F. Maynard Lipe, DC successfully launched an active orthopedics movement after several earlier attempts failed during the 1940s and early 1950s. The movement generated from the desire to train and certify chiropractors to manage personal injury and workers’ compensation low back injuries. In addition to developing interdisciplinary educational programs, the chiropractic orthopedics group was responsible for producing a research agenda, some of the profession’s early orthopedic-focused research, and for starting the National Council on Chiropractic Orthopedics of the National Chiropractic Association, which later became the American Chiropractic Association Council on Orthopedics. These organizations produced thousands of specialists in chiropractic orthopedics, later known as Diplomates of the American Board of Chiropractic Orthopedists. Conclusion: Several orthopedics interest groups were formed and credentialing processes were created to qualify doctors as recognized chiropractic orthopedics specialists. The popularity of this movement resulted in the inclusion of orthopedics into core chiropractic college curricula and

  1. Exploring the relationship between subjective wellbeing and groundwater attitudes and practices of farmers in Rural India

    Science.gov (United States)

    Ward, J.; Varua, M. E.; Maheshwari, B.; Oza, S.; Purohit, R.; Hakimuddin; Dave, S.

    2016-09-01

    Failure to effectively coordinate opportunistic extractions by individual well owners with groundwater recharge has led to increasing Indian groundwater scarcity, affecting future opportunities for improved rural livelihoods and household wellbeing. Investigation of the relationship between groundwater institutions, management attitudes and subjective wellbeing of Indian rural households has substantial potential to reveal initiatives that jointly improve aquifer sustainability and household wellbeing, yet has received limited attention. Subjective wellbeing was calculated as an index of dissatisfaction (IDS), revealing ranked importance and the level of dissatisfaction of individual factors selected from economic, environmental and social/relational wellbeing dimensions. High economic and environmental IDS scores were calculated for respondents in the Meghraj and Dharta watersheds, India, respectively. We tested an exploratory hypothesis that observed IDS differences were correlated with differences in life circumstances, (household attributes, income and assets) and psychological disposition (life guiding values and willingness to adapt). The distribution of ranked IDS wellbeing scores was estimated across four statistically distinct clusters reflecting attitudes towards sustainable groundwater management and practice. Decision tree analysis identified significantly different correlates of overall wellbeing specific to cluster membership and the watershed, supporting the research hypothesis. High income IDS scores were weakly correlated with actual total household income (r < 0.25) consistent with international studies. The results suggest a singular reliance on initiatives to improve household income is unlikely to manifest as improved individual subjective wellbeing for the Dharta and Meghraj watersheds. In conclusion, correlates were tabulated into a systematic decision framework to assist the design of participatory processes at the village level, by

  2. Chiropractic management of postpartum pubic symphysis diastasis: A case report.

    Science.gov (United States)

    Henry, Lucian

    2015-03-01

    This case report describes the chiropractic management of a 30-year-old female patient with severe postpartum pelvic pain secondary to pubic symphysis diastasis. No literature was found on the chiropractic management of postpartum symphysis pubis diastasis. The existing literature concerning chiropractic care for symphysis pubis dysfunction during pregnancy is limited and indicates a potential benefit. Separation of the pubic symphysis may include ligamentous injury to the sacroiliac joints and may lead to chronic pain. Pubic symphysis separation of 17 millimeters was present on digital radiograph. Management consisted of chiropractic adjustments, trigger point release, electrical stimulation, moist heat, sacroiliac belt, and specific stabilizing exercises. The patient's pain improved immediately following treatment on the initial visit. Pain was reduced from 8/10 VAS at the first visit to 2/10 at the fourth visit. She was able to resume normal activities and reached a final pain level of 1/10. The diastasis was reduced by 7 millimeters at 14-weeks post radiograph for a final separation of just under 10 millimeters. Collaboration between obstetricians, midwives and chiropractors may be warranted.

  3. Comparison of Knowledge, Attitude and Practice of Urban and Rural Households toward Iron Deficiency Anemia in three Provinces of Iran

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    R Heshmat

    2009-12-01

    Full Text Available "nBackground: Lack of nutritional knowledge is one of the most important reasons of nutritional problems and consequently im­proper practice, which can lead to several complications. This study has been designed in order to compare knowledge, at­ti­tude and practices of the urban and rural households regarding iron deficiency anemia (IDA in Boushehr, Golestan and Sis­tan & Balouchestan provinces in 2004."nMethods: The sampling method at household's level in each province was the single-stage cluster sampling with equal size clus­ters. The necessary data were gathered with a structured questionnaire and via the interviews between the questioners and the eligible people in each household. Comparison of frequency of variables between urban and rural areas were tested by chi square test."nResults: A total of 2306 households were selected as overall sample size. In urban areas, people recognized iron food sources better than rural areas. Knowledge level of respondents about vulnerable group for IDA and the favorite attitude of house­holds toward IDA were better in urban areas of Sistan & Blouchestan and Golestan provinces. In Sistan & Ba­louchestan and Golestan, rural households who drank tea immediately before or after meal was more than urban ones. The ma­jor­ity of preg­nant and lactating mothers (except for rural areas of Bushehr did not take iron supplement regularly. Less than 60 percent of children used iron drop regularly."nConclusion: Knowledge, attitude, and practice levels of households toward IDA were not acceptable. One of the best ways of improving nutritional practice is nutritional education with focus on applying available food resources.

  4. A comparison of practice issues among occupational therapists in the rural Northwest and the Rocky Mountain regions.

    Science.gov (United States)

    Kohler, E; Mayberry, W

    1993-08-01

    The purpose of this study was to investigate factors that affected occupational therapy practice in the rural regions of the Rocky Mountains. It compared data from the Rocky Mountain region (Wyoming, Colorado, New Mexico, Utah, and Arizona) to a previous study of the Northwest region of Alaska, Idaho, Montana, and Washington and expanded on the Northwest study. Results indicated that the two areas were similar in their demographics and problems, including need for more occupational therapists. The results also have implications regarding specialized preservice training for rural-based occupational therapists, other professions' availability of continuing education, and other support systems. The authors provide recommendations based on the results, other literature, and conjectures, for recruitment, training, and ongoing support of rural occupational therapists through cooperative consortiums and distance learning.

  5. Maternal care practices among the ultra poor households in rural Bangladesh: a qualitative exploratory study

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    Choudhury Nuzhat

    2011-03-01

    Full Text Available Abstract Background Although many studies have been carried out to learn about maternal care practices in rural areas and urban-slums of Bangladesh, none have focused on ultra poor women. Understanding the context in which women would be willing to accept new practices is essential for developing realistic and relevant behaviour change messages. This study sought to fill in this knowledge gap by exploring maternal care practices among women who participated in a grant-based livelihood programme for the ultra poor. This is expected to assist the designing of the health education messages programme in an effort to improve maternal morbidity and survival towards achieving the UN millennium Development Goal 5. Methods Qualitative method was used to collect data on maternal care practices during pregnancy, delivery, and post-partum period from women in ultra poor households. The sample included both currently pregnant women who have had a previous childbirth, and lactating women, participating in a grant-based livelihood development programme. Rangpur and Kurigram districts in northern Bangladesh were selected for data collection. Results Women usually considered pregnancy as a normal event unless complications arose, and most of them refrained from seeking antenatal care (ANC except for confirmation of pregnancy, and no prior preparation for childbirth was taken. Financial constraints, coupled with traditional beliefs and rituals, delayed care-seeking in cases where complications arose. Delivery usually took place on the floor in the squatting posture and the attendants did not always follow antiseptic measures such as washing hands before conducting delivery. Following the birth of the baby, attention was mainly focused on the expulsion of the placenta and various maneuvres were adapted to hasten the process, which were sometimes harmful. There were multiple food-related taboos and restrictions, which decreased the consumption of protein during

  6. Maternal care practices among the ultra poor households in rural Bangladesh: a qualitative exploratory study.

    Science.gov (United States)

    Choudhury, Nuzhat; Ahmed, Syed M

    2011-03-01

    Although many studies have been carried out to learn about maternal care practices in rural areas and urban-slums of Bangladesh, none have focused on ultra poor women. Understanding the context in which women would be willing to accept new practices is essential for developing realistic and relevant behaviour change messages. This study sought to fill in this knowledge gap by exploring maternal care practices among women who participated in a grant-based livelihood programme for the ultra poor. This is expected to assist the designing of the health education messages programme in an effort to improve maternal morbidity and survival towards achieving the UN millennium Development Goal 5. Qualitative method was used to collect data on maternal care practices during pregnancy, delivery, and post-partum period from women in ultra poor households. The sample included both currently pregnant women who have had a previous childbirth, and lactating women, participating in a grant-based livelihood development programme. Rangpur and Kurigram districts in northern Bangladesh were selected for data collection. Women usually considered pregnancy as a normal event unless complications arose, and most of them refrained from seeking antenatal care (ANC) except for confirmation of pregnancy, and no prior preparation for childbirth was taken. Financial constraints, coupled with traditional beliefs and rituals, delayed care-seeking in cases where complications arose. Delivery usually took place on the floor in the squatting posture and the attendants did not always follow antiseptic measures such as washing hands before conducting delivery. Following the birth of the baby, attention was mainly focused on the expulsion of the placenta and various maneuvres were adapted to hasten the process, which were sometimes harmful. There were multiple food-related taboos and restrictions, which decreased the consumption of protein during pregnancy and post-partum period. Women usually failed to

  7. Partnership for implementation of evidence-based mental health practices in rural federally qualified health centers: theory and methods.

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    Hunt, Justin B; Curran, Geoffrey; Kramer, Teresa; Mouden, Sip; Ward-Jones, Susan; Owen, Richard; Fortney, John

    2012-01-01

    Mental health and substance abuse are among the most commonly reported reasons for visits to Federally Qualified Health Centers (CHCs), yet only 6.5% of encounters are with on-site behavioral health specialists. Rural CHCs are significantly less likely to have on-site behavioral specialists than urban CHCs. Because of this lack of mental health specialists in rural areas, the most promising approach to improving mental health outcomes is to help rural primary care (PC) providers deliver evidence-based practices (EBPs). Despite the scope of these problems, no research has developed an effective implementation strategy for facilitating the adoption of mental health EBPs for rural CHCs. We sought to describe the conceptual components of an implementation partnership that focuses on the adaption and adoption of mental health EBPs by rural CHCs in Arkansas. We present a conceptual model that integrates seven separate frameworks: (1) Jones and Wells' Evidence-Based Community Partnership Model, (2) Kitson's Promoting Action on Research Implementation in Health Services (PARiHS) implementation framework, (3) Sackett's definition of evidence-based medicine, (4) Glisson's organizational social context model, (5) Rubenstein's Evidence-Based Quality Improvement (EBQI) facilitation process, (6) Glasgow's RE-AIM evaluation approach, and (7) Naylor's concept of shared decision making. By integrating these frameworks into a meaningful conceptual model, we hope to develop a successful implementation partnership between an academic health center and small rural CHCs to improve mental health outcomes. Findings from this implementation partnership should have relevance to hundreds of clinics and millions of patients, and could help promote the sustained adoption of EBPs across rural America.

  8. Urban-rural inequities in knowledge, attitudes and practices regarding tuberculosis in two districts of Pakistan's Punjab province

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    Omer Fatima

    2011-02-01

    Full Text Available Abstract Objective The aim of this study was to explore inequities in knowledge, attitudes and practices regarding tuberculosis (TB among the urban and rural populations. Design A cross-sectional study was conducted in two districts of Pakistan's Punjab province. The 1080 subjects aged 20 years and above, including 432 urban and 648 rural respondents, were randomly selected using multistage cluster sampling and interviewed after taking verbal informed consent. Logistic regression was used to calculate the crude odds ratio (OR with 95% confidence interval (CI for the urban area. The differences in knowledge, attitudes, practices and information sources between the urban and rural respondents were highlighted using Pearson chi-square test and Fisher's exact test. Results The study revealed poor knowledge regarding TB. The deficit was greater in the rural areas in all aspects. The knowledge regarding symptoms (OR 2.03, 95% CI 1.59-2.61, transmission (OR 1.93, 95% CI 1.44-2.59, prevention (OR 2.24, 95% CI 1.70-2.96, duration of standard treatment (OR 1.88, 95% 1.41-2.49 and DOTS (OR 1.84, 95% CI 1.43-2.38 was significantly higher in the urban areas (all P Conclusion Respondents' knowledge regarding TB was deficient in all aspects, particularly in the rural areas. Intended health seeking behavior was better in the urban areas. Television and health workers were the main sources for TB related information in both the urban as well as the rural areas. Therefore, the area of residence should be considered in tailoring communication strategies and designing future interventions for TB prevention and control.

  9. For money or service? a cross-sectional survey of preference for financial versus non-financial rural practice characteristics among ghanaian medical students

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    Johnson Jennifer C

    2011-11-01

    Full Text Available Abstract Background Health worker shortage and maldistribution are among the biggest threats to health systems in Africa. New medical graduates are prime targets for recruitment to deprived rural areas. However, little research has been done to determine the influence of workers' background and future plans on their preference for rural practice incentives and characteristics. The purpose of this study was to identify determinants of preference for rural job characteristics among fourth year medical students in Ghana. Methods We asked fourth-year Ghanaian medical students to rank the importance of rural practice attributes including salary, infrastructure, management style, and contract length in considering future jobs. We used bivariate and multivariate ordinal logistic regression to estimate the association between attribute valuation and students' socio-demographic background, educational experience, and future career plans. Results Of 310 eligible fourth year medical students, complete data was available for 302 students (97%. Students considering emigration ranked salary as more important than students not considering emigration, while students with rural living experience ranked salary as less important than those with no rural experience. Students willing to work in a rural area ranked infrastructure as more important than students who were unwilling, while female students ranked infrastructure as less important than male students. Students who were willing to work in a rural area ranked management style as a more important rural practice attribute than those who were unwilling to work in a rural area. Students studying in Kumasi ranked contract length as more important than those in Accra, while international students ranked contract length as less important than Ghanaian students. Conclusions Interventions to improve rural practice conditions are likely to be more persuasive than salary incentives to Ghanaian medical students who are

  10. Research progress of chiropractic manipulation treatment for lumbar disc herniation%整脊手法治疗腰椎间盘突出症的研究进展

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    赵志恒; 张仁倩; 王剑歌; 王雷; 祝贺旗

    2015-01-01

    Chiropractic treatment of lumbar disc herniation is a common practice. Chiropractic operation method of the clinical applica-tion and effect is different. To further explore the clinical application of chiropractic treatment of lumbar disc herniation, in this article we reviewed the development of chiropractic therapy and clinical application of chiropractic technique on lumbar intervertebral disc protru-sion, and new insights were put forward.%整脊是治疗腰椎间盘突出症的常用手法,临床上应用的整脊操作方法各不相同,疗效也各有差异,为了进一步探究整脊治疗腰椎间盘突出症的临床应用。从整脊疗法的发展及整脊技术对腰椎间盘突出症的临床应用等方面进行了评述,对整脊的临床应用进展进行了综述,并提出新的见解。

  11. The establishment of the Chiropractic & Osteopathic College of Australasia in Queensland (1996–2002

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    Walker Bruce F

    2005-04-01

    Full Text Available Abstract Introduction For chiropractors and osteopaths after graduation, the learning process continues by way of experience and continuing education (CE. The provision of CE and other vocational services in Queensland between 1996 and 2002 is the subject of this paper. Methods The Chiropractic & Osteopathic College of Australasia (COCA implemented a plan, which involved continuing education, with speakers from a broad variety of health provider areas; and the introduction of the concepts of evidence-based practice. The plan also involved building membership. Results Membership of COCA in Queensland grew from 3 in June 1996 to 167 in 2002. There were a total of 25 COCA symposia in the same period. Evidence-based health care was introduced and attendees were generally satisfied with the conferences. Discussion The development of a vocational body (COCA for chiropractors and osteopaths in Queensland was achieved. Registrants in the field have supported an organisation that concentrates on the vocational aspects of their practice.

  12. Differences in Sexual Practices, Sexual Behavior and HIV Risk Profile between Adolescents and Young Persons in Rural and Urban Nigeria.

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    Folayan, Morenike Oluwatoyin; Adebajo, Sylvia; Adeyemi, Adedayo; Ogungbemi, Kayode Micheal

    2015-01-01

    We aimed to determine differences in sexual practices, HIV sexual risk behaviors, and HIV risk profile of adolescents and young persons' in rural and urban Nigeria. We recruited 772 participants 15 to 24 years old from urban and rural townships in Nigeria through a household survey. Information on participants' socio-demographic profile (age sex, residential area, number of meals taken per day), sexual practices (vagina, oral and anal sex; heterosexual and homosexual sex; sex with spouse, casual acquaintances, boy/girlfriend and commercial sex workers), sexual behavior (age of sexual debut, use of condom, multiple sex partners, transactional sex and age of sexual partner), and other HIV risk factors (use of alcohol and psychoactive substances, reason for sexual debut, knowledge of HIV prevention and HIV transmission, report of STI symptoms) were collected through an interviewer administered questionnaire. Differences in sexual behavior and sexual practices of adolescents and HIV risk profile of adolescents and young persons resident in urban and rural areas were determined. More than half (53.5%) of the respondents were sexually active, with more residing in the rural than urban areas (64.9% vs 44.1%; psexual partner (29.5% vs 20.4%; p = 0.04). Also, 97.3% of sexually active respondents reported having vaginal sex, 8.7% reported oral sex and 1.9% reported anal sex. More male than female respondents in the urban area used condoms during the last vaginal sexual intercourse (69.1% vs 51.9%; p = 0.02), and reported sex with casual partners (7.0% vs 15.3%; p = 0.007). More female than male respondents residing in the rural area engaged in transactional sex (1.0% vs 6.7%; p = 0.005). More females than males in both rural (3.6% vs 10.2%; p = 0.04) and urban (4.7% vs 26.6%; psexual behavior and practices of adolescents and young persons' residing in the urban and rural area with implication for HIV prevention programming.

  13. Peripheral neurectomies: A treatment option for trigeminal neuralgia in rural practice

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    Fareedi Mukram Ali

    2012-01-01

    Full Text Available Background: Trigeminal neuralgia is a commonly diagnosed neurosensory disease of head, neck and face region, involving 5 th cranial nerve. Carbamazepine is the first line drug if there is decrease in efficacy or tolerability of medication, surgery needs to be considered. Factors such as pain relief, recurrence rates, morbidity and mortality rates should be taken in to account while considering which technique to use. Peripheral neurectomy is a safe and effective procedure for elderly patients and in rural and remote centers where neurosurgical facilities are not available. It is also effective in those patients who are reluctant for major neurosurgical procedures. Although loss of sensation along the branches of trigeminal nerve and recurrence rate are associated with peripheral neurectomy, we consider it as the safe and effective procedure in rural practice, which can be done under local anesthesia. Aims: The aim of this prospective study is to evaluate the long term efficacy of peripheral neurectomy with and without the placement of stainless steel screws in the foramina and to calculate the mean remission period after peripheral neurectomies for different branches of trigeminal nerve. Setting and Design: The sample was divided into 2 groups by selecting randomly the patients, satisfying inclusion criteria. Both groups were operated under local anesthesia by regional nerve blocks. In one group of patients after peripheral neurectomy, the proximal nerve stump was left alone in the foramina, and in another group of patients, obturation of foramina was done with stainless steel screws after peripheral neurectomy. Materials and Methods: Peripheral neurectomy was done on the terminal branches of trigeminal nerve in 14 patients. We selected only those cases that were experiencing pain after Carbamazepine therapy, all our patients were from rural and remote areas where facilities to neurosurgical centers are limited. Elderly patients who were unfit

  14. Health care choices: complementary therapy, chronic illness, and older rural dwellers.

    Science.gov (United States)

    Nichols, Elizabeth; Sullivan, Therese; Ide, Bette; Shreffler-Grant, Jean; Weinert, Clarann

    2005-12-01

    To better understand elderly rural dwellers use of complementary and alternative therapies (CAM), perception of efficacy, and their sources of information. Ten participants between ages 60 and 80 years were interviewed by telephone. Qualitative analysis for content and themes was done. Self-directed practices such as vitamin, mineral, and herbal supplements, taken to compensate for perceived dietary deficiencies, were cited most frequently. Therapies used included biofeedback, massage, chiropractic, and podiatry. Information was obtained from the physician or nurse practitioner and supplemented with material from other sources. Respondents were discriminating users of the products they selected and were satisfied with the results, although they did not always have accurate understanding of the effects of the supplement or therapy. Health professionals need to have knowledge about CAM and to include questions about use during patient encounters. Providers must take time to answer questions and provide user friendly information.

  15. Knowledge, Attitude and Practices in Type 2 Diabetes Mellitus Patients in Rural Northern India

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    Rajiv Kumar Gupta

    2015-09-01

    Full Text Available Background: - Type 2 Diabetes Mellitus (T2DM is a leading cause of morbidity and mortality. Generating awareness on prevention of Diabetes is of key importance. For generating awareness, an idea on the level of awareness in general population has to be generated. The present study was conducted with the  aim  to   assess Knowledge, Attitude  and Practices (KAP   among  diabetic  patients  from  a  rural  area.Methods:- The  study  was conducted on diagnosed cases of T2 DM  patients  visiting  Community  Health  Centre,  Ranbir  Singh  Pura, Jammu, J&K   for a follow-up. The study was conducted from October through December 2014   using a pre designed, pre-structured & validated questionnaire.Results: - 230 T2 DM patients comprising 128 males and 102 females   were enrolled   during   the study   period. The  knowledge score  of  the  patients  was  found  to  be  10.13±2.09, attitude  score  was 3.13±1.26  and  practice  score  was  2.86±1.39  out  of   maximum   possible  scores  of  14,6  and  5   for   knowledge, attitude  and  practices  respectively. Knowledge  scores  had  a  strong  association  both  with  attitude  as  well  as  practice  scores (p<0.05.Conclusions: - Knowledge of diabetic patients was good   but   attitude and practices needed   improvement. 

  16. Rural-urban differences in cooking practices and exposures in Northern Ghana

    Science.gov (United States)

    Wiedinmyer, Christine; Dickinson, Katherine; Piedrahita, Ricardo; Kanyomse, Ernest; Coffey, Evan; Hannigan, Michael; Alirigia, Rex; Oduro, Abraham

    2017-07-01

    Key differences between urban and rural populations can influence the adoption and impacts of new cooking technologies and fuels. We examine these differences among urban and rural households that are part of the REACCTING study in Northern Ghana. While urban and rural populations in the study area all use multiple stoves, the types of stoves and fuels differ, with urban participants more likely to use charcoal and LPG while rural households rely primarily on wood. Further, rural and urban households tend to use different stoves/fuels to cook the same dishes—for example, the staple porridge Tuo Zaafi (TZ) is primarily cooked over wood fires in rural areas and charcoal stoves in urban settings. This suggests that fuel availability and ability to purchase fuel may be a stronger predictor of fuel choice than cultural preferences alone. Ambient concentrations of air pollutants also differ in these two types of areas, with urban areas having pollutant hot spots to which residents can be exposed and rural areas having more homogeneous and lower pollutant concentrations. Further, exposures to carbon monoxide and particulate matter differ in magnitude and in timing between urban and rural study participants, suggesting different behaviors and sources of exposures. The results from this analysis highlight important disparities between urban and rural populations of a single region and imply that such a characterization is needed to successfully implement and assess the impacts of household energy interventions.

  17. Australian chiropractic sports medicine: half way there or living on a prayer?

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    Dragasevic George

    2007-09-01

    Full Text Available Abstract Sports chiropractic within Australia has a chequered historical background of unorthodox individualistic displays of egocentric treatment approaches that emphasise specific technique preference and individual prowess rather than standardised evidence based management. This situation has changed in recent years with the acceptance of many within sports chiropractic to operate under an evidence informed banner and to embrace a research culture. Despite recent developments within the sports chiropractic movement, the profession is still plagued by a minority of practitioners continuing to espouse certain marginal and outlandish technique systems that beleaguer the mainstream core of sports chiropractic as a cohesive and homogeneous group. Modern chiropractic management is frequently multimodal in nature and incorporates components of passive and active care. Such management typically incorporates spinal and peripheral manipulation, mobilisation, soft tissue techniques, rehabilitation and therapeutic exercises. Externally, sports chiropractic has faced hurdles too, with a lack of recognition and acceptance by organized and orthodox sports medical groups. Whilst some arguments against the inclusion of chiropractic may be legitimate due to its historical baggage, much of the argument appears to be anti-competitive, insecure and driven by a closed-shop mentality.sequently, chiropractic as a profession still remains a pariah to the organised sports medicine world. Add to this an uncertain continuing education system, a lack of protection for the title 'sports chiropractor', a lack of a recognized specialist status and a lack of support from traditional chiropractic, the challenges for the growth and acceptance of the sports chiropractor are considerable. This article outlines the historical and current challenges, both internal and external, faced by sports chiropractic within Australia and proposes positive changes that will assist in

  18. Case Study of Leadership Practices and School-Community Interrelationships in High-Performing, High-Poverty, Rural California High Schools

    Science.gov (United States)

    Masumoto, Marcia; Brown-Welty, Sharon

    2009-01-01

    Many rural California high schools are impacted by the disadvantages of poverty, non-English speaking students, limited resources, changing demographics, and challenges of the rural context. Focusing on contemporary leadership theories and school-community interrelationships, this qualitative study examines the practices of educational leaders in…

  19. Case Study of Leadership Practices and School-Community Interrelationships in High-Performing, High-Poverty, Rural California High Schools

    Science.gov (United States)

    Masumoto, Marcia; Brown-Welty, Sharon

    2009-01-01

    Many rural California high schools are impacted by the disadvantages of poverty, non-English speaking students, limited resources, changing demographics, and challenges of the rural context. Focusing on contemporary leadership theories and school-community interrelationships, this qualitative study examines the practices of educational leaders in…

  20. Physicians′ therapeutic practice and compliance of diabetic patients attending rural primary health care units in Alexandria

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    Nahla Khamis R Ibrahim

    2010-01-01

    Full Text Available Objectives: The objectives of the study were to investigate physician′s therapeutic practice and the compliance of diabetic patients attending rural primary health units in Alexandria. Material and Methods: A cross-sectional study was conducted and a multistage stratified random sample method was used for the selection of 600 diabetic patients. Data were collected by means of an interviewing questionnaire, an observation checklist, review of prescriptions and laboratory investigations. A scoring system was made for a diabetic patient′s knowledge and skills, patient′s compliance, doctor-patient relationship, and glycemic control. Results: About 57% always took their medication as prescribed by doctor and on time, only 2.2% always complied with dietary regimen while no one reported regular compliance with exercise regimen. Complications of the regimen was the commonest cause (63.3% of noncompliance. A highly statistically significant difference was found between compliance with all regimens and patient′s knowledge of diabetes. The scores for doctor-patient relationship were all unsatisfactory. Results of glycosylated hemoglobin (HbA1c revealed that metabolic control of four-fifth of the patients was satisfactory, 12% had fair and 8% had poor metabolic control. Conclusions: Patient′s compliance with most of the diabetes regimen was low. Doctor-patient relationship and patient′s compliance should be improved by conducting educational and training programs.

  1. Child feces disposal practices in rural Orissa: a cross sectional study.

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    Fiona Majorin

    Full Text Available BACKGROUND: An estimated 2.5 billion people worldwide lack access to improved sanitation facilities. While large-scale programs in some countries have increased latrine coverage, they sometimes fail to ensure optimal latrine use, including the safe disposal of child feces, a significant source of exposure to fecal pathogens. We undertook a cross-sectional study to explore fecal disposal practices among children in rural Orissa, India in villages where the Government of India's Total Sanitation Campaign had been implemented at least three years prior to the study. METHODS AND FINDINGS: We conducted surveys with heads of 136 households with 145 children under 5 years of age in 20 villages. We describe defecation and feces disposal practices and explore associations between safe disposal and risk factors. Respondents reported that children commonly defecated on the ground, either inside the household (57.5% for pre-ambulatory children or around the compound (55.2% for ambulatory children. Twenty percent of pre-ambulatory children used potties and nappies; the same percentage of ambulatory children defecated in a latrine. While 78.6% of study children came from 106 households with a latrine, less than a quarter (22.8% reported using them for disposal of child feces. Most child feces were deposited with other household waste, both for pre-ambulatory (67.5% and ambulatory (58.1% children. After restricting the analysis to households owning a latrine, the use of a nappy or potty was associated with safe disposal of feces (OR 6.72, 95%CI 1.02-44.38 though due to small sample size the regression could not adjust for confounders. CONCLUSIONS: In the area surveyed, the Total Sanitation Campaign has not led to high levels of safe disposal of child feces. Further research is needed to identify the actual scope of this potential gap in programming, the health risk presented and interventions to minimize any adverse effect.

  2. Knowledge of community care workers about key family practices in a rural community in South Africa

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    Ethelwynn Stellenberg

    2015-02-01

    Full Text Available Background: Interventions by community care workers within the context of communitybased integrated management of childhood illness (CIMCI may have a positive effect on child health if the health workers have adequate knowledge about key family practices.Setting: The study was conducted in rural areas of the West Coast district in the Western Cape, South Africa.Objectives: The objective of this study was to determine the knowledge of community care workers about five of the 16 key family practices of CIMCI.Methods: A descriptive survey collected a self-administered questionnaire from 257 community care workers out of a possible total of 270 (95.2% response rate. Descriptive and inferential statistical analysis was applied.Results: Only 25 of the respondents (10% obtained a score higher than 70% on the knowledgebased items of the questionnaire. Less than 25% of respondents answered questions in these key areas correctly (pneumonia [17%], tuberculosis [13%], HIV/AIDS [9%] immunisation [3%] and recommendations for a child with fever [21%]. Statistically significant correlations were found between the total score a respondent achieved and the highest level of education obtained (p < 0.01, the level of in-service training (p < 0.01, attendance of a CIMCI five-day training course (p < 0.01, and completing a subsequent refresher course (p < 0.01.Conclusion: The knowledge of CCWs was inadequate to provide safe, quality CIMCI. CIMCI refresher courses should be offered annually to improve CCWs’ knowledge and the quality of care that they render. Regular update courses could contribute to building competence.

  3. Association between maternal social capital and infant complementary feeding practices in rural Ethiopia.

    Science.gov (United States)

    Kang, Yunhee; Kim, Jane; Seo, Eunkyo

    2017-07-17

    Few studies have explored the potential of social capital in improving child nutritional status; however, most components of pathways between social capital and nutritional status have remained unexplained. Complementary feeding practice is a strong mediator of child nutritional status. This study examined the association between complementary feeding practice and maternal social capital in rural Ethiopia, using cross-sectional data of infant aged 6-12 months and their mother pairs (n = 870). The Short Social Capital Assessment Tool was used to assess maternal structural (i.e., community group membership, having emotional/economic support from individuals, and citizenship activities) and cognitive social capital (i.e., trust, social harmony, and sense of belonging) in the past 12 months. Infant's dietary diversity score (DDS, range: 0-7), minimum dietary diversity (MDD), and minimum meal frequency (MMF) were assessed using a 24-hr dietary recall. Multivariable ordinal/binary logistic regression analyses were conducted. Having support from two or more individuals was associated with higher DDS (OR = 1.84) and meeting a minimum level of dietary diversity (MDD: OR = 5.20) but not with MMF, compared to those having no support. Having two or more group memberships was associated with higher DDS (OR = 2.2) but not with MDD or MMF, compared to those without group membership. Citizenship activities showed mixed associations with MMF and no association with DDS or MDD. Cognitive social capital showed no association with DDS or MDD and lower odds of meeting MMF (OR = 0.56). These mixed results call for further studies to examine other potential pathways (e.g., hygiene and caring behaviours) in which social capital could improve child nutritional status. © 2017 John Wiley & Sons Ltd.

  4. A survey of knowledge, attitudes, and practices towards skin and soft tissue infections in rural Alaska

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    Gregory A. Raczniak

    2016-02-01

    Full Text Available Background: Community-acquired methicillin-resistant Staphylococcus aureus and methicillin-sensitive S. aureus infections are common to south-western Alaska and have been associated with traditional steambaths. More than a decade ago, recommendations were made to affected communities that included preventive skin care, cleaning methods for steambath surfaces, and the use of protective barriers while in steambaths to reduce the risk of S. aureus infection. Objective: A review of community medical data suggested that the number of skin infection clinical encounters has increased steadily over the last 3 years and we designed a public health investigation to seek root causes. Study design: Using a mixed methods approach with in-person surveys, a convenience sample (n=492 from 3 rural communities assessed the range of knowledge, attitudes and practices concerning skin infections, skin infection education messaging, prevention activities and home self-care of skin infections. Results: We described barriers to implementing previous recommendations and evaluated the acceptability of potential interventions. Prior public health messages appear to have been effective in reaching community members and appear to have been understood and accepted. We found no major misconceptions regarding what a boil was or how someone got one. Overall, respondents seemed concerned about boils as a health problem and reported that they were motivated to prevent boils. We identified current practices used to avoid skin infections, such as the disinfection of steambaths. We also identified barriers to engaging in protective behaviours, such as lack of access to laundry facilities. Conclusions: These findings can be used to help guide public health strategic planning and identify appropriate evidence-based interventions tailored to the specific needs of the region.

  5. FAMILY PLANNING PRACTICES AMONG THE ELIGIBLE COUPLES IN A RURAL AREA OF CHIDAMBARAM

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    Vivin Vincent

    2016-06-01

    Full Text Available The family planning programme in the world was first launched by India in 1952 in order to reduce the population growth in the country. India currently faces a vicious cycle of population explosion and poverty. In the above context, this study was conducted so as to learn about the different family planning methods practicing in a rural area of Chidambaram and also to find out any unmet need of family planning which is one of the most important factor that causes hindrance in the success of national family planning programme. OBJECTIVES To find out the proportion of eligible couples practicing any of the family planning methods, both temporary and permanent, the different types and the unmet needs of family planning practices along with the factors associated with unwillingness of acceptance of family planning methods among these eligible couples. MATERIAL AND METHODS It is a cross-sectional study done in 125 eligible couples of 700 families of Omakkulam and Sengattan areas of Chidambaram. Data collected were coded and entered in Microsoft Excel sheet and was analysed using Epi info statistical software. RESULTS The proportion of eligible couples in this study population of 700 families was 18% (125. The proportion of eligible couples practicing family planning methods were 42% and 58% had not adopted any methods. Different types of family planning methods adopted by the eligible couples in this study were Vasectomy (1.89%, PPS (15.09%, CuT (18.87%, OCP (20.76% and Condoms (43.39%. Reasons for non-acceptance of family planning methods among the eligible couples were Hysterectomy (2.78%, Infertility (6.95%, Infection and bleeding (11.11%, Recently married (13.89%, No specific reason (29.16% and Family not complete (36.11%. In this study, 20% of eligible couples had unmet needs of family planning methods. CONCLUSION This study shows there is still a gap in the acceptance of family planning methods by the eligible couples of this study population

  6. Paraplegia in a chiropractic patient secondary to atraumatic dural arteriovenous fistula with perimedullary hypertension: case report

    National Research Council Canada - National Science Library

    Foreman, Stephen M; Stahl, Michael J; Schultz, Gary D

    2013-01-01

    .... This abnormal communication can result in important and frequently misdiagnosed neurological abnormalities.A case of rapid onset paraplegia following cervical chiropractic manipulation is reviewed...

  7. Práctica docente en el aula multigrado rural de una población mexicana Teaching practice in the multigrade rural classes in a Mexican village

    Directory of Open Access Journals (Sweden)

    José Ángel Vera Noriega

    2005-03-01

    support to learning, allowing the identification of five types in the teaching practice. The groups were contrasted with their students' results in basic academic competencies. The article highlights the importance of diversity in the didactic and group supervision strategies, and also of the variety of elements teachers employ in their planning and evaluation, as the characteristics that allow identifying the difference in students' results. Under the perspective of the current educational policy the text analyzes the impact of the mechanisms of incentives and teacher education as elements for the promotion of cognitive abilities for the teaching-learning process. The text emphasizes the conditions of the multigrade teaching in rural areas as a fundamental element in mediating the regulation of discipline control strategies and planning of teaching practice. It criticizes the current systems of compensation for their excessively managerial perspective of teaching. Finally, it emphasizes the usefulness of the classification of teaching practice for future training actions specific to the conditions of the rural area, and to the distinct levels of expertise of the teachers.

  8. Sub-Saharan Africa betwixt and between : rural livelihood practices and policies

    NARCIS (Netherlands)

    Bryceson, Deborah Fahy

    1999-01-01

    Drawing on research findings emanating from the De-Agrarianisation and Rural Employment (DARE) Research Programme, coordinated by the African Studies Centre, Leiden, this paper compares changing economic and social patterns in a wide variety of rural settlements in sub-Saharan Africa. Recently emerg

  9. Barriers and Enablers to Clinical Fieldwork Education in Rural Public and Private Allied Health Practice

    Science.gov (United States)

    Maloney, Phoebe; Stagnitti, Karen; Schoo, Adrian

    2013-01-01

    There is a need to maximise rural clinical fieldwork placement to build health workforce capacity. This study investigated allied health professionals' (AHPs) experience of supervising students as part of work-integrated learning in public and private rural health settings. An anonymous postal questionnaire with 30 questions was used to collect…

  10. Family planning practices of rural community dwellers in cross River State, Nigeria.

    Science.gov (United States)

    Etokidem, A J; Ndifon, W; Etowa, J; Asuquo, E F

    2017-06-01

    Nigeria is the most populous nation in Africa and the seventh most populous in the world. Despite a high fertility rate of 5.5 per woman and a high population growth rate of 3.2%, Nigeria's contraceptive prevalence is 15%, which is one of the lowest in the world. The objective of this study was to determine the knowledge of family planning and family planning preferences and practices of rural community women in Cross River State of Nigeria. This was a cross-sectional study involving 291 rural women. Convenience sampling method was used. The women were assembled in a hall and a semi-structured questionnaire was administered to every consenting woman until the sample size was attained. Data obtained from the study were analyzed using the Statistical Package for the Social Sciences version 20 and presented in tables as frequencies and percentages as well as figures. Association between categorical variables was explored using chi-square test. Binary logistic regression was also performed to determine predictors of use of at least one family planning method at some point in time. Fifty (17.2%) respondents were using at least one family planning method. One hundred and ninety-eight (68.3%) respondents had used at least one family planning method at some point in time. Reasons given for not using any family planning method included "Family planning is against my religious beliefs" (56%); "it is against our culture" (43.8%); "I need more children" (64.9%); "my partner would not agree" (35.3%); "family planning does not work" (42.9%); "it reduces sexual enjoyment" (76%); and "it promotes unfaithfulness/infidelity" (59%). Binary logistic regression conducted to predict the use of at least one family planning method at some point in time using some independent variables showed that who makes the decision regarding family planning use was the strongest predictor of family planning use (OR = 0.567; 95% CI = 0.391-0.821). This suggests that family planning uptake is more

  11. The effects of positive and negative parenting practices on adolescent mental health outcomes in a multicultural sample of rural youth.

    Science.gov (United States)

    Smokowski, Paul R; Bacallao, Martica L; Cotter, Katie L; Evans, Caroline B R

    2015-06-01

    The quality of parent-child relationships has a significant impact on adolescent developmental outcomes, especially mental health. Given the lack of research on rural adolescent mental health in general and rural parent-child relationships in particular, the current longitudinal study explores how rural adolescents' (N = 2,617) perceptions of parenting practices effect their mental health (i.e., anxiety, depression, aggression, self-esteem, future optimism, and school satisfaction) over a 1 year period. Regression models showed that current parenting practices (i.e., in Year 2) were strongly associated with current adolescent mental health outcomes. Negative current parenting, manifesting in parent-adolescent conflict, was related to higher adolescent anxiety, depression, and aggression and lower self-esteem, and school satisfaction. Past parent-adolescent conflict (i.e., in Year 1) also positively predicted adolescent aggression in the present. Current positive parenting (i.e., parent support, parent-child future orientation, and parent education support) was significantly associated with less depression and higher self-esteem, future optimism, and school satisfaction. Past parent education support was also related to current adolescent future optimism. Implications for practice and limitations were discussed.

  12. Urban-rural differences in attitudes and practices toward long-acting reversible contraceptives among family planning providers in Texas.

    Science.gov (United States)

    Vaaler, Margaret L; Kalanges, Lauri K; Fonseca, Vincent P; Castrucci, Brian C

    2012-03-01

    Despite the elevated rates of teen and unplanned pregnancies across the United States, long-acting reversible contraceptives (LARCs) remain a less utilized birth control method. The present study investigated family planning providers' attitudes and considerations when recommending family planning methods and LARCs to clients. Additionally, this study explored whether urban-rural differences exist in providers' attitudes toward LARCs and in clients' use of LARCs. Data were collected using an online survey of family planning providers at Title X clinics in Texas. Survey data was linked to family planning client data from the Family Planning Annual Report (2008). Findings indicated that, although providers were aware of the advantages of LARCs, clients' LARC use remains infrequent. Providers reported that the benefits of hormone implants include their effectiveness for 3 years and that they are an option for women who cannot take estrogen-based birth control. Providers acknowledged the benefits of several types of LARCs; however, urban providers were more likely to acknowledge the benefits of hormone implants compared with their rural counterparts. Results also indicated barriers to recommending LARCs, such as providers' misinformation about LARCs and their caution in recommending LARCs to adolescents. However, findings also indicated providers lack training in LARC insertion, specifically among those practicing in rural areas. In light of the effectiveness and longevity of LARCs, teenagers and clients living in rural areas are ideal LARC candidates. Increased training among family planning providers, especially for those practicing in rural areas, may increase their recommendations of LARCs to clients. Copyright © 2012 Jacobs Institute of Women

  13. Retropharyngeal tendinitis may be more common than we think: a report on 45 cases seen in Danish chiropractic clinics

    DEFF Research Database (Denmark)

    Hviid, Carsten; Salomonsen, Mette; Gelineck, John;

    2009-01-01

    This study presents information from 45 cases of retropharyngeal tendinitis that were collected in Danish chiropractic clinics.......This study presents information from 45 cases of retropharyngeal tendinitis that were collected in Danish chiropractic clinics....

  14. 30 years later: Social Representations about AIDS and sexual practices of rural towns residents.

    Science.gov (United States)

    Furtado, Francisca Marina de Souza Freire; Santos, José Anderson Galdino; Loredanna, Stedile; Araújo, Eunice; Saldanha, Ana Alayde Werba; Silva, Josevânia da

    2016-06-01

    In the 30 years of the AIDS pandemic in Brazil, it is recognized the HIV virus internalization of the phenomenon as a challenge to care and current health policies. In this sense, it aimed to verify sex practices and social representations that rural towns residents have about the disease. Attended by 789 people, men and women, between 18 and 90 years old, residents in 41 towns with fewer than 11,000 inhabitants in the state of Paraiba / Brazil. Data were collected by a questionnaire and the free association of words test. The results showed low concern about disease, perception of invulnerability to HIV infection and not using condoms during sexual intercourse, and confidence in the major reason related partner. Also showed endure derogatory and stereotypical representations, revealing that still persist in rural areas, beliefs and representations concerning the beginning of the epidemic. From these findings, it is possible to point out deficiencies in the care provided by the health services in these localities, which may result in increased vulnerability of this population to diseases, so there is the need to intensify information campaigns and intervention. The results reveal the existence of three different types of modes of learning health literacy skills in informal context: : i) learning that takes place in action, in achieving daily tasks; ii) learning processes that result from problem solving; iii) learning that occurs in an unplanned manner, resulting from accidental circumstances and, in some cases, devoid of intentionality. Nos 30 anos da pandemia da Aids no Brasil, reconhece-se o fenômeno da interiorização do vírus HIV como um desafio ao cuidado e às politicas de saúde atuais. Neste sentido, objetivou-se conhecer práticas sexuais e as representações sociais que residentes de cidades rurais têm acerca da doença. Participaram 789 pessoas, homens e mulheres, entre 18 e 90 anos de idade, residentes em 41 cidades com menos de 11.000 habitantes

  15. A Multi-Site Study on Knowledge, Attitudes, Beliefs and Practice of Child-Dog Interactions in Rural China

    Directory of Open Access Journals (Sweden)

    David C. Schwebel

    2013-03-01

    Full Text Available This study examines demographic, cognitive and behavioral factors that predict pediatric dog-bite injury risk in rural China. A total of 1,537 children (grades 4–6 in rural regions of Anhui, Hebei and Zhejiang Provinces, China completed self-report questionnaires assessing beliefs about and behaviors with dogs. The results showed that almost 30% of children reported a history of dog bites. Children answered 56% of dog-safety knowledge items correctly. Regressions revealed both demographic and cognitive/behavioral factors predicted children’s risky interactions with dogs and dog-bite history. Boys behaved more riskily with dogs and were more frequently bitten. Older children reported greater risks with dogs and more bites. With demographics controlled, attitudes/beliefs of invulnerability, exposure frequency, and dog ownership predicted children’s self-reported risky practice with dogs. Attitudes/beliefs of invulnerability, dog exposure, and dog ownership predicted dog bites. In conclusion, both demographic and cognitive/behavioral factors influenced rural Chinese children’s dog-bite injury risk. Theory-based, empirically-supported intervention programs might reduce dog-bite injuries in rural China.

  16. Constructing a philosophy of chiropractic: evolving worldviews and modern foundation☆

    Science.gov (United States)

    Senzon, Simon A.

    2011-01-01

    Objective The purpose of this article is to trace the foundations of DD Palmer's sense of self and philosophy of chiropractic to its sources in modern Western philosophy as well as current metatheories about modernity. Discussion DD Palmer's sense of self was indicative of a modern self. A modern self is characterized as a self that developed after the Western Enlightenment and must come to terms with the insights of modernity such as Cartesian dualism, Spinoza's substance, Rousseau's expressivism, and Kant's critiques. It is argued that Palmer's philosophy can be viewed as part of the this tradition alongside his involvement in the 19th century American metaphysical religious culture, which was itself a response to these challenges of the modern self of modernity. Conclusion Palmer's development of chiropractic and its philosophy was a reaction to the challenges and promises of modernity. PMID:22693479

  17. Morris Fishbein, M.D.: the "medical Mussolini" and chiropractic.

    Science.gov (United States)

    Donahue, J H

    1996-06-01

    Morris Fishbein, M.D. is the most important non-chiropractor to influence the chiropractic profession. From his post as editor and secretary of the American Medical Association, his anti-chiropractic writings, speeches and political activities had a profound effect on the profession's development. Because he was not only the foremost medical politician of the time, but also perceived as a multi-faceted author on public health issues, his credibility was high across large sections of the population and in most social institutions. His tactics and stature undoubtedly helped keep the profession limited to caring for a small percentage of the population. Because of him, chiropractors devised survival strategies that continue to influence the profession even today.

  18. Understanding Healthcare Workers Self-Reported Practices, Knowledge and Attitude about Hand Hygiene in a Medical Setting in Rural India.

    Science.gov (United States)

    Diwan, Vishal; Gustafsson, Charlotte; Rosales Klintz, Senia; Joshi, Sudhir Chandra; Joshi, Rita; Sharma, Megha; Shah, Harshada; Pathak, Ashish; Tamhankar, Ashok J; Stålsby Lundborg, Cecilia

    2016-01-01

    To describe self-reported practices and assess knowledge and attitudes regarding hand hygiene among healthcare workers in a rural Indian teaching hospital. A rural teaching hospital and its associated medical and nursing colleges in the district of Ujjain, India. The study population consisted of physicians, nurses, teaching staff, clinical instructors and nursing students. Self-administered questionnaires based on the World Health Organization Guidelines on Hand Hygiene in Healthcare were used. Out of 489 healthcare workers, 259 participated in the study (response rate = 53%). The proportion of healthcare workers that reported to 'always' practice hand hygiene in the selected situations varied from 40-96% amongst categories. Reported barriers to maintaining good hand hygiene were mainly related to high workload, scarcity of resources, lack of scientific information and the perception that priority is not given to hand hygiene, either on an individual or institutional level. Previous training on the topic had a statistically significant association with self-reported practice (p = 0.001). Ninety three per cent of the respondents were willing to attend training on hand hygiene in the near future. Self-reported knowledge and adherence varied between situations, but hand hygiene practices have the potential to improve if the identified constraints could be reduced. Future training should focus on enhancing healthcare workers' knowledge and understanding regarding the importance of persistent practice in all situations.

  19. Community based study on married couples' family planning knowledge, attitude and practice in rural and urban Gambia.

    Science.gov (United States)

    Jammeh, Sulayman S S; Liu, Chieh-Yu; Cheng, Su-Fen; Lee-Hsieh, Jane

    2014-06-01

    Family planning services have been free of charge and available in all the health facilities in the Gambia since 1975 yet contraceptive prevalence is only 17.5% and even 6% in some areas. Since the last census in 2003, there existed no available data on married couples' contraception status. To explore married couples' family planning knowledge, attitudes, and practices in rural and urban Gambia and to analyze what factors may affect such knowledge, attitudes and practices. Quantitative cross-sectional study design was used. Through convenience sampling, 176 men and 235 women representing a total of 176 couples participated. A structured questionnaire was used for data collection. The mean scores of the married couples family planning knowledge, attitudes, and practices were 19.00 ± 6.11(ranging from 0 to 64), 6.90 ± 3.08 (0 to 14) and 4.69 ± 3.3 (0 to 19) respectively. Urban residents had higher scores on family planning practice than rural residents (pplanning knowledge, attitude and practice in Gambia", as well as suggesting broader health intervention programs in health education and promotion.

  20. Behavioral change in rural practice: improving patient motivation in primary care.

    Science.gov (United States)

    Clark, Karen; Weir, Christine

    2013-01-01

    As the disparities in rural healthcare have become better understood, the need to adjust and compensate for these unique challenges becomes a priority. This manuscript suggests three constructs that can be readily integrated into rural care providers' daily work to improve treatment outcomes. Autonomy support, relational support, and competence support are among the motivational constructs discussed with a special consideration for the unique cultural and environmental influences of rural West Virginia residents. The overall objective of this review is to renew the basic tenants of shared decision making as they related to successful behavioral change in primary care.

  1. Comparative analysis of individuals with and without chiropractic coverage: patient characteristics, utilization, and costs.

    Science.gov (United States)

    Legorreta, Antonio P; Metz, R Douglas; Nelson, Craig F; Ray, Saurabh; Chernicoff, Helen Oster; Dinubile, Nicholas A

    2004-10-11

    Back pain accounts for more than $100 billion in annual US health care costs and is the second leading cause of physician visits and hospitalizations. This study ascertains the effect of systematic access to chiropractic care on the overall and neuromusculoskeletal-specific consumption of health care resources within a large managed-care system. A 4-year retrospective claims data analysis comparing more than 700 000 health plan members with an additional chiropractic coverage benefit and 1 million members of the same health plan without the chiropractic benefit. Members with chiropractic insurance coverage, compared with those without coverage, had lower annual total health care expenditures ($1463 vs $1671 per member per year, P<.001). Having chiropractic coverage was associated with a 1.6% decrease (P = .001) in total annual health care costs at the health plan level. Back pain patients with chiropractic coverage, compared with those without coverage, had lower utilization (per 1000 episodes) of plain radiographs (17.5 vs 22.7, P<.001), low back surgery (3.3 vs 4.8, P<.001), hospitalizations (9.3 vs 15.6, P<.001), and magnetic resonance imaging (43.2 vs 68.9, P<.001). Patients with chiropractic coverage, compared with those without coverage, also had lower average back pain episode-related costs ($289 vs $399, P<.001). Access to managed chiropractic care may reduce overall health care expenditures through several effects, including (1) positive risk selection; (2) substitution of chiropractic for traditional medical care, particularly for spine conditions; (3) more conservative, less invasive treatment profiles; and (4) lower health service costs associated with managed chiropractic care. Systematic access to managed chiropractic care not only may prove to be clinically beneficial but also may reduce overall health care costs.

  2. The effects of chiropractic treatment on patients' quality of life

    OpenAIRE

    2012-01-01

    M.Tech. The purpose of this study is to determine whether chiropractic care has an effect on a patient's quality of life using the endpoints of: "the ability to perform general activities of daily living" (patient's level of disability, and restored function) and their "general emotional state" (energy level, depression, interference from emotional problems and feeling of wellness), also how these endpoints affect quality of life. Two hundred and fifty-three subjects participated in this s...

  3. Improvement in hearing after chiropractic care: a case series

    Directory of Open Access Journals (Sweden)

    Di Duro Joseph O

    2006-01-01

    Full Text Available Abstract Background The first chiropractic adjustment given in 1895 was reported to have cured deafness. This study examined the effects of a single, initial chiropractic visit on the central nervous system by documenting clinical changes of audiometry in patients after chiropractic care. Case presentation Fifteen patients are presented (9 male, 6 female with a mean age of 54.3 (range 34–71. A Welch Allyn AudioScope 3 was used to screen frequencies of 1000, 2000, 4000 and 500 Hz respectively at three standard decibel levels 20 decibels (dB, 25 dB and 40 dB, respectively, before and immediately after the first chiropractic intervention. Several criteria were used to determine hearing impairment. Ventry & Weinstein criteria of missing one or more tones in either ear at 40 dB and Speech-frequency criteria of missing one or more tones in either ear at 25 dB. All patients were classified as hearing impaired though greater on the right. At 40 dB using the Ventry & Weinstein criteria, 6 had hearing restored, 7 improved and 2 had no change. At 25 dB using the Speech-frequency criteria, none were restored, 11 improved, 4 had no change and 3 missed a tone. Conclusion A percentage of patients presenting to the chiropractor have a mild to moderate hearing loss, most notably in the right ear. The clinical progress documented in this report suggests that manipulation delivered to the neuromusculoskeletal system may create central plastic changes in the auditory system.

  4. Chiropractic manipulation in Adolescent Idiopathic Scoliosis: a pilot study

    Directory of Open Access Journals (Sweden)

    Stoline Michael R

    2006-08-01

    Full Text Available Abstract Background Adolescent idiopathic scoliosis (AIS remains the most common deforming orthopedic condition in children. Increasingly, both adults and children are seeking complementary and alternative therapy, including chiropractic treatment, for a wide variety of health concerns. The scientific evidence supporting the use chiropractic intervention is inadequate. The purpose of this study was to conduct a pilot study and explore issues of safety, patient recruitment and compliance, treatment standardization, sham treatment refinement, inter-professional cooperation, quality assurance, and outcome measure selection. Methods Six patients participated in this 6-month study, 5 of whom were female. One female was braced. The mean age of these patients was 14 years, and the mean Cobb angle was 22.2 degrees. The study design was a randomized controlled clinical trial with two independent and blinded observers. Three patients were treated by standard medical care (observation or brace treatment, two were treated with standard medical care plus chiropractic manipulation, and one was treated with standard medical care plus sham manipulation. The primary outcome measure was Cobb, and the psychosocial measure was Scoliosis Quality of Life Index. Results Orthopedic surgeons and chiropractors were easily recruited and worked cooperatively throughout the trial. Patient recruitment and compliance was good. Chiropractic treatments were safely employed, and research protocols were successful. Conclusion Overall, our pilot study showed the viability for a larger randomized trial. This pilot confirms the strength of existing protocols with amendments for use in a full randomized controlled trial. Trial registration This trial has been assigned an international standard randomized controlled trial number by Current Controlled Trials, Ltd. http://www.controlled-trials.com/isrctn/. The number is ISRCTN41221647.

  5. Prescription writing practices in a rural tertiary care hospital in Western Maharashtra, India

    Directory of Open Access Journals (Sweden)

    Vaishali D Phalke

    2011-01-01

    Full Text Available BackgroundPrescription is a written order from physician to pharmacistwhich contains name of drug, its dose and its method ofdispensing and advice over consuming it. The frequency ofdrug prescription errors is high. Prescribing errorcontributes significantly towards adverse drug events. Thepresent study was undertaken to understand the currentprescription writing practices and to detect the commonerrors in them at a tertiary health care centre situated in arural area of Western Maharashtra, India.MethodA cross sectional study was conducted at a tertiary levelhospital located at a rural area of Maharashtra state, Indiaduring October 2009-March 2010. 499 prescriptions comingto medical store during period of one month wereconsidered for data analysis. Important informationregarding the patient, doctor, drug and the generaldescription of the prescription were obtained.ResultsAll the prescriptions were on the hospital pad. A significantnumber of the prescriptions (n=88, 17.6% were written inillegible handwriting and not easily readable. The name, ageand sex of the patient were mentioned is majority of theprescriptions. All the prescriptions (100% failed todemonstrate the presence of address, height and weight ofthe patient. Only the brand name of the drugs wasmentioned in all the prescriptions with none of them havingthe generic name. The strength, quantity and route ofadministration of the drug were found on 73.1%, 65.3% and75.2% prescriptions.ConclusionThere are widespread errors in prescription writing by thedoctors. Educational intervention programs and use ofcomputer can substantially contribute in the lowering ofsuch errors. A short course on prescription writing beforethe medical student enters the clinical field and strictmonitoring by the administrative authorities may also helpalleviate the problem.Word count: 2980Tables: 2

  6. Determinants of pre-lacteal feeding practices in urban and rural ...

    African Journals Online (AJOL)

    2017-09-03

    Sep 3, 2017 ... Objective: To determine factors associated with PLF in rural and urban Nigeria. Methods: We ... In Nigeria, neonatal, infant and child mortality as well as malnutrition continue to be major health issues affecting the country10.

  7. Study of Knowledge, Attitude & Practice Regarding The Various Methods of Contraception in a Rural Setup of Hoskote

    Directory of Open Access Journals (Sweden)

    Yogendra V, Shuaib Ahmed, Sana Jaweriya, Sagorika Mullick

    2012-01-01

    Full Text Available Background: Contraception is as old as mankind.In view of increasing population there’s need for awareness regarding the use of various contraceptive methods. Aims and Objectives: To assess the Knowledge, Attitude & Practice regarding the various contraceptive methods in a rural setup of Hoskote. Materials & Methods: A cross sectional study was carried out at MVJ, UHC & PHC of Hoskote Taluk on OPD basis. Data was collected by a pre-designed questionnaire at the OPD. Statistical analysis was done using SPSS software. People were simultaneously educated regarding the various contraceptive methods. Results: Total sample size was 150 of which 75 were males and 75 females. Knowledge about contraceptives was seen more in males (93.3% when compared to females (72%. 95.2% of gradates had knowledge regarding the methods of contraception. This suggests that the knowledge about contraception is better perceived and understood among the literate group. Most common method of contraceptive practiced was barrier methods (40%, followed by sterilization procedure (20%, IUCD (18.67%, OCP (12%, coitus interruptus (8.67% and emergency contraception (0.67%. Conclusion: There has been a considerable improvement among the people even in rural setup regarding the contraceptive use, but there still exists lack of awareness and knowledge regarding the use of contraceptive methods in some small groups of people. IEC activities have to be increased especially for females of this rural setup.

  8. Diagnostic work-up of neurological syndromes in a rural African setting: knowledge, attitudes and practices of health care providers.

    Directory of Open Access Journals (Sweden)

    Alain Mpanya

    Full Text Available BACKGROUND: Neurological disorders of infectious origin are common in rural sub-Saharan Africa and usually have serious consequences. Unfortunately, these syndromes are often poorly documented for lack of diagnostic tools. Clinical management of these diseases is a major challenge in under-equipped rural health centers and hospitals. We documented health care provider knowledge, attitudes and practices related to this syndrome in two rural health zones in Bandundu Province, Democratic Republic of Congo. METHODS: We used a qualitative research approach combining observation, in-depth interviews and focus group discussions. We observed 20 patient-provider contacts related to a neurological syndrome, conducted 12 individual interviews and 4 focus group discussions with care providers. All interviews were audiotaped and the transcripts were analyzed with the software ATLAS.ti. RESULTS: Care providers in this region usually limit their diagnostic work-up to clinical examination primarily because of the financial hurdles in this entirely out-of-pocket payment system. The patients prefer to purchase drugs rather than diagnostic tests. Moreover the general lack of diagnostic tools and the representation of the clinician as a "diviner" do not enhance any use of laboratory or other diagnostic methods. CONCLUSION: Innovation in diagnostic technology for neurological disorders is badly needed in Central-Africa, but its uptake in clinical practice will only be a success if tools are simple, affordable and embedded in a patient-centered approach.

  9. The Nordic back pain subpopulation program: predicting outcome among chiropractic patients in Finland

    Directory of Open Access Journals (Sweden)

    Pekkarinen Harri

    2008-11-01

    Full Text Available Abstract Background In a previous Swedish study it was shown that it is possible to predict which chiropractic patients with persistent LBP will not report definite improvement early in the course of treatment, namely those with LBP for altogether at least 30 days in the past year, who had leg pain, and who did not report definite general improvement by the second treatment. The objectives of this study were to investigate if the predictive value of this set of variables could be reproduced among chiropractic patients in Finland, and if the model could be improved by adding some new potential predictor variables. Methods The study was a multi-centre prospective outcome study with internal control groups, carried out in private chiropractic practices in Finland. Chiropractors collected data at the 1st, 2nd and 4th visits using standardized questionnaires on new patients with LBP and/or radiating leg pain. Status at base-line was identified in relation to pain and disability, at the 2nd visit in relation to disability, and "definitely better" at the 4th visit in relation to a global assessment. The Swedish questionnaire was used including three new questions on general health, pain in other parts of the spine, and body mass index. Results The Swedish model was reproduced in this study sample. An alternative model including leg pain (yes/no, improvement at 2nd visit (yes/no and BMI (underweight/normal/overweight or obese was also identified with similar predictive values. Common throughout the testing of various models was that improvement at the 2nd visit had an odds ratio of approximately 5. Additional analyses revealed a dose-response in that 84% of those patients who fulfilled none of these (bad criteria were classified as "definitely better" at the 4th visit, vs. 75%, 60% and 34% of those who fulfilled 1, 2 or all 3 of the criteria, respectively. Conclusion When treating patients with LBP, at the first visits, the treatment strategy should be

  10. Prevalence of domestic accidents in the rural field practice area of a medical college in Bangalore, Karnataka

    Directory of Open Access Journals (Sweden)

    N R Ramesh Masthi

    2012-01-01

    Full Text Available Domestic accidents are worldwide health problems. A cross-sectional study was conducted in the rural field practice area of Kempegowda Institute of Medical Sciences, Bangalore. A total of 5419 individuals were selected from 30 clusters (villages using cluster sampling technique. Of the 5419 study population, 50.9% (2748 were males and the rest were females. The prevalence of domestic accidents in the rural community was found to be 9.6% (522 individuals who had sustained domestic accidents, was found to be more in females compared with males, which was statistically significant with P-value =0.0077 (Z value =9.09. Falls 43% (225 was the most common type of domestic accidents. The most common place of occurrence of domestic accidents was 46% (243 kitchen, most frequent site of injures in domestic accidents was upper limbs.

  11. Shrimp Farming Practices in the Puttallam District of Sri Lanka: Implications for Disease Control, Industry Sustainability, and Rural Development

    Directory of Open Access Journals (Sweden)

    M. Nalaka Munasinghe

    2010-01-01

    Full Text Available Shrimp farming has great potential to diversify and secure income in rural Sri Lanka, but production has significantly declined in recent years due to civil conflicts, some unsustainable practices and devastating outbreaks of disease. We examined management practices affecting disease prevention and control in the Puttalam district to identify extension services outputs that could support sustainable development of Sri Lankan shrimp farming. A survey on 621 shrimp farms (603 operational and 18 nonoperational was conducted within the Puttalam district over 42 weeks comprising a series of three-day field visits from August 2008 to October 2009, covering two consecutive shrimp crops. Fundamental deficits in disease control, management, and biosecurity practices were found. Farmers had knowledge of biosecurity but the lack of financial resources was a major impediment to improved disease control. Smallholder farmers were disproportionately constrained in their ability to enact basic biosecurity practices due to their economic status. Basic breaches in biosecurity will keep disease as the rate limiting step in this industry. Plans to support this industry must recognize the socioeconomic reality of rural Sri Lankan aquaculture.

  12. Core Competencies of the Certified Pediatric Doctor of Chiropractic: Results of a Delphi Consensus Process.

    Science.gov (United States)

    Hewitt, Elise; Hestbaek, Lise; Pohlman, Katherine A

    2016-04-01

    An outline of the minimum core competencies expected from a certified pediatric doctor of chiropractic was developed using a Delphi consensus process. The initial set of seed statements and substatements was modeled on competency documents used by organizations that oversee chiropractic and medical education. These statements were distributed to the Delphi panel, reaching consensus when 80% of the panelists approved each segment. The panel consisted of 23 specialists in chiropractic pediatrics (14 females) from across the broad spectrum of the chiropractic profession. Sixty-one percent of panelists had postgraduate pediatric certifications or degrees, 39% had additional graduate degrees, and 74% were faculty at a chiropractic institution and/or in a postgraduate pediatrics program. The panel were initially given 10 statements with related substatements formulated by the study's steering committee. On all 3 rounds of the Delphi process the panelists reached consensus; however, multiple rounds occurred to incorporate the valuable qualitative feedback received.

  13. History of the Royal College of Chiropractic Sports Sciences (Canada): the early years.

    Science.gov (United States)

    De Finney, John; Lawson, Gordon; Gryfe, David; Gillis-Lawson, Susan; Crawford, John P

    2016-12-01

    In 1978 the Canadian Chiropractic Association recognized the need to establish an organization that would prepare chiropractors to treat athletic injuries and promote these services to sports organizations. Dr. Adrian Grice approached three chiropractors to establish such an organization. The Canadian Chiropractic Sports Academy (CCSA) was established in 1978. This was the start of the chiropractic sports movement which has seen chiropractors playing prominent roles as team doctors to professional and amateur teams and athletes and in the delivery of care at major national and international competitions. This paper will show the work done by the original founders of the CCSA which has helped to pave the way to the present level of acceptance of chiropractic sports injury management and performance enhancement and as the progenitor of the Royal College of Chiropractic Sports Sciences Canada.

  14. History of the Royal College of Chiropractic Sports Sciences (Canada): the early years

    Science.gov (United States)

    De Finney, John; Lawson, Gordon; Gryfe, David; Gillis-Lawson, Susan; Crawford, John P.

    2016-01-01

    In 1978 the Canadian Chiropractic Association recognized the need to establish an organization that would prepare chiropractors to treat athletic injuries and promote these services to sports organizations. Dr. Adrian Grice approached three chiropractors to establish such an organization. The Canadian Chiropractic Sports Academy (CCSA) was established in 1978. This was the start of the chiropractic sports movement which has seen chiropractors playing prominent roles as team doctors to professional and amateur teams and athletes and in the delivery of care at major national and international competitions. This paper will show the work done by the original founders of the CCSA which has helped to pave the way to the present level of acceptance of chiropractic sports injury management and performance enhancement and as the progenitor of the Royal College of Chiropractic Sports Sciences Canada. PMID:28065996

  15. Alcohol consumption practices amongst adult males in a rural area of Haryana

    Directory of Open Access Journals (Sweden)

    Sandeep Sachdeva

    2014-01-01

    Full Text Available Objective: To assess alcohol consumption practices amongst adult males in a rural block area. Materials and Methods: Using multi-stage random sampling frame, at least 12 households were identified from selected anganwadi centers (n = 27, and one resident adult male from each household was interviewed in confidence using pre-designed, pre-tested, semi-structured interview schedule after seeking informed consent. In households with more than one adult male respondent, the elder member was recruited. For operational purpose, a drinker was defined as a person who had consumed at least one alcoholic drink in 1 year immediately preceding the survey. Results: A total of 345 adult males were covered with a mean age of 46.6 (±14.2 years. Nearly 64.6% had 5 years of schooling, 46.4% were farmers, 54.2% lived in joint family system and 59.7% had monthly family income up to Rs 10,000. Nearly 150 (43.5% subjects had some correct knowledge regarding adverse effects of alcohol consumption. Of all the study subjects, 326 (94.4% males had consumed at least one alcohol-based drink and of which 66.3% consumed country liquor. Nearly 239 (73.3% drank at either their respective homes or their friends′ homes. Two hundred and eighty-one (86.2% procured alcohol from a shop within the village; average expenditure per month was Rs 500-900 for 132 (40.5% respondents; and 38.3% subjects did not consume any snacks with alcohol intake. Drinking had become a habit for 194 (59.5% males; however, based on self-assessment, 131 (40.2% considered alcohol consumption as a problem and intended to stop drinking. Conclusion: Within study limitations, high prevalence of alcohol consumption was noted in this study, which may not only eventually lead to health/social issues but also adversely influence the younger generation for easy and early uptake of alcohol.

  16. Health and environmental implications of rural female entrepreneurship practices in osun state Nigeria.

    Science.gov (United States)

    Akinbami, Catherine A O; Momodu, Abiodun S

    2013-09-01

    In rural Nigeria, food processing is mostly engaged in by women and children. Most of these processes are done using outdated technologies that make use of traditional woodstoves. This article presents the health and environmental implications of the rural female entrepreneurs involved in food processing and proffer means of bettering the lot of these women to handle these hazards. A partially structured questionnaire and focus group discussion was used to capture data from respondents. The study revealed that about 73 % of women involved in direct production of garri and palm oil processing could be at risk of early death or disability-adjusted life years from the mentioned diseases. The article concludes that the rural female entrepreneur needs to be better positioned to handle these hazards, for her health, that of her children, as well as for the environment.

  17. Rural Villagers’ Quality of Life Improvement by Economic Self-Reliance Practices and Trust in the Philosophy of Sufficiency Economy

    Directory of Open Access Journals (Sweden)

    Piyapong Janmaimool

    2016-08-01

    Full Text Available The concept of economic self-reliance, widely known by Thai people as the philosophy of sufficiency economy, has been widely promoted in rural Thai societies. By practicing this philosophy, it is expected that the citizens’ quality of life and local environments could be sustainably improved. This study aims to explore the contribution of the community practices of the sufficiency economy philosophy to rural villagers’ quality of life improvement, and to investigate potential factors that determine the trust of villagers in the philosophy. With the purpose to propose strategies which could enhance trust and promote villagers’ practices of the philosophy, the study investigated influences of three relevant factors on trust towards the philosophy. Those factors included factors related to cognitive-based trust, factors related to emotional-based trust, and factors related to demographic characteristics. Questionnaire surveys and in-depth interviews with community leaders and local villagers were conducted in the Ban Jamrung community, in Thailand’s Rayong Province. The results of the statistical analysis revealed that the residents who applied the sufficiency economy philosophy in their daily lives experienced a relatively better quality of life. Additionally, it was found that trust in the philosophy could be predicted more by rational factors than by emotional factors. These findings could be utilized to develop strategies to maintain and enhance the trust of the people in the philosophy of sufficiency economy.

  18. Racial Disparities in Use of Chiropractic Services by Medicare Beneficiaries Aged 65 to 99 in Los Angeles County, California.

    Science.gov (United States)

    Whedon, James M; Kimura, Melissa N; Phillips, Reed B

    2016-04-01

    Racial and ethnic disparities in utilization of chiropractic services have been described at the state level, but little is known about such local disparities. We analyzed Medicare data for the year 2008 to evaluate by ZIP code for utilization of chiropractic services among older adults in Los Angeles County, California. We evaluated for availability and use of chiropractic services by racial/ethnic category, quantified geographic variations by coefficient of variation, and mapped utilization by selected racial/ethnic categories. Among 7502 beneficiaries who used chiropractic services, 72% were white, 12% Asian, 1% black, 1% Hispanic, and 14% other/unknown. Variation in the number of beneficiaries per ZIP code who used chiropractic services was highest among Hispanics, blacks, and Asians. We found evidence of racial disparities in use of chiropractic services at the local level in Los Angeles County. Older blacks and Hispanics in Los Angeles County may be underserved with regard to chiropractic care.

  19. Genealogy of a rural elite: anthropological elucidation of a practice of power

    Directory of Open Access Journals (Sweden)

    Valeria Hernández

    2013-06-01

    Full Text Available In this article the notion of elite is examined as a conceptual tool to analyze the power relationships like they are build in the contemporary Argentinian agro-rural world. For this purpose we studied a specific group, the innovative entrepreneurs enrolled in the agribusiness model, assembled in Asociación Argentina de Productores en Siembra Directa (AAPRESID. Through the ethnographic material generated within the scope of an anthropological fieldwork (2003-2007, it will be analyzed the way in which the identity of elite as a legitimacy factor for the material and symbolic position occupied in the rural scenario

  20. LEVEL OF ADOPTION AND CONSTRAINTS OF SCIENTIFIC BACKYARD POULTRY REARING PRACTICES IN RURAL TRIBAL AREAS OF SIKKIM, INDIA

    OpenAIRE

    2012-01-01

    A study was conducted on level of adoption and constraints of backyard poultry rearing practices in rural tribal areas of Sikkim. The data were collected from 125 respondents of Dzongu area, North Sikkim through personal interview with the help of questionnaire. From the present study it was found that 64.8% respondents were medium level adopters followed by high level (19.2%) and low level (16%) adopters. Housing (43.2%) were highly adopted followed by feeding and watering (41.6%), marketing...

  1. Opportunities and obstacles to the elimination of malaria from Peninsular Malaysia: knowledge, attitudes and practices on malaria among aboriginal and rural communities

    Directory of Open Access Journals (Sweden)

    Al-Mekhlafi Hesham M

    2010-05-01

    Full Text Available Abstract Background Despite continuous efforts by the government and private sectors, malaria is still a public health problem in rural Peninsular Malaysia. This study investigated household knowledge, attitude and practices (KAP regarding malaria in two malaria endemic communities, forest-aboriginal and rural communities, in the Lipis district of Pahang state, Malaysia. Methods A descriptive cross-sectional study with a semi-structured questionnaire was carried out among 100 and 123 households from forest-aboriginal and rural areas, respectively. Results Knowledge about malaria and its transmission is significantly higher among the rural participants than the aborigines (86.2% vs 76%, p Conclusions Both communities were aware of malaria as a disease, but knowledge, attitudes and practices were inadequate. Providing efficient health education to people residing in malaria endemic areas would improve their understanding about malaria prevention in order to bring about the elimination of malaria from the country.

  2. Rural Educators' Understanding of the Legislations That Impact on School Practice with Specific Reference to the Bill of Rights and the South African Schools Act

    Science.gov (United States)

    Duma, M. A. N.

    2009-01-01

    The aim of this article is to investigate the rural educators' understanding of the legislations that impact on school practice. An argument is presented that the understanding of the legal frameworks that govern school practice begins with the educators' understanding of the Bill of Rights and the South African Schools Act. The article reports on…

  3. Practice and Exploration of Rural Sci-tech Service Supermarket:A Case Study of Jurong Economic Forest and Fruit Industrial Branch

    Institute of Scientific and Technical Information of China (English)

    Weizhong; LIU; Yabo; LIU; Jianying; ZHANG; Nini; MAO; Zhijian; WANG

    2013-01-01

    The rural sci-tech supermarket in Jiangsu Province is an innovative model of rural sci-tech service. With reference to the concept of modern commodity supermarket, this model integrates variety, technology and achievement information into the sci-tech supermarket platform, provides various agricultural sci-tech services, and improves farmers recognition and acceptance of science and technology, so as to accelerate conversion of scientific and technological achievements and demonstration and popularization of new varieties, new technologies and new models. This paper analyzes practice of Jurong economic forest and fruit industrial branch and presents recommendations for building Jiangsu rural sci-tech service supermarket.

  4. Frequency of satisfaction and dissatisfaction with practice among rural-based, group-employed physicians and non-physician practitioners.

    Science.gov (United States)

    Waddimba, Anthony C; Scribani, Melissa; Krupa, Nicole; May, John J; Jenkins, Paul

    2016-10-22

    Widespread dissatisfaction among United States (U.S.) clinicians could endanger ongoing reforms. Practitioners in rural/underserved areas withstand stressors that are unique to or accentuated in those settings. Medical professionals employed by integrating delivery systems are often distressed by the cacophony of organizational change(s) that such consolidation portends. We investigated the factors associated with dis/satisfaction with rural practice among doctors/non-physician practitioners employed by an integrated healthcare delivery network serving 9 counties of upstate New York, during a time of organizational transition. We linked administrative data about practice units with cross-sectional data from a self-administered multi-dimensional questionnaire that contained practitioner demographics plus valid scales assessing autonomy/relatedness needs, risk aversion, tolerance for uncertainty/ambiguity, meaningfulness of patient care, and workload. We targeted medical professionals on the institutional payroll for inclusion. We excluded those who retired, resigned or were fired during the study launch, plus members of the advisory board and research team. Fixed-effects beta regressions were performed to test univariate associations between each factor and the percent of time a provider was dis/satisfied. Factors that manifested significant fixed effects were entered into multivariate, inflated beta regression models of the proportion of time that practitioners were dis/satisfied, incorporating clustering by practice unit as a random effect. Of the 473 eligible participants. 308 (65.1 %) completed the questionnaire. 59.1 % of respondents were doctoral-level; 40.9 % mid-level practitioners. Practitioners with heavier workloads and/or greater uncertainty intolerance were less likely to enjoy top-quintile satisfaction; those deriving greater meaning from practice were more likely. Higher meaningfulness and gratified relational needs increased one's likelihood of

  5. Knowledge and practice of mothers/care-takers towards diarrhoea and its treatment in rural communities in Ethiopia.

    Science.gov (United States)

    Ketsela, T; Asfaw, M; Belachew, C

    1991-10-01

    Diarrhoeal diseases are major causes of childhood morbidity and mortality in developing countries. Knowledge and practices of mothers or other care-takers of children are important determinants of the occurrence or outcome of diarrhoeal diseases. Base-line information on these variables is also needed for developing health education programmes and for formulating national policy on home fluid therapy. This study was conducted with the objectives of assessing the knowledge and practice of mothers and other caretakers of children towards diarrhoeal diseases and the sociodemographic correlates of adequate knowledge and practice. A study was conducted in the rural North, South, East and West Shewa Administrative Regions in April, 1990. A two-stage cluster sampling proportionate to size was used to select a total of 750 mothers or other caretakers. These were interviewed by trained and supervised health workers who used a pretested questionnaire. The three major ethnic groups were Oromo, Guragie and Hadya. Of the total respondents, 79.3% were illiterate, 78.5% got their water from unprotected sources, 88.9% had no latrines, 80.4% had no access to mass media and 7.1% spent more than 2 hours to reach to the nearest health facilities. Only 2.6% and 5.7% of mothers had adequate knowledge and practice on diarrhoea or its treatment, respectively. Age and educational level of mothers or other caretakers were found to be positively associated with adequate knowledge and practice towards diarrhoea and its treatment. The study clearly indicated that health education messages have not been effectively disseminated to the rural population. It is, therefore, strongly recommended that the Diarrhoeal Diseases Control Programme strengthens its communication activities through increasing persuasion of health workers who could serve as effective means of reaching the population who have access to health services.

  6. Factors influencing knowledge and practice of hygiene in Water, Sanitation and Hygiene (WASH) programme areas of Bangladesh Rural Advancement Committee.

    Science.gov (United States)

    Akter, Tahera; Ali, Armm Mehrab

    2014-01-01

    Improved hygiene is one of the most effective means of reducing disease occurrence. However, a complete understanding of the factors that contribute to such improvement are not clear. This study explored factors that facilitate and/or impede hygiene behavior in water, sanitation and hygiene (WASH) intervention areas using qualitative research techniques. The Bangladesh Rural Advancement Committee (BRAC) has been providing WASH intervention to 150 rural upazilas (sub-districts) since 2006. For qualitative data collection, in-depth interviews were conducted with 144 purposively selected women from six upazilas across Bangladesh. A woman in the household was considered as a case and interviewed regarding various aspects of sanitation and hygiene, using a checklist. Some practices, such as cleanliness of latrines, and availability of soap, water, slippers in their designated place were physically verified. The respondents' hygiene behavior was mainly facilitated by improved knowledge and awareness of health and environment-related issues. Latrine ownership increased through financial assistance, resulting in improved privacy, social prestige, and a heightened sense of responsibility towards maintaining a healthy life. However, lack of interest in attending cluster meetings, traditional knowledge, poverty, and lack of will were some of the factors impeding knowledge and hygiene practice. In addition, attitude played a definitive role, with some respondents not practicing hygiene in spite of having the financial ability to do so. They expected full financial support for creating sanitation and hygiene facilities in their household despite BRAC's policy of providing such support only to the 'ultra-poor'. The identified impeding factors often act as barriers to transformation of hygiene-related knowledge into practice and practice into habit. More motivational cluster meetings with large-scale participation and periodic home visits by the programme organizers are

  7. Human Rights as Practice: Dalit Women's Collective Action to Secure Livelihood Entitlements in rural South India

    NARCIS (Netherlands)

    Mangubhai, Y.|info:eu-repo/dai/nl/412461277

    2012-01-01

    In this dissertation, I investigate how Dalit women in rural South India secure livelihood entitlements by analysing processes of social exclusion as well as collective action by these women through their perspectives. This problematic requires focus on how caste, class and gender mutually construct

  8. The Creative Countryside: Policy and Practice in the UK Rural Cultural Economy

    Science.gov (United States)

    Bell, David; Jayne, Mark

    2010-01-01

    This paper explores emerging policymaking and research into rural creative industries, drawing on a case study from the county of Shropshire in the UK. It begins with a critique of existing creative industries policy, which is argued to focus almost exclusively on the urban as the site of creative work. The paper highlights an emerging body of…

  9. Unilever's Shakti Project: Empowering rural Indian women: Bottom of the pyramid in practice

    NARCIS (Netherlands)

    Loman, B.

    2010-01-01

    This research is on the positive and negative aspects of Unilever's Shakti-project, a prime example of marketing to the ‘Bottom of the Pyramid’ as put forward by C.K. Prahalad (2006). Poor rural Indian women are recruited to become small-scale entrepreneurs by Hindustan Lever, the Indian subsidiary

  10. Unilever's Shakti Project: Empowering rural Indian women: Bottom of the pyramid in practice

    NARCIS (Netherlands)

    Loman, B.

    2010-01-01

    This research is on the positive and negative aspects of Unilever's Shakti-project, a prime example of marketing to the ‘Bottom of the Pyramid’ as put forward by C.K. Prahalad (2006). Poor rural Indian women are recruited to become small-scale entrepreneurs by Hindustan Lever, the Indian subsidiary

  11. What policy says and practice does : gender, household and community in rural water provision in Tanzania

    NARCIS (Netherlands)

    Mandara, C.G.

    2014-01-01

    Summary

      Since 1945 to date the governance of the rural water sector in Tanzania has passed through multiple phases, from the colonial era to the times characterized by liberalization, decentra

  12. Lessons Learned from Work with International Partners to Inform Rural Practices for Early Childhood Intervention

    Science.gov (United States)

    Grisham-Brown, Jennifer; McCormick, Katherine M.

    2013-01-01

    The United States is becoming increasingly diverse with the largest growth in Hispanic populations. Diversity also is increasing in rural America. This diversity is reflected in the participants in early care and education programs and K-12 students. Unfortunately, demographics for college and university teacher education programs do not match…

  13. What policy says and practice does : gender, household and community in rural water provision in Tanzania

    NARCIS (Netherlands)

    Mandara, C.G.

    2014-01-01

    Summary

      Since 1945 to date the governance of the rural water sector in Tanzania has passed through multiple phases, from the colonial era to the times characterized by liberalization,

  14. Types of Rural Extensionists' Expectations of Psychology and Their Implications on Psychologists' Practice.

    Science.gov (United States)

    Landini, Fernando

    2016-12-01

    Psychology has great potential for contributing to rural development, particularly through supporting rural extension (RE). In this paper, the types of expectations extensionists have of psychology are identified, as well as possible ways of integrating psychosocial knowledge into the RE context. Rural extensionists from 12 Latin American countries were surveyed (n = 654). Of them, 89.4 % considered psychology could contribute to rural extension and commented on how this would be possible. Expectations were categorised and the nine mentioned by more than 20 % of them were utilized to conduct a two-steps cluster analysis. Three types of extensionists' expectations were identified: one wherein working with extensionists was highlighted; another characterised by a focus on working with farmers; and a third featuring a traditional, diffusionist extension approach, which views farmers as objects of psychologists' interventions. With the first type, psychologists should not neglect working with farmers and with the second, with extensionists. With the third type, reflecting on the expectations themselves and their underlying assumptions seems essential.

  15. LEVEL OF ADOPTION AND CONSTRAINTS OF SCIENTIFIC BACKYARD POULTRY REARING PRACTICES IN RURAL TRIBAL AREAS OF SIKKIM, INDIA

    Directory of Open Access Journals (Sweden)

    B.G. NATH

    2012-03-01

    Full Text Available A study was conducted on level of adoption and constraints of backyard poultry rearing practices in rural tribal areas of Sikkim. The data were collected from 125 respondents of Dzongu area, North Sikkim through personal interview with the help of questionnaire. From the present study it was found that 64.8% respondents were medium level adopters followed by high level (19.2% and low level (16% adopters. Housing (43.2% were highly adopted followed by feeding and watering (41.6%, marketing (40.0%, general management (39.2%, health care practices (36.8% and breeding practice (33.6%. The overall adoption of different backyard poultry rearing practices showed medium level adoption. Non availability of backyard poultry chicks, non-availability of medicine, high incidence of diseases, lack of knowledge about scientific practices, lack of market, attack of predators etc. were the major constraints faced by backyard poultry farmers. The study also pointed some suggestions for solving the constraints regarding backyard poultry rearing practices in Dzongu, North Sikkim.

  16. Health Profile Of Aged Persons In Urban & Rural Field Practice Areas Of Medical College, Amrisar

    Directory of Open Access Journals (Sweden)

    Padda A.S

    1998-01-01

    Full Text Available Research question: What is the health status of aged persons in urban and rural area? Objectives: 1. To study the socio-demographic profile. 2. To study the health status of aged persons in urban and rural areas and factors associated with it. Study design: Cross-sectional Participants: Persons aged 60 years and above. Sample size: 698 (423 males and 275 females Study variables: Age, Sex, marital status, occupation, literacy status, addition, morbidity pattern and disability. Results: Among 698 aged persons, 423(60.60% were males and 275(39.40% were females, 393(56.3% were in the age group of 60-65 years while only 34(4.8% were more than 80 years. Majority (58.45% belonged to Sikh community followed by Hindus (39.9%. 61.37% aged persons were literate and 38.63% were illiterate. 73.74% of all aged were living in joint families. 68.39% aged persons were engaged in one or other works while 31.61% were dependent on other family members. It was observed that 46.08% of rural aged and 32.97% of urban aged persons were going for morning/evening walk. 33.69% of urban aged and 20.69% of rural aged were reading newspapers or books. Out of total 423 males, 363(85.81% were addicted to one or the other intoxicants. 374(53.58% were feeling satisfactory at this age while 324(46.42% were not feeling so. Majority of them were ill at the time of survey. Arthritis (60.60% being the commonest cause of illness followed by cataract or visual impairment (54.01%. 16.62% of the aged were hypertensive, it was more (19.35% in urban aged as compared to rural aged (13.79%. Diabetes mellitus was observed in 5.3% aged persons and it was more commonly seen in urban area (6.81% than in rural area (2.51%. Prevalence of peptic ulcers/chromic gastritis was found to be 5.87% (6.09% in urban area (6.27% in rural area aged. The problems due to socio-psychology causes were minimal, probably because majority (73.74% of them were residing with their families

  17. Consistency of Use and Effectiveness of Household Water Treatment Practices Among Urban and Rural Populations Claiming to Treat Their Drinking Water at Home: A Case Study in Zambia.

    Science.gov (United States)

    Rosa, Ghislaine; Kelly, Paul; Clasen, Thomas

    2016-02-01

    Household water treatment (HWT) can improve drinking water quality and prevent disease, if used correctly and consistently. While international monitoring suggests that 1.8 billion people practice HWT, these estimates are based on household surveys that may overstate the level of consistent use and do not address microbiological effectiveness. We sought to examine how HWT is practiced among households identified as HWT users according to international monitoring standards. Case studies were conducted in urban and rural Zambia. After a baseline survey (urban: 203 households, rural: 276 households) to identify HWT users, 95 urban and 82 rural households were followed up for 6 weeks. Consistency of HWT reporting was low; only 72.6% of urban and 50.0% of rural households reported to be HWT users in the subsequent visit. Similarly, availability of treated water was low, only 23.3% and 4.2% of urban and rural households, respectively, had treated water on all visits. Drinking water was significantly worse than source water in both settings. Only 19.6% of urban and 2.4% of rural households had drinking water free of thermotolerant coliforms on all visits. Our findings raise questions about the value of the data gathered through the international monitoring of HWT practices as predictors of water quality in the home.

  18. Dietary intake practices associated with cardiovascular risk in urban and rural Ecuadorian adolescents: a cross-sectional study.

    Science.gov (United States)

    Ochoa-Avilés, Angélica; Verstraeten, Roosmarijn; Lachat, Carl; Andrade, Susana; Van Camp, John; Donoso, Silvana; Kolsteren, Patrick

    2014-09-09

    Cardiovascular diseases (CVD) are amongst the leading causes of death worldwide. Risk factors of CVD develop during childhood and adolescence, and dietary quality has been linked to the development of CVD itself. This study examines the association between dietary patterns and cardiovascular risk in a group of urban and rural Ecuadorian adolescents from different socioeconomic backgrounds. A cross-sectional study was conducted from January 2008 to April 2009 among 606 adolescents from the 8th, 9th and 10th grade in an urban area (Cuenca), and 173 adolescents from a rural area (Nabón) in Ecuador. Data collection involved measuring anthropometric data (weight, height and waist circumference), blood pressure, dietary intake (2-day 24 h recall) and socio-demographic characteristics. Fasting blood lipids and glucose were measured in a subsample of 334 adolescents. Factor analysis was used to identify dietary patterns and linear regression models were used to (i) identify differences in food intake practices according to socioeconomic status and place of residence and (ii) establish relationships between dietary patterns and cardiovascular risk factors. Median energy intake was 1851 kcal/day. Overall, fiber, fish and fruit and vegetables were scarcely consumed, while added sugar, refined cereals and processed food were important constituents of the diet. Two dietary patterns emerged, one labelled as "rice-rich non-animal fat pattern" and the other one as "wheat-dense animal-fat pattern". The first pattern was correlated with a moderate increase in glucose in urban participants, while the second pattern was associated with higher LDL and cholesterol blood levels in rural participants. This group of adolescents presented various dietary practices conducive to CVD development. Effective strategies are needed to prevent CVD in the Ecuadorian population by encouraging a balanced diet, which contains less refined cereals, added sugar, and processed food, but has more fruits

  19. An investigation of the relationship between autonomy, childbirth practices, and obstetric fistula among women in rural Lilongwe District, Malawi.

    Science.gov (United States)

    Kaplan, Julika Ayla; Kandodo, Jonathan; Sclafani, Joseph; Raine, Susan; Blumenthal-Barby, Jennifer; Norris, Alison; Norris-Turner, Abigail; Chemey, Elly; Beckham, John Michael; Khan, Zara; Chunda, Reginald

    2017-06-19

    Obstetric fistula is a childbirth injury caused by prolonged obstructed labor that results in destruction of the tissue wall between the vagina and bladder. Although obstetric fistula is directly caused by prolonged obstructed labor, many other factors indirectly increase fistula risk. Some research suggests that many women in rural Malawi have limited autonomy and decision-making power in their households. We hypothesize that women's limited autonomy may play a role in reinforcing childbirth practices that increase the risk of obstetric fistula in this setting by hindering access to emergency care and further prolonging obstructed labor. A medical student at Baylor College of Medicine partnered with a Malawian research assistant in July 2015 to conduct in-depth qualitative interviews in Chichewa with 25 women living within the McGuire Wellness Centre's catchment area (rural Central Lilongwe District) who had received obstetric fistula repair surgery. This study assessed whether women's limited autonomy in rural Malawi reinforces childbearing practices that increase risk of obstetric fistula. We considered four dimensions of autonomy: sexual and reproductive decision-making, decision-making related to healthcare utilization, freedom of movement, and discretion over earned income. We found that participants had limited autonomy in these domains. For example, many women felt pressured by their husbands, families, and communities to become pregnant within three months of marriage; women often needed to seek permission from their husbands before leaving their homes to visit the clinic; and women were frequently prevented from delivering at the hospital by older women in the community. Many of the obstetric fistula patients in our sample had limited autonomy in several or all of the aforementioned domains, and their limited autonomy often led both directly and indirectly to an increased risk of prolonged labor and fistula. Reducing the prevalence of fistula in Malawi

  20. Jurisprudence and business management course content taught at accredited chiropractic colleges: A comparative audit.

    Science.gov (United States)

    Gleberzon, Brian J

    2010-03-01

    the purpose of this study was to conduct a comparative audit of the jurisprudence and business management courses offered at a number of different accredited chiropractic colleges. Faculty members responsible for teaching students jurisprudence and/or business management courses at a number of accredited colleges were contacted and asked to electronically submit their course outlines for review. Of the 62 different topics delivered at the 11 chiropractic colleges surveyed, not one topic was taught at all of them. The following topics were taught at 10 of the 11 respondent chiropractic colleges: business plan development; ethics and codes of conduct and; office staff/employees. Several topics were only taught at one accredited chiropractic college. While most chiropractic colleges provide some education in the areas of jurisprudence and business management, it would appear that there is no consensus opinion or 'model curriculum' on these topics towards which chiropractic programs may align themselves. Based on a literature search, this study is the first of its kind. A more extensive study is required, as well as a Delphi process to determine what should be taught to chiropractic students with respect to jurisprudence and business management in order to protect the public interest.

  1. Chiropractic management of a patient with benign paroxysmal positional vertigo

    DEFF Research Database (Denmark)

    Nørregaard, Anette R; Lauridsen, Henrik H; Hartvigsen, Jan

    2009-01-01

    OBJECTIVE: This article describes and discusses the case of a patient with benign paroxysmal positional vertigo (BPPV) characterized by severe vertigo with dizziness, nausea, and nystagmus, treated without the use of spinal manipulation by a doctor of chiropractic. CLINICAL FEATURES: A 46-year......-old woman presented for care with complaints of acute vertigo and dizziness. INTERVENTION AND OUTCOME: The patient was examined and diagnosed with left posterior canalolithiasis by means of the Dix-Hallpike maneuver. She was treated successfully with the Epley maneuver once and subsequently discharged...

  2. Spinal cord injury following chiropractic manipulation to the neck.

    Science.gov (United States)

    Chakraverty, Julian; Curtis, Olivia; Hughes, Tom; Hourihan, Margaret

    2011-12-01

    Spinal cord injury is a rare complication of chiropractic treatment. This case report describes a 50-year-old man who developed neurological symptoms a few hours after manipulation (high velocity low amplitude [HVLA] technique) of the cervical spine. Magnetic resonance (MR) imaging of the cervical spine revealed intramedullary high signal at the C2/3 level of the right side of the cervical cord on the T2-weighted images. The potential mechanism of injury and causes of the radiological appearance are discussed.

  3. Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?

    Directory of Open Access Journals (Sweden)

    Duplantie Julie

    2006-08-01

    Full Text Available Abstract Background Telehealth, as other information and communication technologies (ICTs introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. In Canada, many telehealth projects are taking place, mostly targeting rural, remote or isolated populations. So far, various telehealth applications have been implemented and have shown promising outcomes. However, telehealth utilisation remains limited in many settings, despite increased availability of technology and telecommunication infrastructure. Methods A qualitative field study was conducted in four remote regions of Quebec (Canada to explore perceptions of physicians and managers regarding the impact of telehealth on clinical practice and the organisation of health care services, as well as the conditions for improving telehealth implementation. A total of 54 respondents were interviewed either individually or in small groups. Content analysis of interviews was performed and identified several effects of telehealth on remote medical practice as well as key conditions to ensure the success of telehealth implementation. Results According to physicians and managers, telehealth benefits include better access to specialised services in remote regions, improved continuity of care, and increased availability of information. Telehealth also improves physicians' practice by facilitating continuing medical education, contacts with peers, and access to a second opinion. At the hospital and health region levels, telehealth has the potential to support the development of regional reference centres, favour retention of local expertise, and save costs. Conditions for successful implementation of telehealth networks include the participation of clinicians in decision-making, the availability of dedicated human and material resources, and a planned diffusion strategy. Interviews with physicians and

  4. Cholera vaccination campaign contributes to improved knowledge regarding cholera and improved practice relevant to waterborne disease in rural Haiti.

    Directory of Open Access Journals (Sweden)

    Omowunmi Aibana

    2013-11-01

    Full Text Available Haiti's cholera epidemic has been devastating partly due to underlying weak infrastructure and limited clean water and sanitation. A comprehensive approach to cholera control is crucial, yet some have argued that oral cholera vaccination (OCV might result in reduced hygiene practice among recipients. We evaluated the impact of an OCV campaign on knowledge and health practice in rural Haiti.We administered baseline surveys on knowledge and practice relevant to cholera and waterborne disease to every 10th household during a census in rural Haiti in February 2012 (N = 811. An OCV campaign occurred from May-June 2012 after which we administered identical surveys to 518 households randomly chosen from the same region in September 2012. We compared responses pre- and post-OCV campaign. Post-vaccination, there was improved knowledge with significant increase in percentage of respondents with ≥ 3 correct responses on cholera transmission mechanisms (odds ratio[OR] 1.91; 95% confidence interval[CI] 1.52-2.40, preventive methods (OR 1.83; 95% CI 1.46-2.30, and water treatment modalities (OR 2.75; 95% CI 2.16-3.50. Relative to pre-vaccination, participants were more likely post-OCV to report always treating water (OR 1.62; 95% CI 1.28-2.05. Respondents were also more likely to report hand washing with soap and water >4 times daily post-vaccine (OR 1.30; 95% CI 1.03-1.64. Knowledge of treating water as a cholera prevention measure was associated with practice of always treating water (OR 1.47; 95% CI 1.14-1.89. Post-vaccination, knowledge was associated with frequent hand washing (OR 2.47; 95% CI 1.35-4.51.An OCV campaign in rural Haiti was associated with significant improvement in cholera knowledge and practices related to waterborne disease. OCV can be part of comprehensive cholera control and reinforce, not detract from, other control efforts in Haiti.

  5. Cholera Vaccination Campaign Contributes to Improved Knowledge Regarding Cholera and Improved Practice Relevant to Waterborne Disease in Rural Haiti

    Science.gov (United States)

    Aibana, Omowunmi; Franke, Molly; Teng, Jessica; Hilaire, Johanne; Raymond, Max; Ivers, Louise C.

    2013-01-01

    Background Haiti's cholera epidemic has been devastating partly due to underlying weak infrastructure and limited clean water and sanitation. A comprehensive approach to cholera control is crucial, yet some have argued that oral cholera vaccination (OCV) might result in reduced hygiene practice among recipients. We evaluated the impact of an OCV campaign on knowledge and health practice in rural Haiti. Methodology/Principal Findings We administered baseline surveys on knowledge and practice relevant to cholera and waterborne disease to every 10th household during a census in rural Haiti in February 2012 (N = 811). An OCV campaign occurred from May–June 2012 after which we administered identical surveys to 518 households randomly chosen from the same region in September 2012. We compared responses pre- and post-OCV campaign. Post-vaccination, there was improved knowledge with significant increase in percentage of respondents with ≥3 correct responses on cholera transmission mechanisms (odds ratio[OR] 1.91; 95% confidence interval[CI] 1.52–2.40), preventive methods (OR 1.83; 95% CI 1.46–2.30), and water treatment modalities (OR 2.75; 95% CI 2.16–3.50). Relative to pre-vaccination, participants were more likely post-OCV to report always treating water (OR 1.62; 95% CI 1.28–2.05). Respondents were also more likely to report hand washing with soap and water >4 times daily post-vaccine (OR 1.30; 95% CI 1.03–1.64). Knowledge of treating water as a cholera prevention measure was associated with practice of always treating water (OR 1.47; 95% CI 1.14–1.89). Post-vaccination, knowledge was associated with frequent hand washing (OR 2.47; 95% CI 1.35–4.51). Conclusion An OCV campaign in rural Haiti was associated with significant improvement in cholera knowledge and practices related to waterborne disease. OCV can be part of comprehensive cholera control and reinforce, not detract from, other control efforts in Haiti. PMID:24278498

  6. Knowledge, attitude, beliefs and practices in HIV/AIDS in India:identifying the gender and rural-urban differences

    Institute of Scientific and Technical Information of China (English)

    Indrajit; Hazarika

    2010-01-01

    Objective:To promote the use of preventive measures and raise awareness regardingHIV/AIDS in India.Methods:Data from the population-basedNFHS-3 survey2005-06 was used. In this study, information collected on87 961women aged15-49years and44 717 men aged15-54years was used in the final analysis. The data collected was stratified by gender and place of residence. Analyses of the variables related to the outcomes i.e. knowledge, attitude, belief and practices, was conducted usingChi-square test to calculate significant differences among proportions of categorical variables.Results: We found that knowledge of HIV transmission and prevention was low among women and rural residents. Most of the respondents had a non-discriminatory attitude towardsHIV positives and majority agreed that children should be educated onHIV/AIDS. The use of condoms and proportion of respondents who had undergoneHIV testing was found to be significantly low. We found a significant gap in the beliefs regarding ways to avoid HIV.Conclusions: There are significant gender and urban-rural differentials in India in terms of knowledge, attitude, beliefs and practices inHIV/AIDS. Information dissemination in India should be designed in a way that not only raises the level of awareness but also result in behavioral change.

  7. A study on knowledge and practices regarding menstrual hygiene among rural and urban adolescent girls in Udupi Taluk, Manipal, India

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    Kamath R

    2013-09-01

    Full Text Available Background Adolescent girls often lack knowledge regarding reproductive health including menstruation hygiene which can be due to socio-cultural barriers in which they grow up. Objectives: To explore the knowledge, practices and sources of information regarding menstruation and hygiene among adolescent girls in Udupi taluk, India. Methods: An epidemiologic study was undertaken using cross-sectional study method among 550 school-going adolescent girls aged13-16 years. A total of 270 were from urban and 280 from the rural area. Stratified cluster sampling was adopted to select the schools and simple random sampling technique to select the participants. Data was collected using a pre-tested questionnaire and analyzed using SPSS version 15.Results Around 34% participants were aware about menstruation prior to menarche, and mothers were the main source of information among both groups. Overall, 70.4% of adolescent girls were using sanitary napkins as menstrual absorbent, while 25.6% were using both cloth and sanitary napkins. Almost half of the rural participants dried the absorbent inside their homes. Conclusions: There is a need to equip the adolescent girls with knowledge regarding safe, hygienic practices to enable them to lead a healthy reproductive life.

  8. Practicality of solar drier for drying tropical fruits and marine products as income generating for rural development

    Energy Technology Data Exchange (ETDEWEB)

    Pablo, I.S.

    1978-01-01

    The feasibility and technical efficiency of a polythene solar drier for drying tropical fruits and marine products was investigated. Four popular tropical fruits were studied, namely: mango, langka (jackfruit), papaya and banana. These four fruits are generally popular on the market. In this study, the results of a polythene solar drier are compared to those of direct sun drying and it was found that the drier products had the more appealing color and texture. Also, a 25 to 40% reduction in drying time was obtained when the above fruits were dried using the solar drier as compared to direct sun drying. The solar drier was also found to be highly practical and efficient for the drying of marine products, namely: striped mackerel (Rastrelliger chrysozonus), short-bodied mackerel (R. brachysomus) and squid (Loligo opalescens). The drying time was reduced from 20 to 14 hours using the solar drier as compared to direct sun-drying. A reduction of 40% of the required salt resulted from the use of the solar drier, since microbial contamination from the environment was totally arrested. Solar technology is considered practical for rural communities because of the following advantages: low investment, labor cost savings, low delivery costs, products free from insect and mold contamination, longer product shelf life and better organoleptic characteristics. Solar drying provides a processing technology which results in higher profits and more savings for rural processors. 20 references.

  9. Dairy intensification, mothers and children: an exploration of infant and young child feeding practices among rural dairy farmers in Kenya.

    Science.gov (United States)

    Wyatt, Amanda J; Yount, Kathryn M; Null, Clair; Ramakrishnan, Usha; Webb Girard, Aimee

    2015-01-01

    Agricultural strategies such as dairy intensification have potential to improve human nutrition through increased household food security. Increasing dairy productivity could also adversely affect infant and young child feeding (IYCF) practices because of increased maternal stress, demands on maternal time, and beliefs about the timing and appropriate types of complementary foods. Yet, few studies have looked rigorously at how interventions can affect young children (0-60 months). The study explores, within the context of rural dairy farming in Kenya, the relationship between level of household dairy production and selected IYCF practices using a mixed-methods approach. Six focus group discussions with women involved in dairy farming investigated their attitudes towards breastfeeding, introduction of complementary foods and child diets. Ninety-two households involved in three levels of dairy production with at least one child 0-60 months participated in a household survey. Quantitative results indicated that women from higher dairy producing households were more likely to introduce cow's milk to infants before they reached 6 months than women from households not producing any dairy. Themes from the focus group discussions demonstrated that women were familiar with exclusive breastfeeding recommendations, but indicated a preference for mixed feeding of infants. Evidence from this study can inform nutrition education programmes targeted to farmers participating in dairy interventions in rural, low-income settings to minimise potential harm to the nutritional status of children.

  10. Away-from-home drinking water consumption practices and the microbiological quality of water consumed in rural western Kenya.

    Science.gov (United States)

    Onyango-Ouma, W; Gerba, Charles P

    2011-12-01

    A cross-sectional descriptive study was conducted to examine away-from-home drinking water consumption practices and the microbiological quality of water consumed in rural western Kenya. The study involved adults and schoolchildren. Data were collected using focus group discussions, questionnaire survey, observations, diaries and interviews. The findings suggest that away-from-home drinking water consumption is a common practice in the study area; however, the microbiological quality of the water consumed is poor. While some respondents perceive the water to be safe for drinking mainly because of the clear colour of the water, others are forced by circumstances to drink the water as it is owing to a lack of alternative safe sources. It is concluded that there is a need for new innovative approaches to address away-from-home drinking water consumption in resource-poor settings in order to complement and maximize the benefits of point-of-use water treatment at the household level.

  11. Risk of Carotid Stroke after Chiropractic Care: A Population-Based Case-Crossover Study.

    Science.gov (United States)

    Cassidy, J David; Boyle, Eleanor; Côté, Pierre; Hogg-Johnson, Sheilah; Bondy, Susan J; Haldeman, Scott

    2017-04-01

    Chiropractic manipulation is a popular treatment for neck pain and headache, but may increase the risk of cervical artery dissection and stroke. Patients with carotid artery dissection can present with neck pain and/or headache before experiencing a stroke. These are common symptoms seen by both chiropractors and primary care physicians (PCPs). We aimed to assess the risk of carotid artery stroke after chiropractic care by comparing association between chiropractic and PCP visits and subsequent stroke. A population-based, case-crossover study was undertaken in Ontario, Canada. All incident cases of carotid artery stroke admitted to hospitals over a 9-year period were identified. Cases served as their own controls. Exposures to chiropractic and PCP services were determined from health billing records. We compared 15,523 cases to 62,092 control periods using exposure windows of 1, 3, 7, and 14 days prior to the stroke. Positive associations were found for both chiropractic and PCP visits and subsequent stroke in patients less than 45 years of age. These associations tended to increase when analyses were limited to visits for neck pain and headache-related diagnoses. There was no significant difference between chiropractic and PCP risk estimates. We found no association between chiropractic visits and stroke in those 45 years of age or older. We found no excess risk of carotid artery stroke after chiropractic care. Associations between chiropractic and PCP visits and stroke were similar and likely due to patients with early dissection-related symptoms seeking care prior to developing their strokes. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  12. Breast Cancer Downstaging Practices and Breast Health Messaging Preferences Among a Community Sample of Urban and Rural Ugandan Women

    Science.gov (United States)

    Molina, Yamile; Patrick, Donald L.; Anderson, Benjamin O.; Nakigudde, Gertrude; Lehman, Constance D.; Thompson, Beti

    2017-01-01

    Purpose Among a community sample of Ugandan women, we provide information about breast cancer downstaging practices (breast self-examination, clinical breast examination [CBE]) and breast health messaging preferences across sociodemographic, health care access, and prior breast cancer exposure factors. Methods Convenience-based sampling was conducted to recruit Ugandan women age 25 years and older to assess breast cancer downstaging practices as well as breast health messaging preferences to present early for a CBE in the theoretical scenario of self-detection of a palpable lump (breast health messaging preferences). Results The 401 Ugandan women who participated in this survey were mostly poor with less than a primary school education. Of these women, 27% had engaged in breast self-examination, and 15% had undergone a CBE. Greater breast cancer downstaging practices were associated with an urban location, higher education, having a health center as a regular source of care, and receiving breast cancer education (P < .05). Women indicated a greater breast health messaging preference from their provider (66%). This preference was associated with a rural location, having a health center as a regular source of care, and receiving breast cancer education (P < .05). Conclusion Most Ugandan women do not participate in breast cancer downstaging practices despite receipt of breast cancer education. However, such education increases downstaging practices and preference for messaging from their providers. Therefore, efforts to downstage breast cancer in Uganda should simultaneously raise awareness in providers and support improved education efforts in the community. PMID:28503660

  13. Rural male health workers in Western Jamaica: Knowledge, attitudes and practices toward prostate cancer screening

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    Paul Andrew Bourne

    2010-01-01

    Full Text Available Background: Statistics have shown that since 1988, a significant percentage of males are unwilling to seek medical care. The question is if they had the knowledge, worked in the health system and were educated, would this be any different? Aim: The current study aims to fill this void in the literature by examining the perception of rural male health workers (from the Western Region about prostate examination, and why they are reluctant to inquire about the probability of having, or the likelihood of not having prostate cancer. Materials and Methods: The study utilized primary cross-sectional data that was collected during February and March 2008 from 170 males (ages 29 years and older, health-care workers who were employed in particular rural health institutions in Jamaica (i.e. Western Regional Health Authority. SPSS was used to analyze the data. Results: When the respondents were asked “Have you ever heard about the screening procedure for prostate?” 71.2% indicated yes, but only 27.1% had got their prostate checked by a health practitioner. When respondents were asked to state what influenced their choice of not doing a digital rectal examination, 20.6% indicated comfort level; 9.4% stated the gender of the health practitioner, 5.3% mentioned fear and others did not respond. Of those who had the examination 2 years ago, 96.5% did not state the choice of method. Conclusion: The current study is limited in terms of its generalizability to rural males or rural males in Western Jamaica, but it does provide an insight into the difficulty of men in breaking away from culture.

  14. The use and abuse of participatory rural appraisal: reflections from practice

    OpenAIRE

    Cornwall, Andrea; Pratt, Garett

    2010-01-01

    Abstract Over the course of the 1990s, donor enthusiasm for participation came to be institutionalized in a variety of ways. One particular methodology?Participatory Rural Appraisal (PRA)?came to enjoy phenomenal popularity. New aid modalities may have shifted donor and lender concern away from the grassroots towards ?policy dialogue.? But ?civil society participation,? ?social accountability,? and ?empowerment??some of the issues PRA grapples with?retain a place in the new aid dis...

  15. What policy says and practice does : gender, household and community in rural water provision in Tanzania

    OpenAIRE

    Mandara, C.G.

    2014-01-01

    Summary   Since 1945 to date the governance of the rural water sector in Tanzania has passed through multiple phases, from the colonial era to the times characterized by liberalization, decentralisation and privatization. Generally, changes in the policies and governance strategies reflect a correspondence with national and international reforms in the political and economic spheres. In turn, these changes made the sector to experience pendulum swings over time in terms of policies and a...

  16. The 'radiographer-referrer game': image interpretation dynamics in rural practice.

    Science.gov (United States)

    Squibb, Kathryn; Smith, Anthony; Dalton, Lisa; Bull, Rosalind M

    2016-03-01

    Effective interprofessional communication is intrinsic to safe health care. Despite the identified positive impact of collaborative radiographic interpretation between rural radiographers and referrers, communication difficulties still exist. This article describes the strategies that Australian rural radiographers use for communication of their radiographic opinion to the referring doctor. In a two-phase interpretive doctoral study completed in 2012, data were collected from radiographers working in rural New South Wales, Western Australia and Tasmania using a paper based questionnaire followed by in-depth semistructured interviews. Data were analysed thematically in order to identify, analyse and report the emergent themes. The overarching theme was Patient Advocacy, where in the interest of patient care radiographers took measures to ensure that a referring doctor did not miss radiographic abnormalities. Strong interprofessional relationships enabled direct communication pathways. Interprofessional boundaries shaped by historical hierarchical relationships, together with a lack of confidence and educational preparation for radiographic interpretation result in barriers to direct communication pathways. These barriers prompted radiographers to pursue indirect communication pathways, such as side-stepping and hint and hope. A lack of formal communication pathways and educational preparation for this role has resulted in radiographers playing the radiographer-referrer game to overtly or covertly assist referrers in reaching a radiographic diagnosis. The findings from this study may be used to plan interventions for strengthening interprofessional communication pathways and improve quality of healthcare for patients.

  17. Chiropractic care and public health: answering difficult questions about safety, care through the lifespan, and community action.

    Science.gov (United States)

    Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre; Hestbaek, Lise; Injeyan, H Stephen; Puhl, Aaron; Green, Bart; Napuli, Jason G; Dunn, Andrew S; Dougherty, Paul; Killinger, Lisa Zaynab; Page, Stacey A; Stites, John S; Ramcharan, Michael; Leach, Robert A; Byrd, Lori D; Redwood, Daniel; Kopansky-Giles, Deborah R

    2012-09-01

    The purpose of this collaborative summary is to document current chiropractic involvement in the public health movement, reflect on social ecological levels of influence as a profession, and summarize the relationship of chiropractic to the current public health topics of: safety, health issues through the lifespan, and effective participation in community health issues. The questions that are addressed include: Is spinal manipulative therapy for neck and low-back pain a public health problem? What is the role of chiropractic care in prevention or reduction of musculoskeletal injuries in children? What ways can doctors of chiropractic stay updated on evidence-based information about vaccines and immunization throughout the lifespan? Can smoking cessation be a prevention strategy for back pain? Does chiropractic have relevance within the VA Health Care System for chronic pain and comorbid disorders? How can chiropractic use cognitive behavioral therapy to address chronic low back pain as a public health problem? What opportunities exist for doctors of chiropractic to more effectively serve the aging population? What is the role of ethics and the contribution of the chiropractic profession to public health? What public health roles can chiropractic interns perform for underserved communities in a collaborative environment? Can the chiropractic profession contribute to community health? What opportunities do doctors of chiropractic have to be involved in health care reform in the areas of prevention and public health? What role do citizen-doctors of chiropractic have in organizing community action on health-related matters? How can our future chiropractic graduates become socially responsible agents of change?

  18. Do chiropractic college faculty understand informed consent: a pilot study

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    Hondras Maria A

    2006-12-01

    Full Text Available Abstract Background The purpose of this study was to survey full-time faculty at a single chiropractic college concerning their knowledge of Institutional Review Board (IRB policies in their institution as they pertain to educational research. Methods All full-time faculty were invited to participate in an anonymous survey. Four scenarios involving educational research were described and respondents were asked to select from three possible courses of action for each. In addition, respondents were queried about their knowledge of IRB policies, how they learned of these policies and about their years of service and departmental assignments. Results The response rate was 55%. In no scenario did the level of correct answers by all respondents score higher than 41% and in most, the scores were closer to just under 1 in 3. Sixty-five percent of respondents indicated they were unsure whether Palmer had any policies in place at all, while 4% felt that no such policies were in place. Just over one-quarter (27% were correct in noting that students can decline consent, while more than half (54% did not know whether there were any procedures governing student consent. Conclusion Palmer faculty have only modest understanding about institutional policies regarding the IRB and human subject research, especially pertaining to educational research. The institution needs to develop methods to provide knowledge and training to faculty. The results from this pilot study will be instrumental in developing better protocols for a study designed to survey the entire chiropractic academic community.

  19. Opportunities and obstacles to the elimination of malaria from Peninsular Malaysia: knowledge, attitudes and practices on malaria among aboriginal and rural communities.

    Science.gov (United States)

    Al-Adhroey, Abdulelah H; Nor, Zurainee M; Al-Mekhlafi, Hesham M; Mahmud, Rohela

    2010-05-24

    Despite continuous efforts by the government and private sectors, malaria is still a public health problem in rural Peninsular Malaysia. This study investigated household knowledge, attitude and practices (KAP) regarding malaria in two malaria endemic communities, forest-aboriginal and rural communities, in the Lipis district of Pahang state, Malaysia. A descriptive cross-sectional study with a semi-structured questionnaire was carried out among 100 and 123 households from forest-aboriginal and rural areas, respectively. Knowledge about malaria and its transmission is significantly higher among the rural participants than the aborigines (86.2% vs 76%, p education to people residing in malaria endemic areas would improve their understanding about malaria prevention in order to bring about the elimination of malaria from the country.

  20. Impact of health education intervention on malaria prevention practices among nursing mothers in rural communities in Nigeria

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    Olorunfemi Emmanuel Amoran

    2013-01-01

    Full Text Available Introduction: Malaria is the most prevalent parasitic endemic disease in Africa, which is preventable, treatable and curable. This study aims to assess the effect of health education intervention on the knowledge, attitude, and prevention practices amongst mothers of under-five children in a rural area of Ogun State, Nigeria. Materials and Methods: The study design was a quasi-experimental study carried out in Ijebu North Local Government Area of Ogun State. A multistage random sampling technique was used in choosing the required samples and a semi-structured questionnaire was used to collect relevant information. A total of 400 respondents were recruited into the study with 200 each in both the experimental and control groups and were followed up for a period of 3 months. Results: There was no statistically significant differences observed between the experimental and control groups. Knowledge of indoor spraying increased from 14.7% to 58.2% (P < 0.001 and window and door nets increased from 48.3% to 74.8% (P < 0.001. The proportion of those with ITN use increased from 50.8% to 87.4% (P < 0.001 while those with practice of maintaining clean environment also increased from 40.4% to 54.5% (P < 0.001. There were no significant changes in all the practice of malaria prevention methods in the control group. Conclusion: This suggests that malaria control can be significantly improved in rural areas, if the caregivers are adequately empowered through appropriate health education intervention though change in attitude and belief may require a longer and persistent effort.

  1. Improving childhood malaria treatment and referral practices by training patent medicine vendors in rural south-east Nigeria

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    Uzochukwu Benjamin SC

    2009-11-01

    Full Text Available Abstract Background Malaria remains a major cause of morbidity and mortality among children under five years of age in Nigeria. Most of the early treatments for fever and malaria occur through self-medication with anti-malarials bought over-the-counter (OTC from untrained drug vendors. Self-medication through drug vendors can be ineffective, with increased risks of drug toxicity and development of drug resistance. Global malaria control initiatives highlights the potential role of drug vendors to improve access to early effective malaria treatment, which underscores the need for interventions to improve treatment obtained from these outlets. This study aimed to determine the feasibility and impact of training rural drug vendors on community-based malaria treatment and advice with referral of severe cases to a health facility. Methods A drug vendor-training programme was carried out between 2003 and 2005 in Ugwuogo-Nike, a rural community in south-east Nigeria. A total of 16 drug vendors were trained and monitored for eight months. The programme was evaluated to measure changes in drug vendor practice and knowledge using exit interviews. In addition, home visits were conducted to measure compliance with referral. Results The intervention achieved major improvements in drug selling and referral practices and knowledge. Exit interviews confirmed significant increases in appropriate anti-malarial drug dispensing, correct history questions asked and advice given. Improvements in malaria knowledge was established and 80% compliance with referred cases was observed during the study period, Conclusion The remarkable change in knowledge and practices observed indicates that training of drug vendors, as a means of communication in the community, is feasible and strongly supports their inclusion in control strategies aimed at improving prompt effective treatment of malaria with referral of severe cases.

  2. Reporting new cases of anaemia in primary care settings in Crete, Greece: a rural practice study

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    Lionis Christos

    2012-04-01

    Full Text Available Abstract Background Early diagnosis of anaemia represents an important task within primary care settings. This study reports on the frequency of new cases of anaemia among patients attending rural primary care settings in Crete (Greece and to offer an estimate of iron deficiency anaemia (IDA frequency in this study group. Methods All patients attending the rural primary health care units of twelve general practitioners (GPs on the island of Crete for ten consecutive working days were eligible to participate in this study. Hemoglobin (Hb levels were measured by portable analyzers. Laboratory tests to confirm new cases of anaemia were performed at the University General Hospital of Heraklion. Results One hundred and thirteen out of 541 recruited patients had a low value of Hb according to the initial measurement obtained by the use of the portable analyzer. Forty five (45.5% of the 99 subjects who underwent laboratory testing had confirmed anaemia. The mean value of the Hb levels in the group with confirmed anaemia, as detected by the portable analyzer was 11.1 g/dl (95% Confidence Interval (CI from 10.9 to 11.4 and the respective mean value of the Hb levels obtained from the full blood count was 11.4 g/dl (95% CI from 11.2 to 11.7 (P = 0.01. Sixteen out of those 45 patients with anaemia (35.6% had IDA, with ferritin levels lower than 30 ng/ml. Conclusion Keeping in mind that this paper does not deal with specificity or sensitivity figures, it is suggested that in rural and remote settings anaemia is still invisible and point of care testing may have a place to identify it.

  3. Awareness, knowledge, and practice: A survey of glaucoma in north Indian rural residents

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    Parveen Rewri

    2014-01-01

    Full Text Available Background: Studies done on the prevalence of glaucoma have reported a high proportion of undiagnosed patients. Late diagnosis is related to increased risk of glaucoma associated with visual disability. Lack of awareness and non-availability of appropriate screening procedures are among the major reasons for non-diagnosis or late diagnosis of glaucoma. The present study has been undertaken to evaluate the level of awareness about glaucoma among the North Indian rural population. Materials and Methods: A group-administered, questionnaire-based survey, involving 5000 rural residents (aged 20 and above was conducted through random sampling. The questionnaire was structured to evaluate the level of awareness and knowledge about glaucoma and the effect of gender, education status, and glaucoma diagnosis was also studied. The source of awareness about glaucoma was also questioned. Results: Of the 5000 individuals enrolled for the survey, responses from 4927 (98.5%; 95% Confidence Interval (CI: 98.2 - 98.9 participants, including 3104 males (63%; 95% CI: 61.7 - 64.3 and 1823 females (37%; 95% CI: 35.7 - 38.3 were evaluated. A total of 409 (~8.3%; 95% CI: 7.6 - 9.14 respondents were aware about glaucoma and only 93 (1.89%; 95% CI: 1.55 - 2.31 were qualified as having knowledge about glaucoma as per the set questionnaire. Education was the only variable significantly correlated (P value < 0.001 with the awareness and knowledge of glaucoma out of the parameters included in this study. Close acquaintance with a glaucoma patient was the most common source of information. Conclusions: There is a lack of awareness about glaucoma among the rural residents of North India. The study findings stress the need to spread awareness about glaucoma for prevention of glaucoma-related blindness.

  4. Alleviating poverty or reinforcing inequality? Interpreting micro-finance in practice, with illustrations from rural China.

    Science.gov (United States)

    Hsu, Becky Yang

    2014-06-01

    Academic and political discussions about micro-finance have been found lacking in predictive power, because they are based on orthodox economic theory, which does not properly comprehend the social components of credit. I take a better approach, utilizing credit theory--specifically, Ingham's explication of how the nature of money as credit leads to social inequality. I also expound the perspective that morality is not separate from considerations borrowers make in micro-finance programmes on the micro level. I draw upon illustrations from my fieldwork in rural China, where a group-lending micro-finance programme was administered as part of a larger government-initiated effort across the country.

  5. The nature of nursing practice in rural and remote areas of Greenland

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Jensen, A. B.; Wilche, J.P.

    2013-01-01

    it meets the requirements of healthcare reform. Design This ethnographic study utilised documentary analysis, participant observation and qualitative interviewing carried out in remote areas of Greenland during 2011–2012. Eight registered nurses, four women and four men, aged between 35 and 55......, and subsequently interviewed. Interviews included in-depth questioning, based on emerging outcomes from observation. Interviews were recorded and transcribed; they were analysed within a phenomenological–hermeneutic approach. Results Nurses in rural and remote areas navigate their health promotion and preventive...

  6. Effectiveness and Economic Evaluation of Chiropractic Care for the Treatment of Low Back Pain

    DEFF Research Database (Denmark)

    Blanchette, Marc-André; Stochkendahl, Mette Jensen; Borges Da Silva, Roxane;

    2016-01-01

    evidence regarding the effectiveness and economic evaluation of care offered by these provider groups. PURPOSE: To estimate the clinical effectiveness and to systematically review the literature of full economic evaluation of chiropractic care compared to other commonly used care approaches among adult...... patients with non-specific LBP. STUDY DESIGN: Systematic reviews of interventions and economic evaluations. METHODS: A comprehensive search strategy was conducted to identify 1) pragmatic randomized controlled trials (RCTs) and/or 2) full economic evaluations of chiropractic care for low back pain compared...... were scientifically admissible. Five RCTs with low risk of bias compared chiropractic care to exercise therapy (n = 1), physical therapy (n = 3) and medical care (n = 1). Overall, we found similar effects for chiropractic care and the other types of care and no reports of serious adverse events. Three...

  7. Generalizability of a composite student selection procedure at a university-based chiropractic program

    DEFF Research Database (Denmark)

    O'Neill, Lotte Dyhrberg; Korsholm, Lars; Wallstedt, Birgitta;

    2009-01-01

    PURPOSE: Non-cognitive admission criteria are typically used in chiropractic student selection to supplement grades. The reliability of non-cognitive student admission criteria in chiropractic education has not previously been examined. In addition, very few studies have examined the overall test...... generalizability of composites of non-cognitive admission variables in admission to health science programs. The aim of this study was to estimate the generalizability of a composite selection to a chiropractic program, consisting of: application form information, a written motivational essay, a common knowledge...... test, and an admission interview. METHODS: Data from 105 Chiropractic applicants from the 2007 admission at the University of Southern Denmark were available for analysis. Each admission parameter was double scored using two random, blinded, and independent raters. Variance components for applicant...

  8. From rhetoric to reality? Putting HIV and AIDS rights talk into practice in a South African rural community.

    Science.gov (United States)

    Campbell, Catherine; Nair, Yugi

    2014-01-01

    Whilst international rhetoric on HIV and AIDS frequently invokes discourses of human rights to inspire and guide action, translating universal rights talk into practice in specific settings remains a challenge. Community mobilisation is often strategy of choice. We present a case study of the Entabeni Project in South Africa--in which a foreign-funded NGO sought to work with female health volunteers in a deep rural community to increase their access to two HIV-relevant rights: women's rights (especially gender equality) and rights to health (especially access to HIV- and AIDS-related services). Whilst the project had short-term health-related successes, it was less successful in implementing a gender empowerment agenda. The concept of women's rights had no purchase with women who had little interest in directly challenging male power, foregrounding the fight against poverty as their main preoccupation. The area's traditional chief and gatekeeper insisted the project should remain 'apolitical'. Project funders prioritised 'numbers reached' over a gender empowerment orientation. In the absence of (1) a marginalised group who are willing to assert their rights; and (2) a context where powerful people are willing to support these claims, 'rights' may be a blunt tool for HIV-related work with women in deeply oppressive and remote rural communities beyond the reach of international treaties and urban-based activist movements.

  9. Swearing the custom. Social practices and memory of power in rural Italy (1000c.-1250c.

    Directory of Open Access Journals (Sweden)

    Alessio Fiore

    2012-12-01

    Full Text Available Aim of this work is to explore the world of oral custom in rural Italy, during the high Middle Ages, using evidence (until now quite neglected from central and northern Italy, with a special focus on the area of Verona. In a social space characterized by the centrality of ritual and of oral word, the local custom was tightly connected with the placitum generale, the local village assembly, of Carolingian origin. During the placitum, three (o more jurors swore the local norms in front of the assembly of the men of the village and of the lord and his retinue (a ritual very similar to the well-known German Weisungen. It was a crucial moment, in which the local balance of power and the local set of rights was confirmed, contested or denied. We can also observe a complex interaction between the oral custom, connected with the performances of the jurors, the (often partial registrations of these performances and other documents about local rights (franchises, pacts between lords and subjects, etc.. With the half of thirteenth century the rural rules were increasingly written up in statuta, following the urban example; this marked the end of the ceremony of the swearing of custom.

  10. Development of disease-specific quality indicators for danish chiropractic patients with low back pain

    DEFF Research Database (Denmark)

    Sorensen, Line P; Krog, Birgitte R; Kongsted, Alice;

    2011-01-01

    The purpose of this study is to develop disease-specific quality indicators for Danish chiropractic patients with low back pain (LBP) as an initial effort to include chiropractors in the Danish Health Care Quality Programme.......The purpose of this study is to develop disease-specific quality indicators for Danish chiropractic patients with low back pain (LBP) as an initial effort to include chiropractors in the Danish Health Care Quality Programme....

  11. Effects of Expanded Coverage for Chiropractic Services on Medicare Costs in a CMS Demonstration

    OpenAIRE

    Stason, William B.; Ritter, Grant A.; Timothy Martin; Jeffrey Prottas; Christopher Tompkins; Donald S Shepard

    2016-01-01

    Background Moderately convincing evidence supports the benefits of chiropractic manipulations for low back pain. Its effectiveness in other applications is less well documented, and its cost-effectiveness is not known. These questions led the Centers for Medicaid and Medicare Services (CMS) to conduct a two-year demonstration of expanded Medicare coverage for chiropractic services in the treatment of beneficiaries with neuromusculoskeletal (NMS) conditions affecting the back, limbs, neck, or ...

  12. Chiropractic treatment and the enhancement of sport performance: a narrative literature review

    OpenAIRE

    Miners, Andrew L.

    2010-01-01

    A literature search and narrative review was carried out with the intent of determining the current level of knowledge regarding the chiropractic treatment of athletes for the purpose of sport performance enhancement. Of the fifty-nine relevant articles retrieved, only 7 articles of variable quality were obtained which specifically investigated/discussed chiropractic treatment and its involvement in sport performance enhancement. The role of the chiropractor in sport, unsubstantiated claims o...

  13. Attitudes towards fibromyalgia: A survey of Canadian chiropractic, naturopathic, physical therapy and occupational therapy students

    OpenAIRE

    Badwall Parminder; Kulkarni Abhaya V; Busse Jason W; Guyatt Gordon H

    2008-01-01

    Abstract Background The frequent use of chiropractic, naturopathic, and physical and occupational therapy by patients with fibromyalgia has been emphasized repeatedly, but little is known about the attitudes of these therapists towards this challenging condition. Methods We administered a cross-sectional survey to 385 senior Canadian chiropractic, naturopathic, physical and occupational therapy students in their final year of studies, that inquired about attitudes towards the diagnosis and ma...

  14. Posterior rib fractures in a young infant who received chiropractic care.

    Science.gov (United States)

    Wilson, Paria Majd; Greiner, Mary V; Duma, Elena M

    2012-11-01

    We report on a 21-day-old infant with healing posterior rib fractures that were noted after a chiropractic visit for colic. Chiropractors are the third largest group of health care professionals in the United States, and colic is the leading complaint for pediatric chiropractic care. Rib fractures, specifically when posterior, are traditionally considered to be secondary to nonaccidental trauma. Thorough investigation is necessary to rule out bone fragility and genetic disorders, but patient history is key when evaluating unexplained fractures.

  15. Effects of Expanded Coverage for Chiropractic Services on Medicare Costs in a CMS Demonstration

    OpenAIRE

    Stason, William B.; Grant A Ritter; Timothy Martin; Jeffrey Prottas; Christopher Tompkins; Shepard, Donald S.

    2016-01-01

    Background Moderately convincing evidence supports the benefits of chiropractic manipulations for low back pain. Its effectiveness in other applications is less well documented, and its cost-effectiveness is not known. These questions led the Centers for Medicaid and Medicare Services (CMS) to conduct a two-year demonstration of expanded Medicare coverage for chiropractic services in the treatment of beneficiaries with neuromusculoskeletal (NMS) conditions affecting the back, limbs, neck, or ...

  16. INTEREXAMINER RELIABILITY OF CHIROPRACTIC EVALUATION FOR CERVICAL SPINE PROBLEMS—A Pilot Study

    OpenAIRE

    Tuchin, Peter J.; Hart, Christopher J.; Johnson, Catriona; Colman, Robert; Gee, Adam; Edwards, Ian; Plucknett, Mark; Bonello, Rod

    1996-01-01

    Objective: A pilot study was conducted to determine whether untrained examiners could agree on palpatory findings in the cervical spine. Design: Fifty-three university students, (most of whom were chiropractic students), had their cervical spines examined by seven different chiropractors using their own clinical methods, of which motion palpation was a common, but not standard component. Setting: Chiropractic Centre in Macquarie University. Participants: Volunteer university students. Main Ou...

  17. Clean delivery practices in rural northern Ghana: a qualitative study of community and provider knowledge, attitudes, and beliefs

    Directory of Open Access Journals (Sweden)

    Moyer Cheryl A

    2012-06-01

    Full Text Available Abstract Background Knowledge, attitudes and practices of community members and healthcare providers in rural northern Ghana regarding clean delivery are not well understood. This study explores hand washing/use of gloves during delivery, delivering on a clean surface, sterile cord cutting, appropriate cord tying, proper cord care following delivery, and infant bathing and cleanliness. Methods In-depth interviews and focus group discussions were audiotaped, transcribed, and analyzed using NVivo 9.0. Results 253 respondents participated, including women with newborn infants, grandmothers, household and compound heads, community leaders, traditional birth attendants, and formally trained health care providers. There is widespread understanding of the need for clean delivery to reduce the risk of infection to both mothers and their babies during and shortly after delivery. Despite this understanding, the use of gloves during delivery and hand washing during and after delivery were mentioned infrequently. The need for a clean delivery surface was raised repeatedly, including explicit discussion of avoiding delivering in the dirt. Many activities to do with cord care involved non-sterile materials and practices: 1 Cord cutting was done with a variety of tools, and the most commonly used were razor blades or scissors; 2 Cord tying utilized a variety of materials, including string, rope, thread, twigs, and clamps; and 3 Cord care often involved applying traditional salves to the cord - including shea butter, ground shea nuts, local herbs, local oil, or “red earth sand.” Keeping babies and their surroundings clean was mentioned repeatedly as an important way to keep babies from falling ill. Conclusions This study suggests a widespread understanding in rural northern Ghana of the need for clean delivery. Nonetheless, many recommended clean delivery practices are ignored. Overarching themes emerging from this study included the increasing use of

  18. Recent illness, feeding practices and father's education as determinants of nutritional status among preschool children in a rural Nigerian community.

    Science.gov (United States)

    Balogun, Titilola B; Yakubu, Alhassan M

    2015-04-01

    Good nutrition is necessary for the growth and development of preschool children. In sub-Saharan Africa, however, data on the determinants of their nutritional status are lacking. A cross-sectional survey of 366 preschool children was conducted in a rural community in northern Nigeria. Anthropometric measurements of the children were taken and information about feeding practices, immunization and parental education was obtained from their mothers. Fifty-two percent were stunted, 30% were underweight and 25% were wasted. Recent history of diarrhea was associated with wasting (OR = 2.66, p education were less likely to be stunted (OR = 0.45, p = 0.01) or underweight (OR = 0.37, p = 0.005). Promoting exclusive breastfeeding, preventing recurrent diarrhea and including fathers in community interventions will improve the health of children in this community.

  19. Beyond the Dams: Linking Rural Smallholder Soil and Water Management Practices in Tropical Deltas to Sea Level Rise Vulnerability

    Science.gov (United States)

    Rogers, K. G.; Syvitski, J. P.; Brondizio, E. S.

    2014-12-01

    The increased vulnerability of deltaic communities to coastal flooding as a result of upstream engineering has been acknowledged for decades. What has received less attention is the sensitivity of deltas to the interactions of river basin modifications and cultivation and irrigation in their coastal regions, particularly in tropical deltas. Embanking, tilling, and crop or stock choice all affect the movement of sediment and water on deltas. Combined with reduced river and sediment discharge, soil and water management practices in coastal areas may in fact exacerbate the risk of tidal flooding, erosion of arable land, and salinization of soils and groundwater associated with sea level rise. Thus exists a cruel irony to smallholder subsistence farmers whose priorities are food, water and economic security, rather than sustainability of the regional environment. Such issues challenge disciplinary approaches and require integrated social-biophysical models able to understand and diagnose these complex relationships. The complementary Institutional Analysis and Development and SocioEcological Systems frameworks are applied to the southwestern Bengal Delta (Bangladesh). The method helps to define the relevant social and physical units operating on the common pool of environmental resources, those of climate, water and sediment. The conceptual frameworks are designed to inform development of a nested geospatial analysis and a dynamic coupled model to identify the social-biophysical feedbacks associated with smallholder soil and water management practices, coastal dynamics, and climate vulnerability in rural Bangladesh. Our presentation will discuss components of the conceptual frameworks and will introduce a bi-directional pilot study designed for obtaining and disseminating information about environmental change to farmers in southwest Bangladesh with potential application to rural farming communities in other tropical deltas.

  20. Chiropractic: Is it Efficient in Treatment of Diseases? Review of Systematic Reviews

    Directory of Open Access Journals (Sweden)

    Alireza Salehi

    2015-10-01

    Full Text Available Abstract Chiropractic is a complementary medicine that has been growing increasingly in different countries over recent decades. It addresses the prevention, diagnosis and treatment of the neuromusculoskeletal system disorders and their effects on the whole body health. This study aims to evaluate the effectiveness of chiropractic in the treatment of different diseases. To gather data, scientific electronic databases, such as Cochrane, Medline, Google Scholar, and Scirus were searched and all systematic reviews in the field of chiropractic were obtained. Reviews were included if they were specifically concerned with the effectiveness of chiropractic treatment, included evidence from at least one clinical trial, included randomized studies and focused on a specific disease. The research data including the article’s first author’s name, type of disease, intervention type, number and types of research used, meta-analysis, number of participants, and overall results of the study, were extracted, studied and analyzed. Totally, 23 chiropractic systematic reviews were found, and 11 articles met the defined criteria. The results showed the influence of chiropractic on improvement of neck pain, shoulder and neck trigger points, and sport injuries. In the cases of asthma, infant colic, autism spectrum disorder, gastrointestinal problems, fibromyalgia, back pain and carpal tunnel syndrome, there was no conclusive scientific evidence. There is heterogeneity in some of the studies and also limited number of clinical trials in the assessed systematic reviews. Thus, conducting comprehensive studies based on more reliable study designs are highly recommended.

  1. Chiropractic diagnosis and management of non-musculoskeletal conditions in children and adolescents

    Directory of Open Access Journals (Sweden)

    Miller Joyce

    2010-06-01

    Full Text Available Abstract Background A great deal has been published in the chiropractic literature regarding the response, or lack thereof, of various common pediatric conditions to chiropractic care. The majority of that literature is of low scientific value (that is, case reports or case series. The purpose of this review is to summarize the literature from the point of view of clinicians, rather than researchers, and to discuss some additional detail of the conditions themselves. Methods Databases searched were PubMed, Mantis, Index to Chiropractic Literature, and CINAHL. Keywords were chiropractic paired with colic, crying infant, nocturnal enuresis, asthma, otitis media and attention deficit hyperactivity disorder. Results Most of the published literature centers around case reports or series. The more scientifically rigorous studies show conflicting results for colic and the crying infant, and there is little data to suggest improvement of otitis media, asthma, nocturnal enuresis or attention deficit hyperactivity disorder. Discussion The efficacy of chiropractic care in the treatment of non-musculoskeletal disorders has yet to be definitely proven or disproven, with the burden of proof still resting upon the chiropractic profession.

  2. Constructing a philosophy of chiropractic I: an Integral map of the territory.

    Science.gov (United States)

    Senzon, Simon A

    2010-12-01

    The purpose of this article is to establish a metatheoretical framework for constructing a philosophy of chiropractic by using Integral Theory and Integral Methodological Pluralism. This is the first in a series of 3 articles. The philosophy of chiropractic has not thrived as a philosophic discipline for multiple reasons. Most notably, these include disparate personal and cultural worldviews within the profession, a historical approach to chiropractic's roots, and an undeveloped framework for exploring philosophy from multiple perspectives. A framework is suggested to bridge divides and create a groundwork for a philosophical discipline using Integral Methodological Pluralism developed from Integral Theory. A review of the literature on the philosophy of chiropractic is mapped according to the 8 primordial perspectives of Integral Methodological Pluralism. It is argued that this approach to constructing a philosophy of chiropractic will bridge the historical divides and ensure a deep holism by pluralistically including every known approach to knowledge acquisition. Integral Methodological Pluralism is a viable way to begin constructing a philosophy of chiropractic for the 21st century.

  3. Factors affecting dengue fever knowledge, attitudes and practices among selected urban, semi-urban and rural communities in Malaysia.

    Science.gov (United States)

    Al-Dubai, Sami Abdo Radman; Ganasegeran, Kurubaran; Mohanad Rahman, Alwan; Alshagga, Mustafa Ahmed; Saif-Ali, Riyadh

    2013-01-01

    Dengue fever is a major public health problem in Malaysia. This study aimed to assess factors affecting knowledge, attitudes, and practices regarding dengue fever among a selected population in Malaysia. A descriptive, community-based, cross sectional study was conducted with 300 participants from three different geographical settings in urban, semi-urban, and rural areas within the states of Selangor and Kuala Lumpur. The questionnaire included questions on demographic data, knowledge, attitudes, and practices regarding dengue fever. Mean age of respondents was 34.4 (+/- 5.7) years, and the age ranged from 18 to 65 years. The majority of respondents were married (54.7%), Malays (72.7%) and heard about dengue fever (89.7%). Television was the common source of information about dengue fever (97.0%). Participants answered 4 out of 15 items of knowledge incorrectly. There was no significant association between knowledge score and socio-demographic factors. About one-fifth of the respondents (24%) believed that immediate treatment is not necessary for dengue fever, and the majority of them were not afraid of the disease (96.0%). Attitudes toward dengue fever were significantly associated with the level of education and employment status (p dengue fever (p = 0.030). There is a need to increase health promotion activities through campaigns and social mobilization to increase knowledge regarding dengue fever. This would help to mold positive attitudes and cultivate better preventive practices among the public to eliminate dengue in the country.

  4. Informal mobile learning in nurse education and practice in remote areas--a case study from rural South Africa.

    Science.gov (United States)

    Pimmer, Christoph; Brysiewicz, Petra; Linxen, Sebastian; Walters, Fiona; Chipps, Jennifer; Gröhbiel, Urs

    2014-11-01

    With the proliferation of portable digital technology, mobile learning is becoming increasingly popular in nursing education and practice. Most of the research in this field has been concentrated on small-scale projects in high income countries. Very little is known about the ways in which nurses and midwives use mobile technology in remote and resource poor areas in informal learning contexts in low and middle income countries. To address this gap, this study investigates whether nurses use mobile phones as effective educational tools in marginalized and remote areas, and if so, how and why. In rural South Africa, 16 nurses who attended an advanced midwifery education program, facilitators and clinical managers were interviewed about their use of digital mobile technology for learning. Techniques of qualitative content analysis were used to examine the data. Several rich "organically-grown", learning practices were identified: mobile phone usage facilitated (1) authentic problem solving; (2) reflective practice; (3) emotional support and belongingness; (4) the realization of unpredictable teaching situations; and (5) life-long learning. It is concluded that mobile phones, and the convergence of mobile phones and social media, in particular, change learning environments. In addition, these tools are suitable to connect learners and learning distributed in marginalized areas. Finally, a few suggestions are made about how these insights from informal settings can inform the development of more systematic mobile learning formats. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Expanding the scope of practice for enrolled nurses working in an Australian rural health service - implications for job satisfaction.

    Science.gov (United States)

    Hoodless, Mary; Bourke, Lisa

    2009-05-01

    Career opportunities have been limited for enrolled nurses (ENs) working in small, rural health services. Medication endorsement offers ENs expanded scope of practice which may lead to improved job satisfaction. This small study compared job satisfaction between a group of ENs with recent medication endorsement and a group who elected not to undertake the course in a small, isolated health service. A questionnaire was designed to measure job satisfaction containing the measure of job satisfaction (MJS) scale and other information regarding the course in medication administration. Interviews were also conducted with medication endorsed nurses to gain a greater understanding about the course and their expanded scope of practice. Medication endorsed nurses were newer to nursing and their current job, and reported higher job satisfaction on all five factors. Non-medication endorsed nurses cited lack of confidence and ability as key reasons for not undertaking the course while medication endorsed nurses reported professional and personal reasons for expanding their scope of practice. Most enjoyed the responsibility and reported satisfaction from distributing medications and responding to pain while one viewed it as added work. The findings from this small study suggest that providing local education will improve job satisfaction of ENs.

  6. Rural nurses

    DEFF Research Database (Denmark)

    Wilson, Rhonda L.; Usher, Kim

    2015-01-01

    with descriptive techniques. In-depth interviews were conducted and the transcribed data were analysed using thematic techniques. Results: The results of this study demonstrate that in general rural people are willing to seek mental health care, and that rural nurses are well suited to provide initial care...... to young people. Conclusions: Non-traditional venues such as community, school and justice settings are ideal places where more convenient first conversations about mental health with young people and their families, and rural nurses should be deployed to these settings. Relevance to Clinical Practice......: Rural nurses are able to contribute important initial engagement interventions that enhance the early mental health care for young people when it is needed....

  7. Poultry slaughtering practices in rural communities of Bangladesh and risk of avian influenza transmission

    DEFF Research Database (Denmark)

    Rimi, Nadia Ali; Sultana, Rebeca; Ishtiak-Ahmed, Kazi

    2014-01-01

    Slaughtering sick poultry is a risk factor for human infection with highly pathogenic avian influenza and is a common practice in Bangladesh. This paper describes human exposures to poultry during slaughtering process and the customs and rituals influencing these practices in two Bangladeshi rura...

  8. Diabetes Treatment as "Homework": Consequences for Household Knowledge and Health Practices in Rural Uganda

    Science.gov (United States)

    Nielsen, Jannie; Bahendeka, Silver K.; Bygbjerg, Ib C.; Meyrowitsch, Dan W.; Whyte, Susan R.

    2016-01-01

    Background: Health professionals assign diabetes patients "homework" in that they give them instructions on how to manage diabetes, recognizing that most diabetes care takes place in the home setting. We studied how homework is practiced and whether knowledge and behavioral practices related to diabetes self-management diffuse from…

  9. Diabetes Treatment as "Homework": Consequences for Household Knowledge and Health Practices in Rural Uganda

    Science.gov (United States)

    Nielsen, Jannie; Bahendeka, Silver K.; Bygbjerg, Ib C.; Meyrowitsch, Dan W.; Whyte, Susan R.

    2016-01-01

    Background: Health professionals assign diabetes patients "homework" in that they give them instructions on how to manage diabetes, recognizing that most diabetes care takes place in the home setting. We studied how homework is practiced and whether knowledge and behavioral practices related to diabetes self-management diffuse from…

  10. Engaging Students in Life and Literature: A Qualitative Study of Rural North Alabama Community College American Literature Instructors' Course Design and Pedagogical Practices

    Science.gov (United States)

    Ward, Steven Jerome

    2012-01-01

    The purpose of this qualitative study was to examine the course design decisions and pedagogical practices of American literature teachers at three rural community colleges of varying size in North Alabama. Fink's (2003) Integrated Course Design (ICD) model provided a framework for this study, and the researcher attempted to determine if and…

  11. An investigation into possibilities for implementation of a virtual community of practice delivered via a mobile social network for rural community media in the Eastern Cape South Africa

    CSIR Research Space (South Africa)

    Herselman, M

    2017-03-01

    Full Text Available The purpose of this article is to provide an overview of how a virtual community of practice can be delivered via a mobile social networking framework to support rural community media in the Eastern Cape Province of South Africa. The article...

  12. 'What mother wouldn't want to save her baby?' HIV testing and counselling practices in a rural Ugandan antenatal clinic

    NARCIS (Netherlands)

    Vernooij, E.; Hardon, A.

    2013-01-01

    Drawing on an exploratory qualitative case study investigating everyday practices within an antenatal clinic in rural Uganda, this paper investigates the dynamics of consent and counselling within a prevention of mother-to-child HIV transmission (PMTCT) programme, from the perspectives of various he

  13. Beliefs and practices during pregnancy, post-partum and in the first days of an infant's life in rural Cambodia.

    Science.gov (United States)

    Turner, Claudia; Pol, Sreymom; Suon, Kamsan; Neou, Leakhena; Day, Nicholas P J; Parker, Michael; Kingori, Patricia

    2017-04-12

    The aim of this study was to record the beliefs, practices during pregnancy, post-partum and in the first few days of an infant's life, held by a cross section of the community in rural Cambodia to determine beneficial community interventions to improve early neonatal health. Qualitative study design with data generated from semi structured interviews (SSI) and focus group discussions (FGD). Data were analysed by thematic content analysis, with an a priori coding structure developed using available relevant literature. Further reading of the transcripts permitted additional coding to be performed in vivo. This study was conducted in two locations, firstly the Angkor Hospital for Children and secondarily in five villages in Sotnikum, Siem Reap Province, Cambodia. A total of 20 participants underwent a SSIs (15 in hospital and five in the community) and six (three in hospital and three in the community; a total of 58 participants) FGDs were conducted. Harmful practices that occurred in the past (for example: discarding colostrum and putting mud on the umbilical stump) were not described as being practiced. Village elders did not enforce traditional views. Parents could describe signs of illness and felt responsible to seek care for their child even if other family members disagreed, however participants were unaware of the signs or danger of neonatal jaundice. Cost of transportation was the major barrier to healthcare that was identified. In the population examined, traditional practices in late pregnancy and the post-partum period were no longer commonly performed. However, jaundice, a potentially serious neonatal condition, was not recognised. Community neonatal interventions should be tailored to the populations existing practice and knowledge.

  14. Ethnic and gender differences in farm tasks and safety practices among rural California farm youth.

    Science.gov (United States)

    McCurdy, Stephen A; Kwan, Jonathan A

    2012-01-01

    Agricultural work is hazardous and is common among rural youth, especially those living on farms or ranches. Previous work has shown differences in farm work and injury patterns between boys and girls, but little data exist addressing ethnic differences. This study examined ethnic and gender differences in farm tasks, safety attitudes, and use of protective measures among rural California youth working on farms or ranches. The University of California, Davis Youth Agricultural Injury Study is a longitudinal study focusing on agricultural work experience among youth enrolled in an agricultural sciences curriculum in 10 public high schools in California's Central Valley during the 2001-2005 school years. Using cross-sectional data from the initial entrance survey, we studied 946 participants who reported farm work in the previous year. Median annual hours of farm work varied significantly between boys and girls (p hr; Hispanic girls: 189 hr; White/Other boys: 832 hr; White/Other girls: 468 hr). Girls and Hispanic students were less likely than boys and White/Other students, respectively, to perform hazardous tasks involving tractors, machinery, and chemicals. Median age for initiating work on selected hazardous tasks was up to 3 years later for Hispanic students. Use of task-appropriate safety measures was low in all groups for most hazardous tasks. Boys were more likely than girls to use task-appropriate safety measures, with the exception of seatbelt use when in a car or truck. Hispanic students were more likely than White/Other students to employ safety measures. Girls and Hispanic youth worked fewer farm hours and had reduced exposure to selected hazardous tasks. Use of task-appropriate safety measures was low for all groups but increased for Hispanic students. Further study should explore reasons for low use of safety measures and develop educational efforts to bring about social norm changes promoting their use.

  15. Constructing a philosophy of chiropractic: evolving worldviews and postmodern core☆

    Science.gov (United States)

    Senzon, Simon A.

    2011-01-01

    Objective The purpose of this article is to explore the postmodern, postrational, and postconventional core of DD Palmer's self-sense and philosophy. Discussion DD Palmer's self and philosophy can be viewed as a reaction to the self of modernity and its challenges of a fracture between mind and body, spirit, and nature. It is argued that Palmer's solution to these vexing problems facing the modern self was to use postrational and postconventional logic to overcome the dualisms. His philosophy resonates with similar postrational approaches, most notably, the German idealist Schelling. Conclusion It is argued that Palmer was one of the first postrational individuals in America and that chiropractic was an attempt at the first postrational health profession. PMID:22693480

  16. Psychosocial factors and their predictive value in chiropractic patients with low back pain: a prospective inception cohort study

    Directory of Open Access Journals (Sweden)

    Breen Alan C

    2007-03-01

    Full Text Available Abstract Background Being able to estimate the likelihood of poor recovery from episodes of back pain is important for care. Studies of psychosocial factors in inception cohorts in general practice and occupational populations have begun to make inroads to these problems. However, no studies have yet investigated this in chiropractic patients. Methods A prospective inception cohort study of patients presenting to a UK chiropractic practice for new episodes of non-specific low back pain (LBP was conducted. Baseline questionnaires asked about age, gender, occupation, work status, duration of current episode, chronicity, aggravating features and bothersomeness using Deyo's 'Core Set'. Psychological factors (fear-avoidance beliefs, inevitability, anxiety/distress and coping, and co-morbidity were also assessed at baseline. Satisfaction with care, number of attendances and pain impact were determined at 6 weeks. Predictors of poor outcome were sought by the calculation of relative risk ratios. Results Most patients presented within 4 weeks of onset. Of 158 eligible and willing patients, 130 completed both baseline and 6-week follow-up questionnaires. Greatest improvements at 6 weeks were in interference with normal work (ES 1.12 and LBP bothersomeness (ES 1.37. Although most patients began with moderate-high back pain bothersomeness scores, few had high psychometric ones. Co-morbidity was a risk for high-moderate interference with normal work at 6 weeks (RR 2.37; 95% C.I. 1.15–4.74. An episode duration of >4 weeks was associated with moderate to high bothersomeness at 6 weeks (RR 2.07; 95% C.I. 1.19 – 3.38 and negative outlook (inevitability with moderate to high interference with normal work (RR 2.56; 95% C.I. 1.08 – 5.08. Conclusion Patients attending a private UK chiropractic clinic for new episodes of non-specific LBP exhibited few psychosocial predictors of poor outcome, unlike other patient populations that have been studied. Despite

  17. The effect of a sports chiropractic manual therapy intervention on the prevention of back pain, hamstring and lower limb injuries in semi-elite Australian Rules footballers: a randomized controlled trial

    OpenAIRE

    Pollard Henry; Hoskins Wayne

    2010-01-01

    Abstract Background Hamstring injuries are the most common injury in Australian Rules football. It was the aims to investigate whether a sports chiropractic manual therapy intervention protocol provided in addition to the current best practice management could prevent the occurrence of and weeks missed due to hamstring and other lower-limb injuries at the semi-elite level of Australian football. Methods Sixty male subjects were assessed for eligibility with 59 meeting entry requirements and r...

  18. Women's work in farming, child feeding practices and nutritional status among under-five children in rural Rukwa, Tanzania.

    Science.gov (United States)

    Nordang, Sunniva; Shoo, Tiransia; Holmboe-Ottesen, Gerd; Kinabo, Joyce; Wandel, Margareta

    2015-11-28

    Some progress has been achieved in reducing the prevalence of undernutrition among children under 5 years of age in Tanzania. In the Rukwa region (2010), the level of stunted and underweight children was 50·4 and 13·5 %, respectively. The aim of this study was to assess the nutritional status of children under 5 years of age, feeding practices and risk factors of undernutrition in a rural village in the Rukwa region, as well as to discuss the results in light of a similar study conducted in 1987/1988. This cross-sectional study was conducted in 152 households with children under 5 years of age. Data were obtained from the child's main caretaker and the household head, using a structured questionnaire and a 24 h dietary recall. Children's length/height and weight were measured. The prevalence of stunting and underweight was found to be 63·8 and 33·6 % (Z-scorechildren on the first day after birth. A thin gruel was introduced after a median of 2 months (25th-75th percentiles; 1-3). The time mothers spent farming was a significant risk factor for stunting (P=0·04). Illness, food shortage and dry-season cultivation were significant risk factors for underweight (Pfeeding practices were not in line with WHO recommendations. Women working in farms, food shortage, dry-season cultivation and diseases partly explain the children's poor nutritional status.

  19. Audit and feedback intervention: An examination of differences in chiropractic record-keeping compliance.

    Science.gov (United States)

    Homb, Nicole M; Sheybani, Shayan; Derby, Dustin; Wood, Kurt

    2014-10-01

    Objective : The objective of this study was to investigate the association of a clinical documentation quality improvement program using audit-feedback with clinical compliance to indicators of quality chart documentation. Methods : This was an analysis of differences between adherence to quality indicators of chiropractic record documentation and audit-feedback intervention (feedback report only vs. feedback report with one-on-one educational consultation) at different campuses. Comparisons among groups were analyzed using analysis of variance (ANOVA), Tukey or Dunnett post hoc tests, and Cohen's d effect size estimates. Results : There was a significant increase in the mean percentile compliance in 2 of 5 compliance areas and 1 of 11 compliance objectives. Campus B demonstrated significantly higher levels of compliance relative to campus A and/or campus C in 5 of 5 compliance areas and 7 of 11 compliance objectives. Across-campus comparisons indicated that the compliance area Review (Non-Medicare) Treatment Plan [F(2,18) = 17.537, p importance for clinical compliance practice. Conclusions : Feedback of performance improved compliance to indicators of quality health record documentation, especially when baseline adherence is relatively low. Required educational consultations with clinicians combined with audit-feedback were no more effective at increasing compliance to indicators of quality health record documentation than audit-feedback alone.

  20. Stress in chiropractic education: a student survey of a five-year course.

    Science.gov (United States)

    Hester, Hilary; Cunliffe, Christina; Hunnisett, Adrian

    2013-01-01

    Objective : Stress encompasses academic issues, such as time management, increased work load, and new subject matter, but cannot be separated from stressors, such as social adjustment and financial pressure. Our study investigated whether perceived level of academic or practical attainment and the method of study were associated with the amount of perceived stress during students" studies. Methods : A semi-structured self-administered questionnaire was piloted and distributed to 134 students at a chiropractic college at the end of a lecture. Results : The survey had a response rate of 81%. Students in their fourth year consistently reported the highest perceived levels of stress, with 81% feeling that their ability to study was affected by their financial situation and 56% felt overwhelmed at their ability to cope with their college workload. All year groups were stressed during their course of studies, but the stressor varies depending on the year of study. Conclusions : Year 4 consistently demonstrated the highest levels of stress. All students, regardless of year group, experienced varying degrees of stress while studying and the central stressor changed depending on the time position within the course.

  1. Knowledge, attitudes and practices related to visceral leishmaniasis in rural communities of Amhara State: a longitudinal study in northwest Ethiopia.

    Directory of Open Access Journals (Sweden)

    Noemí López-Perea

    2014-04-01

    Full Text Available BACKGROUND: In the northwest of Ethiopia, at the South Gondar region, there was a visceral leishmaniasis (VL outbreak in 2005, making the disease a public health concern for the regional health authorities ever since. The knowledge on how the population perceives the disease is essential in order to propose successful control strategies. METHODOLOGY/PRINCIPAL FINDINGS: Two surveys on VL knowledge, attitudes and practices were conducted at the beginning (May 2009 and at the end (February 2011 of a VL longitudinal study carried out in rural communities of Libo Kemkem and Fogera, two districts of the Amhara Regional State. Results showed that VL global knowledge was very low in the area, and that it improved substantially in the period studied. Specifically, from 2009 to 2011, the frequency of proper knowledge regarding VL signs and symptoms increased from 47% to 71% (p<0.0001, knowledge of VL causes increased from 8% to 25% (p<0.0001, and knowledge on VL protection measures from 16% to 55% (p<0.0001. Moreover, the improvement observed in VL knowledge was more marked among the families with no previous history of VL case. Finally, in 2011 more than 90% of the households owned at least an impregnated bed net and had been sprayed, and attitudes towards these and other protective measures were very positive (over 94% acceptance for all of them. CONCLUSIONS/SIGNIFICANCE: In 2009 the level of knowledge regarding VL was very low among the rural population of this area, although it improved substantially in the study period, probably due to the contribution of many actors in the area. VL patients and relatives should be appropriately informed and trained as they may act as successful health community agents. VL risk behavioural patterns are subject to change as attitudes towards protective measures were very positive overall.

  2. Promoting Weight Maintenance among Overweight and Obese Hispanic Children in a Rural Practice.

    Science.gov (United States)

    Parra-Medina, Deborah; Mojica, Cynthia; Liang, Yuanyuan; Ouyang, Yongjian; Ramos, Awilda I; Gomez, Ismaela

    2015-08-01

    US Hispanic children experience a disproportionate burden of overweight and obesity. Comprehensive high-intensity behavioral programs have demonstrated effectiveness in improving weight status among obese children. However, there remains a need to develop more efficient interventions that are feasible in primary care and demonstrate effectiveness in Hispanic children. The pilot study used a two-group randomized design. Eligible overweight (BMI between the 85th and 94th percentile for age and gender) or obese (BMI ≥95th percentile) Hispanic children and their parents (N=118 child/parent dyads) were recruited from a rural pediatric clinic and randomized to: standard care (SC; n=61 dyads) or behavioral intervention (INT; n=57 dyads). The primary outcomes-weight, waist circumference, and zBMI-were measured at baseline, 2, 6, and 18 weeks. Multivariate logistic regression was used to examine the effect of INT on the likelihood of weight maintenance adjusting for potential confounding variables. Significantly fewer INT children (68.5%) experienced weight gain, compared to SC children (89.7%; p=0.009). The same pattern was observed for waist circumference, where fewer INT children (44%) experienced an increase in waist circumference, compared to SC children (68.6%; p=0.02). Although a trend of improvement in favor of the INT was observed for zBMI, it was not significant. This study provides preliminary evidence for the feasibility of a primary-care-based approach to promoting weight maintenance among a high-risk population.

  3. Veneration and Spiritual Pleading through Stone: observations and musings on current practice in rural Turkmenistan

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    Glenys McLaren

    2009-09-01

    Full Text Available Although the population of Turkmenistan is essentially Moslem, older traditions co-exist. In the rural areas medical services are poor, infant mortality and maternal mortality and morbidity are higher than in the West, and superstition is rife. Barrenness is considered a female failing. Women of child-bearing age are under great pressure to be fertile, and make spiritual pleas at venerated sites when pregnancy fails to occur or an infant is lost. There is veneration not only of shrines and revered burial sites but also of ancient sites and old dead trees. Many offerings are in the form of stone or fossils, with continued reuse and deposition of ancient materials. Cloth strips and miniature cradles bearing 'babies' are left in association with stones in pleas for child-bearing. Some stones are handled in special ways. One large stone was used for masturbation in the hope of fecundity. The legend of Paraw Bibi incorporates many of the beliefs and features related to rock that occur across many cultures and are common to folklore of old. Resonances of the same thought processes and behaviour patterns could have originated in the ancient past.

  4. Child supervision practices for drowning prevention in rural Bangladesh: a pilot study of supervision tools.

    Science.gov (United States)

    Callaghan, J A; Hyder, A A; Khan, R; Blum, L S; Arifeen, S; Baqui, A H

    2010-07-01

    Injuries are an increasing child health concern and have become a leading cause of child mortality in the 1-4 years age group in many developing countries, including Bangladesh. Household observations during 9 months of a community-based pilot of two supervision tools-a door barrier and a playpen-designed to assess their community acceptability in rural Bangladesh are reported in this article. Statistical analysis of 2694 observations revealed that children were directly supervised or protected by a preventive tool in 96% of visits. Households with a supervision tool had a significantly lower proportion of observations with the child unsupervised and unprotected than households without a tool. Families that received a playpen had 6.89 times the odds of using it at the time of the visit than families that received a door barrier. Interventions such as the playpen, when introduced to households through community-based programs, are accepted by parents. Field trials are urgently needed to establish the effectiveness of barrier-based interventions at reducing under-five drowning mortality rates in low-income countries like Bangladesh.

  5. [The practice of breast feeding in rural communities of a semi-arid area of Bahia].

    Science.gov (United States)

    Assis, A M; Prado, M da S; Freitas, M do C; Silva, R de C; Ramos, L B; Machado, A D

    1994-10-01

    A Research project in the establishment and duration of total and exclusive breast-feeding in rural communities of Cansação, BA, Brazil, is presented. It included 226 children, from zero to two years old, of families of peasants living on small-holdings in one of the driest and poorest regions of the Brazilian Northeast. The data were collected through questionnaires answered by mothers or any adult responsible for the child during 1988 and 1989. It relates to all children from these families who were two years of age at the time of the study. The survival time was the statistical method used to calculate the median duration of breast-feeding; 91.6% of the 226 children started to be breast-fed. This finding shows that the establishment of the breast-feeding was high. The median duration of total breast-feeding was of 90.28 days and exclusive breast-feeding presented a median duration of 0.1 day. Through the establishment of breast-feeding can be considered high, the median duration of total breast-feeding is extremely short and that of exclusive breast-feeding insignificant.

  6. Professional, practice and political issues in the history of New Zealand's remote rural 'backblocks' nursing: the case of Mokau, 1910-1940.

    Science.gov (United States)

    Wood, Pamela J

    2008-10-01

    The new role of 'backblocks' nursing, established in 1909 to provide a nursing, midwifery, emergency and public health service to New Zealand's remote rural regions, created opportunities and challenges for the profession. For three decades, the novel nature of the role also provided numerous stakeholders with the opportunity to contest their authority and influence. This article explores the professional, practice and political issues of backblocks nursing through a case study of Mokau, a remote rural community in the North Island of New Zealand, 1910-1940. In particular, it considers professional issues of recruitment and retention, practice issues in delivering the new service in a challenging environment with few resources, and political issues in defining the scope of nurses' practice and dealing with competing stakeholders keen to determine its potential and limits. These issues were exacerbated by the location of the Mokau district in two administrative health regions.

  7. Physical injury assessment of male versus female chiropractic students when learning and performing various adjustive techniques: a preliminary investigative study

    Directory of Open Access Journals (Sweden)

    Huber Laura L

    2006-08-01

    Full Text Available Abstract Background Reports of musculoskeletal injuries that some chiropractic students experienced while in the role of adjustor became increasingly evident and developed into the basis of this study. The main objective of this study was to survey a select student population and identify, by gender, the specific types of musculoskeletal injuries they experienced when learning adjustive techniques in the classroom, and performing them in the clinical setting. Methods A survey was developed to record musculoskeletal injuries that students reported to have sustained while practicing chiropractic adjustment set-ups and while delivering adjustments. The survey was modeled from similar instruments used in the university's clinic as well as those used in professional practice. Stratified sampling was used to obtain participants for the study. Data reported the anatomical areas of injury, adjustive technique utilized, the type of injury received, and the recovery time from sustained injuries. The survey also inquired as to the type and area of any past physical injuries as well as the mechanism(s of injury. Results Data obtained from the study identified injuries of the shoulder, wrist, elbow, neck, low back, and mid-back. The low back was the most common injury site reported by females, and the neck was the most common site reported by males. The reported wrist injuries in both genders were 1% male complaints and 17% female complaints. A total of 13% of female respondents reported shoulder injuries, whereas less than 1% of male respondents indicated similar complaints. Conclusion The data collected from the project indicated that obtaining further information on the subject would be worthwhile, and could provide an integral step toward developing methods of behavior modification in an attempt to reduce and/or prevent the incidence of musculoskeletal injuries.

  8. Patterns and Determinants of Essential Newborn Care Practices in Rural Areas of Northern Ghana

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    Mahama Saaka

    2014-01-01

    Full Text Available Background. This study was designed to understand the patterns and determinants of three essential newborn care practices: safe cord care, optimal thermal care, and neonatal feeding practices. Methods. A community-based cross-sectional study was carried out on a sample of 404 lactating mothers who have delivered a live baby at home within the past one year prior to the study. Results. Overall, the prevalence of essential newborn practices on safe cord care and optimal thermal care was exceptionally low. Of the 404 newborns, only 0.2% (1 had safe cord care, 5.2% (21 optimal thermal care, and 50.2% (203 were considered to have had adequate neonatal feeding. In logistic regression analysis, the main predictors of good neonatal feeding were maternal age, timing of the first antenatal care (ANC, and maternal knowledge of newborn danger signs. Women who could mention at least 4 danger signs of the neonate were 4 times more likely to give good neonatal feeding to their babies (AOR = 4.7, Cl: 2.43–9.28, P<0.001. Conclusion. Evidence from this study strongly suggests that the expected essential newborn care practices are not available to a substantial number of the newborns. Efforts should therefore be made by the Ghana Health Service (GHS to expand essential newborn care interventions beyond institutional level into the communities.

  9. Lessons for Research Policy and Practice: The Case of Co-Enquiry Research with Rural Communities

    Science.gov (United States)

    Caruso, Emily; Schunko, Christoph; Corbera, Esteve; Ruiz Mallén, Isabel; Vogl, Christian R.; Martin, Gary; Arrázola, Susana; Bandeira, Fábio Pedro; Calvo Boyero, Diana; Camacho Benavides, Claudia; Cardoso, Thiago Mota; Chan-Dzul, Albert; Conde, Esther; del Campo García, Carlos; Huanca, Tomás; Sampaio, José Augusto Laranjeiras; Oliveros Lopez, Sara; Porter-Bolland, Luciana; Ruiz Betancourt, Olga

    2016-01-01

    This article explores the relationship between institutional funding for research and community-based or co-enquiry research practice. It examines the implementation of co-enquiry research in the COMBIOSERVE project, which was funded by the European Commission's Seventh Framework Programme for research and innovation, between the years 2012 and…

  10. General practice in urban and rural Europe: the range of curative services.

    NARCIS (Netherlands)

    Boerma, W.G.W.; Groenewegen, P.P.; Zee, J. van der

    1998-01-01

    The variation in the range of services provided by general practitioners (GPs) is not only related to personal characteristics and features of the country's health care system but also to the geographical circumstances of the practice location. In conurbations health services are more widely

  11. Raising Backyard Poultry in Rural Bangladesh: Financial and Nutritional Benefits, but Persistent Risky Practices

    DEFF Research Database (Denmark)

    Shanta, I. S.; Hasnat, Md A.; Zeidner, N.

    2016-01-01

    was 480%. Yearly, median family consumption of eggs was one-fifth of the total produced eggs and three poultry from their own flock. Respondents’ reported practices conflicted with government recommendations. Sixty per cent of raisers had never heard of avian influenza or ‘bird flu’. Among the respondents...

  12. The Reported Value of Rural Internal Medicine Residency Electives and Factors That Influence Rural Career Choice.

    Science.gov (United States)

    Jensen, Christine C.; DeWitt, Dawn E.

    2002-01-01

    A survey of 58 medical residents participating in a 1-2 month rural elective and 51 matched nonparticipants found that participants' interest in rural practice increased significantly after the elective. Respondents suggested means to increase rural career choice, barriers to rural practice, and ways of increasing the rural elective's influence on…

  13. MENSTRUAL HYGIENE PRACTICES AND RTI AMONG EVER-MARRIED WOMEN IN RURAL SLUM

    Directory of Open Access Journals (Sweden)

    Sadhana Singh

    2011-06-01

    Full Text Available Background:Considering huge burden of RTI across community based study settings- either iatrogenic or endogenous and not necessarily sexually transmitted, menstrual hygiene practices by reproductive age group women have documented evidence of being a key determinant/ predictor of RTI and bear causal association with key Socio-demographic attributes. This is more so in view of vulnerability to health risk, access to treatment and reduced economical choice for a marginal & disadvantaged population like the ‘in-migrants/itinerants. Objectives: 1. To study menstrual hygiene practices of ever-married ‘in-migrant’ women from Dehradun as a key determinant of reproductive health needs. 2. To establish causal association between menstrual hygiene practices and (i key socio-demographic attributes & (ii RTI. Methodology: An observational (cross-sectional study was designed with a probability sample from 5033 ever-married women from 06 ‘make-shift settlements’/slums along immediate precincts i.e 50 meters into the mainland from the banks of rivers ‘Chandrabhaga’, ‘Ganga’, ‘Song’ and ‘Rispana’- all in the district of Dehradun. Result& Conclusion: The present study findings revealed that as key determinant of reproductive health needs, menstrual hygiene practices of the study population bore significant statistical association with their (i literacy status or education (ii religion (iii key reproductive tract infection symptoms and (iv socio-economic status. The findings reinforced the felt need to address knowledge, attitude and practices of the disadvantaged study population by appropriate behaviour change communication, build community & provider capacity and strategies to deliver services at such resource - poor setting keeping in view the four A’s of primary health care.

  14. Prevalence of hypertension and its association with dietary practices in a rural area of Ranchi district of Jharkhand

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    Chandramani Kumar

    2014-12-01

    Full Text Available Background: Hypertension is a major public health problem affecting people across the globe. Rapid change in life style and dietary practices are important factors for increasing prevalence of hypertension. High salt consumption, fat intake and low consumption of dietary fibres are important modifiable risk factors of hypertension. Aims & Objectives: 1 To determine the prevalence of hypertension in community under study. 2 To describe the association of dietary practices and hypertension in community. Materials and Methods: A descriptive cross sectional study in one of the rural field practice area (Ormanjhi of RIMS, Ranchi was done. Sample size was determined using nMaster 2.0 software. Total 500 people were included in the study. Cluster sampling method was adopted to draw the sample. Subjects 20 years and above from both sex were eligible for the study. Pre-tested semi structured questionnaire were used for data collection. Template was generated in MS excel and data analysis was done using SPSS 13 software. Results: Prevalence of hypertension in the present study was found to be 19.8%. Mean systolic and diastolic blood pressure was found to be 122.83 mm of Hg (SD – 15.83 and 79.24 mm of Hg (SD - 8.73 respectively. Prevalence of hypertension was higher among male (22.8% than female (16.5% although this difference was statistically not significant (p – value = 0.075. Prevalence of hypertension was more among non-vegetarians (23.9% compared to vegetarians (8.3%. Added salt intake was found to be significantly associated with hypertension (p - value = 0.023. Conclusions: Prevalence of hypertension was more among male population. Higher prevalence of hypertension was found among subjects with non-vegetarian diet and high salt in their diet.

  15. The role of public health inspectors in maintaining housing in northern and rural communities: recommendations to support public health practice.

    Science.gov (United States)

    Lefebvre, Stephanie; Montgomery, Phyllis; Michel, Isabelle; Warren, Claire; Larose, Tricia; Kauppi, Carol

    2012-01-01

    Although there is much evidence about the effects of particular housing conditions on health, less is known about the practices of public health inspectors (PHIs) in relation to minimizing or eliminating potential housing health risks. The purpose of this qualitative study was to illuminate the practices of PHIs in relation to types of biological and physical housing risks. This study used photo vignettes to focus on PHIs' perceptions, options, and resultant interventions with regards to typical housing risks encountered by PHIs in northeastern Ontario. The vignettes represented two general categories of potential housing risks: biological exposures, and physical characteristics of housing. During a semi-structured interview, 34 PHI participants viewed the vignettes, assessed the housing hazard depicted in each, and described the most appropriate intervention. Traditional content analysis methods were used. The assessment of the physical housing hazards was fairly consistent among the PHIs. There seemed to be more variation in their assessment of risk associated with biological factors. Variation in responses was often explained by their different interpretations of the scope of the provincial legislation as well as local public health unit policies and practices. This study demonstrated that PHIs' assessment and responses to potential physical housing hazards were influenced by an interplay between variables related to residents, local service partners, organizational culture, and policy. The recommendations for action also range from specific public health unit protocol to broader research and policy advocacy initiatives. Collectively, the recommendations focus on strategies for optimizing the role of PHIs in reducing housing health risks in mid-size urban or rural areas.

  16. In a rural area of Bangladesh, traditional birth attendant training improved early infant feeding practices: a pragmatic cluster randomized trial.

    Science.gov (United States)

    Talukder, Shamim; Farhana, Dina; Vitta, Bineti; Greiner, Ted

    2017-01-01

    In rural Bangladesh, most births take place at home. There is little evidence regarding the influence of traditional birth attendants (TBAs) or community volunteers (CVs) on early infant feeding practices. We conducted a pragmatic cluster randomized controlled trial in Panchagarh District to examine the effects of training and post-training supervision of TBAs/CVs on early breastfeeding practices. Nine unions were randomized into three groups of three unions. We compared outcomes between mothers in a control group (CG), those living in unions where TBAs/CVs had received a 5-day training in early feeding practices (TG) and those living in unions where TBAs/CVs were both trained and supervised (SG). A total of 1182 mothers of infants aged 0-6 months were interviewed at baseline. After 6 months of intervention, an endline survey was conducted on a different sample of 1148 mothers of infants aged 0-6 months in the same areas. In both intervention areas, TBAs/CVs made regular home visits and attended births whenever possible. Rates of early initiation of breastfeeding, avoidance of prelacteal feeds and exclusive breastfeeding were compared between groups using cluster-controlled mixed model logistic regression. At endline, both intervention groups had significantly higher proportions of mothers who reported early initiation of breastfeeding (CG: 88%, TG: 96%, SG: 96%) and avoidance of prelacteal feeds (CG: 48%, TG: 80%, SG: 88%) compared with the control group; there were no significant differences between the two intervention groups. The endline rates of reported exclusive breastfeeding were not significantly different among groups (CG: 67%, TG: 76%, SG: 83%). © 2016 John Wiley & Sons Ltd.

  17. Evaluation of Infant and young child feeding through a Trial for Improved Practices (TIPs in rural Varanasi

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    Fahmina Anwar

    2014-12-01

    Full Text Available Background: Intervention targeting exclusive breastfeeding and complementary feeding has the greatest impact on child survival. In view of these facts a formative research was conducted in rural Varanasi with objectives-To assess the status of IYCF practices prevailing in the experimental area and to demonstrate the effect of intervention among selected mothers for improved IYCF practices. Methodology: Follow up intervention study, on 2 types of cohort (0-6 and 7-36 months old mother & child pair conducted for the period of November 2011- October 2012.  Cohorts were followed for a period of 3 months, using a formative research methodology. A total of 293 mother & child pair were enrolled for intervention using appropriate sampling methodology. WHO Infant and Young Child Feeding (IYCF and a child feeding index (CFI were created. The latter consisted of five components: breastfeeding, use of bottle, dietary diversity, food frequency and meal frequency which were adjusted for three age groups: 7-24 and 25-36 months Results: There was inadequacy of optimal breastfeeding and sub optimal Practice regarding Complementary feeding. Measurement of anthropometric Indies indicates that 46.7% were stunted, 35.5% are wasted and 29.6% are underweight. Inferential analysis for Difference in exclusive breast feeding and complementary feeding Index during pre and post TIPs intervention phase indicated a significant (p=0.001 change in exclusive breast and complementary feeding. Conclusion: Study indicated, it is possible to change short-term child-feeding behaviours to promote exclusive breast feeding and complementary feeding using TIPs methodology. However, long-term sustainability of these changes requires further study, and the effect of increased feeding of complementary foods, intakes of breast milk and total daily consumption of energy & nutrients requires further research.

  18. Care-seeking practices in rural Rajasthan: barriers and facilitating factors.

    Science.gov (United States)

    Mohan, P; Iyengar, S D; Agarwal, K; Martines, J C; Sen, K

    2008-12-01

    Poor care seeking contributes significantly to high neonatal mortality in developing countries. The study was conducted to identify care-seeking patterns for sick newborns in rural Rajasthan, India, and to understand family perceptions and circumstances that explain these patterns. Of the 290 mothers interviewed when the infant was 1 to 2 months of age, 202 (70%) reported at least one medical condition during the neonatal period that would have required medical care, and 106 (37%) reported a danger sign during the illness. However, only 63 (31%) newborns with any reported illness were taken to consult a care provider outside home, about half of these to an unqualified modern or traditional care provider. In response to hypothetical situations of neonatal illness, families preferred home treatment as the first course of action for almost all conditions, followed by modern treatment if the child did not get better. For babies born small and before time, however, the majority of families does not seem to have any preference for seeking modern treatment even as a secondary course of action. Perceptions of 'smallness', not appreciating the conditions as severe, ascribing the conditions to the goddess or to evil eye, and fatalism regarding surviving newborn period were the major reasons for the families' decision to seek care. Mothers were often not involved in taking this critical decision, especially first-time mothers. Decision to seek care outside home almost always involved the fathers or another male member. Primary care providers (qualified or unqualified) do not feel competent to deal with the newborns. The study findings provide important information on which to base newborn survival interventions in the study area: need to target the communication initiatives on mothers, fathers and grandmothers, need for tailor-made messages based on specific perceptions and barriers, and for building capacity of the primary care providers in managing sick newborns.

  19. Malaria-related perceptions and practices of women with children under the age of five years in rural Ethiopia

    Directory of Open Access Journals (Sweden)

    Ali Ahmed

    2009-07-01

    Full Text Available Abstract Background Malaria remains to be the major cause of morbidity and mortality among pregnant women and children in Ethiopia. The aim of this study was to investigate the local perceptions, practices and treatment seeking behaviour for malaria among women with children under the age of five years. Methods This community-based study was conducted in 2003 in an area of seasonal malaria transmission in Adami Tulu District, south-central Ethiopia. Total samples of 2087 rural women with children less than five years of age from 18 rural kebeles (the smallest administrative units were interviewed about their perceptions and practices regarding malaria. In addition, focus group discussions and in-depth interviews were conducted on similar issues to complement the quantitative data. Results Malaria, locally known as busaa, is perceived as the main health problem in the study area. Mosquitoes are perceived to be the main cause of the disease, and other misperceptions were also widespread. The use of prevention measures was very low. Most mothers were familiar with the main signs and symptoms of mild malaria, and some of them indicated high grade fever, convulsions and mental confusion as a manifestation of severe malaria. Very few households (5.6% possessed one or two nets. More than 60% of the mothers with recent episodes of malaria received initial treatment from non-public health facilities such as community health workers (CHWs (40% and private care providers (21%. Less than 40% of the reported malaria cases among women were treated by public health facilities. Conclusion Malaria was perceived as the main health problem among women and children. The use of malaria preventive measures was low. A significant proportion of the respondents received initial malaria treatments from CHWs, private care providers and public health facilities. Concerted effort is needed to scale-up the distribution of insecticide-treated nets and improve the knowledge of

  20. Exploring best practices in territorial management for rural tourism and agritourism

    OpenAIRE

    Ciani, Adriano

    2014-01-01

    This paper suggests that we need to change the management strategy of territory to prevent harmful event and natural disasters. We need to move from an “emergency management” to a “preventive management” that tends to preserve the characteristics and potential of the areas. The paper shows in concrete several examples and schemes of the best practices of Sustainable Management and Promotion of Territory–SMPT which can drive toward a Green Virtuous Territory Circuit necessary to guarantee the ...

  1. A randomized clinical trial of chiropractic treatment and self-management in patients with acute musculoskeletal chest pain

    DEFF Research Database (Denmark)

    Stochkendahl, Mette J; Christensen, Henrik W; Vach, Werner;

    2012-01-01

    We have previously reported short-term follow-up from a pragmatic randomized clinical trial comparing 2 treatments for acute musculoskeletal chest pain: (1) chiropractic treatment and (2) self-management. Results indicated a positive effect in favor of the chiropractic treatment after 4 and 12...

  2. 'Offensive' snakes: cultural beliefs and practices related to snakebites in a Brazilian rural settlement

    Directory of Open Access Journals (Sweden)

    Schiavetti Alexandre

    2010-03-01

    Full Text Available Abstract This paper records the meaning of the term 'offense' and the folk knowledge related to local beliefs and practices of folk medicine that prevent and treat snake bites, as well as the implications for the conservation of snakes in the county of Pedra Branca, Bahia State, Brazil. The data was recorded from September to November 2006 by means of open-ended interviews performed with 74 individuals of both genders, whose ages ranged from 4 to 89 years old. The results show that the local terms biting, stinging and pricking are synonymous and used as equivalent to offending. All these terms mean to attack. A total of 23 types of 'snakes' were recorded, based on their local names. Four of them are Viperidae, which were considered the most dangerous to humans, besides causing more aversion and fear in the population. In general, local people have strong negative behavior towards snakes, killing them whenever possible. Until the antivenom was present and available, the locals used only charms, prayers and homemade remedies to treat or protect themselves and others from snake bites. Nowadays, people do not pay attention to these things because, basically, the antivenom is now easily obtained at regional hospitals. It is understood that the ethnozoological knowledge, customs and popular practices of the Pedra Branca inhabitants result in a valuable cultural resource which should be considered in every discussion regarding public health, sanitation and practices of traditional medicine, as well as in faunistic studies and conservation strategies for local biological diversity.

  3. 'Offensive' snakes: cultural beliefs and practices related to snakebites in a Brazilian rural settlement

    Science.gov (United States)

    2010-01-01

    This paper records the meaning of the term 'offense' and the folk knowledge related to local beliefs and practices of folk medicine that prevent and treat snake bites, as well as the implications for the conservation of snakes in the county of Pedra Branca, Bahia State, Brazil. The data was recorded from September to November 2006 by means of open-ended interviews performed with 74 individuals of both genders, whose ages ranged from 4 to 89 years old. The results show that the local terms biting, stinging and pricking are synonymous and used as equivalent to offending. All these terms mean to attack. A total of 23 types of 'snakes' were recorded, based on their local names. Four of them are Viperidae, which were considered the most dangerous to humans, besides causing more aversion and fear in the population. In general, local people have strong negative behavior towards snakes, killing them whenever possible. Until the antivenom was present and available, the locals used only charms, prayers and homemade remedies to treat or protect themselves and others from snake bites. Nowadays, people do not pay attention to these things because, basically, the antivenom is now easily obtained at regional hospitals. It is understood that the ethnozoological knowledge, customs and popular practices of the Pedra Branca inhabitants result in a valuable cultural resource which should be considered in every discussion regarding public health, sanitation and practices of traditional medicine, as well as in faunistic studies and conservation strategies for local biological diversity. PMID:20346120

  4. 'Offensive' snakes: cultural beliefs and practices related to snakebites in a Brazilian rural settlement.

    Science.gov (United States)

    Fita, Dídac S; Costa Neto, Eraldo M; Schiavetti, Alexandre

    2010-03-26

    This paper records the meaning of the term 'offense' and the folk knowledge related to local beliefs and practices of folk medicine that prevent and treat snake bites, as well as the implications for the conservation of snakes in the county of Pedra Branca, Bahia State, Brazil. The data was recorded from September to November 2006 by means of open-ended interviews performed with 74 individuals of both genders, whose ages ranged from 4 to 89 years old. The results show that the local terms biting, stinging and pricking are synonymous and used as equivalent to offending. All these terms mean to attack. A total of 23 types of 'snakes' were recorded, based on their local names. Four of them are Viperidae, which were considered the most dangerous to humans, besides causing more aversion and fear in the population. In general, local people have strong negative behavior towards snakes, killing them whenever possible. Until the antivenom was present and available, the locals used only charms, prayers and homemade remedies to treat or protect themselves and others from snake bites. Nowadays, people do not pay attention to these things because, basically, the antivenom is now easily obtained at regional hospitals. It is understood that the ethnozoological knowledge, customs and popular practices of the Pedra Branca inhabitants result in a valuable cultural resource which should be considered in every discussion regarding public health, sanitation and practices of traditional medicine, as well as in faunistic studies and conservation strategies for local biological diversity.

  5. Chiropractic care for paediatric and adolescent Attention-Deficit/Hyperactivity Disorder: A systematic review

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    Bonello Rod

    2010-06-01

    Full Text Available Abstract Background Psychostimulants are first line of therapy for paediatric and adolescent AD/HD. The evidence suggests that up to 30% of those prescribed stimulant medications do not show clinically significant outcomes. In addition, many children and adolescents experience side-effects from these medications. As a result, parents are seeking alternate interventions for their children. Complementary and alternative medicine therapies for behavioural disorders such as AD/HD are increasing with as many as 68% of parents having sought help from alternative practitioners, including chiropractors. Objective The review seeks to answer the question of whether chiropractic care can reduce symptoms of inattention, impulsivity and hyperactivity for paediatric and adolescent AD/HD. Methods Electronic databases (Cochrane CENTRAL register of Controlled Trials, Cochrane Database of Systematic reviews, MEDLINE, PsycINFO, CINAHL, Scopus, ISI Web of Science, Index to Chiropractic Literature were searched from inception until July 2009 for English language studies for chiropractic care and AD/HD. Inclusion and exclusion criteria were applied to select studies. All randomised controlled trials were evaluated using the Jadad score and a checklist developed from the CONSORT (Consolidated Standards of Reporting Trials guidelines. Results The search yielded 58 citations of which 22 were intervention studies. Of these, only three studies were identified for paediatric and adolescent AD/HD cohorts. The methodological quality was poor and none of the studies qualified using inclusion criteria. Conclusions To date there is insufficient evidence to evaluate the efficacy of chiropractic care for paediatric and adolescent AD/HD. The claim that chiropractic care improves paediatric and adolescent AD/HD, is only supported by low levels of scientific evidence. In the interest of paediatric and adolescent health, if chiropractic care for AD/HD is to continue, more rigorous

  6. Predictors of ante-natal care, delivery and infant feeding practices among rural women in Madhya Pradesh, India

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    Indrapal Ishwarji Meshram

    2014-10-01

    Full Text Available Background: Maternal and infant mortality rates and prevalence of under nutrition are high in the State Madhya Pradesh. Regular ante-natal check-ups (ANC, delivery by trained health personnel, delivery practices and optimal infant feeding practices are important to reduce maternal and infant mortality. Objectives: The aim was to assess antenatal care, delivery and infant feeding practices of mothers of <1-year-old children in Madhya Pradesh. Materials and Methods: This was community-based cross-sectional study carried out in the rural areas of Madhya Pradesh by adopting systematic random sampling procedure. Data were collected from 5324 mothers having <1-year-old children. Information on household (HH socioeconomic and demographic particulars was collected from the mothers. Bivariate and multivariate analysis was performed to study the association between dependent and independent variables. Results and Interpretations: About 36% mothers had undergone at least three ante-natal check-ups and 73% delivered either at government or private hospitals. Only 26% mothers initiated breastfeeding within 1-h of birth and 92% fed colostrum. Step-wise regression analysis showed that ante-natal care for <3 times was significantly (P < 0.01 higher among women with high parity (≥5, illiterate women, and among lower socioeconomic group,s while home delivery was higher among women with high parity (≥5 (odds ratio [OR]: 2.3, among Scheduled Caste and Tribe women (OR: 1.5, illiteracy of head of HH (OR: 2, and among lower socioeconomic groups (OR: 1.3. Discarding colostrum was higher among illiterate women (OR: 1.6, belonging to lower socioeconomic groups (OR: 1.4 and delivery conducted by untrained person (OR: 3.9, while initiation of breastfeeding after 1-h of childbirth was higher among ≥30 years women (OR: 1.9, illiterate women (OR: 1.4, and delivery by untrained person (OR: 2.9. Conclusions: It was observed that antenatal care, delivery and infant and

  7. Navigating the science-policy-practice interface in rural SW China

    Science.gov (United States)

    Naylor, Larissa; Zheng, Ying; Oliver, David; Buckerfield, Sarah; Peng, Tao; Wang, Shijie; Waldron, Susan

    2017-04-01

    There is growing academic, funder and government interest in developing effective methods of successfully navigating the science-policy-practice interface. The practice of interaction between the science community and policy and practice is often termed 'knowledge exchange'. This involves the two-way co-production of knowledge between researchers and practitioners to improve the usefulness of science for society. We report here on an examination of current knowledge exchange understanding and practice by critical zone scientists in the UK and China, as well as report on surveys of 24 leaders from county to village levels of governance and 312 farmers. The practitioner data were collected in Puding catchment, Guizhou province, China as part of a joint UK-China funded research programme that is designed to help improve the resiliency of fragile karst agricultural landscapes in this region. We asked each group of participants (scientists, leaders (county, town and village) and farmers) about their experience of knowledge exchange, of working with each other and how they would like to learn. These data show that UK based scientists have more understanding and experience of knowledge exchange than the Chinese scientists. They also demonstrate consistencies in the types of KE processes (farm visits) that were most suitable, and variation between these methods and those that we identified as being suitable in the project proposal (e.g. decision support tool). Semi-structured interviews were used to gain greater insight into the science-policy-practice interface, where it was evident that farmers had little or no direct interaction with scientists, where the majority of training is delivered county-level schemes where scientists are appointed to deliver the training. Between village differences in understanding of critical zone science issues and access to training and advice were evident. All practitioners surveyed were very enthusiastic about the science team returning

  8. In Pursuit of Best Practices: A Research Agenda for Rural Education in Illinois. Rural Research Report. Volume 16, Issue 7, Summer 2005

    Science.gov (United States)

    Collins, Timothy

    2005-01-01

    This report discusses the need for a research agenda to understand how rural public schools can work with their communities to improve student performance while building the community. It focuses on the potential strengths of school-community relationships. Described herein are four community engagement models a school can adopt: (1) School as…

  9. Alternative futures: Fields, boundaries, and divergent professionalisation strategies within the Chiropractic profession.

    Science.gov (United States)

    Brosnan, Caragh

    2017-08-19

    Sociological studies of the complementary and alternative medicine (CAM) occupations have documented the professionalisation strategies these groups use to establish boundaries between themselves and their competitors, including seeking educational accreditation and statutory regulation/licensure. Chiropractic has been particularly successful at professionalising and in Australia and the UK it is taught within public universities. Recent events have threatened chiropractic's university foothold, however, showing that professionalisation needs to be understood as an ongoing process of negotiation. Based on interviews with chiropractors in Australia and the UK, this paper examines the professionalisation strategies deployed by chiropractors within and outside of the university. Highly divergent strategies are identified across different sectors of the profession, relating to defining the chiropractic paradigm, directing education and constructing professional identity. In each domain, chiropractic academics tended to prioritise building the evidence base and becoming more aligned with medicine and other allied health professions. Although some practitioners supported this agenda, others strove to preserve chiropractic's vitalistic philosophy and professional distinction. Following Bourdieu, these intra-professional struggles are interpreted as occurring within a field in which chiropractors compete for different forms of capital, pulled by two opposing poles. The differing orientations and strategies pursued at the two poles of the field point to a number of possible futures for this CAM profession, including a potential split within the profession itself. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. 'Offensive' snakes: cultural beliefs and practices related to snakebites in a Brazilian rural settlement

    OpenAIRE

    Schiavetti Alexandre; Neto Eraldo; Fita Dídac S

    2010-01-01

    Abstract This paper records the meaning of the term 'offense' and the folk knowledge related to local beliefs and practices of folk medicine that prevent and treat snake bites, as well as the implications for the conservation of snakes in the county of Pedra Branca, Bahia State, Brazil. The data was recorded from September to November 2006 by means of open-ended interviews performed with 74 individuals of both genders, whose ages ranged from 4 to 89 years old. The results show that the local ...

  11. Results of a survey to determine demographic and business management factors associated with size and growth rate of rural mixed-animal veterinary practices.

    Science.gov (United States)

    Brusk, Amy M; White, Brad J; Goehl, Dan R; Dhuyvetter, Kevin C

    2010-12-15

    To determine potential associations between demographic and business management factors and practice size and growth rate in rural mixed-animal veterinary practices. Cross-sectional survey. 54 mixed-animal practitioners. A cross-sectional survey (96 questions) was electronically disseminated. Responses were collected, and outcomes (number of veterinarians [NV], growth in number of veterinarians [NVG], gross practice income [GPI], growth in gross practice income [GPIG], gross practice income per veterinarian [GPIV], and growth in gross practice income per veterinarian [GPIVG]) were calculated. Bivariate analyses were performed and multivariable models created to determine associations between survey responses and outcomes of interest. Survey respondents were from mixed-animal practices, and most (46/54 [85.2%]) practiced in small communities (business manager. Typically, practices had positive mean growth in NVG (4.4%), GPIG (8.5%), and GPIVG (8.1%), but growth rate was highly variable among practices. Factors associated with growth rate included main species interest, frequency for adjusting prices, use of a marketing plan, service fee structure, and sending a client newsletter. Mixed-animal practices had a large range in size and growth rate. Economic indices were impacted by common business management practices.

  12. Reflexive assessment of practical and holistic sanitation development tools using the rural and peri-urban case of Mexico.

    Science.gov (United States)

    Tiberghien, J E; Robbins, P T; Tyrrel, S F

    2011-03-01

    Lack of sanitation affects the lives of billions of people worldwide. It is now generally agreed that sustainable solutions to this complex problem require social and cultural factors to be addressed in addition to the habitual economic and technical aspects. Increasingly, sector professionals view the fragmented approaches to sanitation as a limiting factor. This refers to the fragmentation of the knowledge on the subject among often hermetic disciplines and to the distribution of political mandates on sanitation across many institutions, which independently tackle specific aspects of the issue. Holistic approaches have often been suggested as a solution. This paper presents the development of such a holistic approach, designed to assess sanitation development in rural and peri-urban settings. Tested in three Mexican communities, it relies on qualitative research tools to identify critical influences to sanitation development. This article presents generic results about micro and macro-factors affecting sanitation development in Mexican villages, and reflexively examines the research process as well as the strengths and limitations of the approach. The conceptual map developed for each case study successfully highlights the interconnectedness of all factors affecting sanitation development. Despite some weaknesses, these maps constitute a practical assessment tool for interdisciplinary teams deployed in integrated water and sanitation development programs and a valuable didactic tool for training activities.

  13. Prescribing practices of topical corticosteroids in the outpatient dermatology department of a rural tertiary care teaching hospital.

    Science.gov (United States)

    Rathod, Suvarna S; Motghare, Vijay M; Deshmukh, Vinod S; Deshpande, Rushikesh P; Bhamare, Chetanraj G; Patil, Jyoti R

    2013-09-01

    Inappropriate or excessive use of topical corticosteroids can lead to cutaneous and systemic adverse effects which occur more commonly with the use of very potent steroids. Monitoring and analysis of the prescription practices of topical steroids can help to achieve rational prescription of these drugs. The present study was carried out to study and analyze the pattern of prescribing topical corticosteroids among outpatients attending the dermatology clinic in a rural tertiary care and teaching hospital, Ambajogai, Maharashtra. A cross-sectional descriptive study was conducted for a duration of two months from August 2011 to September 2011, and 500 prescriptions were randomly collected from the dermatology pharmacy and analyzed. About 66% of the prescriptions contained four to five drugs per prescription. Topical steroids were given in 28.4% of all the prescriptions. In almost all the prescriptions, strength, quantity of the steroid to be used, frequency, site, and duration of application was not mentioned. The chief complaints and diagnoses were not mentioned in about 85% of the prescriptions for topical corticosteroids. About 94.36% of the prescriptions contained very potent steroids. Inadequate prescribing information is a clear characteristic of the dermatological prescriptions containing topical corticosteroids. Doctors should be educated about the importance of giving patients sufficient information regarding the use of steroids. There is a need to revise hospital formulary where low-potency steroids can also be included along with potent ones so that the latter can be avoided in conditions where they are unnecessary.

  14. Rural Education Issues: Rural Administrators Speak Out

    Science.gov (United States)

    Williams, Julia; Nierengarten, Gerry

    2010-01-01

    The purpose of this study was to identify the issues that most affect Minnesota's rural public school administrators as they attempt to fulfill the mandates required from state legislation and communities. A second purpose was to identify exemplary practices valued by individual Minnesota rural schools and districts. Electronic surveys were sent…

  15. The Nordic maintenance care program – case management of chiropractic patients with low back pain: A survey of Swedish chiropractors

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    Jørgensen Kristian

    2008-06-01

    Full Text Available Abstract Background Chiropractic treatment for low back pain (LBP can often be divided into two phases: Initial treatment of the problem to attempt to remove pain and bring it back into its pre-clinical or maximum improvement status, and "maintenance care", during which it is attempted to maintain this status. Although the use of chiropractic maintenance care has been described and discussed in the literature, there is no information as to its precise indications. The objective of this study is to investigate if there is agreement among Swedish chiropractors on the overall patient management for various types of LBP-scenarios, with a special emphasis on maintenance care. Method The design was a mailed questionnaire survey. Members of the Swedish Chiropractors' Association, who were participants in previous practice-based research, were sent a closed-end questionnaire consisting of nine case scenarios and six clinical management alternatives and the possibility to create one's own alternative, resulting in a "nine-by-seven" table. The research team defined its own pre hoc choice of "clinically logical" answers based on the team's clinical experience. The frequency of findings was compared to the suggestions of the research team. Results Replies were received from 59 (60% of the 99 persons who were invited to take part in the study. A pattern of self-reported clinical management strategies emerged, largely corresponding to the "clinically logical" answers suggested by the research team. In general, patients of concern would be referred out for a second opinion, cases with early recovery and without a history of previous low back pain would be quickly closed, and cases with quick recovery and a history of recurring events would be considered for maintenance care. However, also other management patterns were noted, in particular in the direction of maintenance care. Conclusion To a reasonable extent, Swedish chiropractors participating in this

  16. A Nutrition Education Program in Rural Bangladesh Was Associated with Improved Feeding Practices but Not with Child Growth.

    Science.gov (United States)

    Owais, Aatekah; Schwartz, Benjamin; Kleinbaum, David G; Suchdev, Parminder S; Faruque, Abu Syed Golam; Das, Sumon K; Rahman, Shahed; Stein, Aryeh D

    2017-05-01

    Background: Childhood undernutrition is a major public health problem in Bangladesh. Evaluating child nutrition programs is a priority.Objective: The objective of this study was to evaluate a community-based nutrition education program (implemented from 2011 to 2013) aimed at improving infant and young child feeding (IYCF) practices and growth in rural Bangladesh.Methods: A cohort-based evaluation was conducted that included 2400 women (1200 from Karimganj, the intervention subdistrict, and 1200 from Katiadi, the control subdistrict) enrolled at 28-31 wk gestation in 3 waves between January and October 2011. Follow-up occurred at 3, 9, 16, and 24 mo of offspring age. The main outcomes were exclusive breastfeeding (EBF), measured at 3 mo, timing of complementary feeding (CF) initiation and minimum acceptable diet (MAD), measured at 9 mo, and child growth [assessed via length-for-age z score (LAZ) and weight-for-length z score], measured at all follow-ups. The main exposures were subdistrict of residence and wave of enrollment. For IYCF practices as outcome, logistic regressions were used. Generalized estimating equations were used for child growth as outcome.Results: EBF rates at 3 mo remained unchanged between waves 1 and 3 in Karimganj (55.6% compared with 57.3%), but the proportion of infants receiving timely CF initiation and MAD at 9 mo increased significantly (CF: 27.1-54.7%; MAD: 8.4-35.3%). Mean LAZ at 24 mo remained unchanged between waves 1 and 3 in Karimganj (-2.18 compared with -1.98).Conclusions: The program was successful in improving the quality of infant diet at 9 mo and timely CF initiation, but not EBF at 3 mo or LAZ. These findings support the case for implementing simple messages in all programs aimed at improving infant diet, especially in settings in which supplementing overall household diet may not be feasible. © 2017 American Society for Nutrition.

  17. Linking River Basin Modifications and Rural Soil and Water Management Practices in Tropical Deltas to Sea Level Rise Vulnerability

    Science.gov (United States)

    Rogers, K. G.; Brondizio, E.; Roy, K.; Syvitski, J. P.

    2015-12-01

    The increased vulnerability of deltaic communities to coastal flooding as a result of upstream engineering has been acknowledged for decades. What has received less attention is the sensitivity of deltas to the interactions between river basin modifications and local scale cultivation and irrigation. Combined with reduced river and sediment discharge, soil and water management practices in coastal areas may exacerbate the risk of tidal flooding, erosion of arable land, and salinization of soils and groundwater associated with sea level rise. This represents a cruel irony to smallholder subsistence farmers whose priorities are food, water and economic security, rather than sustainability of the environment. Such issues challenge disciplinary approaches and require integrated social-biophysical models able to understand and diagnose these complex relationships. This study applies a new conceptual framework to define the relevant social and physical units operating on the common pool resources of climate, water and sediment in the Bengal Delta (Bangladesh). The new framework will inform development of a nested geospatial analysis and a coupled model to identify multi-scale social-biophysical feedbacks associated with smallholder soil and water management practices, coastal dynamics, basin modification, and climate vulnerability in tropical deltas. The framework was used to create household surveys for collecting data on climate perceptions, land and water management, and governance. Test surveys were administered to rural farmers in 14 villages during a reconnaissance visit to coastal Bangladesh. Initial results demonstrate complexity and heterogeneity at the local scale in both biophysical conditions and decision-making. More importantly, the results illuminate how national and geopolitical-level policies scale down to impact local-level environmental and social stability in communities already vulnerable to coastal flooding. Here, we will discuss components of the

  18. Determinants of appropriate child health and nutrition practices among women in rural Gambia.

    Science.gov (United States)

    Mwangome, Martha; Prentice, Andrew; Plugge, Emma; Nweneka, Chidi

    2010-04-01

    Health education and awareness involves providing knowledge about causes of illness and choices to promote a change in individual behaviour and, thus, improves survival of individuals. Studies have, however, shown that improved knowledge and awareness is not always translated into appropriate actions. This study aimed at exploring the factors determining mothers' choices of appropriate child health and nutrition practices in the Gambia. Eight focus-group discussions (FGDs) were held with 63 women whose children had been seen at the Keneba MRC Clinic within the 12 months preceding the study. The FGDs were analyzed using a thematic framework. Gender inequality, presence or absence of support networks, alternative explanatory models of malnutrition, and poverty were identified as the main factors that would determine the ability of a mother to practise what she knows about child health and nutrition. The findings highlight the need to consider the broader social, cultural and economic factors, including the value of involving men in childcare, when designing nutritional interventions.

  19. mHealth Series: Text messaging data collection of infant and young child feeding practice in rural China – A feasibility study

    Directory of Open Access Journals (Sweden)

    Xiaozhen Du

    2013-12-01

    Full Text Available Face–to–face interviews by trained field workers are commonly used in household surveys. However, this data collection method is labor–intensive, time–consuming, expensive, prone to interviewer and recall bias and not easily scalable to increase sample representativeness. The study explored the feasibility of using text messaging to collect information on infant and young child feeding practice in rural China.

  20. Congestive heart failure: a review and case report from a chiropractic teaching clinic.

    Science.gov (United States)

    Osterhouse, Melanie D; Kettner, Norman W; Boesch, Ron

    2005-06-01

    To discuss the case of a 62-year-old woman with congestive heart failure (CHF), precipitated by a previous arteriovenous malformation, and to review the clinical presentation, pathophysiology, and treatment options for patients with CHF. The patient complained of pain, rapid weight gain, and shortness of breath. The index event for this patient was known to be an arteriovenous malformation. Biventricular cardiomegaly with pulmonary venous hypertension was evident on chest radiographs. The patient received both medical care (drug therapy) and chiropractic care (manipulation and soft tissue techniques to alleviate symptoms and discomfort). Patients with known and undiagnosed CHF may visit the chiropractic physician; thus, knowledge of comprehensive care, differential diagnosis, and continuity of care are important. Chiropractic management may be helpful in alleviating patient discomfort. Further clinical investigations may help to clarify the role of complementary and alternative care in the diagnosis and treatment of CHF.

  1. Chiropractic Treatment for Gastrointestinal Problems: A Systematic Review of Clinical Trials

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    E Ernst

    2011-01-01

    Full Text Available Many chiropractors believe that chiropractic treatments are effective for gastrointestinal disorders. The aim of the present systematic review was to critically evaluate the evidence from controlled clinical trials supporting or not supporting this notion. Six electronic databases were searched for relevant studies. No limits were applied to language or publication date. Prospective, controlled, clinical trials of any type of chiropractic treatment for any type of gastrointestinal problem, except infant colic, were included. Only two trials were found – one was a pilot study, and the other had reached a positive conclusion; however, both had serious methodological flaws. There is no supportive evidence that chiropractic is an effective treatment for gastrointestinal disorders.

  2. Analysis of zygapophyseal joint cracking during chiropractic manipulation.

    Science.gov (United States)

    Reggars, J W; Pollard, H P

    1995-02-01

    To determine if there is a relationship between the side of head rotation and the side of joint crack during "diversified" rotatory manipulation of the cervical spine. Randomized experimental study. Macquarie University, Centre for Chiropractic, Summer Hill, New South Wales. Fifty asymptomatic subjects were recruited from the students and staff of the above college. Single, unilateral "diversified," high velocity, low amplitude, rotatory thrust technique. Joint crack sound wave analysis of digital audio tape (DAT) recordings, taken from two skin mounted microphones positioned on either side of the cervical spine. All 50 subjects exhibited at least one audible joint crack sound during manipulation. Forty-seven subjects (94%) exhibited cracking on the ipsilateral side to head rotation (95% confidence interval, 83.5% to 98.7%). One subject exhibited joint cracking on the contralateral side only, while two subjects exhibited bilateral joint crack sounds. There was a statistically significant lower rate of exclusively ipsilateral joint cracking in subjects with a history of neck trauma (80% vs. 100%, p = .023). This research suggests that during the "diversified" rotatory manipulation of the cervical spine utilized in this study, there is a higher occurrence of the joint crack on the ipsilateral side to head rotation.

  3. Test anxiety and academic performance in chiropractic students.

    Science.gov (United States)

    Zhang, Niu; Henderson, Charles N R

    2014-01-01

    Objective : We assessed the level of students' test anxiety, and the relationship between test anxiety and academic performance. Methods : We recruited 166 third-quarter students. The Test Anxiety Inventory (TAI) was administered to all participants. Total scores from written examinations and objective structured clinical examinations (OSCEs) were used as response variables. Results : Multiple regression analysis shows that there was a modest, but statistically significant negative correlation between TAI scores and written exam scores, but not OSCE scores. Worry and emotionality were the best predictive models for written exam scores. Mean total anxiety and emotionality scores for females were significantly higher than those for males, but not worry scores. Conclusion : Moderate-to-high test anxiety was observed in 85% of the chiropractic students examined. However, total test anxiety, as measured by the TAI score, was a very weak predictive model for written exam performance. Multiple regression analysis demonstrated that replacing total anxiety (TAI) with worry and emotionality (TAI subscales) produces a much more effective predictive model of written exam performance. Sex, age, highest current academic degree, and ethnicity contributed little additional predictive power in either regression model. Moreover, TAI scores were not found to be statistically significant predictors of physical exam skill performance, as measured by OSCEs.

  4. Outcomes of usual chiropractic, harm & efficacy, the ouch study: study protocol for a randomized controlled trial

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    Walker Bruce F

    2011-10-01

    Full Text Available Abstract Background Previous studies have demonstrated that adverse events occur during chiropractic treatment. However, because of these studies design we do not know the frequency and extent of these events when compared to sham treatment. The principal aims of this study are to establish the frequency and severity of adverse effects from short term usual chiropractic treatment of the spine when compared to a sham treatment group. The secondary aim of this study is to establish the efficacy of usual short term chiropractic care for spinal pain when compared to a sham intervention. Methods One hundred and eighty participants will be randomly allocated to either usual chiropractic care or a sham intervention group. To be considered for inclusion the participants must have experienced non-specific spinal pain for at least one week. The study will be conducted at the clinics of registered chiropractors in Western Australia. Participants in each group will receive two treatments at intervals no less than one week. For the usual chiropractic care group, the selection of therapeutic techniques will be left to the chiropractors' discretion. For the sham intervention group, de-tuned ultrasound and de-tuned activator treatment will be applied by the chiropractors to the regions where spinal pain is experienced. Adverse events will be assessed two days after each appointment using a questionnaire developed for this study. The efficacy of short term chiropractic care for spinal pain will be examined at two week follow-up by assessing pain, physical function, minimum acceptable outcome, and satisfaction with care, with the use of the following outcome measures: Numerical Rating Scale, Functional Rating Index, Neck Disability Index, Minimum Acceptable Outcome Questionnaire, Oswestry Disability Index, and a global measure of treatment satisfaction. The statistician, outcome assessor, and participants will be blinded to treatment allocation. Trial

  5. Feeding practices and non-nutritive sucking habits in children from rural Paraíba

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    Franklin Delano Soares Forte

    2011-06-01

    Full Text Available Objectives: To verify the patterns of breastfeeding and frequency of non-nutritive sucking habits in children at Chã de Areia Family Health Unit (FHU in Mogeiro-PB. Methods: A cross-sectional descriptive study involving 71 mothers of children aged 0 to 24 months. The instrument was a structured interview, being performed by a single professional. Results: We found that 67 (94.4% children were breast fed, being exclusive until 3months old in 35 (49.3% of these. In relation to artificial feeding, 38 (53.5% did it. Regarding the use of other forms of ingestion, spoons/cups were the most mentioned by 51 (71.8% mothers. About 38 (53.5% interviewers reported that the contents of the bottle mostly used was artificialmilk associated to sugar and farinaceous dough, and 43 (60.2% confirmed the presence of non-nutritive sucking habits. Conclusion: The practice of breastfeeding in the region was reported by many mothers; however we observed an early introduction of bottles and of other foods, especially artificial milk and/or sugar in the diet of children. The prevalence of habits was significant in the sample.

  6. Anaemia in infancy in rural Bangladesh: contribution of iron deficiency, infections and poor feeding practices.

    Science.gov (United States)

    Rawat, Rahul; Saha, Kuntal Kumar; Kennedy, Andrew; Rohner, Fabian; Ruel, Marie; Menon, Purnima

    2014-01-14

    Few data exist on the aetiology of anaemia and Fe deficiency (ID) during early infancy in South Asia. The present study aimed to determine the contribution of ID, infections and feeding practices to anaemia in Bangladeshi infants aged 6-11 months. Baseline data from 1600 infants recruited into a cluster-randomised trial testing the effectiveness of micronutrient powder sales by frontline health workers on the prevalence of anaemia were used. Multivariate logistic regression was used to identify risk factors for anaemia and ID, and population attributable fractions (PAF) were computed to estimate the proportion of anaemia that might be prevented by the elimination of individual risk factors. It was found that 68 % of the infants were anaemic, 56 % were Fe deficient, and one-third had evidence of subclinical infections. The prevalence of anaemia and ID increased rapidly, until 8-9 months of age, while that of subclinical infections was constant. ID (adjusted OR (AOR) 2·6-5·0; Panaemia, in addition to age and male sex. Similarly, subclinical infections, age and male sex were significant risk factors for ID. Previous-day consumption of Fe-rich foods was very low and not associated with anaemia or ID. The PAF of anaemia attributable to ID was 67 % (95 % CI 62, 71) and that of subclinical infections was 16 % (95 % CI 11, 20). These results suggest that a multipronged strategy that combines improvements in dietary Fe intake alongside infection control strategies is needed to prevent anaemia during infancy in Bangladesh.

  7. CIRCULAR ECONOMY AND SUSTAINABLE RURAL DEVELOPMENT. THEORY AND BEST PRACTICE: A CHALLENGE FOR ROMANIA

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    ADRIANO CIANI

    2016-12-01

    Full Text Available The implementation of the Sustainable Development Strategy through the Sustainable Development Goals 2015-2030 needs take into consideration the EU’ package from December 2015 concerning the achievement of the Circular Economy under the vision of the 3R - Recycle, Reuse, Reduce. The concept of Circular Economy has started to develop in response to the crisis of the traditional model and the need to deal with limited resources. A key role in the pursuit and implementation of circular economy is taken by investments in innovation and technologies that enhance the scraps of industrial and / or agricultural sectors. This can lead not only to a reduction of waste and hence environmental impacts but also in net savings for businesses of up to 604 billion Euros throughout the European Union, in line with the global framework (Sustainable Development Goals 2015 -2030. The paper try to demonstrate through an inductive model, several tables, figures and our analysis that the success of the Strategy of Sustainable Development depend, in the next years, by the application of the best practices of the Circular Economy.

  8. Knowledge of diabetes mellitus in privately- funded diabetic patients attending a rural optometric practice in Malmesbury, South Africa*

    Directory of Open Access Journals (Sweden)

    K. C. Phillips

    2012-12-01

    Full Text Available Patient knowledge about diabetes mellitus (DM and appropriate timely management with respect to the condition are important factors for limiting the complications of the disease. The aim of this study was to evaluate knowledge and practices regarding DM, its ocular effects and management protocols among privately-funded diabetic patients. A questionnaire containing questions on these issues and certain demographics was provided to 73 self-funding or privately-funded diabetic patients attending an optometric practice in a rural district of the Western Cape. Respondents ages ranged from 33 to 80 years (mean = 57 ± 11.2 years and included 59% males and 41% females. Above half(56% of the respondents knew that there were two main types of DM. Less than half (46% of the respondents reported having Type 2 DM, 4% reported having Type 1 DM and 49% did not knowwhat type of DM they had. Although 82% of the respondents reported owning a glucometer and 98% knew that controlling their blood sugar levels may help reduce diabetic complications, only 29% measured their blood sugar levels on a daily basis. Most respondents (97% agreed that DM could affect their vision yet only 37% stated that they had annual eye examinations. A significant proportion of the respondents did not know that DM could cause strabismus (57%, colour vision problems (44%, cataracts (41%, retinopathy (37% and contribute to causing glaucoma (63%. Most respondents took their medication regularly and as prescribed (89% and underwent regular medical check-ups (82%. However, a large proportion of the respondents did not exercise regularly (61%, had no regular eye testing (63% nor Body Mass Index (BMI monitoring (84% in their manage-ment of DM. This study indicates that, despite access to private health care, these subjects level of knowledge of DM and its ocular effects was sub-optimal. It also indicated poor self-management practices of the diabetic patients towards diabetes care and

  9. Internal carotid artery dissection following chiropractic treatment in a pregnant woman with Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Morton Adam

    2012-12-01

    Full Text Available Abstract A case of internal carotid artery dissection in a pregnant woman with Systemic Lupus Erythematosus (SLE immediately following chiropractic treatment is presented. The literature regarding complications of neck manipulation during pregnancy, spontaneous dissection of craniocervical arteries in pregnancy and the postpartum period, and dissection of craniocervical arteries in SLE are reviewed. To the best of the author’s knowledge, this is the first case of carotid artery dissection following chiropractic treatment in a pregnant woman published in the literature.

  10. TEMPORARY CONTRACEPTION PRACTICES AMONG ELIGIBLE COUPLES IN A RURAL AREA OF CHITTOOR DISTRICT , A. P

    Directory of Open Access Journals (Sweden)

    Gopi Krishna

    2015-07-01

    Full Text Available BACKGROUND: Family welfare services prevent one third of all maternal deaths by allowing women to delay motherhood, space births, avoid unintended pregnancies & unsafe abortions and stop child bearing when they have reached their desired family size. However, national - level surveys show that the adoption of contraceptive methods for spacing has remained low in India. In this context, this present study was conducted to find out the awareness and practice of temporary contraceptive methods among the eligible couples and its association with certain socio - demographic factors. MATERIAL & METHODS : This present study is a cross sectional analytical study carried out in the Pakala Primary Health Centre (PHC in Chittoor district of Andhra Pradesh among 6 , 206 eligible couples during January to June 2015. The findings were analysed using Epiinfo software 7 version (CDC, Atlanta, USA. RESULTS : The awareness regarding oral contraceptive pills (56.4% and i ntrauterine devices (50.0 was found to be relatively higher compared to other methods and least with injectable contraceptives (6.8%. The oral contraceptive pill was found to be the most preferred method of contraception (5.7% followed by intrauterine d evices (4.4% while condom usage was the least preferred method (1.9%. The health worker was the most common person providing motivation for family planning (65.0% followed by friends and neighbours (25.9%. Overall, the temporary contraceptive usage was found to be 12.0%. The adoption was found to be significantly higher in 31 & above years (13.0%, business occupation of husband (15.2%, Hindus (12.6% and backward classes (13.1%. CONCLUSIONS : In depth studies are required to explore the reasons behind non - adoption of spacing methods of contraception in order to promote contraception and reduce fertility

  11. Applying Rank Sum Ratio (RSR) to the Evaluation of Feeding Practices Behaviors, and Its Associations with Infant Health Risk in Rural Lhasa, Tibet.

    Science.gov (United States)

    Wang, Zhenjie; Dang, Shaonong; Xing, Yuan; Li, Qiang; Yan, Hong

    2015-12-01

    To evaluate the status of feeding practices and analyze the association between feeding practice and health status among Tibetan infants, a cross-sectional survey of 386 women with children aged under 24 months was conducted in rural areas surrounding Lhasa, Tibet. All participants were selected using simple random sampling and were interviewed face-to-face by trained interviewers. Mothers were interviewed to collect information on their feeding practices. A feeding practices index was created using the rank sum ratio method. Most of the infants had been or were being breastfed at the time of the interview. The feeding practices index was significantly and inversely associated with the prevalence of acute upper respiratory infection, and the odds ratio for the qualified feeding practices index vs. the non-qualified feeding practices index was 0.43 (95% confidence interval: 0.20-0.94). There were no measurable associations observed between acute upper respiratory infection, diarrhea, and the feeding practices index after controlling for selected factors. The method of rank sum ratio provides a flexible way to evaluate feeding practices and is easy to understand. Furthermore, appropriate infant feeding practices might play a protective role in Tibetan infants' health.

  12. Effects of feeding practices on milk yield and composition in peri-urban and rural smallholder dairy cow and pastoral camel herds in Kenya.

    Science.gov (United States)

    Kashongwe, O B; Bebe, B O; Matofari, J W; Huelsebusch, C G

    2017-03-29

    Associations between feeding practices, milk yield, and composition were assessed in smallholder rural and peri-urban dairy cow (n = 97) and pastoral camel (n = 15) herds. A cross-sectional survey supplemented by follow-up collection of feed and milk samples for laboratory analyses was conducted. Data was analyzed using descriptive, correlation, and analysis of variance statistics. Feeding practices in rural smallholder dairy cows' herds were pastured based (87.7%) with napier grass (89.4%) and concentrates (93.9%) as forage and concentrate supplements. In smallholder peri-urban dairy cows' herds, it was napier grass based (68.4%) with concentrates (100%), oat forages (42.9%), and crop residues (28.6%). Pastoral camel herds were shrub browsing (53%), rangeland pasture grazing (20%), or Euphorbia tirucalli feeding (27%). Smallholder rural farmers offered more feeds (16.1 vs 15.3 kg/day) than peri-urban farmers, hence net energy for lactation (1.4 vs 1.3 Mcal/kg), crude protein (CP) (10 vs 12%), and milk yields (12 vs 9 kg/herd/day) was higher. Milk fat was higher in smallholder peri-urban (4.3%) than that of rural (3.9%). In pastoral camels, E. tirucalli feeding had higher daily milk yield/herd, fat, and CP (63 kg, 4.5 and 3.6%) than shrub browsing (35 kg, 4.2 and 3.0%) and grazing (23 kg yield, 2.6 and 2.7%). Five feeding practices out of 14 in smallholder dairy cattle herds resulted in more than 10 kg milk/cow/day because of low forage-to-concentrate ratio (2.5), inclusion of legume crop residue, or processing forages. They present opportunities for improved production in smallholder herds. In pastoral camel, E. tirucalli feeding showed the highest potential.

  13. 浅谈农村实用人才队伍建设路径选择%Brief Discussion on Routing Selection of Team Construction of Rural Practical Talent

    Institute of Scientific and Technical Information of China (English)

    李颖

    2014-01-01

    China, as a big agricultural country, is lack of agricultural productivity. The main reasons for the gap between ur-ban and rural areas in our country are slow development of rural economy, culture and all construction. The construction of rural practical talent team is an important part of the talent team construction and the key work. As introduction and imple-mentation of important historical tasks of building a new socialist countryside, problems of agriculture, rural areas and farmers is facing great opportunities and challenges, strengthening the construction of rural practical talent team is put forward new and higher requirements. In this paper, the authors pointed out problem of route choice of the building rural practical talent team, which indicated the existing difficulties in China, and put forward the solutions had certain guiding significance for es-tablishing moderately prosperous society in an all-round way in current situation.%我国虽然是农业大国,但农业生产力相对落后。农村经济、文化和各项建设事业发展缓慢,是造成我国城乡差距大的主要原因。农村实用人才队伍建设是人才队伍建设工作的重要组成部分和重点工作。随着建设社会主义新农村、构建社会主义和谐社会重大历史任务的提出和实施,农业、农村、农民问题面临重大机遇和挑战,对加强农村实用人才队伍建设提出了更高的要求。为此笔者指出了农村实用人才队伍建设路径选择的问题,表明了我国在这方面存在的困难,并提出了解决的办法,对当前在农村全面建设小康社会有一定的指导意义。

  14. Prescribing practices of topical corticosteroids in the outpatient dermatology department of a rural tertiary care teaching hospital

    Directory of Open Access Journals (Sweden)

    Suvarna S Rathod

    2013-01-01

    Full Text Available Background: Inappropriate or excessive use of topical corticosteroids can lead to cutaneous and systemic adverse effects which occur more commonly with the use of very potent steroids. Monitoring and analysis of the prescription practices of topical steroids can help to achieve rational prescription of these drugs. Aim: The present study was carried out to study and analyze the pattern of prescribing topical corticosteroids among outpatients attending the dermatology clinic in a rural tertiary care and teaching hospital, Ambajogai, Maharashtra. Materials and Methods: A cross-sectional descriptive study was conducted for a duration of two months from August 2011 to September 2011, and 500 prescriptions were randomly collected from the dermatology pharmacy and analyzed. Results: About 66% of the prescriptions contained four to five drugs per prescription. Topical steroids were given in 28.4% of all the prescriptions. In almost all the prescriptions, strength, quantity of the steroid to be used, frequency, site, and duration of application was not mentioned. The chief complaints and diagnoses were not mentioned in about 85% of the prescriptions for topical corticosteroids. About 94.36% of the prescriptions contained very potent steroids. Conclusion: Inadequate prescribing information is a clear characteristic of the dermatological prescriptions containing topical corticosteroids. Doctors should be educated about the importance of giving patients sufficient information regarding the use of steroids. There is a need to revise hospital formulary where low-potency steroids can also be included along with potent ones so that the latter can be avoided in conditions where they are unnecessary.

  15. Capacity development through reflective practice and collaborative research among clinic supervisors in rural South Africa--a case study.

    Science.gov (United States)

    Lehmann, U; Blom, W; Dlanjwa, M; Fikeni, L; Hewana, N; Madlavu, N; Makaula, V; Pennacchini, M; Seal, S; Sivuku, T; Snyman, K

    2004-03-01

    This article provides an example of one form of action research, collaborative enquiry, in the health sector. It argues that collaborative inquiry is a powerful tool to develop reflective capacity among health workers and can facilitate the ownership of learning and the production of usable knowledge. It reports the results of a research project investigating the roles and functions of clinic supervisors in three districts in the Eastern Cape Province, South Africa. Clinics are the cornerstone of the new district-based health system. They are staffed primarily by nurses and are often the only contact point for large parts of the rural population. In conditions of remoteness and isolation, clinic staff depend upon personal interaction with clinic supervisors to enable them to function productively. Yet experience has shown that supervisors do not always fulfil this role. This project aimed at gaining insight into the status of clinic supervision, understanding the factors that hinder effective supervision and making recommendations for improvements. Using a participative approach of Collaborative Inquiry, a team of 10 clinic supervisors and the research co-ordinator collected data reflecting on their own practice over a period of 5 months. These data were then jointly analysed and written up. The participating clinic supervisors went through several periods of uncertainty, when many of them asked themselves why they agreed to this project. However, the engagement with stakeholders and colleagues and the joint analysis of research data soon proved to be a valuable source of insight. There was unanimity in the end that the research process had been very valuable and enabling.

  16. Práctica docente en el aula multigrado rural de una población mexicana Teaching practice in the multigrade rural classes in a Mexican village

    OpenAIRE

    José Ángel Vera Noriega; Rosario Leticia Domínguez Guedea

    2005-01-01

    Con el objeto de presentar el escenario del aula multigrado en la zona rural en pobreza extrema se emplea una estrategia de clasificación estadística con el procedimiento por conglomerados. La muestra poblacional fue de 206 docentes que se clasificaron en base a datos de observación y reporte verbal de estrategias didácticas, control de grupo, planeación, evaluación y apoyo al aprendizaje, identificándose 5 tipos en la práctica docente. Los grupos se contrastan con los resultados en competenc...

  17. Nutritional Deficiencies, the Absence of Information and Caregiver Shortcomings: A Qualitative Analysis of Infant Feeding Practices in Rural China

    OpenAIRE

    Yue, Ai; Marsh, Lauren; Zhou, Huan; Medina, Alexis; Luo, Renfu; Shi, Yaojiang; Zhang, Linxiu; Kenny, Kaleigh; Rozelle, Scott

    2016-01-01

    Background and Objectives Development during the first two years of life is critical and has a lasting impact on a child’s health. Poor infant and child nutrition can lead to deficiencies in essential micronutrients, which may cause a weakened immune system and lasting effects on children's growth and development. Recent studies in rural Shaanxi Province found an anemia prevalence of 54.3% among rural children aged six to twelve months. While new large-scale, quantitative research has begun t...

  18. Comparative effects of chiropractic adjustment versus chiropractic adjustment combined with static magnetic field therapy on acupuncture points for the treatment of mechanical neck pain

    OpenAIRE

    2014-01-01

    M.Tech. (Chiropractic) Purpose: This study was undertaken in order to demonstrate the effects of static magnetic field therapy on acupuncture points in the treatment of those suffering from mechanical neck pain. Isolated spinal manipulative therapy of the cervical spine was compared to spinal manipulative therapy of the cervical spine in conjunction with magnetic field therapy on acupuncture points using both objective and subjective measurements. Before the execution of this study, it was...

  19. The evidence base for chiropractic treatment of musculoskeletal conditions in children and adolescents: The emperor's new suit?

    DEFF Research Database (Denmark)

    Hestbæk, Lise; Stochkendahl, Mette Jensen

    2010-01-01

    ABSTRACT: Five to ten percent of chiropractic patients are children and adolescents. Most of these consult because of spinal pain, or other musculoskeletal complaints. These musculoskeletal disorders in early life not only affect the quality of children's lives, but also seem to have an impact...... have detected a paradox within the chiropractic profession: Although the major reason for pediatric patients to attend a chiropractor is spinal pain, no adequate studies have been performed in this area. It is time for the chiropractic profession to take responsibility and systematically investigate...

  20. A practical demonstration in modelling diclofenac and propranolol river water concentrations using a GIS hydrology model in a rural UK catchment

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, A.C. [Centre for Ecology and Hydrology (CEH) Wallingford, Benson Lane, Wallingford, Oxfordshire OX10 8BB (United Kingdom)]. E-mail: ajo@ceh.ac.uk; Keller, V. [Centre for Ecology and Hydrology (CEH) Wallingford, Benson Lane, Wallingford, Oxfordshire OX10 8BB (United Kingdom); Williams, R.J. [Centre for Ecology and Hydrology (CEH) Wallingford, Benson Lane, Wallingford, Oxfordshire OX10 8BB (United Kingdom); Young, A. [Centre for Ecology and Hydrology (CEH) Wallingford, Benson Lane, Wallingford, Oxfordshire OX10 8BB (United Kingdom)

    2007-03-15

    An existing GIS hydrology water quality model, LF2000-WQX, was applied to predict the concentrations of the pharmaceuticals diclofenac and propranalol in catchments. As a practical exercise the predominantly rural Tamar (UK) catchment was chosen. Consumption, excretion, and fate data were used to estimate the pharmaceutical input load for the model. The predicted concentrations throughout most of the catchment were 1 ng/L or less under low flow (90th percentile) conditions. However, at a few locations, downstream of small sewage treatment plants, concentrations above 25 ng/L were predicted. This exercise shows that it is relatively straightforward to predict the concentrations of new and emerging organic microcontaminants in real catchments using existing GIS hydrology water quality models. Further testing will be required to establish their accuracy. - A GIS hydrology model was used to predict pharmaceutical concentration hot spots in a rural catchment.

  1. Brief screening questions for depression in chiropractic patients with low back pain

    DEFF Research Database (Denmark)

    Kongsted, Alice; Aambakk, Benedicte; Bossen, Sanne;

    2014-01-01

    Depression is an important prognostic factor in low back pain (LBP) that appears to be infrequent in chiropractic populations. Identification of depression in few patients would consequently implicate screening of many. It is therefore desirable to have brief screening tools for depression...

  2. Adding chiropractic to standard medical therapy for nonspecific low back pain

    DEFF Research Database (Denmark)

    Goertz, Christine M; Long, Cynthia R; Hondras, Maria;

    2013-01-01

    Study Design. Randomized controlled trial.Objective. To assess changes in pain levels and physical functioning in response to standard medical care (SMC) versus SMC plus chiropractic manipulative therapy (CMT) for the treatment of low back pain (LBP) among 18 to 35-year-old active-duty military...

  3. Self-Regulation of a Chiropractic Association through Participatory Action Research

    Science.gov (United States)

    Sheppard, Lorraine A.; Jorgensen, Anna Maria S.; Crowe, Michael J.

    2012-01-01

    Participatory action research (PAR) can be used in the health professions to redefine their roles. This study investigated a small health professional group, the members of The Chiropractic Association Singapore (TCAS), by using a PAR method; researchers and participants gained insights into the self-regulation of a health profession. A…

  4. Overview of Clinical Application of Chiropractic Therapy in the Past ten Years

    Institute of Scientific and Technical Information of China (English)

    ZHOU Er-chun

    2004-01-01

    捏脊疗法是推拿常用手法之一,这一疗法具有简、便、验、廉的特点.近年来捏脊疗法临床应用的范围不断扩大,用于治疗的疾病已达数十种.遍及内科、妇科、儿科等各科及预防、保健、美容等方面,临床报道很多.本文收集近十年有关捏脊疗法的文献21篇,在分析了这些文献的基础上从捏脊疗法临床运用的角度进行归纳总结.%Chiropractic therapy is a common massage method of simplicity, convenience, efficacy and low cost. In the past years, chiropractic therapy is increasingly used to treat many diseases in relation to internal medicine, gynecology, pediatrics, medical prevention, healthcare and cosmetology, etc.This paper collects 21 articles concerning chiropractic therapy in the past 10 years, and then sums up the clinical application of chiropractic therapy.

  5. Predictors of outcome in neck pain patients undergoing chiropractic care: comparison of acute and chronic patients

    Directory of Open Access Journals (Sweden)

    Peterson Cynthia

    2012-08-01

    Full Text Available Abstract Background Neck pain is a common complaint in patients presenting for chiropractic treatment. The few studies on predictors for improvement in patients while undergoing treatment identify duration of symptoms, neck stiffness and number of previous episodes as the strong predictor variables. The purpose of this study is to continue the research for predictors of a positive outcome in neck pain patients undergoing chiropractic treatment. Methods Acute ( 3 months (n = 255 neck pain patients with no chiropractic or manual therapy in the prior 3 months were included. Patients completed the numerical pain rating scale (NRS and Bournemouth questionnaire (BQ at baseline prior to treatment. At 1 week, 1 month and 3 months after start of treatment the NRS and BQ were completed along with the Patient Global Impression of Change (PGIC scale. Demographic information was provided by the clinician. Improvement at each of the follow up points was categorized using the PGIC. Multivariate regression analyses were done to determine significant independent predictors of improvement. Results Baseline mean neck pain and total disability scores were significantly (p  Conclusions The most consistent predictor of clinically relevant improvement at both 1 and 3 months after the start of chiropractic treatment for both acute and chronic patients is if they report improvement early in the course of treatment. The co-existence of either radiculopathy or dizziness however do not imply poorer prognosis in these patients.

  6. VARK Learning Preferences and Mobile Anatomy Software Application Use in Pre-Clinical Chiropractic Students

    Science.gov (United States)

    Meyer, Amanda J.; Stomski, Norman J.; Innes, Stanley I.; Armson, Anthony J.

    2016-01-01

    Ubiquitous smartphone ownership and reduced face-to-face teaching time may lead to students making greater use of mobile technologies in their learning. This is the first study to report on the prevalence of mobile gross anatomy software applications (apps) usage in pre-clinical chiropractic students and to ascertain if a relationship exists…

  7. Chiropractic patients in Denmark 2002: an expanded description and comparison with 1999 survey

    DEFF Research Database (Denmark)

    Sorensen, Line Press; Stochkendahl, Mette Jensen; Hartvigsen, Jan

    2006-01-01

    of activities of daily living, mode of referral, duration of sick leave, previous treatments, comorbidity, SF-12, smoking habits, and use of x-ray. RESULTS: Eighty-five percent of all chiropractic clinics in Denmark participated in the study, and 1595 patients (81%) filled out a self-administered questionnaire...

  8. Assessing the consistency and microbiological effectiveness of household water treatment practices by urban and rural populations claiming to treat their water at home: a case study in Peru.

    Directory of Open Access Journals (Sweden)

    Ghislaine Rosa

    Full Text Available Household water treatment (HWT can improve drinking water quality and prevent disease if used correctly and consistently by vulnerable populations. Over 1.1 billion people report treating their water prior to drinking it. These estimates, however, are based on responses to household surveys that may exaggerate the consistency and microbiological performance of the practice-key factors for reducing pathogen exposure and achieving health benefits. The objective of this study was to examine how HWT practices are actually performed by households identified as HWT users, according to international monitoring standards.We conducted a 6-month case study in urban (n = 117 households and rural (n = 115 households Peru, a country in which 82.8% of households report treating their water at home. We used direct observation, in-depth interviews, surveys, spot-checks, and water sampling to assess water treatment practices among households that claimed to treat their drinking water at home. While consistency of reported practices was high in both urban (94.8% and rural (85.3% settings, availability of treated water (based on self-report at time of collection was low, with 67.1% and 23.0% of urban and rural households having treated water at all three sampling visits. Self-reported consumption of untreated water in the home among adults and children <5 was common and this was corroborated during home observations. Drinking water of self-reported users was significantly better than source water in the urban setting and negligible but significantly better in the rural setting. However, only 46.3% and 31.6% of households had drinking water <1 CFU/100 mL at all follow-up visits.Our results raise questions about the usefulness of current international monitoring of HWT practices and their usefulness as a proxy indicator for drinking water quality. The lack of consistency and sub-optimal microbiological effectiveness also raises questions about the potential

  9. Nurse Practitioner Autonomy and Satisfaction in Rural Settings.

    Science.gov (United States)

    Spetz, Joanne; Skillman, Susan M; Andrilla, C Holly A

    2016-01-29

    Rural primary care shortages may be alleviated if more nurse practitioners (NPs) practiced there. This study compares urban and rural primary care NPs (classified by practice location in urban, large rural, small rural, or isolated small rural areas) using descriptive analysis of the 2012 National Sample Survey of NPs. A higher share of rural NPs worked in states without physician oversight requirements, had a DEA (drug enforcement administration) number, hospital admitting privileges, and billed using their own provider identifier. Rural NPs more often reported they were fully using their NP skills, practicing to the fullest extent of the legal scope of practice, satisfied with their work, and planning to stay in their jobs. We found lower per capita NP supply in rural areas, but the proportion in primary care increased with rurality. To meet rural primary care needs, states should support rural NP practice, in concert with support for rural physician practice.

  10. Retrospective Demographic Analysis of Patients Seeking Care at a Free University Chiropractic Clinic

    Science.gov (United States)

    Stevens, Gerald; Campeanu, Michael; Sorrento, Andrew T.; Ryu, Jiwoon; Burke, Jeanmarie

    2016-01-01

    Objective The purpose of this study was to describe the demographics, presenting complaints, and health history of new patients seeking treatment at a free chiropractic clinic within a university health center. Methods A retrospective analysis of patient files from 2008 to 2009 was performed for a free student chiropractic clinic in the Buffalo, NY, area. Demographics, presenting complaints, and health history of new patients seeking treatment were recorded. Results There were 343 new chiropractic patient files. Most patients were between the ages of 18 and 30 years (n = 304, 88%) with an almost equal distribution of men (n = 163, 48%) and women (n = 180, 52%). The patients were mostly single (n = 300, 87%). Patients self-reported that their case histories excluded a current medical diagnosis (n = 261, 76%), previous history of disease (n = 216, 63%), allergies (n = 240, 70%), previous surgical procedures (n = 279, 81%), and medication use (n = 250, 73%). The frequencies of spinal complaints were as follows: lumbar spine, n = 176 (51%); cervical spine, n = 78 (23%); and thoracic spine, n = 44 (13%). Maintenance care, headaches, and spine-related upper and lower extremities complaints accounted for the other 13% of patients treated. Half were chronic (n = 172, 50%), and a third were acute (n=108, 31%). Patients averaged 6 chiropractic visits, with 88% having 11 visits or less. Conclusion This study found that new patients seeking care at a free student chiropractic clinic within a university health center in the Buffalo area mainly consisted of young single adults, with chronic lumbar spine complaints with few comorbidities. PMID:27069428

  11. Rural Medical Education in New Zealand.

    Science.gov (United States)

    Mayer, Heidi; Renouf, Tia

    2016-10-11

    Despite a large number of yearly medical graduates, rural New Zealand is faced with a scarcity of practicing physicians. Opportunities to learn and practice in rural settings start at the undergraduate level and extend to practicing physicians. There are a number of different programs available to facilitate rural medical education for all students and physicians. These programs will be discussed in this article.

  12. Blood pressure changes in African American patients receiving chiropractic care in a teaching clinic: a preliminary study

    National Research Council Canada - National Science Library

    McMasters, Kim L; Wang, Joe; York, Jennifer; Hart, John; Neely, Cheneir; Delain, Rochelle J

    2013-01-01

    The purpose of this preliminary study was to determine if a course of chiropractic care would change blood pressure measurements in African American patients and to determine if a study was feasible...

  13. Effectiveness and Economic Evaluation of Chiropractic Care for the Treatment of Low Back Pain: A Systematic Review of Pragmatic Studies.

    Science.gov (United States)

    Blanchette, Marc-André; Stochkendahl, Mette Jensen; Borges Da Silva, Roxane; Boruff, Jill; Harrison, Pamela; Bussières, André

    2016-01-01

    Low back pain (LBP) is one of the leading causes of disability worldwide and among the most common reasons for seeking primary sector care. Chiropractors, physical therapists and general practitioners are among those providers that treat LBP patients, but there is only limited evidence regarding the effectiveness and economic evaluation of care offered by these provider groups. To estimate the clinical effectiveness and to systematically review the literature of full economic evaluation of chiropractic care compared to other commonly used care approaches among adult patients with non-specific LBP. Systematic reviews of interventions and economic evaluations. A comprehensive search strategy was conducted to identify 1) pragmatic randomized controlled trials (RCTs) and/or 2) full economic evaluations of chiropractic care for low back pain compared to standard care delivered by other healthcare providers. Studies published between 1990 and 4th June 2015 were considered. Primary outcomes included pain, functional status and global improvement. Study selection, critical quality appraisal and data extraction were conducted by two independent reviewers. Data from RCTs with low risk of bias were included in a meta-analysis to determine effect estimates. Cost estimates of full economic evaluations were converted to 2015 USD and results summarized using Slavin's qualitative best-evidence synthesis. Six RCTs and three full economic evaluations were scientifically admissible. Five RCTs with low risk of bias compared chiropractic care to exercise therapy (n = 1), physical therapy (n = 3) and medical care (n = 1). Overall, we found similar effects for chiropractic care and the other types of care and no reports of serious adverse events. Three low to high quality full economic evaluations studies (one cost-effectiveness, one cost-minimization and one cost-benefit) compared chiropractic to medical care. Given the divergent conclusions (favours chiropractic, favours medical care

  14. Effectiveness and Economic Evaluation of Chiropractic Care for the Treatment of Low Back Pain: A Systematic Review of Pragmatic Studies

    Science.gov (United States)

    Blanchette, Marc-André; Stochkendahl, Mette Jensen; Borges Da Silva, Roxane; Boruff, Jill; Harrison, Pamela; Bussières, André

    2016-01-01

    Background Context Low back pain (LBP) is one of the leading causes of disability worldwide and among the most common reasons for seeking primary sector care. Chiropractors, physical therapists and general practitioners are among those providers that treat LBP patients, but there is only limited evidence regarding the effectiveness and economic evaluation of care offered by these provider groups. Purpose To estimate the clinical effectiveness and to systematically review the literature of full economic evaluation of chiropractic care compared to other commonly used care approaches among adult patients with non-specific LBP. Study Design Systematic reviews of interventions and economic evaluations. Methods A comprehensive search strategy was conducted to identify 1) pragmatic randomized controlled trials (RCTs) and/or 2) full economic evaluations of chiropractic care for low back pain compared to standard care delivered by other healthcare providers. Studies published between 1990 and 4th June 2015 were considered. Primary outcomes included pain, functional status and global improvement. Study selection, critical quality appraisal and data extraction were conducted by two independent reviewers. Data from RCTs with low risk of bias were included in a meta-analysis to determine effect estimates. Cost estimates of full economic evaluations were converted to 2015 USD and results summarized using Slavin’s qualitative best-evidence synthesis. Results Six RCTs and three full economic evaluations were scientifically admissible. Five RCTs with low risk of bias compared chiropractic care to exercise therapy (n = 1), physical therapy (n = 3) and medical care (n = 1). Overall, we found similar effects for chiropractic care and the other types of care and no reports of serious adverse events.