Ultrasound-guided Breast Biopsy in the Resource-limited Setting: An Initial Experience in Rural Uganda

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Christopher R. Stark

2017-06-01

Full Text Available Purpose: To describe the methodology and initial experience behind creation of an ultrasoundguided percutaneous breast core biopsy program in rural Uganda. Methods and Materials: Imaging the World Africa (ITWA is the registered non-governmental organization division of Imaging the World (ITW, a not-for-profit organization whose primary aim is the integration of affordable high-quality ultrasound into rural health centers. In 2013, ITWA began the pilot phase of an IRB-approved breast care protocol at a rural health center in Uganda. As part of the protocol’s diagnostic arm, an ultrasound-guided percutaneous breast core biopsy training curriculum was implemented in tandem with creation of regionally supplied biopsy kits. Results: A surgeon at a rural regional referral hospital was successfully trained and certified to perform ultrasound-guided percutaneous breast core biopsies. Affordable and safe biopsy kits were created using locally available medical supplies with the cost of each kit totaling $10.62 USD. Conclusion: Successful implementation of an ultrasound-guided percutaneous breast core biopsy program in the resource-limited setting is possible and can be made sustainable through incorporation of local health care personnel and regionally supplied biopsy materials. Our hope is that ITWA’s initial experience in rural Uganda can serve as a model for similar programs in the future.

Creative practicum leadership experiences in rural settings.

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Schoenfelder, Deborah Perry; Valde, Jill Gaffney

2009-01-01

Rural healthcare systems provide rich learning environments for nursing students, where strong nursing leaders manage care for people with diverse health problems across the lifespan. The authors describe the development, implementation, and evaluation of rural clinical leadership practicum, a prelicensure course that specifically focuses on the application of leadership concepts in small rural healthcare systems.

Psychological wellbeing, physical impairments and rural aging in a developing country setting

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Tangchonlatip Kanchana

2009-07-01

Full Text Available Abstract Background There has been very little research on wellbeing, physical impairments and disability in older people in developing countries. Methods A community survey of 1147 older parents, one per household, aged sixty and over in rural Thailand. We used the Burvill scale of physical impairment, the Thai Psychological Wellbeing Scale and the brief WHO Disability Assessment Schedule. We rated received and perceived social support separately from children and from others and rated support to children. We used weighted analyses to take account of the sampling design. Results Impairments due to arthritis, pain, paralysis, vision, stomach problems or breathing were all associated with lower wellbeing. After adjusting for disability, only impairment due to paralysis was independently associated with lowered wellbeing. The effect of having two or more impairments compared to none was associated with lowered wellbeing after adjusting for demographic factors and social support (adjusted difference -2.37 on the well-being scale with SD = 7.9, p Conclusion In this Thai setting, as found in western settings, most of the association between physical impairments and lower wellbeing is explained by disability. Disability is potentially mediating the association between impairment and low wellbeing. Received support may buffer the impact of some impairments on wellbeing in this setting. Giving actual support to children is associated with less wellbeing unless the support being given to children is perceived as good, perhaps reflecting parental obligation to support adult children in need. Improving community disability services for older people and optimizing received social support will be vital in rural areas in developing countries.

Physician recruitment and retention in Manitoba: results from a survey of physicians' preferences for rural jobs.

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Witt, Julia

2017-01-01

Rural recruitment and retention continues to present challenges to health workforce planners. This paper reports and analyzes the results of a survey sent to physicians in Manitoba, eliciting their opinions regarding rural jobs. A survey was sent to all physicians in Manitoba. Part 1 of the survey included questions about background and demographic information; part 2 was a set of job satisfaction questions regarding respondents' current job; and part 3 included 2 sets of stated-choice questions eliciting preferences for a set of attributes relevant to rural recruitment and retention. Of the 2487 physicians who received surveys, 561 (22.6%) responded. Respondents indicated that income, hours worked and on-call frequency are very important: overall job satisfaction increased with income and decreased with hours worked. Income, hours and on-call frequency were ranked "very important" by the largest proportions of physicians. The estimated compensation for on-call more frequent than 1-in-4 was very high (82% of average income), and additional hours worked were worth $183 per hour. Other attributes that were important included professional interaction, housing availability and community incentives during the first year, which were valued at 11%-31% of annual income. Work-life balance is a key consideration for rural jobs, and there are incentives that can compensate for less desirable attributes.

A casemix study of patients seen by a dermatology trainee in rural and urban outpatient settings.

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Tilakaratne, Dev; Warren, Lachlan; Menz, Jennifer

2016-02-01

For 8 years South Australian dermatologists have provided an outreach service to the Northern Territory (NT), including rural and remote areas. In 2012 and 2013, a trainee accompanied a dermatologist on these outreach visits. This is the first prospective study that documents the spectrum of dermatological diseases requiring outpatient specialist input in various settings in the NT, and also the first study to compare the clinical experience of one Australian dermatology trainee in urban and rural settings. Characteristics of patients managed primarily by the outreach dermatology registrar were recorded prospectively from February 2013 to July 2013. The data from the trainee's urban encounters were compared to that of the rural centres. The spectrum of conditions seen in these two settings was placed in the disease categories specified in the Australasian College of Dermatologists (ACD) curriculum. The Royal Adelaide Hospital outpatient experience provided greater exposure to skin neoplasms, lymphoproliferative and myeloproliferative disorders and non-infectious neutrophilic/eosinophilic disorders. The outreach sites provided greater exposure to infections, adnexal diseases and genodermatoses. Both urban and rural experiences provided a broad exposure to the disease categories outlined in the ACD curriculum. The spectrum of disease requiring specialist dermatology input varies between urban South Australia and rural NT. The inclusion of dermatology trainees in outreach visits broadens their clinical exposure. It is recommended that other dermatology service providers in Australia consider documenting clinical casemix comparisons to assess dermatology demand, outcomes and trainee exposure. © 2014 The Australasian College of Dermatologists.

US Health Care Reform and Rural America: Results From the ACA's Medicaid Expansions.

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Benitez, Joseph A; Seiber, Eric E

2018-03-01

Medicaid expansions, prompted by the Affordable Care Act, generated generally positive effects on coverage and alleviated much of the financial burden associated with seeking health care. We do not know if these shifts also extend to the nation's rural populations. Using 2011-2015 Behavioral Risk Factor Surveillance System data, this study compares trend changes for coverage, access to care, and health care utilization in response to Medicaid expansion among urban and rural residents using a difference-in-differences regression approach. Following Medicaid expansion, low-income rural and urban residents both experienced reductions in uninsurance; however, the coverage uptake in rural settings (8.5 percentage points [pp], P .10). In spite of larger uptakes in coverage among rural residents, reductions in cost-related barriers to medical care were slightly larger among urban residents, and access to a regular source of medical care (5.2 pp, P rural residents than urban residents; however, it appears there remain opportunities to improve access to care among potentially vulnerable rural residents. © 2017 National Rural Health Association.

Goal setting for health behavior change: evidence from an obesity intervention for rural low-income women.

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Ries, A V; Blackman, L T; Page, R A; Gizlice, Z; Benedict, S; Barnes, K; Kelsey, K; Carter-Edwards, L

2014-01-01

Rural, minority populations are disproportionately affected by overweight and obesity and may benefit from lifestyle modification programs that are tailored to meet their unique needs. Obesity interventions commonly use goal setting as a behavior change strategy; however, few have investigated the specific contribution of goal setting to behavior change and/or identified the mechanisms by which goal setting may have an impact on behavior change. Furthermore, studies have not examined goal setting processes among racial/ethnic minorities. Using data from an obesity intervention for predominately minority women in rural North Carolina, this study sought to examine whether intervention participation resulted in working on goals and using goal setting strategies which in turn affected health behavior outcomes. It also examined racial/ethnic group differences in working on goals and use of goal setting strategies. Data came from a community-based participatory research project to address obesity among low-income, predominately minority women in rural North Carolina. A quasi-experimental intervention design was used. Participants included 485 women aged 18 years and over. Intervention participants (n=208) received health information and goal setting support through group meetings and tailored newsletters. Comparison participants (n = 277) received newsletters on topics unrelated to obesity. Surveys assessed physical activity, fruit and vegetable intake, goal-related stage of change, and use of goal setting strategies. Chi squared statistics were used to assess intervention group differences in changes in goal-related stage of change and use of goal setting strategies as well as racial/ethnic group differences in stage of change and use of goal setting strategies at baseline. The causal steps approach of Baron and Kenny was used to assess mediation. Intervention compared to comparison participants were more likely to move from contemplation to action/maintenance for the

Exploring Rural High School Learners' Experience of Mathematics Anxiety in Academic Settings

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Hlalele, Dipane

2012-01-01

The purpose of the study was to explore rural high school learners' experience of mathematics anxiety in academic settings. Mathematics anxiety has been found to have an adverse effect on confidence, motivation and achievement. This quantitative study is exploratory and descriptive in nature. The participants were 403 learners doing mathematics in…

Development of a tool to measure person-centered maternity care in developing settings: validation in a rural and urban Kenyan population.

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Afulani, Patience A; Diamond-Smith, Nadia; Golub, Ginger; Sudhinaraset, May

2017-09-22

Person-centered reproductive health care is recognized as critical to improving reproductive health outcomes. Yet, little research exists on how to operationalize it. We extend the literature in this area by developing and validating a tool to measure person-centered maternity care. We describe the process of developing the tool and present the results of psychometric analyses to assess its validity and reliability in a rural and urban setting in Kenya. We followed standard procedures for scale development. First, we reviewed the literature to define our construct and identify domains, and developed items to measure each domain. Next, we conducted expert reviews to assess content validity; and cognitive interviews with potential respondents to assess clarity, appropriateness, and relevance of the questions. The questions were then refined and administered in surveys; and survey results used to assess construct and criterion validity and reliability. The exploratory factor analysis yielded one dominant factor in both the rural and urban settings. Three factors with eigenvalues greater than one were identified for the rural sample and four factors identified for the urban sample. Thirty of the 38 items administered in the survey were retained based on the factors loadings and correlation between the items. Twenty-five items load very well onto a single factor in both the rural and urban sample, with five items loading well in either the rural or urban sample, but not in both samples. These 30 items also load on three sub-scales that we created to measure dignified and respectful care, communication and autonomy, and supportive care. The Chronbach alpha for the main scale is greater than 0.8 in both samples, and that for the sub-scales are between 0.6 and 0.8. The main scale and sub-scales are correlated with global measures of satisfaction with maternity services, suggesting criterion validity. We present a 30-item scale with three sub-scales to measure person

Exploring rural high school learners' experience of mathematics anxiety in academic settings

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Dipane Hlalele

2012-01-01

Full Text Available The purpose of the study was to explore rural high school learners' experience of mathematics anxiety in academic settings. Mathematics anxiety has been found to have an adverse effect on confidence, motivation and achievement. This quantitative study is exploratory and descriptive in nature. The participants were 403 learners doing mathematics in 18 rural schools in the Free State province of South Africa. Participants completed a 20-item questionnaire and 373 (92.5% questionnaires were found to contain valid responses and were analysed by a professional statistician at the University of the Free State using the Statistical Package for the Social Sciences (SPSS, Version 17.0. The questionnaire was testedfor reliability using the Cronbach alpha coefficient and was found to have a reliability score of .841, indicating an acceptable reliability coefficient. Findings reveal that all learners sometimes, often, or always experience mathematics anxiety in academic settings. It is therefore important for teachers and authorities in education to observe its prevalence and to implement strategies toward the alleviation of the effects ofmathematics anxiety.

Extensive diversity in the allelic frequency of Plasmodium falciparum merozoite surface proteins and glutamate-rich protein in rural and urban settings of southwestern Nigeria.

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Funwei, Roland I; Thomas, Bolaji N; Falade, Catherine O; Ojurongbe, Olusola

2018-01-02

Nigeria carries a high burden of malaria which makes continuous surveillance for current information on genetic diversity imperative. In this study, the merozoite surface proteins (msp-1, msp-2) and glutamate-rich protein (glurp) of Plasmodium falciparum collected from two communities representing rural and urban settings in Ibadan, southwestern Nigeria were analysed. A total of 511 febrile children, aged 3-59 months, whose parents/guardians provided informed consent, were recruited into the study. Capillary blood was obtained for malaria rapid diagnostic test, thick blood smears for parasite count and blood spots on filter paper for molecular analysis. Three-hundred and nine samples were successfully genotyped for msp-1, msp-2 and glurp genes. The allelic distribution of the three genes was not significantly different in the rural and urban communities. R033 and 3D7 were the most prevalent alleles in both rural and urban communities for msp-1 and msp-2, respectively. Eleven of glurp RII region genotypes, coded I-XII, with sizes ranging from 500 to 1100 base pairs were detected in the rural setting. Genotype XI (1000-1050 bp) had the highest prevalence of 41.5 and 38.5% in rural and urban settings, respectively. Overall, 82.1 and 70.0% of samples had multiclonal infection with msp-1 gene resulting in a mean multiplicity of infection (MOI) of 2.8 and 2.6 for rural and urban samples, respectively. Msp-1 and msp-2 genes displayed higher levels of diversity and higher MOI rates than the glurp gene. Significant genetic diversity was observed between rural and urban parasite populations in Ibadan, southwestern Nigeria. The results of this study show that malaria transmission intensity in these regions is still high. No significant difference was observed between rural and urban settings, except for a completely different msp-1 allele, compared to previous reports, thereby confirming the changing face of malaria transmission in these communities. This study provides

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

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

2018-12-01

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

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.

Ergonomics work assessment in rural industrial settings: a student occupational therapy project.

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Bowman, Peter J

2012-01-01

This case study describes a student occupational therapy (OT) program, the creation of a worksite assessment project as a part of a Community Connections: Partners for Learning and Service grant funded by Health Resources and Services Administration. The primary goals were to design occupation-based community learning experiences in a variety of rural community settings, so that students might benefit from participating in the community based learning and: based on the results, embed occupation-based learning into existing occupational therapy curriculum. The components of the project and the ergonomics content of the OT education program are described; details of the work assessment are presented with analysis of data from the student evaluation of this project.

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

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Parry, James D.; Ferrara, Joseph M.

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

User and provider perspectives on emergency obstetric care in a tanzanian rural setting

DEFF Research Database (Denmark)

Sørensen, Bjarke Lund; Nielsen, Birgitte Bruun; Rasch, Vibeke

2011-01-01

The aim of this field study was to analyze the main dynamics and conflicts in attending and providing good quality delivery care in a local Tanzanian rural setting. The women and their relatives did not see the problems of pregnancy and birth in isolation but in relation to multiple other problems...

Relative professional roles in antenatal care: results of a survey in Scottish rural general practice.

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Farmer, Jane; Stimpson, Paul; Tucker, Janet

2003-11-01

There is evidence of variation and some ambiguity about self-perceived relative professional roles in antenatal care in the UK. There is little information about models of antenatal care provision in UK rural areas. In rural areas, in particular, women have limited choice in accessing health care professionals or alternative primary care delivery settings. In the light of a recent review of Scottish maternity services, it is important and timely to examine models of care and interprofessional working in antenatal care in rural areas. This study explores midwives' and GPs' perceptions about their relative professional roles in remote and rural general practice in Scotland. A questionnaire survey involving all 174 Scottish remote and rural general practices (using one definition of rurality) was conducted, followed by 20 interviews. At least one professional returned a completed questionnaire from 91% of rural practices. A number of areas of dissonance were noted between GPs' and midwives' perceptions of their roles in maternity care and, given the context of service provision, these may impact upon rural patients. Findings are relevant to wider debates on extending the primary care team and strengthening inter-disciplinary working, particularly in rural areas.

Barriers in implementing evidence-informed health decisions in rural rehabilitation settings: a mixed methods pilot study.

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Prakash, V; Hariohm, K; Balaganapathy, M

2014-08-01

Literature on the barriers to implementing research findings into physiotherapy practice are often urban centric, using self report based on the hypothetical patient scenario. The objective of this study was to investigate the occurrence of barriers, encountered by evidence informed practice-trained physiotherapists in the management of "real world" patients in rural rehabilitation settings. A mixed-methods research design was used. Physiotherapists working in rural outpatient rehabilitation settings participated in the study. In the first phase, we asked all participants (N = 5) to maintain a log book for a 4-week period to record questions that arose during their routine clinical encounters and asked them also to follow first four of the five steps of evidence-informed practice (ask, access, appraise and apply). In the second phase (after 4 weeks), we conducted a semistructured, direct interviews with the participants exploring their experiences involved in the process of implementing evidence-informed clinical decisions made during the study period. At the end of 4 weeks, 30 questions were recorded. For 17 questions, the participants found evidence but applied that evidence into their practice only in 9 instances. Being generalist practitioners, lack of outcomes specific to the patients were reported as barriers more so than time constraints in implementing evidence-informed practice. Practice setting, lack of patient-centered research and evidence-informed practice competency of physiotherapists can be significant barriers to implementing evidence-informed health decisions in rural rehabilitation setting. © 2014 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

Opportunities for AIDS prevention in a rural state in criminal justice and drug treatment settings.

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Farabee, D; Leukefeld, C G

1999-01-01

This study examined the likelihood that drug users would receive HIV/ AIDS prevention information and supplies (e.g., condoms and bleach) in the rural state of Kentucky. Despite evidence of high HIV risk among criminal justice and substance-using populations, incarceration and substance-user treatment were only minimally associated with prior HIV prevention exposure or HIV testing. These data strongly support the use of criminal justice and treatment settings to provide AIDS prevention interventions for the high-risk drug-using populations they serve, and to target HIV prevention services in rural as well as urban areas.

Is There A Rural-Urban Technology Gap? Results of the ERS Rural Manufacturing Survey

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Gale, H. Frederick, Jr.

1997-01-01

Advanced technology use is less prevalent in rural than in urban manufacturing plants, but plants of comparable size in the same industry use about the same level of technology, regardless of urban/rural location. The rural gap comes about because the mix of rural industries is more heavily weighted with "low-technology" industries. Both rural and urban businesses rate inadequate worker skills as the most important barrier to use of new production technologies and management practices, while ...

Compounding medications in a rural setting: an interprofessional perspective

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Taylor S

2018-04-01

Full Text Available Selina Taylor,1 Catherine Hays,1 Beverley Glass2 1Mount Isa Centre for Rural and Remote Health, James Cook University, Mount Isa, QLD, Australia; 2College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia Background: Interprofessional learning (IPL which focuses on the pharmacist’s role in specialty practices as part of a multidisciplinary health care team has not been explored. This study aimed to determine health care students’ understanding of the role of the pharmacist in compounding medications to optimize health outcomes for patients in rural and remote health care services.Methods: Four workshops followed by focus group interviews were conducted with undergraduate pharmacy, medical, nursing, physiotherapy, dentistry, Aboriginal public health, and speech pathology students (n=15. After an introductory lecture, students working in multidisciplinary teams undertook to compound three products. Focus groups were held at the end of the compounding workshops to explore students’ understanding and perceptions of these compounding activities. Thematic analysis was undertaken on the qualitative data obtained from the focus groups.Results: Student participants responded positively both to the opportunity to undertake a compounding exercise and being part of an interprofessional team, perceiving benefit for their future rural and remote health practice. Four major themes emerged from the qualitative analysis: improved knowledge and understanding; application to practice; interprofessional collaboration; and rural, remote, and Indigenous context. Students acknowledged that the workshops improved their understanding of the role of the pharmacist in compounding and how they, as part of a multidisciplinary team, could deliver better health outcomes for patients with special needs, especially in a rural and remote context.Conclusion: This study highlights that workshops of this nature have a role to play in developing

Barriers to accessing termination of pregnancy in a remote and rural setting: a qualitative study.

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Heller, R; Purcell, C; Mackay, L; Caird, L; Cameron, S T

2016-09-01

To explore the experiences of women from a remote and rural setting who had a termination of pregnancy (TOP), in relation to any barriers they may have experienced trying to access TOP. Qualitative interview study. Scottish Highlands and Western Isles. Women who had undergone TOP in the Scottish Highlands National Health Service between October 2014 and May 2015. Sixteen semi-structured, audio-recorded telephone interviews were conducted by a researcher with women who had consented to be interviewed at their initial assessment. Six stages of thematic analysis were followed to explore themes in and across participant accounts. Themes derived from interview transcripts. Four themes emerged relating to barriers to access and experience: (1) the impact of travel for TOP, (2) temporal factors unique to this population and how they affected women, (3) the attitude of health professionals, notably general practitioners, as a result of local culture, and (4) stigma surrounding TOP and the expectation that abortion will be traumatising. Women in remote and rural areas experience barriers to accessing TOP. Prompt referrals, more providers of TOP and tackling stigma associated with TOP could make delivery of this service more equitable and improve women's journey through TOP. Women in remote and rural areas of Scotland face multiple barriers to accessing termination of pregnancy. © 2016 Royal College of Obstetricians and Gynaecologists.

Programa de Fortalecimiento de Capacidades: Reflections on a Case Study of Community-Based Teacher Education Set in Rural Northern Peru

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Alsop, Steve; Ames, Patricia; Arroyo, Graciela Cordero; Dippo, Don

2010-01-01

This article explores distinctive features of a 5-year international education development project set in rural northern Peru (PROMEB, the "Proyecto de Mejoramiento de la Educacion Basica"). Grounded within a partnership between teacher educators from Peru, Mexico and Canada, and rural Peruvian teachers, students and their communities,…

Growth and development in school-age children from Rostov region, Russia: Comparison between urban and rural settings.

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Voynov, V B; Kulba, S N; Arapova, Yu Yu

2017-12-01

The purposes of the current study were: (1) to describe growth and physical development and establish norms for schoolchildren from Rostov region in Russia; (2) to compare major characteristics of development between urban and rural children by sex and age. Nearly 200,000 children (198,712) aged between 7 and 17 years from 232 urban and rural schools of Rostov region (Southern Federal District of Russia) participated in the study. School age is a period of intensive growth and physiological and psychological development. Irregularities of personal development are caused by a multitude of factors, such as sex differences, heredity, socio-economic status of a family, standard of living, particular environmental conditions, and lifestyle. It has been established that children from the Southern Federal District of Russia had body mass index values higher than age-appropriate norms for all Russians (Total Russian, Rudnev et al., 2014) and World Health Organization charts. Children from urban settings were taller and heavier than children from rural settings. Sex is one of the most influential factors which play key role in determining specific characteristics of growth and personal development. According to our results, boys and girls both had similar age-related changes in weight and height, but their respective dynamics differed. Girls' height and weight values accelerated at the age 10 to 12 years and plateaued after the age fourteen, whereas in boys height and weight steadily increased with age, showing slight acceleration at the age 12 to 13 years, and reached a plateau by the age of seventeen. Copyright © 2017 Elsevier GmbH. All rights reserved.

Urban Rural Comparisons of Polycystic Ovary Syndrome Burden among Adolescent Girls in a Hospital Setting in India

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Swetha Balaji

2015-01-01

Full Text Available Background. Polycystic ovarian syndrome (PCOS is a multifaceted disorder characterized by varying clinical presentations. Objective. The aim of this study was to determine urban and rural differences in the burden of polycystic ovarian syndrome among Indian adolescent females aged 12 to 19 years. Methods. A pilot cross-sectional study was conducted for a period of one month (August-September 2013 at Balaji Hospital, Vellore, Tamil Nadu, India. The final sample included 126 study participants located in various urban (50%, n=63 and rural (50%, n=63 settings. Information was gathered on sociodemographic and anthropometric characteristics, clinical history, occurrence of acne and hirsutism, serum testosterone levels, obstetric history, family history of chronic diseases, menstrual history, physical activity, and dietary intake. Results. Eighteen percent of the participants were confirmed of having PCOS by recent guidelines of Rotterdam Consensus for adolescent diagnosis of PCOS (presence of all three elements. Majority of the individuals with PCOS had an average age of 16 (SD = 2 (P=.02 years with an average age of menarche 12 years (SD = 1. Conclusion. The proportion of participants diagnosed with PCOS was higher among urban participants in comparison to rural participants.

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

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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.

Comparison of two approaches for measuring household wealth via an asset-based index in rural and peri-urban settings of Hunan province, China

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Balen Julie

2010-09-01

Full Text Available Abstract Background There are growing concerns regarding inequities in health, with poverty being an important determinant of health as well as a product of health status. Within the People's Republic of China (P.R. China, disparities in socio-economic position are apparent, with the rural-urban gap of particular concern. Our aim was to compare direct and proxy methods of estimating household wealth in a rural and a peri-urban setting of Hunan province, P.R. China. Methods We collected data on ownership of household durable assets, housing characteristics, and utility and sanitation variables in two village-wide surveys in Hunan province. We employed principal components analysis (PCA and principal axis factoring (PAF to generate household asset-based proxy wealth indices. Households were grouped into quartiles, from 'most wealthy' to 'most poor'. We compared the estimated household wealth for each approach. Asset-based proxy wealth indices were compared to those based on self-reported average annual income and savings at the household level. Results Spearman's rank correlation analysis revealed that PCA and PAF yielded similar results, indicating that either approach may be used for estimating household wealth. In both settings investigated, the two indices were significantly associated with self-reported average annual income and combined income and savings, but not with savings alone. However, low correlation coefficients between the proxy and direct measures of wealth indicated that they are not complementary. We found wide disparities in ownership of household durable assets, and utility and sanitation variables, within and between settings. Conclusion PCA and PAF yielded almost identical results and generated robust proxy wealth indices and categories. Pooled data from the rural and peri-urban settings highlighted structural differences in wealth, most likely a result of localized urbanization and modernization. Further research is needed

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

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

2014-06-01

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

The Impact of Family Setting and Local Opportunities on Leaving Home and Migration Destinations of Rural Youths, The Netherlands 1860-1940

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Mönkediek, Bastian; Kok, Jan; Mandemakers, Kees

2016-01-01

In this article we aim to study how Dutch children’s individual destinies result from the complex interplay of family setting and local conditions in a rural environment. We focus on their final move from the parental home, and we will analyse not only timing and incidence of leaving, but also the

Fine Needle Aspiration of Thyroid Nodules Using the Bethesda System for Reporting Thyroid Cytopathology: An Institutional Experience in a Rural Setting

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Aili Guo

2017-01-01

Full Text Available Background. Fine needle aspiration (FNA remains the first-line diagnostic in management of thyroid nodules and reduces unnecessary surgeries. However, it is still challenging since cytological results are not always straightforward. This study aimed to examine the results of thyroid FNA using the Bethesda system for reporting thyroid cytopathology (TBSRTC to establish the level of accuracy of FNA procedures in a rural practice setting. Method. A retrospective chart review was conducted on existing thyroid FNA performed in a referral endocrine center between December 2011 and November 2015. Results. A total of 159 patients (18–88 years old and 236 nodule aspirations were performed and submitted for evaluation. 79% were benign, 3% atypia/follicular lesion of unknown significance (AUS/FLUS, 5% follicular neoplasm/suspicious for follicular neoplasm (FN/SFN, 4% suspicious for malignancy (one case was indeed an atypical parathyroid neoplasm by surgical pathology, 2% malignant, and 7% nondiagnostic. Two cases also had advanced molecular analysis on FNA specimens before thyroidectomy. Conclusion. The diagnostic yield of FNA cytology from our practice in a rural setting suggests that accuracy and specificity are comparable to results from larger centers.

Conceptualization and Measurement of the Neighborhood in Rural Settings: A Systematic Review of the Literature

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De Marco, Allison; De Marco, Molly

2010-01-01

Interest in the effects of neighborhood context on individual wellbeing has increased in recent years. We now know that neighborhood conditions, such as poverty and deprivation, negatively impact residents. However, most of the extant work has taken an urban focus. Less is known about these processes in rural settings. Neighborhood…

HIV-positive pregnant women attending the prevention of mother-to-child transmission of HIV/AIDS (PMTCT) services in Ethiopia: economic productivity losses across urban-rural settings.

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Zegeye, Elias Asfaw; Mbonigaba, Josue; Kaye, Sylvia Blanche

2018-06-01

HIV/AIDS impacts significantly on pregnant women and on children in Ethiopia. This impact has a multiplier effect on household economies and on productivity losses, and is expected to vary across rural and urban settings. Applying the human capital approach to data collected from 131 respondents, this study estimated productivity losses per HIV-positive pregnant woman-infant pair across urban and rural health facilities in Ethiopia, which in turn were used to estimate the national productivity loss. The study found that the annual productivity loss per woman-infant pair was Ethiopian birr (ETB) 7,433 or United States dollar (US$) 378 and ETB 625 (US$ 32) in urban and rural settings, respectively. The mean patient days lost per year due to inpatient admission at hospitals/health centres was 11 in urban and 22 in rural health facilities. On average, urban home care-givers spent 20 (SD = 21) days annually providing home care services, while their rural counterparts spent 23 days (SD = 26). The productivity loss accounted for 16% and 7% of household income in urban and rural settings, respectively. These high and varying productivity losses require preventive interventions that are appropriate to each setting to ensure the welfare of women and children in Ethiopia.

The prevalence and correlates of lifetime psychiatric disorders and trauma exposures in urban and rural settings: results from the national comorbidity survey replication (NCS-R.

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Jennifer S McCall-Hosenfeld

Full Text Available Distinctions between rural and urban environments produce different frequencies of traumatic exposures and psychiatric disorders. We examine the prevalence of psychiatric disorders and frequency of trauma exposures by position on the rural-urban continuum.The National Comorbidity Survey Replication (NCS-R was used to evaluate psychiatric disorders among a nationally-representative sample of the U.S. population. Rurality was designated using the Department of Agriculture's 2003 rural-urban continuum codes (RUCC, which differentiate counties into levels of rurality by population density and adjacency to metropolitan areas. Lifetime psychiatric disorders included post-traumatic stress disorder (PTSD, anxiety disorders, major depressive disorder, mood disorders, impulse-control disorders, and substance abuse. Trauma exposures were classified as war-related, accident-related, disaster-related, interpersonal or other. Weighted logistic regression models examined the odds of psychiatric disorders and trauma exposures by position on the rural-urban continuum, adjusted for relevant covariates.75% of participants were metropolitan, 12.2% were suburban, and 12.8% were from rural counties. The most common disorder reported was any anxiety disorder (38.5%. Drug abuse was more common among metropolitan (8.7%, p = 0.018, compared to nonmetropolitan (5.1% suburban, 6.1% rural participants. A one-category increase in rurality was associated with decreased odds for war-related trauma (aOR = 0.86, 95%CI 0.78-0.95. Rurality was not associated with risk for any other lifetime psychiatric disorders or trauma exposure.Contrary to the expectation of some rural primary care providers, the frequencies of most psychiatric disorders and trauma exposures are similar across the rural-urban continuum, reinforcing calls to improve mental healthcare access in resource-poor rural communities.

Psychological wellbeing, physical impairments and rural aging in a developing country setting.

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Abas, Melanie A; Punpuing, Sureeporn; Jirapramupitak, Tawanchai; Tangchonlatip, Kanchana; Leese, Morven

2009-07-16

There has been very little research on wellbeing, physical impairments and disability in older people in developing countries. A community survey of 1147 older parents, one per household, aged sixty and over in rural Thailand. We used the Burvill scale of physical impairment, the Thai Psychological Wellbeing Scale and the brief WHO Disability Assessment Schedule. We rated received and perceived social support separately from children and from others and rated support to children. We used weighted analyses to take account of the sampling design. Impairments due to arthritis, pain, paralysis, vision, stomach problems or breathing were all associated with lower wellbeing. After adjusting for disability, only impairment due to paralysis was independently associated with lowered wellbeing. The effect of having two or more impairments compared to none was associated with lowered wellbeing after adjusting for demographic factors and social support (adjusted difference -2.37 on the well-being scale with SD = 7.9, p effect of paralysis was -2.97, p = 0.001). In this Thai setting, received support from children and from others and perceived good support from and to children were all independently associated with greater wellbeing whereas actual support to children was associated with lower wellbeing. Low received support from children interacted with paralysis in being especially associated with low wellbeing. In this Thai setting, as found in western settings, most of the association between physical impairments and lower wellbeing is explained by disability. Disability is potentially mediating the association between impairment and low wellbeing. Received support may buffer the impact of some impairments on wellbeing in this setting. Giving actual support to children is associated with less wellbeing unless the support being given to children is perceived as good, perhaps reflecting parental obligation to support adult children in need. Improving community disability

Mapping knowledge management resources of maternal, newborn and child health (MNCH) among people living in rural and urban settings of Ilorin, Nigeria.

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Bolarinwa, Oladimeji Akeem; Ameen, Hafsat Abolore; Durowade, Kabir Adekunle; Akande, Tanimola Makanjuola

2014-01-01

Lack of access to information and knowledge about mother and child health was identified as a major contributor to poor maternal and child health in Nigeria. The Partnership for Maternal, Newborn and Child Health (PMNCH) has recognized mapping the knowledge management of Maternal Newborn and Child Health (MNCH) as one of the major strategies to be deployed in improving the health of these vulnerable groups. The main aim of this study is to map the knowledge management resources of Maternal, Newborn and Child Health (MNCH) in rural and urban settings of Ilorin West LGA of Kwara state Nigeria. It is a descriptive cross-sectional study with a comparative analysis of findings from urban and rural settings. Epi-mapping was used to carve out the LGA and map responses. The p-value of less than 0.05 was considered significant at 95% confidence level. The study showed that traditional leader was responsible for more than half of the traditional way of obtaining information by rural (66.7%) and urban (56.2%) respondents while documentation accounts for the main MNCH knowledge preservation for the rural (40.6%) and the urban (50%) dwellers. Traditional leaders (32.2%) and elders (46.7%) were the main people responsible for dissemination of knowledge in rural areas whereas elders (35.9%) and Parents (19.9%) were the main people responsible in urban areas. It was concluded that traditional and family institutions are important in the knowledge management of MNCH in both rural and urban settings of Nigeria.

Measuring participant rurality in Web-based interventions

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McKay H Garth

2007-08-01

Full Text Available Abstract Background Web-based health behavior change programs can reach large groups of disparate participants and thus they provide promise of becoming important public health tools. Data on participant rurality can complement other demographic measures to deepen our understanding of the success of these programs. Specifically, analysis of participant rurality can inform recruitment and social marketing efforts, and facilitate the targeting and tailoring of program content. Rurality analysis can also help evaluate the effectiveness of interventions across population groupings. Methods We describe how the RUCAs (Rural-Urban Commuting Area Codes methodology can be used to examine results from two Randomized Controlled Trials of Web-based tobacco cessation programs: the ChewFree.com project for smokeless tobacco cessation and the Smokers' Health Improvement Program (SHIP project for smoking cessation. Results Using RUCAs methodology helped to highlight the extent to which both Web-based interventions reached a substantial percentage of rural participants. The ChewFree program was found to have more rural participation which is consistent with the greater prevalence of smokeless tobacco use in rural settings as well as ChewFree's multifaceted recruitment program that specifically targeted rural settings. Conclusion Researchers of Web-based health behavior change programs targeted to the US should routinely include RUCAs as a part of analyzing participant demographics. Researchers in other countries should examine rurality indices germane to their country.

Economic Costs of Patients Attending the Prevention of Mother-to- Child Transmission of HIV/AIDS (PMTCT Services in Ethiopia: Urban-Rural Settings

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Elias Asfaw Zegeye

2016-08-01

Full Text Available Economic analyses of patients’ costs are pertinent to improve effective healthcare services including the prevention of mother-to-child HIV/AIDS transmission (PMTCT. This study assessed the direct and non-direct medical costs borne by pregnant women attending PMTCT services in urban (high-HIV prevalence and rural (low-HIV prevalence settings, in Ethiopia. Patient-level direct medical costs and direct non-medical data were collected from HIV-positive pregnant women in six regions. The cost estimation was classified as direct medical (service fee, drugs and laboratory and direct non-medical (food, transportation and accommodation. The mean direct medical expense per patient per year was Ethiopian birr (ETB 746 (US$ 38 in the urban settings, as compared to ETB 368 (US$ 19 in the rural settings. On average, a pregnant woman from urban and rural catchments incurred direct non-medical costs of ETB 6,435 (US$ 327 and ETB 2,154 (US$ 110 per year, respectively. On average, non-medical costs of friend/relative/guardian were ETB 2,595 (US$ 132 and ETB 2,919 (US$ 148.39 in the urban and rural settings, respectively. Although the PMTCT service is provided free of charge, HIV-positive pregnant women and infant pairs still face a substantial amount of out-of-pocket spending due to direct medical and non-medical costs.

Low prevalence of methicillin-resistant Staphylococcus aureus nasal carriage in urban and rural community settings in Bolivia and Peru.

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Bartoloni, Alessandro; Pallecchi, Lucia; Fernandez, Connie; Mantella, Antonia; Riccobono, Eleonora; Magnelli, Donata; Mannini, Dario; Strohmeyer, Marianne; Bartalesi, Filippo; Segundo, Higinio; Monasterio, Joaquin; Rodriguez, Hugo; Cabezas, César; Gotuzzo, Eduardo; Rossolini, Gian Maria

2013-05-01

To investigate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage in rural and urban community settings of Bolivia and Peru. MRSA nasal carriage was investigated in 585 individuals living in rural and urban areas of Bolivia and Peru (one urban area, one small rural village, and two native communities, one of which was highly isolated). MRSA isolates were subjected to molecular analysis for the detection of virulence genes, characterization of the staphylococcal cassette chromosome mec (SCCmec), and genotyping (multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE)). An overall very low prevalence of MRSA nasal carriage was observed (0.5%), with MRSA carriers being detected only in a small rural village of the Bolivian Chaco. The three MRSA isolates showed the characteristics of community-associated MRSA (being susceptible to all non-beta-lactam antibiotics and harboring the SCCmec type IV), were clonally related, and belonged to ST1649. This study provides an insight into the epidemiology of MRSA in community settings of Bolivia and Peru. Reliable, time-saving, and low-cost methods should be implemented to encourage continued surveillance of MRSA dissemination in resource-limited countries. Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Response to antiretroviral therapy of HIV type 1-infected children in urban and rural settings of Uganda.

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Musiime, Victor; Kayiwa, Joshua; Kiconco, Mary; Tamale, William; Alima, Hillary; Mugerwa, Henry; Abwola, Mary; Apilli, Eunice; Ahimbisibwe, Fred; Kizito, Hilda; Abongomera, George; Namusoke, Asia; Makabayi, Agnes; Kiweewa, Francis; Ssali, Francis; Kityo, Cissy; Colebunders, Robert; Mugyenyi, Peter

2012-12-01

From 2006 to 2011, a cohort study was conducted among 1000 children resident in urban and rural settings of Uganda to ascertain and compare the response to antiretroviral therapy (ART) among urban versus rural children and the factors associated with this response. Clinical, immunological, and virological parameters were ascertained at baseline and weeks 24, 48, 96, and 144 after ART initiation. Adherence to ART was assessed at enrollment by self-report (SR) and pill counts (PC). Overall, 499/948 (52.6%) children were resident in rural areas, 504/948 (53.1%) were male, and their mean age was 11.9±4.4 years (urban children) and 11.4±4.1 years (rural children). The urban children were more likely to switch to second-line ART at a rate of 39.9 per 1000 person-years (95% CI: 28.2-56.4) versus 14.9 per 1000 person-years (95% CI: 8.7-25.7), p=0.0038, develop any new WHO 3/4 events at 127/414 (30.7%) versus 108/466 (23.2%), p=0.012, and have a higher cumulative incidence of hospitalization of 54/449 (12.0%) versus 32/499 (6.4%), p=0.003, when compared to rural children. No differences were observed in mean changes in weight, height, CD4 count and percentage, and hemoglobin and viral load between urban and rural children. Adherence of ≥95% was observed in 88.2% of urban versus 91.3% of rural children by SR (p=0.130), and in 78.8% of urban versus 88.8% of rural children by PC (pART than urban children.

County-Level Poverty Is Equally Associated with Unmet Health Care Needs in Rural and Urban Settings

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Peterson, Lars E.; Litaker, David G.

2010-01-01

Context: Regional poverty is associated with reduced access to health care. Whether this relationship is equally strong in both rural and urban settings or is affected by the contextual and individual-level characteristics that distinguish these areas, is unclear. Purpose: Compare the association between regional poverty with self-reported unmet…

Access to chlamydia testing in remote and rural Scotland.

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Hawkins, Katherine E; Thompson, Lucy; Wilson, Philip

2016-01-01

The aim of this study was to assess access to sexual health care in remote and rural settings using Chlamydia testing as a focus by measuring the extent of Chlamydia testing and positivity across the Scottish Highlands in relation to the Scottish Index of Multiple Deprivation Quintile (SIMD) and Urban Rural 8-fold index (UR8). Tests processed through Raigmore Hospital in Inverness, the main testing laboratory for microbiology tests in North and West and South and Mid Highlands, were studied. Where people are tested in relation to where they live was assessed, as well as the type of test they opt for. Also assessed was the rate of positivity in male and female patients in rural compared with urban settings using the Scottish Government UR8 and in relation to the SIMD. 9644 results were analysed. 77.2% of the results were for females and 22.4% for males. 8.1% of the results were positive and 84.4% were negative. There were proportionately more positive tests from the sexual health sources than from general practice. The proportion of men who had positive tests was almost double that for women (12.7% vs 6.6%) although men made up only 27.9% of the total number of tests. There was no significant difference in positivity when compared with UR8 index or SIMD. 37.7% of people living in the most rural areas (UR8 7-8) had their test performed in a more urban setting (UR8 1-6), and 20.4% people had their test performed in a very urban setting (UR8 1-2). Of these tests, there was a tendency for UR8 7-8 patients to be more likely to have a positive test if tested in an urban setting. These results are similar to previous results in other countries that suggest that Chlamydia positivity is similar in rural and urban settings. A large proportion of people living in more rurally classified areas, and perhaps those with a higher risk, have their test in a central setting, suggesting that they may be bypassing local resources to get a test. The reason for this is not clear. The

Report on the International Workshop on Drug Prevention and Treatment in Rural Settings Organized by United Nation Office on Drugs and Crime (UNODC) and World Health Organization (WHO).

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Milano, Giulia; Saenz, Elizabeth; Clark, Nicolas; Busse, Anja; Gale, John; Campello, Giovanna; Mattfeld, Elizabeth; Maalouf, Wadih; Heikkila, Hanna; Martelli, Antonietta; Morales, Brian; Gerra, Gilberto

2017-11-10

Very little evidence has been reported in literature regarding the misuse of substances in rural areas. Despite the common perception of rural communities as a protective and risk-mitigating environment, the scientific literature demonstrated the existence of many risk factors in rural communities. The Drug Prevention and Health Branch (DHB) of the United Nations Office on Drugs and Crime (UNODC), and the World Health Organization (WHO), in June 2016, organized a meeting of experts in treatment and prevention of SUDs in rural settings. The content presented during the meeting and the related discussion have provided materials for the preparation of an outline document, which is the basis to create a technical tool on SUDs prevention and treatment in rural settings. The UNODC framework for interventions in rural settings is a technical tool aimed to assist policy makers and managers at the national level. This paper is a report on UNODC/WHO efforts to improve the clinical conditions of people affected by SUDs and living in rural areas. The purpose of this article is to draw attention on a severe clinical and social problem in a reality forgotten by everyone.

Action Learning Sets and Social Capital: Ameliorating the Burden of Clergy Isolation in One Rural Diocese

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Muskett, Judith A.; Village, Andrew

2016-01-01

Rural clergy often lack colleagues and may struggle with isolation, especially if over-extended in multi-parish benefices. Theory suggests that this sense of isolation could be addressed by launching clergy action learning sets, which have the potential to establish a peer support network through the formation of social capital as a by-product of…

Rural women caregivers in Canada.

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Crosato, Kay E; Leipert, Beverly

2006-01-01

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

Supervisors' experiences of workplace supervision of nursing and paramedic students in rural settings: a scoping review.

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Trede, Franziska; McEwen, Celina; Kenny, Amanda; O'Meara, Peter

2014-05-01

We present our findings from a scoping review that sought to identify what is known about nursing and paramedic clinical supervisors' experiences of their supervision practices in rural settings. Our interest in these two groups is based on the central role that nurses and paramedics play in rural health care. Scoping reviews support identification of a broad range of literature, including all types of study designs. We adopted Arksey and O'Malley's five-stage approach: identifying the research question; identifying relevant studies; study selection; charting the data; and collating, summarising and reporting results. Databases searched included Academic Search Complete, Springer, Factiva, ProQuest, Ebsco, Informit, VOCEDplus and Scopus. Based on our research question and inclusion and exclusion criteria we selected relevant literature and summarised and reported it using Arksey and O'Malley's framework. The review yielded five articles from four countries: Sweden, Belgium, Malaysia and Australia. From this scoping review, we identified key themes related to supervisors' experiences, including clarification of expectations, support from managers and colleagues, the need for shared understanding between university, students and supervisors and required skills and competence in supervising students. © 2013.

Variations in fresh fruit and vegetable quality by store type, urban-rural setting and neighbourhood deprivation in Scotland.

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Cummins, Steven; Smith, Dianna M; Taylor, Mathew; Dawson, John; Marshall, David; Sparks, Leigh; Anderson, Annie S

2009-11-01

Neighbourhood differences in access to fresh fruit and vegetables may explain social inequalities in diet. Investigations have focused on variations in cost and availability as barriers to the purchase and consumption of fresh produce; investigations of quality have been neglected. Here we investigate whether produce quality systematically varies by food store type, rural-urban location and neighbourhood deprivation in a selection of communities across Scotland. Cross-sectional survey of twelve fresh fruit and vegetable items in 288 food stores in ten communities across Scotland. Communities were selected to reflect a range of urban-rural settings and a food retail census was conducted in each location. The quality of twelve fruit and vegetable items within each food store was evaluated. Data from the Scottish Executive were used to characterise each small area by deprivation and urban-rural classification. Scotland. Quality of fruit and vegetables within the surveyed stores was high. Medium-sized stores, stores in small town and rural areas, and stores in more affluent areas tended to have the highest-quality fresh fruit and vegetables. Stores where food is secondary, stores in urban settings and stores in more deprived areas tended have the lowest-quality fresh produce. Although differences in quality were not always statistically significant, patterns were consistent for the majority of fruit and vegetable items. The study provides evidence that variations in food quality may plausibly be a micro-environmental mediating variable in food purchase and consumption and help partially explain neighbourhood differences in food consumption patterns.

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

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Salmanzadeh, Cyrus

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

The Impact of Family Setting and Local Opportunities on Leaving Home and Migration Destinations of Rural Youths, The Netherlands 1860-1940

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Bastian Mönkediek

2015-11-01

Full Text Available In this article we aim to study how Dutch children’s individual destinies result from the complex interplay of family setting and local conditions in a rural environment. We focus on their final move from the parental home, and we will analyse not only timing and incidence of leaving, but also the destinations. To do this, we propose a multi-level competing risk analysis of migration destinations. We focus on two groups: the children of farmers and those of rural workers. Dutch farmers and workers differ in the type of family economy in which children were integrated, and contrasting them will allow us to explain the speed, the directions, and the individual and family backgrounds of the process of leaving agriculture. We make use of the Historical Sample of the Netherlands to analyse last migrations of 8,338 children of farmers and rural workers. As we cover the entire country, we can study the full impact of regional differences on type of agriculture and inheritance, in combination with the family composition. Our results indicate significant effects of specialised versus traditional, mixed farming on the migration behaviour of farmers’ and rural workers’ children, as well as the importance of the number of siblings of the same sex and birth order. The variations in the effects of the sibship among regions with different agricultural systems demonstrate the importance of gender-specific divisions of labour on leaving home.

Epidemiologic profile of patients seen in primary care clinics in an urban and a rural setting in Haiti, 2010-11.

Science.gov (United States)

Dickstein, Yaakov; Neuberger, Ami; Golus, Miri; Schwartz, Eli

2014-09-01

This study examined the demographic and epidemiological differences between patient populations presenting to a rural and an urban clinic in Haiti. A primary health clinic was established in urban Leogane, and a once-weekly clinic was established in Magandou, a rural village. Patient data were recorded for all individuals presenting to each clinic. Over 7 months, 6632 patients (median age 25) were seen in the urban clinic, and 567 (median age 47) in the rural clinic. There was a female majority at both sites. Hypertension was diagnosed in 41.9% (238/567) of the rural population over 40 years of age, while 29.5% (1956/6632) of patients in the urban setting had the same diagnosis (pHaiti must address the wide rural prevalence. STDs are a major urban health issue requiring treatment for both patients and their partners. Vector-borne disease was unseen in the rural clinic, despite an altitude insufficient to prevent mosquito-borne illness. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Understanding low uptake of contraceptives in resource-limited settings: a mixed-methods study in rural Burundi.

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Ndayizigiye, M; Fawzi, M C Smith; Lively, C Thompson; Ware, N C

2017-03-15

Family planning can reduce deaths, improve health, and facilitate economic development in resource-limited settings. Yet, modern contraceptive methods are often underused. This mixed-methods study, conducted in rural Burundi, sought to explain low uptake of contraceptives by identifying utilization barriers. Results may inform development of family planning interventions in Burundi and elsewhere. We investigated uptake of contraceptives among women of reproductive age in two rural districts of Burundi, using an explanatory sequential, mixed-methods research design. We first assessed availability and utilization rates of modern contraceptives through a facility-based survey in 39 health clinics. Barriers to uptake of contraceptives were then explored through qualitative interviews (N = 10) and focus groups (N = 7). Contraceptives were generally available in the 39 clinics studied, yet uptake of family planning averaged only 2.96%. Greater uptake was positively associated with the number of health professionals engaged and trained in family planning service provision, and with the number of different types of contraceptives available. Four uptake barriers were identified: (1) lack of providers to administer contraception, (2) lack of fit between available and preferred contraceptive methods, (3) a climate of fear surrounding contraceptive use, and (4) provider refusal to offer family planning services. Where resources are scarce, availability of modern contraceptives alone will likely not ensure uptake. Interventions addressing multiple uptake barriers simultaneously have the greatest chance of success. In rural Burundi, examples are community distribution of contraceptive methods, public information campaigns, improved training for health professionals and community health workers, and strengthening of the health infrastructure.

Area-level risk factors for adverse birth outcomes: trends in urban and rural settings.

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Kent, Shia T; McClure, Leslie A; Zaitchik, Ben F; Gohlke, Julia M

2013-06-10

Significant and persistent racial and income disparities in birth outcomes exist in the US. The analyses in this manuscript examine whether adverse birth outcome time trends and associations between area-level variables and adverse birth outcomes differ by urban-rural status. Alabama births records were merged with ZIP code-level census measures of race, poverty, and rurality. B-splines were used to determine long-term preterm birth (PTB) and low birth weight (LBW) trends by rurality. Logistic regression models were used to examine differences in the relationships between ZIP code-level percent poverty or percent African-American with either PTB or LBW. Interactions with rurality were examined. Population dense areas had higher adverse birth outcome rates compared to other regions. For LBW, the disparity between population dense and other regions increased during the 1991-2005 time period, and the magnitude of the disparity was maintained through 2010. Overall PTB and LBW rates have decreased since 2006, except within isolated rural regions. The addition of individual-level socioeconomic or race risk factors greatly attenuated these geographical disparities, but isolated rural regions maintained increased odds of adverse birth outcomes. ZIP code-level percent poverty and percent African American both had significant relationships with adverse birth outcomes. Poverty associations remained significant in the most population-dense regions when models were adjusted for individual-level risk factors. Population dense urban areas have heightened rates of adverse birth outcomes. High-poverty African American areas have higher odds of adverse birth outcomes in urban versus rural regions. These results suggest there are urban-specific social or environmental factors increasing risk for adverse birth outcomes in underserved communities. On the other hand, trends in PTBs and LBWs suggest interventions that have decreased adverse birth outcomes elsewhere may not be reaching

Reporting diarrhoea through a vernacular term in Quechua-speaking settings of rural Bolivia.

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Pacheco, Gonzalo Durán; Christen, Andri; Arnold, Ben; Hattendorf, Jan; Colford, John M; Smith, Thomas A; Mäusezahl, Daniel

2011-12-01

Field studies often use caregiver-reported diarrhoea and related symptoms to measure child morbidity. There are various vernacular terms to define diarrhoea that vary across the local cultural contexts. The relationship between vernacular definitions of diarrhoea and symptoms-based definitions is not well-documented. This paper describes the association of the vernacular Quechua term k'echalera with the symptoms-based standard definition of diarrhoea in rural Bolivian settings. During a cluster randomized trial in rural Bolivia, both signs and symptoms of diarrhoea and reports of k'echalera were collected for children aged less than five years. Reported k'echalera were found to be associated with important changes in stool frequency, consistency, and presence of blood and mucus. Reported k'echalera were highly related to three of four recorded categories of watery stool. The intermediate (milk-rice) stool consistency, which fits into the definition of watery stool, was not strongly related to k'echalera. Mucus in the stool was also associated with k'echalera; however, its presence in k'echalera-free days accounted for at least 50% of the possible false negatives. The sensitivity and specificity of the term k'echalera were estimated by Bayesian methods, allowing for both symptoms of diarrhoea and reports of k'echalera to be subject to diagnosis error. An average specificity of at least 97% and the sensitivity of at least 50% were obtained. The findings suggest that the use of k'echalera would identify fewer cases of diarrhoea than a symptom-based definition in rural Bolivia.

Cross-sectional study of malnutrition and associated factors among school aged children in rural and urban settings of Fogera and Libo Kemkem districts, Ethiopia.

Science.gov (United States)

Herrador, Zaida; Sordo, Luis; Gadisa, Endalamaw; Moreno, Javier; Nieto, Javier; Benito, Agustín; Aseffa, Abraham; Cañavate, Carmen; Custodio, Estefania

2014-01-01

Little information is available on malnutrition-related factors among school-aged children ≥5 years in Ethiopia. This study describes the prevalence of stunting and thinness and their related factors in Libo Kemkem and Fogera, Amhara Regional State and assesses differences between urban and rural areas. In this cross-sectional study, anthropometrics and individual and household characteristics data were collected from 886 children. Height-for-age z-score for stunting and body-mass-index-for-age z-score for thinness were computed. Dietary data were collected through a 24-hour recall. Bivariate and backward stepwise multivariable statistical methods were employed to assess malnutrition-associated factors in rural and urban communities. The prevalence of stunting among school-aged children was 42.7% in rural areas and 29.2% in urban areas, while the corresponding figures for thinness were 21.6% and 20.8%. Age differences were significant in both strata. In the rural setting, fever in the previous 2 weeks (OR: 1.62; 95% CI: 1.23-2.32), consumption of food from animal sources (OR: 0.51; 95% CI: 0.29-0.91) and consumption of the family's own cattle products (OR: 0.50; 95% CI: 0.27-0.93), among others factors were significantly associated with stunting, while in the urban setting, only age (OR: 4.62; 95% CI: 2.09-10.21) and years of schooling of the person in charge of food preparation were significant (OR: 0.88; 95% CI: 0.79-0.97). Thinness was statistically associated with number of children living in the house (OR: 1.28; 95% CI: 1.03-1.60) and family rice cultivation (OR: 0.64; 95% CI: 0.41-0.99) in the rural setting, and with consumption of food from animal sources (OR: 0.26; 95% CI: 0.10-0.67) and literacy of head of household (OR: 0.24; 95% CI: 0.09-0.65) in the urban setting. The prevalence of stunting was significantly higher in rural areas, whereas no significant differences were observed for thinness. Various factors were associated with one or both types of

How to Set Up a Research Framework to Analyze Social-Ecological Interactive Processes in a Rural Landscape

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Marc Deconchat

2007-06-01

Full Text Available Interdisciplinary research frameworks can be useful in providing answers to the environmental challenges facing rural environments, but concrete implementation of them remains empirical and requires better control. We present our practical experience of an interdisciplinary research project dealing with non-industrial private forestry in rural landscapes. The theoretical background, management, and methodological aspects, as well as results of the project, are presented in order to identify practical key factors that may influence its outcomes. Landscape ecology plays a central role in organizing the project. The efforts allocated for communication between scientists from different disciplines must be clearly stated in order to earn reciprocal trust. Sharing the same nested sampling areas, common approaches, and analytical tools (GIS is important, but has to be balanced by autonomy for actual implementation of field work and data analysis in a modular and evolving framework. Data sets are at the heart of the collaboration and GIS is necessary to ensure their long-term management and sharing. The experience acquired from practical development of such projects should be shared more often in networks of teams to compare their behavior and identify common rules of functioning.

Service user involvement in mental health system strengthening in a rural African setting: qualitative study

OpenAIRE

Abayneh, Sisay; Lempp, Heidi; Alem, Atalay; Alemayehu, Daniel; Eshetu, Tigist; Lund, Crick; Semrau, Maya; Thornicroft, Graham; Hanlon, Charlotte

2017-01-01

Background It is essential to involve service users in efforts to expand access to mental health care in integrated primary care settings in low- and middle-income countries (LMICs). However, there is little evidence from LMICs to guide this process. The aim of this study was to explore barriers to, and facilitators of, service user/caregiver involvement in rural Ethiopia to inform the development of a scalable approach. Methods Thirty nine semi-structured interviews were carried out with pur...

Serving an Indigenous community: Exploring the cultural competence of medical students in a rural setting

OpenAIRE

Wong, Chin Hoong; Chen, Lee Ping; Koh, Kwee Choy; Chua, Siew Houy; Jong, Darren Chee Hiung; Mohd Fauzi, Nurliyana Mardhiah; Lim, Sue Yin

2017-01-01

Since 2013, medical students from the International Medical University (IMU) in Malaysia have been providing primary healthcare services, under the supervision of faculty members, to the indigenous people living in Kampung Sebir. The project has allowed the students to learn experientially within a rural setting. This study aims to examine the cultural competence of IMU medical students through an examination of their perspective of the indigenous people who they serve and the role of this co...

Moderation of Genetic Influences on Alcohol Involvement by Rural Residency among Adolescents: Results from the 1962 National Merit Twin Study.

Science.gov (United States)

Davis, Christal N; Natta, Shanaliz S; Slutske, Wendy S

2017-11-01

Adolescents in rural and urban areas may experience different levels of environmental restrictions on alcohol use, with those in rural areas experiencing greater monitoring and less access to alcohol. Such restrictions may limit expression of genetic vulnerability for alcohol use, resulting in a gene-environment interaction (G × E). This phenomenon has previously been reported in Finnish and Minnesota adolescents. The current study used data from 839 same-sex twin pairs from the 1962 National Merit Scholarship Qualifying Test to determine whether the G × E interaction would be evident in this earlier time period. We also assessed whether the G × E interaction would be moderated by sex, and whether family socioeconomic status (SES; income and parental education) may mediate the G × E interaction. Findings showed the expected interaction among females, with a weaker contribution of genes (2 vs. 44%) and greater contribution of shared environment (62 vs. 29%) to variation in alcohol involvement among rural as compared to urban residents. The G × E interaction was not observed among males, and operated independently from differences in family SES among rural and urban adolescents. This study represents a partial replication in a novel setting of the moderation of the genetic contribution to alcohol use by rural/urban residency, and suggests that SES differences may not explain this effect.

Setting up an index for the appropriatness of energy sources for rural India

Energy Technology Data Exchange (ETDEWEB)

Tewari, S K

1979-07-01

In India, widespread poverty is noticed specially in the rural section, the poverty being attributed to a variety of reasons. Rural development comprises the development of basic necessities like water, power, etc. Availability of energy is therefore a major pre-requisite for rural development. The author discusses a model with which various alternate sources can be evaluated with the rural context in picture.

Dementia and rural nuclear medicine

International Nuclear Information System (INIS)

Cowell, S.F.; Davison, A.; Logan-Sinclair, P.; Sturt University, Dubbo, NSW; Greenough, R.

2003-01-01

Full text: The rapid increase in dementia is directly related to the growing number of aged people in developed countries, such as Australia. This increase heightens the need for accurate dementia diagnosis to ensure treatment resources are appropriately allocated. However, current diagnostic methods are unable to determine specific dementia types limiting the effectiveness of many care plans. The lack of specialist resources in rural Australian communities presents nuclear medicine with an opportunity to make a significant impact on the management of this disease. This investigation aimed to identify how SPECT perfusion imaging could maximise its role in the management of dementia in a rural New South Wales setting. The study reviewed all Technetium 99m HMPAO SPECT brain studies over a three-year period. This included a medical record audit, review of all diagnostic imaging reports and an analysis of referral patterns. The results of this study provide compelling evidence that, even in a rural setting, brain SPECT, in conjunction with neuropsychological testing, offers high accuracy in determining the presence and type of dementia. In addition, the study found more than 30% of referrers had no training in SPECT, emphasising the importance of ensuring that brain SPECT reports, in a rural setting, educate and specify to referrers the significance and exact disease type found in the study. Copyright (2003) The Australian and New Zealand Society of Nuclear Medicine Inc

Results of an action-research on epilepsy in rural Mali.

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Elisa Bruno

Full Text Available To evaluate the RARE (Réseau Action-Recherche sur l'Epilepsie program, a model of managing and treating people with epilepsy (PWE at a primary health-care level in rural areas of Mali, we assessed treatment efficacy and compliance of patients who underwent the first year follow-up.A network of rural general practitioners (GPs settled in six rural districts of the regions of Koulikoro, Segou and Sikasso, was involved in the diagnosis, evaluation and monitoring of all the identified PWE and in the distribution of phenobarbital (PB. All the participants were included in a prospective database and followed-up by GPs at 4 months intervals during the first year. Seizure frequency, treatment doses and appearance of adverse events (AEs were systematically recorded. Efficacy was evaluated in terms of reduction of seizures frequency while noncompliance in terms of time to study withdrawal for any cause.596 patients treated with PB were included in the analysis. Of these, 74.0% completed the first year follow-up. At the final visit, 59.6% were seizure-free: 31.0% for 12 months, 10.2% for 8 months and 18.4% for 4 months. Adults and patients with convulsive seizures were the most drug-resistant (p<0.002. Few AEs were recorded. The multivariate analysis showed that being a woman, presenting convulsive seizures, having more than 5 seizures/month and had never be treated were predictors of withdrawal (p ≤ 0.05 at 12 months.This study showed a good response and compliance to the treatment and allowed the identification of some factors associated with failure of management in a setting very near to clinical practice. Awareness campaigns are needed to assure a broader accessibility to treatment and to improve the compliance and continuity with treatment programs.

Intra-facility linkage of HIV-positive mothers and HIV-exposed babies into HIV chronic care: rural and urban experience in a resource limited setting.

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Christine Mugasha

Full Text Available INTRODUCTION: Linkage of HIV-infected pregnant women to HIV care remains critical for improvement of maternal and child outcomes through prevention of maternal-to-child transmission of HIV (PMTCT and subsequent chronic HIV care. This study determined proportions and factors associated with intra-facility linkage to HIV care and Early Infant Diagnosis care (EID to inform strategic scale up of PMTCT programs. METHODS: A cross-sectional review of records was done at 2 urban and 3 rural public health care facilities supported by the Infectious Diseases Institute (IDI. HIV-infected pregnant mothers, identified through routine antenatal care (ANC and HIV-exposed babies were evaluated for enrollment in HIV clinics by 6 weeks post-delivery. RESULTS: Overall, 1,025 HIV-infected pregnant mothers were identified during ANC between January and June, 2012; 267/1,025 (26% in rural and 743/1,025 (74% in urban facilities. Of these 375/1,025 (37% were linked to HIV clinics [67/267(25% rural and 308/758(41% urban]. Of 636 HIV-exposed babies, 193 (30% were linked to EID. Linkage of mother-baby pairs to HIV chronic care and EID was 16% (101/636; 8/179 (4.5%] in rural and 93/457(20.3% in urban health facilities. Within rural facilities, ANC registration <28 weeks-of-gestation was associated with mothers' linkage to HIV chronic care [AoR, 2.0 95% CI, 1.1-3.7, p = 0.019] and mothers' multi-parity was associated with baby's linkage to EID; AoR 4.4 (1.3-15.1, p = 0.023. Stigma, long distance to health facilities and vertical PMTCT services affected linkage in rural facilities, while peer mothers, infant feeding services, long patient queues and limited privacy hindered linkage to HIV care in urban settings. CONCLUSION: Post-natal linkage of HIV-infected mothers to chronic HIV care and HIV-exposed babies to EID programs was low. Barriers to linkage to HIV care vary in urban and rural settings. We recommend targeted interventions to rapidly improve linkage to

SOCIAL PORTRAIT OF RURAL TEACHERS: THE RESULTS OF A COMPARATIVE SOCIOLOGICAL STUDY COUNTRY AND CITY TEACHERS

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Lyudmila Alexandrovna Amirova

2017-11-01

Full Text Available The article presents the results of application of the comparative sociological study of rural and urban schools. The characteristic of a social portrait of the rural teacher. The basic social problems, an assessment of social well-being of rural and urban teachers. Purpose. The authors aimed to identify specific problems of the rural school for making sound management decisions in the field of social educational policy. Methodology. A comparative type of applied sociological research is realized by applying such methodological approaches as structural and functional analysis and its variety – typological analysis [2; 3; 5]. Results. In summary, the social portrait of a rural educator is characterized by the following social characteristics. He lives mostly in his own house. One member of his family has, mainly, 12-18 or more square meters of living space. Entrepreneurship and tutoring are poorly distributed in rural areas. In comparison with urban teachers, rural teachers are more oriented to vocational training, rather than to the formation of spiritual and intellectual culture of students. This is the practicality of the rural educator. Employment in the subsidiary farm is also the reason for the greater practicality of the rural teacher and his relatively low spiritual activity. In rural educational institutions the level of collectivism is higher, but the desire for individual achievements is lower. Practical implications. The management of social processes at the level of a rural school can be implemented in the form of social planning, drawing up of social programs, social projects aimed at solving social problems of a rural teacher and optimizing the development of a rural school.

Rural transformations in the context of changing rural-urban connections

DEFF Research Database (Denmark)

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

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

The impact of ACE gene polymorphism on the incidence and phenotype of sarcoidosis in rural and urban settings.

Science.gov (United States)

Kieszko, Robert; Krawczyk, Paweł; Powrózek, Tomasz; Szudy-Szczyrek, Aneta; Szczyrek, Michał; Homa, Iwona; Daniluk, Jadwiga; Milanowski, Janusz

2016-12-01

Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Current theory on the etiology of this disease involves participation of genetic factors and unknown antigens present in the patients' environment. The aim of the study was to evaluate the prevalence of different polymorphic forms of the ACE gene in healthy individuals and sarcoidosis patients, and to estimate the risk of sarcoidosis in carriers of different ACE genotypes living in rural and urban settings. The study group included 180 patients with pulmonary sarcoidosis. Assessment of the disease was based on clinical features, laboratory and imaging examinations, as well as bronchoscopy with bronchoalveolar lavage (BAL). ACE gene polymorphism was examined in DNA isolated from peripheral blood or BAL fluid (BALF) leukocytes. Incidence of sarcoidosis was not influenced by gender, age or place of residence of the patients. There were no differences in the frequency of particular genotypes in patients with sarcoidosis and in healthy individuals. The risk of disease did not depend on the ACE gene polymorphism. There were no differences in the frequencies of the different genotypes and alleles of the ACE gene in patients with sarcoidosis divided by gender, age and place of residence or by clinical manifestation of sarcoidosis. Our results do not support the previous concept which suggested a higher incidence of sarcoidosis in individuals living in rural areas and in carriers of selected ACE genotypes. It is possible that this is related to the changing environment of rural areas, increasing urbanization and pollution.

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

Science.gov (United States)

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

1993-01-01

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

Returns to nursing education: rural and nonrural practice.

Science.gov (United States)

Pan, S; Straub, L

1997-01-01

This study uses data from a national sample of registered nurses to compare earnings of nurses in rural and nonrural practice. The comparisons, conditioned by the nurses' education level, are analogous to the concept of "returns to human capital investment" used in labor economics. A general linear model is applied within a framework of labor economics analysis. Results show that nurses with more education receive less for their investment if they practice in rural areas. Work experience and employment setting are also related to lower annualized earnings for rural practice. One exception to the otherwise consistent findings is that returns to advanced practice nursing are higher in rural areas. Results and policy implications are discussed.

Goal setting using telemedicine in rural underserved older adults with diabetes: experiences from the informatics for diabetes education and telemedicine project.

Science.gov (United States)

West, Susan P; Lagua, Carina; Trief, Paula M; Izquierdo, Roberto; Weinstock, Ruth S

2010-05-01

To describe the use of telemedicine for setting goals for behavior change and examine the success in achieving these goals in rural underserved older adults with diabetes. Medicare beneficiaries with diabetes living in rural upstate New York who were enrolled in the telemedicine intervention of the Informatics for Diabetes Education and Telemedicine (IDEATel) project (n = 610) participated in home televisits with nurse and dietitian educators every 4-6 weeks for 2-6 years. Behavior change goals related to nutrition, physical activity, monitoring, diabetes health maintenance, and/or use of the home telemedicine unit were established at the conclusion of each televisit and assessed at the next visit. Collaborative goal setting was employed during 18,355 televisits (mean of 33 goal-setting televisits/participant). The most common goals were related to monitoring, followed by diabetes health maintenance, nutrition, exercise, and use of the telemedicine equipment. Overall, 68% of behavioral goals were rated as "improved" or "met." The greatest success was achieved for goals related to proper insulin injection technique and daily foot care. These elderly participants had the most difficulty achieving goals related to use of the computer. No gender differences in goal achievement were observed. Televisits can be successfully used to collaboratively establish behavior change goals to help improve diabetes self-management in underserved elderly rural adults.

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

Science.gov (United States)

Harmon, Lisa M

2013-02-01

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

Breastfeeding Patterns in the Rural Community of Hilo, Hawai‘i: An Exploration of Existing Data Sets

OpenAIRE

Flood, Jeanie L

2013-01-01

Before any breastfeeding promotion effort, an understanding of the existing breastfeeding patterns is essential. Hawai‘i County is a rural, ethnically diverse, medically underserved community. The purpose of this study was to describe the breastfeeding patterns of women living in Hilo, Hawai‘i. Data from several existing national, state, and local data sets were accessed to identify and describe the breastfeeding patterns of women in this community. Available breastfeeding data about women in...

TOURIST MOTIVATION FOR RURAL DESTINATIONS

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Angela BOTEZATU

2014-04-01

Full Text Available City daily overexertion impels tourists wish to travel. Rural tourism behavior is determined by a set of motivational factors that makes him appreciate favorable tourist destinations. In order to analyze and assess the opinions and attitudes of tourists in rural areas we realized a market survey, the results being presented in the article below. Future trends, the growth rate of market depend largely on the wishes and intentions of goods or services consumers. This study involves the engagement of a number of 658 respondents, which were interviewed to determine the basic motivations in choosing countryside. The working methods used were analysis, synthesis and questionnaire survey as a research method. Results refer to the following: about 59 percent, spend up to 10% of annual income for vacations and travel, for rural tourism this amount is much lower; the association of the term „rural tourism” in the local tourist mind, oscillates among „a villa” in rural areas or „active vacation” (biking, hiking, riding, swimming or hunting; customer loyalty is one of the goals of marketing activities undertaken in hostels or other travel service providers. In conclusion, we mention that the variety of motivational factors in choosing tourist destinations in rural areas drive this type of tourism.

Barriers to access to antiretroviral treatment in Mozambique, as perceived by patients and health workers in urban and rural settings.

NARCIS (Netherlands)

Posse, M.E.; Baltussen, R.M.P.M.

2009-01-01

This study identifies, ranks, and compares factors perceived as barriers to accessing antiretroviral treatment (ART) in urban and rural settings in Mozambique. Data were collected between March and July 2008. It consisted of 13 focus group discussions and a structured questionnaire administered to

Aged-care nurses in rural Tasmanian clinical settings more likely to think hypothetical medication error would be reported and disclosed compared to hospital and community nurses.

Science.gov (United States)

Carnes, Debra; Kilpatrick, Sue; Iedema, Rick

2015-12-01

This study aims to determine the likelihood that rural nurses perceive a hypothetical medication error would be reported in their workplace. This employs cross-sectional survey using hypothetical error scenario with varying levels of harm. Clinical settings in rural Tasmania. Participants were 116 eligible surveys received from registered and enrolled nurses. Frequency of responses indicating the likelihood that severe, moderate and near miss (no harm) scenario would 'always' be reported or disclosed. Eighty per cent of nurses viewed a severe error would 'always' be reported, 64.8% a moderate error and 45.7% a near-miss error. In regards to disclosure, 54.7% felt this was 'always' likely to occur for a severe error, 44.8% for a moderate error and 26.4% for a near miss. Across all levels of severity, aged-care nurses were more likely than nurses in other settings to view error to 'always' be reported (ranging from 72-96%, P = 0.010 to 0.042,) and disclosed (68-88%, P = 0.000). Those in a management role were more likely to view error to 'always' be disclosed compared to those in a clinical role (50-77.3%, P = 0.008-0.024). Further research in rural clinical settings is needed to improve the understanding of error management and disclosure. © 2015 The Authors. Australian Journal of Rural Health published by Wiley Publishing Asia Pty Ltd on behalf of National Rural Health Alliance.

The adoption of provider-based rural health clinics by rural hospitals: a study of market and institutional forces.

Science.gov (United States)

Krein, S L

1999-04-01

To examine the response of rural hospitals to various market and organizational signals by determining the factors that influence whether or not they establish a provider-based rural health clinic (RHC) (a joint Medicare/Medicaid program). Several secondary sources for 1989-1995: the AHA Annual Survey, the PPS Minimum Data Set and a list of RHCs from HCFA, the Area Resource File, and professional associations. The analysis includes all general medical/surgical rural hospitals operating in the United States during the study period. A longitudinal design and pooled cross-sectional data were used, with the rural hospital as the unit of analysis. Key variables were examined as sets and include measures of competitive pressures (e.g., hospital market share), physician resources, nurse practitioner/physician assistant (NP/PA) practice regulation, hospital performance pressures (e.g., operating margin), innovativeness, and institutional pressure (i.e., the cumulative force of adoption). Adoption of provider-based RHCs by rural hospitals appears to be motivated less as an adaptive response to observable economic or internal organizational signals than as a reaction to bandwagon pressures. Rural hospitals with limited resources may resort to imitating others because of uncertainty or a limited ability to fully evaluate strategic activities. This can result in actions or behaviors that are not consistent with policy objectives and the perceived need for policy changes. Such activity in turn could have a negative effect on some providers and some rural residents.

Psychometric assessment of the patient activation measure short form (PAM-13) in rural settings.

Science.gov (United States)

Hung, Man; Carter, Marjorie; Hayden, Candace; Dzierzon, Rhonda; Morales, Jose; Snow, Laverne; Butler, Jorie; Bateman, Kim; Samore, Matthew

2013-04-01

The patient activation measure short form (PAM-13) assesses patients' self-reported health management skills, knowledge, confidence, and motivation. We used item response theory to evaluate the psychometric properties of the PAM-13 utilized in rural settings. A Rasch partial credit model analysis was conducted on the PAM-13 instrument using a sample of 812 rural patients recruited by providers and our research staff. Specially, we examined dimensionality, item fit, and quality of measures, category response curves, and item differential functioning. Convergent and divergent validities were also examined. The PAM-13 instrument has excellent convergent and divergent validities. It is fairly unidimensional, and all items fit the Rasch model well. It has relatively high person and item reliability indices. Majority of the items were free of item differential functioning. There were, however, some issues with ceiling effects. Additionally, there was a lack of responses for category one across all items. Patient activation measure short form (PAM-13) performs well in some areas, but not all. In general, more items need to be added to cover the upper end of the trait. The four response categories of PAM-13 should be collapsed into three.

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

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Marcella M S Kwan

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

Exploring the impact of wheelchair design on user function in a rural South African setting.

Science.gov (United States)

Visagie, Surona; Duffield, Svenje; Unger, Mariaan

2015-01-01

Wheelchairs provide mobility that can enhance function and community integration. Function in a wheelchair is influenced by wheelchair design. To explore the impact of wheelchair design on user function and the variables that guided wheelchair prescription in the study setting. A mixed-method, descriptive design using convenience sampling was implemented. Quantitative data were collected from 30 wheelchair users using the functioning every day with a Wheelchair Scale and a Wheelchair Specification Checklist. Qualitative data were collected from ten therapists who prescribed wheelchairs to these users, through interviews. The Kruskal-Wallis test was used to identify relationships, and content analysis was undertaken to identify emerging themes in qualitative data. Wheelchairs with urban designs were issued to 25 (83%) participants. Wheelchair size, fit, support and functional features created challenges concerning transport, operating the wheelchair, performing personal tasks, and indoor and outdoor mobility. Users using wheelchairs designed for use in semi-rural environments achieved significantly better scores regarding the appropriateness of the prescribed wheelchair than those using wheelchairs designed for urban use ( p = <0.01). Therapists prescribed the basic, four-wheel folding frame design most often because of a lack of funding, lack of assessment, lack of skills and user choice. Issuing urban type wheelchairs to users living in rural settings might have a negative effect on users' functional outcomes. Comprehensive assessments, further training and research, on long term cost and quality of life implications, regarding provision of a suitable wheelchair versus a cheaper less suitable option is recommended.

Motivators of couple HIV counseling and testing (CHCT uptake in a rural setting in Uganda

Directory of Open Access Journals (Sweden)

Victoria Nannozi

2017-01-01

Full Text Available Abstract Background Couple HIV Counseling and Testing (CHCT is one of the key preventive strategies used to reduce the spread of HIV. In Uganda, HIV prevalence among married/living together is 7.2% among women and 7.6% among men. CHCT can help ease disclosure of HIV-positive status, which in turn may help increase opportunities to get social support and reduce new infections. The uptake of CHCT among attendees of health facilities in rural Uganda is as high as 34%. The purpose of this study was to explore the motivators of CHCT uptake in Mukono district, a rural setting in Uganda. Methods The study was conducted in two sub-counties in a rural district (Mukono district about 28 km east of the capital Kampala, using a descriptive and explorative qualitative research design. Specifically, we conducted focus group discussions and key informant interviews with HIV focal persons, village health team (VHT members, religious leaders and political leaders. We also interviewed persons in couple relationships. Data was analysed using NVivo 8 software. Ethical clearance was received from the Mengo Hospital Research Review Board and from the Uganda National Council of Science and Technology. Results The study was conducted from June 2013 to July 2013 We conducted 4 focus group discussions, 10 key informant interviews and interviewed 53 persons in couple relationships. None of the participants were a couple. The women were 68% (36/53 and 49% (26/53 of them were above 29 years old. The motivators of CHCT uptake were; perceived benefit of HIV testing, sickness of a partner or child in the family and suspicion of infidelity. Other important motivators were men involvement in antenatal care (ANC attendance and preparation for marriage. Conclusion The motivators for CHCT uptake included the perceived benefit of HIV testing, sickness of a partner or child, preparation for marriage, lack of trust among couples and men involvement in antenatal care. Greater

The business cycle and mortality: Urban versus rural counties.

Science.gov (United States)

Sameem, Sediq; Sylwester, Kevin

2017-02-01

Many studies have found that mortality declines during recessions, but do such results remain consistent in both urban and rural settings? To help uncover explanations for such a pro-cyclical nature of mortality, the present study revisits this topic but allows for associations between unemployment and mortality to differ between urban and rural areas. Using a total of 66 863 observations across 3066 counties of the U.S. from 1990 to 2013, we allow the coefficient on unemployment to differ between urban and rural counties. With an exception of deaths due to external accidents being pro-cyclical in rural settings, we find that the negative association between unemployment and mortality more generally holds for urban areas, particularly for females and the elderly. Moreover, we find death due to circulatory disease or influenza/pneumonia to be especially more prevalent in urban areas. Given that the negative associations between unemployment and mortality are generally stronger in cities, views attempting to explain pro-cyclical mortality should focus on characteristics in urban settings. Copyright © 2016 Elsevier Ltd. All rights reserved.

Free Access to Point of Care Resource Results in Increased Use and Satisfaction by Rural Healthcare Providers

Directory of Open Access Journals (Sweden)

Lindsay Alcock

2016-12-01

Full Text Available A Review of: Eldredge, J. D., Hall, L. J., McElfresh, K. R., Warner, T. D., Stromberg, T. L., Trost, J. T., & Jelinek, D. A. (2016. Rural providers’ access to online resources: A randomized controlled trial. Journal of the Medical Library Association, 104(1, 33-41. http://dx.doi.org/10.3163/1536-5050.104.1.005 Objective – To determine whether free access to the point of care (PoC resource Dynamed or the electronic book collection AccessMedicine was more useful to rural health care providers in answering clinical questions in terms of usage and satisfaction. Design – Randomized controlled trial. Setting – Rural New Mexico. Subjects – Twenty-eight health care providers (physicians, nurses, physician assistants, and pharmacists with no reported access to PoC resources, (specifically Dynamed and AccessMedicine or electronic textbook collections prior to enrollment.

Breastfeeding Patterns in the Rural Community of Hilo, Hawai‘i: An Exploration of Existing Data Sets

Science.gov (United States)

2013-01-01

Before any breastfeeding promotion effort, an understanding of the existing breastfeeding patterns is essential. Hawai‘i County is a rural, ethnically diverse, medically underserved community. The purpose of this study was to describe the breastfeeding patterns of women living in Hilo, Hawai‘i. Data from several existing national, state, and local data sets were accessed to identify and describe the breastfeeding patterns of women in this community. Available breastfeeding data about women in Hilo was obtained from the Hawai‘i WIC program and includes initiation, duration, exclusivity of breastfeeding, and reasons for not breastfeeding. These data were compared to data from published reports available at the county, state, and national level. The State of Hawai‘i and Hilo exceed national targets for breastfeeding initiation; however, rates soon drop following delivery, and mixed feedings of infants is common. The highest percentage of mothers weaned their infants within the first four weeks postpartum. The reasons the majority of the mothers gave for weaning were tied to breastfeeding situations that are amenable to skilled lactation support (eg, milk supply issues and latch or sucking problems). While available data sets offer valuable information on the breastfeeding patterns in this rural community, there are limitations to their usefulness, primarily due to the inconsistent operational definitions of infant feeding variables used in the surveys, and the lack of availability of community level data. PMID:23520565

Breastfeeding patterns in the rural community of Hilo, Hawai'i: an exploration of existing data sets.

Science.gov (United States)

Flood, Jeanie L

2013-03-01

Before any breastfeeding promotion effort, an understanding of the existing breastfeeding patterns is essential. Hawai'i County is a rural, ethnically diverse, medically underserved community. The purpose of this study was to describe the breastfeeding patterns of women living in Hilo, Hawai'i. Data from several existing national, state, and local data sets were accessed to identify and describe the breastfeeding patterns of women in this community. Available breastfeeding data about women in Hilo was obtained from the Hawai'i WIC program and includes initiation, duration, exclusivity of breastfeeding, and reasons for not breastfeeding. These data were compared to data from published reports available at the county, state, and national level. The State of Hawai'i and Hilo exceed national targets for breastfeeding initiation; however, rates soon drop following delivery, and mixed feedings of infants is common. The highest percentage of mothers weaned their infants within the first four weeks postpartum. The reasons the majority of the mothers gave for weaning were tied to breastfeeding situations that are amenable to skilled lactation support (eg, milk supply issues and latch or sucking problems). While available data sets offer valuable information on the breastfeeding patterns in this rural community, there are limitations to their usefulness, primarily due to the inconsistent operational definitions of infant feeding variables used in the surveys, and the lack of availability of community level data.

Barriers facing junior doctors in rural practice.

Science.gov (United States)

Smith, Deborah M

2005-01-01

Early postgraduate, or junior doctors, are still required to practise in rural and remote communities, and they continue to face numerous issues and difficulties. Within the hospital setting, exposure to rural practice appears to be very limited during internship, and also to some extent, during the second postgraduate year and beyond. This is a major issue for those required to undertake country relieving, rural terms or who will be bonded to rural and remote practice for several years after internship. This research investigated the current issues and difficulties faced by junior doctors, required to undertake rural and remote practice in Queensland, Australia. An exploratory study was undertaken. Primary data were collected through semi-structured interviews held with key stakeholders. Stakeholders included: directors of clinical training; medical educators; junior doctors; rural practitioners; academic rural practitioners; and medical administrators. Of the 23 people approached, a total of 19 agreed to be interviewed. The response rate was 82.6%. Similar to the issues identified in the literature, there are currently a number of barriers influencing the ability of junior doctors to practise competently and confidently when undertaking practice in rural and remote communities. Minimal clinical experience, lack of supervision and on-site support, inadequate orientation and uninformed expectations, limited access to relevant education, and the influence of isolation, results in an overall lack of preparation both professionally and personally. When asked, respondents supported the identification of core skills and knowledge, and integration of these and other issues affecting rural practice, into their hospital-based programs. Current hospital-based education and training programs were not adequately preparing junior doctors for rural and remote practice. It was commented that orientation and education, with a rural emphasis, could assist junior doctors in their

Risk Factor Profile of Motorcycle Crash Victims in Rural Kenya ...

African Journals Online (AJOL)

Background: Road traffic injuries involving motorcycles are increasing especially in rural Kenya resulting in both human and economic loss. This study was done to identify the risk factors and the host characteristics associated with motorcycle injury victims in rural setting so as to institute appropriate interventions for ...

Rural-Nonrural Disparities in Postsecondary Educational Attainment Revisited

Science.gov (United States)

Byun, Soo-yong; Meece, Judith L.; Irvin, Matthew J.

2013-01-01

Using data from the National Educational Longitudinal Study, this study revisited rural-nonrural disparities in educational attainment by considering a comprehensive set of factors that constrain and support youth's college enrollment and degree completion. Results showed that rural students were more advantaged in community social resources compared to nonrural students, and these resources were associated with a significant increase in the likelihood of bachelor's degree attainment. Yet results confirmed that rural students lagged behind nonrural students in attaining a bachelor's degree largely due to their lower socioeconomic background. The findings present a more comprehensive picture of the complexity of geographic residence in shaping college enrollment and degree attainment. PMID:24285873

Strengthening training in rural practice in Germany: new approach for undergraduate medical curriculum towards sustaining rural health care.

Science.gov (United States)

Holst, Jens; Normann, Oliver; Herrmann, Markus

2015-01-01

After decades of providing a dense network of quality medical care, Germany is facing an increasing shortage of medical doctors in rural areas. Current graduation rates of generalists do not counterbalance the loss due to retirement. Informed by international evidence, different strategies to ensure rural medical care are under debate, including innovative teaching approaches during undergraduate training. The University of Magdeburg in Saxony-Anhalt was the first medical school in Germany to offer a rural elective for graduate students. During the 2014 summer semester, 14 medical students attended a two-weekend program in a small village in Northern Saxony-Anhalt that allowed them to become more familiar with a rural community and rural health issues. The elective course raised a series of relevant topics for setting up rural practice and provided students with helpful insight into living and working conditions in rural practice. Preliminary evaluations indicate that the rural medicine course allowed medical students to reduce pre-existing concerns and had positive impact on their willingness to set up a rural medical office after graduation. Even short-term courses in rural practice can help reduce training-related barriers that prevent young physicians from working in rural areas. Undergraduate medical training is promising to attenuate the emerging undersupply in rural areas.

Association between Childhood Diarrhoeal Incidence and Climatic Factors in Urban and Rural Settings in the Health District of Mbour, Senegal

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Sokhna Thiam

2017-09-01

Full Text Available We assessed the association between childhood diarrhoeal incidence and climatic factors in rural and urban settings in the health district of Mbour in western Senegal. We used monthly diarrhoeal case records among children under five years registered in 24 health facilities over a four-year period (2011–2014. Climatic data (i.e., daily temperature, night temperature and rainfall for the same four-year period were obtained. We performed a negative binomial regression model to establish the relationship between monthly diarrhoeal incidence and climatic factors of the same and the previous month. There were two annual peaks in diarrhoeal incidence: one during the cold dry season and one during the rainy season. We observed a positive association between diarrhoeal incidence and high average temperature of 36 °C and above and high cumulative monthly rainfall at 57 mm and above. The association between diarrhoeal incidence and temperature was stronger in rural compared to urban settings, while higher rainfall was associated with higher diarrhoeal incidence in the urban settings. Concluding, this study identified significant health–climate interactions and calls for effective preventive measures in the health district of Mbour. Particular attention should be paid to urban settings where diarrhoea was most common in order to reduce the high incidence in the context of climatic variability, which is expected to increase in urban areas in the face of global warming.

Association between Childhood Diarrhoeal Incidence and Climatic Factors in Urban and Rural Settings in the Health District of Mbour, Senegal.

Science.gov (United States)

Thiam, Sokhna; Diène, Aminata N; Sy, Ibrahima; Winkler, Mirko S; Schindler, Christian; Ndione, Jacques A; Faye, Ousmane; Vounatsou, Penelope; Utzinger, Jürg; Cissé, Guéladio

2017-09-12

We assessed the association between childhood diarrhoeal incidence and climatic factors in rural and urban settings in the health district of Mbour in western Senegal. We used monthly diarrhoeal case records among children under five years registered in 24 health facilities over a four-year period (2011-2014). Climatic data (i.e., daily temperature, night temperature and rainfall) for the same four-year period were obtained. We performed a negative binomial regression model to establish the relationship between monthly diarrhoeal incidence and climatic factors of the same and the previous month. There were two annual peaks in diarrhoeal incidence: one during the cold dry season and one during the rainy season. We observed a positive association between diarrhoeal incidence and high average temperature of 36 °C and above and high cumulative monthly rainfall at 57 mm and above. The association between diarrhoeal incidence and temperature was stronger in rural compared to urban settings, while higher rainfall was associated with higher diarrhoeal incidence in the urban settings. Concluding, this study identified significant health-climate interactions and calls for effective preventive measures in the health district of Mbour. Particular attention should be paid to urban settings where diarrhoea was most common in order to reduce the high incidence in the context of climatic variability, which is expected to increase in urban areas in the face of global warming.

Tensions between the local and the global: contemporary rural and teaching in rural schools

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Elizeu Clementino de Souza

2012-05-01

Full Text Available The paper aims to investigate potential tensions between local and global context of contemporary ruralities, emphasizing the times, rhythms and spaces constructed from the experiences of teachers and students in the organization of the routines of rural schools. The paper presents theoretical considerations resulting from two studies in the Graduate Program in Education and Contemporary - PPGEduC / UNEB. The clipping and analysis undertaken focus on education developed in rural areas and tensions present in this context in view, discuss issues concerning the new ruralities contemporary. This discussion has as its central theme the issues of timing and the rhythm in schools with multigrade classes Island Tide that articulates with dilemmas and tensions surrounding the experience lived by teachers of geography of the city engaged in teaching in rural areas in semi-arid region of Bahia. Research has pointed to difficulties faced by rural school to consider the different temporalities that exist in rural areas in their educational processes, as well as difficulties of articulation in these contexts of learning, between the local-global dimensions through which passes the contemporary space. This movement creates stress for teachers’ work, since it complicates the relationship between the times established, standardized and rigid, with times of personal students and teachers, covering aspects such as age, life histories, movements and experiences socio-historical and geographical subjects involved in the processes of teaching and learning in rural settings in contemporary times.

Managing Ebola from rural to urban slum settings: experiences from Uganda.

Science.gov (United States)

Okware, Sam I; Omaswa, Francis; Talisuna, Ambrose; Amandua, Jacinto; Amone, Jackson; Onek, Paul; Opio, Alex; Wamala, Joseph; Lubwama, Julius; Luswa, Lukwago; Kagwa, Paul; Tylleskar, Thorkild

2015-03-01

Five outbreaks of ebola occurred in Uganda between 2000-2012. The outbreaks were quickly contained in rural areas. However, the Gulu outbreak in 2000 was the largest and complex due to insurgency. It invaded Gulu municipality and the slum- like camps of the internally displaced persons (IDPs). The Bundigugyo district outbreak followed but was detected late as a new virus. The subsequent outbreaks in the districts of Luwero district (2011, 2012) and Kibaale (2012) were limited to rural areas. Detailed records of the outbreak presentation, cases, and outcomes were reviewed and analyzed. Each outbreak was described and the outcomes examined for the different scenarios. Early detection and action provided the best outcomes and results. The ideal scenario occurred in the Luwero outbreak during which only a single case was observed. Rural outbreaks were easier to contain. The community imposed quarantine prevented the spread of ebola following introduction into Masindi district. The outbreak was confined to the extended family of the index case and only one case developed in the general population. However, the outbreak invasion of the town slum areas escalated the spread of infection in Gulu municipality. Community mobilization and leadership was vital in supporting early case detection and isolations well as contact tracing and public education. Palliative care improved survival. Focusing on treatment and not just quarantine should be emphasized as it also enhanced public trust and health seeking behavior. Early detection and action provided the best scenario for outbreak containment. Community mobilization and leadership was vital in supporting outbreak control. International collaboration was essential in supporting and augmenting the national efforts.

Helping behavior in a rural and an urban setting: professional and casual attire.

Science.gov (United States)

Wilson, Shauna B; Kennedy, Janice H

2006-02-01

This study assessed differences in helping behavior in a rural versus an urban location when directed toward either a professionally or a casually dressed woman. Convenience samples included 40 men and 40 women (10 people of each sex assigned to each condition: rural and professional, rural and casual, urban and professional, and urban and casual). A 21-yr.-old female confederate dropped an envelope near each target helper individually and recorded number of seconds for the target helper to retrieve or point out the dropped item. Analysis indicated significantly faster helping occurred in the rural than in the urban location and that men helped the confederate more often than women. No difference in frequencey of help was related to kind of attire.

Self-Assessed Competence of Experienced Expatriate Nurses in a Rural and Remote Setting

Directory of Open Access Journals (Sweden)

Salah Aqtash

2017-04-01

Full Text Available We aimed to measure the self-assessed level of competence among nurses working in the public hospitals of Al-Gharbia Region, a remote rural region of United Arab Emirates, and to explore the factors associated with the nurses’ self-perceived competency. The Nurse Competency Scale, which measures the self-assessed level of competency of nurses, has been validated in a variety of clinical settings, in facilities of various sizes, and in small and large cohorts. However, its application among an expatriate nursing workforce working in small hospitals and health facilities in remote and rural areas has not been examined. We used the Nurse Competency Scale to survey the nursing workforce in Al-Gharbia’s public hospitals in United Arab Emirates. All 435 practicing registered nurses with more than 3 months clinical experience in the network were invited to participate. Data were collected electronically and analyzed by international collaborators. Statistical analysis included analysis of variance, Kruskal–Wallis, multiple linear regression, χ 2 test of independence, and Cronbach’s α. Totally, 189 responses were analyzed (43.4% response rate. Overall self-assessed levels of competence were uniformly “very good” across all competence categories. The overall score (84.3 was higher than those found in most other studies. Frequency of use was the most outstanding variable influencing self-assessed competence. Total years of experience were the next significant variable. Some items of the scale were not yet applicable to activities in the region, particularly those relating to supervision of students. The high scores achieved by expatriate nurses in the small hospitals of Al-Gharbia reflect well on the rigor of the recruitment process, ongoing cross-training and functional competency assessment. Policies and practices aimed at recruiting experienced expatriate nurses and providing opportunities to use competencies continue to be critical in

Urban rural differences in diet, physical activity and obesity in India: are we witnessing the great Indian equalisation? Results from a cross-sectional STEPS survey

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Jaya Prasad Tripathy

2016-08-01

Full Text Available Abstract Background The rising morbidity and mortality due to non-communicable diseases can be partly attributed to the urbanized lifestyle leading to unhealthy dietary practices and increasing physical levels of inactivity. The demographic and nutrition transition in India has also contributed to the emerging epidemic of non-communicable diseases in this country. In this context, there is limited information in India on dietary patterns, levels of physical activity and obesity. The aim of the present study was thus to assess the urban rural differences in dietary habits, physical activity and obesity in India. Methods A household survey was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals using the WHO STEPS questionnaire. Results No rural urban difference was found in dietary practices and prevalence of overweight and obesity except the fact that a significantly higher proportion of respondents belonging to rural area (15.6 % always/often add salt before/when eating as compared to urban area (9.1 %. Overall 95.8 % (94.6–97.0 of participants took less than 5 servings of fruits and/or vegetables on average per day. No significant urban rural difference was noted in both sexes in all three domains of physical activity such as work, transport and recreation. However, rural females (19.1 % were found to be engaged in vigorous activity more than the urban females (6.3 %. Males reported high levels of physical activity in both the settings. Absence of recreational activity was reported by more than 95 % of the subjects. Higher prevalence of obesity (asian cut offs used was seen among urban females (34.3 % as compared to their rural counterparts (23.2 %. Abdominal obesity was found to be significantly higher among females in both the settings compared to males (p < 0.001. Conclusions Poor dietary practices and physical inactivity seems to fuel the non-communicable disease epidemic in India. Non

Setting Priorities Personal Values, Organizational Results

CERN Document Server

(CCL), Center for Creative Leadership

2011-01-01

To be a successful leader, you need to get results. To get results, you need to set priorities. This book can help you do a better job of setting priorities, recognizing the personal values that motivate your decision making, the probable trade-offs and consequences of your decisions, and the importance of aligning your priorities with your organization's expectations. In this way you can successfully meet organizational objectives and consistently produce results.

Foreign-Born Latinos Living in Rural Areas are more likely to Experience Health Care Discrimination: Results from Proyecto de Salud para Latinos.

Science.gov (United States)

López-Cevallos, Daniel F; Harvey, S Marie

2016-08-01

Health care discrimination is increasingly considered a significant barrier to accessing health services among minority populations, including Latinos. However, little is known about the role of immigration status. The purpose of this study was to examine the association between immigration status and perceived health care discrimination among Latinos living in rural areas. Interviews were conducted among 349 young-adult Latinos (ages 18 to 25) living in rural Oregon, as part of Proyecto de Salud para Latinos. Over a third of participants experienced health care discrimination (39.5 %). Discrimination was higher among foreign-born (44.9 %) rather than US-born Latinos (31.9 %). Multivariate results showed that foreign-born Latinos were significantly more likely to experience health care discrimination, even after controlling for other relevant factors (OR = 2.10, 95 % CI 1.16-3.82). This study provides evidence that health care discrimination is prevalent among young-adult Latinos living in rural areas, particularly the foreign-born. Effective approaches towards reducing discrimination in health care settings should take into consideration the need to reform our broken immigration system.

STATE AND PROSPECTS OF RURAL DEVELOPMENT IN UKRAINE

Directory of Open Access Journals (Sweden)

Eleonora Kirieieva

2017-09-01

. Evaluation of the biggest problems of development of rural development in Ukraine is made. It is determined that Vinnytsia region is one of the agrarian-oriented regions and thus rural development in this region becomes of paramount importance. The article analyses dynamics of the number of rural population of Vinnytsia region, investigates a relative share of rural population in the general structure of the population of regions of Vinnytsia region, conducts an assessment of the ratio of income and expenditure of the rural population of Vinnytsia region. Based on the research done, conclusions and proposals are formulated, which are a set of measures for providing rural development, the main of which are: stimulating counselling to raise the level of knowledge and practical skills of peasants based on active teaching methods, as a tool of state support for the agricultural producer and rural population, contribution to the development of cooperation and creation of cluster associations able to provide for a higher added value of agricultural production, “green tourism” development. Practical importance. Research results allowed determining a set of measures to further improve rural development and ensuring a higher level of well-being of rural population who can be used in the development of state targetoriented programs and regional strategies of rural development.

Transforming rural health systems through clinical academic leadership: lessons from South Africa.

Science.gov (United States)

Doherty, J E; Couper, I D; Campbell, D; Walker, J

2013-01-01

Under-resourced and poorly managed rural health systems challenge the achievement of universal health coverage, and require innovative strategies worldwide to attract healthcare staff to rural areas. One such strategy is rural health training programs for health professionals. In addition, clinical leadership (for all categories of health professional) is a recognised prerequisite for substantial improvements in the quality of care in rural settings. Rural health training programs have been slow to develop in low- and middle-income countries (LMICs); and the impact of clinical leadership is under-researched in such settings. A 2012 conference in South Africa, with expert input from South Africa, Canada and Australia, discussed these issues and produced recommendations for change that will also be relevant in other LMICs. The two underpinning principles were that: rural clinical leadership (both academic and non-academic) is essential to developing and expanding rural training programs and improving care in LMICs; and leadership can be learned and should be taught. The three main sets of recommendations focused on supporting local rural clinical academic leaders; training health professionals for leadership roles in rural settings; and advancing the clinical academic leadership agenda through advocacy and research. By adopting the detailed recommendations, South Africa and other LMICs could energise management strategies, improve quality of care in rural settings and impact positively on rural health outcomes.

Rural maternity care.

Science.gov (United States)

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

2012-10-01

rural settings. Remuneration models should facilitate interprofessional collaboration. 9. Practitioners skilled in neonatal resuscitation and newborn care are essential to rural maternity care. 10. Training of rural maternity health care providers should include collaborative practice as well as the necessary clinical skills and competencies. Sites must be developed and supported to train midwives, nurses, and physicians and provide them with the skills necessary for rural maternity care. Training in rural and northern settings must be supported. 11. Generalist skills in maternity care, surgery, and anaesthesia are valued and should be supported in training programs in family medicine, surgery, and anaesthesia as well as nursing and midwifery. 12. All physicians and nurses should be exposed to maternity care in their training, and basic competencies should be met. 13. Quality improvement and outcome monitoring should be integral to all maternity care systems. 14. Support must be provided for ongoing, collaborative, interprofessional, and locally provided continuing education and patient safety programs.

Educational strategies for rural new graduate registered nurses.

Science.gov (United States)

Dowdle-Simmons, Sara

2013-03-01

Rural health care facilities are geographically remote, tend to be small, and often possess limited resources. Although newly graduated registered nurses are important to the work force of many rural communities, maintaining a formal preceptorship/mentorship program within a rural hospital may prove difficult as a result of limited resources. Unfortunately, the new graduate may become overwhelmed by the many expectations for clinical practice and the facility can experience high turnover rates of new graduate hires. This article explores the unique traits of the rural hospital and the new graduate nurse as well as the pros and cons of a formal preceptorship program within a rural setting. Constructivist learning theory is used to develop practical teaching strategies that can be used by the preceptor and the new graduate. These strategies are inexpensive, yet effective, and are feasible for even the smallest of facilities. Copyright 2013, SLACK Incorporated.

Active living in rural Appalachia: Using the rural active living assessment (RALA tools to explore environmental barriers

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Adam Hege

2017-12-01

Full Text Available People residing in rural communities are more likely to be physically inactive and subsequently have elevated risks for chronic disease. Recent evidence has shown this could stem from environmental barriers, inadequate programming and policies directed at the promotion of physical activity (PA in rural settings. The objective of this research was to assess active living features in rural towns and townships (n=16 across seven counties in northwestern North Carolina (NC. The study utilized the Town-Wide and Street Segment components of the Rural Active Living Assessment (RALA as well as the 2014 American Community Survey results. The assessments were conducted in the summer of 2016 in the rural Appalachia region of NC. Using the RALA town-wide assessment scoring system (0−100, the range of scores was 18–84, with the mean being 50.06. Three towns had no sidewalks, nine towns had sidewalks on only one side of the main streets, and four had sidewalks on both sides of the main streets. One town was rated as highly walkable, seven towns as moderately walkable, five towns as moderately unwalkable, and three towns as highly unwalkable. The rural Appalachia region of NC offers unique topographic, geographic and environmental barriers to PA. However, our findings indicate many rural towns offer common PA amenities. Future research should utilize qualitative methods and a community-based participatory research approach to more fully understand the challenges with increasing PA in the rural and often isolated Appalachia communities. Keywords: Rural active living assessment (RALA, Health disparities, Physical activity, Rural Appalachia

Rural Households

DEFF Research Database (Denmark)

Bruun, Ole

2013-01-01

dependency on state institutions under the Vietnamese transition to a market society. It discusses present poverty definitions and measures by comparing survey data with the formal economic categorization of rural households. Both the overall characteristics of rural society and qualitative data indicate...... that the reforms have set in motion a process by which a mix of new opportunities and increasing pressures creates new winners and losers. Second, the chapter draws attention to the nature of interactions between households, local communities and the Vietnamese state. This shows both potentials and limitations...

Training child psychiatrists in rural public mental health.

Science.gov (United States)

Petti, T A; Benswanger, E G; Fialkov, M J; Sonis, M

1987-04-01

Lack of appropriate training in both public mental health service and rural mental health service is a major factor in the critical shortage of child psychiatrists in rural settings. The authors describe a residency training program in rural public mental health designed to help alleviate that shortage. The program familiarizes fourth-year residents in child psychiatry with the clinical, political, and social aspects of rural public mental health services through didactic and supervisory sessions as well as an eight-month practicum experience involving provision of inservice training and administrative and case-related consultation to staff of mental health agencies. An assessment of the program indicated that participants felt it was beneficial, but the program was only partly successful in increasing the number of child psychiatrists entering practice in rural areas. The authors urge that residency programs in child psychiatry give priority to training child psychiatrists for work in rural settings.

Prevalence, awareness, treatment and control of diabetes mellitus in rural China: results from Shandong Province.

Science.gov (United States)

Yang, F; Qian, D; Chen, J; Hu, D; Hou, M; Chen, S; Wang, P

2016-04-01

To estimate the prevalence, awareness, treatment and control of diabetes in rural areas in Shandong Province, China. The Luxemburg-WHO-Shandong Project on Rural Health Personnel Training and Chronic Disease Control, a cross-sectional study, examined 16 375 rural residents aged 25 years and over using multistage cluster sampling in April 2007. An overnight fasting blood specimen was collected to measure plasma glucose and a 2-h 75-g oral glucose tolerance test was conducted among people with a fasting blood glucose of ≥ 6.1 mmol/l. Information on the history of diabetes and hypoglycaemic medication was obtained using a standard questionnaire. Diabetes and prediabetes were defined according to the 1999 World Health Organization diagnostic criteria. Overall, the prevalence rates for diabetes, prediabetes and previously diagnosed diabetes in the rural population were estimated to be 3.5%, 6.0% and 1.2%, respectively. Among those with diabetes, only 34.8% were aware of their condition, 30.6% were currently undergoing medication treatment, and 11.5% achieved glycaemic control. These results indicate that diabetes has become a public health problem in poor rural areas of China and the rates of awareness, treatment and control of diabetes were relatively low. There is an urgent need for strategies aimed at the prevention and treatment of diabetes in the rural population in Shandong Province, China. © 2015 Diabetes UK.

Broadband provision to underprivileged rural communities

CSIR Research Space (South Africa)

Makitla, I

2010-09-01

Full Text Available Providing access to remote rural areas presents a unique set of technical and non-technical challenges. These challenges are key issues that arise when deploying wireless networks to remote rural areas in developing countries; long distances between...

New Partner Recruitment to Rural Versus Urban Ob-Gyn Practices

Directory of Open Access Journals (Sweden)

Michael F. Fialkow

2017-09-01

Full Text Available Purpose: The purpose of this pilot study was to investigate the recruitment efforts of practicing obstetrics and gynecology (ob-gyns from rural and urban practices. Method: The authors surveyed practicing ob-gyns from 5 states in the Pacific Northwest in 2016 about their background, practice setting, practice profile, partner recruitment, and retention. Results: Seventy-three patients completed the study (53.2% response rate. Thirty-seven percent of respondents work in an urban practice and 43% have a rural practice, with the remainder in a suburban setting. A majority of the respondents attempted to recruit a new partner in the past 5 years. Respondents were most interested in experience and diversity in new recruits. Urban respondents, however, were more interested in hiring those with specialized skills (χ 2 = 7.842, P = .02 than rural providers who were more interested in partners familiar with their community (χ 2 = 7.153, P = .03. Reasons most often cited to leave their practice were reimbursement, limited social/marital options, and workload, other than rural providers who more often also cited lack of access to specialty care (χ 2 = 13.256, P = .001. Rural providers were more likely to cite marital and family status as an advantage to recruitment, whereas urban and suburban providers were more often neutral. Conclusions: Reduced access to care has led to significant health disparities for women living in rural communities. Understanding which providers are most likely to be successful in these settings might help preserve access as our health-care systems evolves.

Energy use in the rural areas of India: setting up a rural energy data base

International Nuclear Information System (INIS)

Sinha, Chandra Shekhar; Sinha, Shirish; Joshi, Veena

1998-01-01

Aggregating and forecasting demand are crucial parts of energy planning. While a large number of energy consumption surveys have been conducted in the past in the rural energy sector of India, the lack of sufficient data and its compilation, coupled with doubt about the quality of data, has made the task extremely difficult. This paper summarizes recent efforts to compile, computerize and analyze data from 638 village energy consumption surveys covering over 39,000 households, carried out by different organisations between 1985 and 1989. The details of the level of information provided in the survey reports, area of survey, land use pattern, asset ownership, etc., of the collated studies are presented. Results based on the analysis of the energy consumption data compiled are then discussed. The paper also compares the estimates with those based on other surveys in India. (author)

Chinese Gini Coefficient from 2005 to 2012, Based on 20 Grouped Income Data Sets of Urban and Rural Residents

Directory of Open Access Journals (Sweden)

Jiandong Chen

2015-01-01

Full Text Available Data insufficiency has become the primary factor affecting research on income disparity in China. To resolve this issue, this paper explores Chinese income distribution and income inequality using distribution functions. First, it examines 20 sets of grouped data on family income between 2005 and 2012 by the China Yearbook of Household Surveys, 2013, and compares the fitting effects of eight distribution functions. The results show that the generalized beta distribution of the second kind has a high fitting to the income distribution of urban and rural residents in China. Next, these results are used to calculate the Chinese Gini ratio, which is then compared with the findings of relevant studies. Finally, this paper discusses the influence of urbanization on income inequality in China and suggests that accelerating urbanization can play an important role in narrowing the income gap of Chinese residents.

The Involvement of Rural Entrepreneurship In The Regional Development

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Marin Burcea

2014-12-01

Full Text Available The aims of the present paper are to emphasize the importance of the rural entrepreneurship involvement in the regional development and to analyse the results of a research regarding the cooperation between the stakeholders of the local and regional development. A set of two hypotheses has been tested by using the data of a sociological survey focused on entrepreneurship and on the potential entrepreneurs from the rural area, belonging to five development regions. The results of our research highlight that the relationships between the rural area business environment and the other actors involved in the regional development (local public authorities, professional associations, institutions centred on regional development are influenced by the framework of organisation and cooperation with the local business environment.

Quality of Colonoscopy Performed in Rural Practice: Experience From the Clinical Outcomes Research Initiative and the Oregon Rural Practice-Based Research Network.

Science.gov (United States)

Holub, Jennifer L; Morris, Cynthia; Fagnan, Lyle J; Logan, Judith R; Michaels, LeAnn C; Lieberman, David A

2018-02-01

Colon cancer screening is effective. To complete screening in 80% of individuals over age 50 years by 2018 will require adequate colonoscopy capacity throughout the country, including rural areas, where colonoscopy providers may have less specialized training. Our aim was to study the quality of colonoscopy in rural settings. The Clinical Outcomes Research Initiative (CORI) and the Oregon Rural Practice-based Research Network (ORPRN) collaborated to recruit Oregon rural practices to submit colonoscopy reports to CORI's National Endoscopic Database (NED). Ten ORPRN sites were compared to non-ORPRN rural (n = 11) and nonrural (n = 43) sites between January 2009 and October 2011. Established colonoscopy quality measures were calculated for all sites. No ORPRN physicians were gastroenterologists compared with 82% of nonrural physicians. ORPRN practices reached the cecum in 87.4% of exams compared with 89.3% of rural sites (P = .0002) and 90.9% of nonrural sites (P 9mm 16.6% vs 18.7% (P = .106). ORPRN sites performed well on most colonoscopy quality measures, suggesting that high-quality colonoscopy can be performed in rural settings. © 2016 National Rural Health Association.

Rapid risk household screening by neonatal arm circumference: results from a cohort study in rural Burkina Faso.

Science.gov (United States)

Benzler, J; Sauerborn, R

1998-12-01

Neonatal arm circumference (NAC) and other attributes of the newborn and its household were analysed as potential predictors of child death in a cohort of 1367 newborn children representing the majority of births in a rural area of Burkina Faso from 1992 to 1994. During 3872 person years observed 264 children died, resulting in an average mortality rate of 6.8% per year. 90 mm was chosen as the best cut-off to differentiate low NAC associated with high mortality from normal NAC. The hazard ratio of children with low NAC (15.7%) compared to others was 1.7 (P cash crop production. We propose a simple risk score for rapid household screening in rural Burkina Faso and comparable settings elsewhere for identifying households at risk of experiencing child death. As much of the other variables' contribution to the explanation of survival pattern is absorbed by NAC in more parsimonious models, even simpler screening strategies based on NAC make sense. In the study area risk households will be offered periodical home visits by the local nurse promoting immunization, treatment of illness and strengthening the mothers' competence to recognize and manage frequent health problems of their children as part of a 'Shared Care' concept.

Applicability of direct agglutination test (DAT) at a rural health setting in Bangladesh and feasibility of local antigen production.

Science.gov (United States)

Chowdhury, M S; al Masum, A; al Karim, E; Semiáo-Santos, S; Rahman, K M; Ar-Rashid, H; el Harith, A

1993-01-01

As part of a large-scale sero-epidemiological survey on visceral leishmaniasis (VL) carried out in Mymensingh district of Bangladesh, applicability of DAT was assessed at the level of a rural health setting in Trishal (upazila) subdistrict. Despite the relatively less optimal conditions encountered, 5854 inhabitants from 7 villages appendant to Trishal were assessed for VL. The demographic distribution for sero-positivity obtained at the rural setting was comparable to that found by DAT as executed at the central laboratory (IEDC&R, Dhaka) on 9619 inhabitants from the same upazila. The overall sero-prevalence rate was 4.4% compared to 3.7% obtained in the population assessed at the central laboratory. In either study, similar VL prevalence rates of 2.1% were obtained in the male populations. Irrespective of sex, younger population ( or = 90 years (1.4% and 1.8%). Local production of DAT antigen employing an authochtonus L. donovani isolate was attempted at the central laboratory (IEDC&R) in Dhaka. By comparison with the reference antigen, titres obtained in all 33 VL sera tested were equally higher (1:6400- > or =: 51200) than in 35 out of 38 negative controls (< or = 1:400-1:1600). A comparable level of reactivity was also obtained in 53 VL and 52 negative control sera using a well characterized L. donovani strain (MHOM/IN/80/D88) from India. However, unlike the reference strain, titres obtained in 7 endemic controls were significantly higher with the authochtonous and homologous antigen (1:3200 - 1:6400) than with the reference (1:100 - 1:1600). The results signify the advantage of employing indigenous L. donovani isolates to further improve DAT sensitivity for detection of early and sub-clinical VL.

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,…

What keeps health professionals working in rural district hospitals in South Africa?

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Louis S. Jenkins

2015-06-01

Full Text Available Background: The theme of the 2014 Southern African Rural Health Conference was ‘Building resilience in facing rural realities’. Retaining health professionals in South Africa is critical for sustainable health services. Only 12% of doctors and 19% of nurses have been retained in the rural areas. The aim of the workshop was to understand from health practitioners why they continued working in their rural settings. Conference workshop: The workshop consisted of 29 doctors, managers, academic family physicians, nurses and clinical associates from Southern Africa, with work experience from three weeks to 13 years, often in deep rural districts. Using the nominal group technique, the following question was explored, ‘What is it that keeps you going to work every day?’ Participants reflected on their work situation and listed and rated the important reasons for continuing to work. Results: Five main themes emerged. A shared purpose, emanating from a deep sense of meaning, was the strongest reason for staying and working in a rural setting. Working in a team was second most important, with teamwork being related to attitudes and relationships, support from visiting specialists and opportunities to implement individual clinical skills. A culture of support was third, followed by opportunities for growth and continuing professional development, including teaching by outreaching specialists. The fifth theme was a healthy work-life balance. Conclusion: Health practitioners continue to work in rural settings for often deeper reasons relating to a sense of meaning, being part of a team that closely relate to each other and feeling supported.

Panic disorder in rural Tanzania: an explorative study | Nordgreen ...

African Journals Online (AJOL)

... patients as especially useful. Conclusion: A manual for brief interventions for PD may be adapted to a rural Tanzanian setting, also taking into consideration the limited financial and human resources in a rural low-income country setting. Keywords: Panic disorder; Culture; Cognitive behaviour therapy; Low-income country ...

rural medicine as a sub-specialty

African Journals Online (AJOL)

hospital for a year can be regarded as a rural medical specialist. Most often they realise ... of them, that they leave the public service for ever, for a situation that is ... So for rural medicine, it is an extremely wide set of skills that best describes ...

Training resources and e-Government services for rural SMEs: the rural inclusion platform

OpenAIRE

Axel Maroudas; Pantelis Karamolegkos; Nikos Manouselis

2010-01-01

Rural Inclusion, a project supported by the Information and Communication Technologies Policy Support Programme of the European Commission, aims to adopt, adapt, and deploy a Web infrastructure, in rural settings, combining semantics with a collaborativetraining and networking approach, offering e-Government services that will be supported by a rigorous and reusable service process analysis and modeling, and facilitating the disambiguation of the small businesses needs and requirements when t...

Managing Ebola from rural to urban slum settings: experiences from ...

African Journals Online (AJOL)

The Bundigugyo district outbreak followed but was detected late as a new virus. The subsequent outbreaks in the districts of Luwero district (2011, 2012) and Kibaale (2012) were limited to rural areas. Methods: Detailed records of the outbreak presentation, cases, and outcomes were reviewed and analyzed. Each outbreak ...

Project of setting to contribution of renewable energies for an pre-electrification to support rural development

International Nuclear Information System (INIS)

1999-01-01

The document is a project of the Government of Burkina Faso. The project aim is to increase the energy utilization renewable by the populations living in the rural areas. It aims moreover the improvement of the standard living in the rural areas, the access of rural population to basic elements to fight against poverty and rural depopulation. It is a question of popularizing in rural area, the use of the renewable energy equipment consumers, in particular the photovoltaic one. This equipment will make it possible to satisfy the requirements in lighting with the Community systems, in leisure by providing a minimum of equipment in the community centres of leisure, in drugs conservation installation in the health centres and in using energy to pump drinking water. The use of this energy source will make it possible to mitigate the non access of the rural areas to the energy produced by the National Company of Electricity of Burkina [fr

Preparing for success: Readiness models for rural telehealth

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Jennett P

2005-01-01

Full Text Available Background: Readiness is an integral and preliminary step in the successful implementation of telehealth services into existing health systems within rural communities. Methods and Materials: This paper details and critiques published international peer-reviewed studies that have focused on assessing telehealth readiness for rural and remote health. Background specific to readiness and change theories is provided, followed by a critique of identified telehealth readiness models, including a commentary on their readiness assessment tools. Results: Four current readiness models resulted from the search process. The four models varied across settings, such as rural outpatient practices, hospice programs, rural communities, as well as government agencies, national associations, and organizations. All models provided frameworks for readiness tools. Two specifically provided a mechanism by which communities could be categorized by their level of telehealth readiness. Discussion: Common themes across models included: an appreciation of practice context, strong leadership, and a perceived need to improve practice. Broad dissemination of these telehealth readiness models and tools is necessary to promote awareness and assessment of readiness. This will significantly aid organizations to facilitate the implementation of telehealth.

Urban-Rural Differences in Aerobic Physical Activity, Muscle Strengthening Exercise, and Screen-Time Sedentary Behavior.

Science.gov (United States)

Robertson, Michael C; Song, Jaejoon; Taylor, Wendell C; Durand, Casey P; Basen-Engquist, Karen M

2018-02-16

Compared to their urban counterparts, US residents in rural settings face an increased risk of premature mortality and health problems that have been linked to insufficient physical activity (PA) levels. There is limited literature regarding urban-rural differences in adherence to national guidelines for all 3 PA-related behaviors. We investigated urban-rural differences in aerobic PA, leisure-time muscle strengthening PA, and leisure screen-time sedentary behavior in a combined data set of the 2011-2014 waves (N = 14,188) of the nationally representative National Cancer Institute's Health Information National Trends Survey. We found no evidence of a difference between large urban and rural residents' aerobic PA levels. The typical number of weekly bouts of leisure-time muscle strengthening PA was 25% lower for rural residents (incidence rate ratio [IRR] = 0.751, P rural residents to engage in 6.6% less daily leisure screen-time sedentary behavior than their large urban counterparts (IRR = 0.934, P = .031). Taken together with previous literature, these results suggest that rural residents may engage in comparable levels of total PA, but less leisure-time PA, than their urban counterparts. © 2018 National Rural Health Association.

Differences in cardiovascular risk factors in rural, urban and rural-to-urban migrants in Peru

Science.gov (United States)

Miranda, J. Jaime; Gilman, Robert H.; Smeeth, Liam

2011-01-01

Objectives To assess differences in cardiovascular risk profiles among rural-to-urban migrants and non-migrant groups. Design Cross-sectional study. Setting Ayacucho and Lima, Peru Participants rural (n=201); rural-urban migrants (n=589) and urban (n=199). Main outcome measures Cardiovascular risk factors were assessed according to migrant status (migrants vs. non-migrants), age at first migration, length of residency in an urban area and lifetime exposure to an urban area. Results For most risk factors, the migrant group had intermediate levels of risk between those observed for the rural and urban groups. Prevalences, for rural, migrant and urban groups, was 3%, 20% and 33% for obesity and 0.8%, 3% and 6% for type-2 diabetes. This gradient of risk was not observed uniformly across all risk factors. Blood pressure did not show a clear gradient of difference between groups. The migrant group had similar systolic blood pressure (SBP) but lower diastolic blood pressure (DBP) than the rural group. The urban group had higher SBP but similar DBP than rural group. Hypertension was more prevalent among the urban (29%) compared to both rural and migrant groups (11% and 16% respectively). For HbA1c, although the urban group had higher levels, the migrant and rural groups were similar to each other. No differences were observed in triglycerides between the three groups. Within migrants, those who migrated when aged older than 12 years had higher odds of diabetes, impaired fasting glucose and metabolic syndrome compared to people who migrated at younger ages. Adjustment for age, sex and socioeconomic indicators had little impact on the patterns observed. Conclusions The impact of rural to urban migration on cardiovascular risk profile is not uniform across different risk factors, and is further influenced by the age at which migration occurs. A gradient in levels was observed for some risk factors across study groups. This observation indicates that urbanization is indeed

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

Science.gov (United States)

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

1998-04-01

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

Peer mentoring supports the learning needs of nurses providing palliative care in a rural acute care setting.

Science.gov (United States)

Rabbetts, Lyn

2017-06-02

A specific set of assessment scales can underpin the management of distressing symptoms of patients requiring palliative care. A research assistant supported nurses working in a rural hospital setting during the introduction of these scales. A secondary analysis was conducted to further explore the qualitative data of a previously reported mixed-method study. In particular, the experiences of nurses working alongside a research assistant in the facilitation of using a new assessment form. Purposeful sampling was employed: participating nurses were invited to attend one of three focus group meetings. Data analysis revealed three main themes: a contact person, coach/mentor and extra help initiatives. Three to four subthemes corresponded with each main theme. Findings suggest nurses benefit from having someone to assist in learning about new documentation. Nurses respond positively to mentorship and practical guidance when integrating a new assessment form into routine evidence-based practice.

Motivators of couple HIV counseling and testing (CHCT) uptake in a rural setting in Uganda.

Science.gov (United States)

Nannozi, Victoria; Wobudeya, Eric; Matsiko, Nicholas; Gahagan, Jacqueline

2017-01-23

Couple HIV Counseling and Testing (CHCT) is one of the key preventive strategies used to reduce the spread of HIV. In Uganda, HIV prevalence among married/living together is 7.2% among women and 7.6% among men. CHCT can help ease disclosure of HIV-positive status, which in turn may help increase opportunities to get social support and reduce new infections. The uptake of CHCT among attendees of health facilities in rural Uganda is as high as 34%. The purpose of this study was to explore the motivators of CHCT uptake in Mukono district, a rural setting in Uganda. The study was conducted in two sub-counties in a rural district (Mukono district) about 28 km east of the capital Kampala, using a descriptive and explorative qualitative research design. Specifically, we conducted focus group discussions and key informant interviews with HIV focal persons, village health team (VHT) members, religious leaders and political leaders. We also interviewed persons in couple relationships. Data was analysed using NVivo 8 software. Ethical clearance was received from the Mengo Hospital Research Review Board and from the Uganda National Council of Science and Technology. The study was conducted from June 2013 to July 2013 We conducted 4 focus group discussions, 10 key informant interviews and interviewed 53 persons in couple relationships. None of the participants were a couple. The women were 68% (36/53) and 49% (26/53) of them were above 29 years old. The motivators of CHCT uptake were; perceived benefit of HIV testing, sickness of a partner or child in the family and suspicion of infidelity. Other important motivators were men involvement in antenatal care (ANC) attendance and preparation for marriage. The motivators for CHCT uptake included the perceived benefit of HIV testing, sickness of a partner or child, preparation for marriage, lack of trust among couples and men involvement in antenatal care. Greater attention to enhancers of CHCT programming is needed in trying to

The Impact of Tobacco Consumption on Rural Household Expenditure and Self-rated Health Among Rural Household Members in China.

Science.gov (United States)

Li, Changle; Supakankunti, Siripen

2018-03-26

To estimate how tobacco consumption affects household expenditure on other goods and services in rural China and to assess the tobacco consumption affects self-rated health among rural household members in China. A Seemingly Unrelated Regression was used to assess the impact of tobacco consumption on rural household expenditure. To detect tobacco consumption causing heterogeneity in self-rated health among adults in rural China, this study employed a random effects generalized ordered probit model. 2010-2014 China Family Panel Studies was used for the analysis. The data set included 3,611 households and 10,610 adults in each wave. Tobacco consumption households assign significantly lower budget shares to food, health care, dress, and education in rural China. Moreover, self-rated health factor has a significantly positive coefficient with respect to non-smokers and ex-smokers, that is, when the individuals is a non-smoker or ex-smoker, he/ she will be more likely to report his/her health status as positive. The first analysis showed that tobacco consumption crowds out expenditures on food, dress, health care, and education for rural households in China, and the second analysis indicated that non-smokers and ex-smokers are more likely to report their health status as better compared with last year. The results of the present study revealed that Chinese policymakers might consider controlling tobacco consumption since tobacco control can improve not only rural household welfare but also rural household members' health status. Therefore, the tobacco tax policy and brief clinical interventions by the doctor should be implemented in rural China.

Rural communities’ vulnerability to farmland poverty in varied ecological settings of northwest Ethiopia

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Menberu Teshome

2018-01-01

Full Text Available Environmental and climate changes are among the serious threats to the world’s land resources in the 21st Century. Particularly, in the developing countries the impact inevitably goes as the continuing toll on agricultural production, human lives, and properties. It is also a driving force of poverty and impediment of overall economic development in many less developed nations, like Ethiopia. Therefore, this paper assesses the rural communities’ vulnerability to farmland poverty in different ecological settings of northwest Ethiopia. Data were collected from 525 randomly selected farming households using questionnaire. Meteorological data were collected from Global Weather Data for soil and water assessment tool (SWAT from 1979 to 2010. Rainfall and temperature trends were characterized using simple linear regression model. Rural communities’ vulnerability to farmland poverty was determined using livelihood vulnerability index (LVI. Indices were constructed using simple and weighted average approaches to measure farmlands’ exposure, sensitivity and adaptive capacity. Overall communities’ levels of vulnerability to farmlands poverty were found to be 0.76 in the lowland, 0.57 in the flat highland and 0.51 in the midland areas. In almost all indicators the lowland (Abay Valley is more vulnerable to farmland-related troubles as the biophysical and socio-economic contexts were found to be the worst there. Communities and government and non-government officials have observed significant negative impacts of drought and extreme weather events on farmlands, pasturelands with declining availability, productivity and quality of farmlands. This study suggests education and research interventions for enhancing community-based participatory integrated watershed management approach supported with best indigenous knowledge and farmers’ practices. Adaptation interventions should also consider local communities’ resource capacity (low

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

Science.gov (United States)

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

2017-12-01

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

Sustainability effects of household-scale biogas in rural China

NARCIS (Netherlands)

Gosens, J.; Lu Yonglong,; He Guizhen,; Bluemling, B.; Beckers, T.A.M.

2013-01-01

Households in rural China rely heavily on low quality fuels which results in reduced quality of life and environmental degradation. This study assesses the comparative contribution of household scale biogas installations to the broad set of sustainability objectives in the Chinese biogas policy

METHODOLOGICAL PECULIARITIES OF RURAL ECONOMY RESEARCH FROM NEORURALISM STANDPOINT

Directory of Open Access Journals (Sweden)

Nataliia Kutsmus

2015-11-01

Full Text Available The purpose of the study is to summarize the existing theoretical and methodological approaches to understanding the essence of the notion ‘rural economics’ and to reason that multifunctionality is a precondition of stable development. The methodology of research is based on a systematic approach, according to which rural economics is considered to be an open type of social and economic system that transforms exogenous and endogenous potential of rural territories into a certain level of rural development. The methodology of rural economic development is based on the following methodological approaches: economic, ecological, social and institutional, each one of which completes the idea of interdependence of rural economics and its territorial basis, i.e. rural area. The subject of study is a scientific-theoretical and applied principles of rural economy development. The results of the study demonstrate that agro-centric model of rural economics, the development of which focuses on formation and support of goods safety, is being displaced by multifunctional model in conditions of strengthening of human-centric priorities of the social development. Contents of this model lies in the perception of the rural economy as a diversified, multifunctional socio-economic system, whose development aimed at the welfare of the rural population. As the goal of rural economies is ensuring high welfare standards of the rural population, providing interconnection problems in the functioning of the system of rural development policy. It’s proved that the sustainable development of the rural economy it provides for the implementation of the set of economic and socially important function that displays the development of socio-economic system beyond the actual production and contributes to its focus on material and non-material welfare of the rural population. Qualitative changes in the properties of the rural economy aiming at self-development and self

Mobile phone-based clinical guidance for rural health providers in India.

Science.gov (United States)

Gautham, Meenakshi; Iyengar, M Sriram; Johnson, Craig W

2015-12-01

There are few tried and tested mobile technology applications to enhance and standardize the quality of health care by frontline rural health providers in low-resource settings. We developed a media-rich, mobile phone-based clinical guidance system for management of fevers, diarrhoeas and respiratory problems by rural health providers. Using a randomized control design, we field tested this application with 16 rural health providers and 128 patients at two rural/tribal sites in Tamil Nadu, Southern India. Protocol compliance for both groups, phone usability, acceptability and patient feedback for the experimental group were evaluated. Linear mixed-model analyses showed statistically significant improvements in protocol compliance in the experimental group. Usability and acceptability among patients and rural health providers were very high. Our results indicate that mobile phone-based, media-rich procedural guidance applications have significant potential for achieving consistently standardized quality of care by diverse frontline rural health providers, with patient acceptance. © The Author(s) 2014.

Nurses who work in rural and remote communities in Canada: a national survey.

Science.gov (United States)

MacLeod, Martha L P; Stewart, Norma J; Kulig, Judith C; Anguish, Penny; Andrews, Mary Ellen; Banner, Davina; Garraway, Leana; Hanlon, Neil; Karunanayake, Chandima; Kilpatrick, Kelley; Koren, Irene; Kosteniuk, Julie; Martin-Misener, Ruth; Mix, Nadine; Moffitt, Pertice; Olynick, Janna; Penz, Kelly; Sluggett, Larine; Van Pelt, Linda; Wilson, Erin; Zimmer, Lela

2017-05-23

In Canada, as in other parts of the world, there is geographic maldistribution of the nursing workforce, and insufficient attention is paid to the strengths and needs of those providing care in rural and remote settings. In order to inform workforce planning, a national study, Nursing Practice in Rural and Remote Canada II, was conducted with the rural and remote regulated nursing workforce (registered nurses, nurse practitioners, licensed or registered practical nurses, and registered psychiatric nurses) with the intent of informing policy and planning about improving nursing services and access to care. In this article, the study methods are described along with an examination of the characteristics of the rural and remote nursing workforce with a focus on important variations among nurse types and regions. A cross-sectional survey used a mailed questionnaire with persistent follow-up to achieve a stratified systematic sample of 3822 regulated nurses from all provinces and territories, living outside of the commuting zones of large urban centers and in the north of Canada. Rural workforce characteristics reported here suggest the persistence of key characteristics noted in a previous Canada-wide survey of rural registered nurses (2001-2002), namely the aging of the rural nursing workforce, the growth in baccalaureate education for registered nurses, and increasing casualization. Two thirds of the nurses grew up in a community of under 10 000 people. While nurses' levels of satisfaction with their nursing practice and community are generally high, significant variations were noted by nurse type. Nurses reported coming to rural communities to work for reasons of location, interest in the practice setting, and income, and staying for similar reasons. Important variations were noted by nurse type and region. The proportion of the rural nursing workforce in Canada is continuing to decline in relation to the proportion of the Canadian population in rural and remote

Electric distribution infrastructures for rural areas in developing countries

International Nuclear Information System (INIS)

Thirault, D.

2004-03-01

The main objective of the thesis was to study the architecture (network topology, mode of distribution, operation of energy sources, etc) distribution networks possible and adapted to the problem of rural electrification. Chapter I sets the context of rural electrification by detailing first the challenges of rural electrification for sustainable economic development and energy resources of these countries and the various existing network architectures. Specifications for the study is finally defined. Chapter II describes the design method developed to compare the costs of different architectures and choose the most suitable. Chapter III shows a method of sizing systems Decentralized Rural Electrification including generators, batteries and windmills. Chapter IV describes the results of a reliability study was carried out on different solutions. Chapter V describes the work done to analyze the operation of a production center consists of a generator and a wind turbine. (author)

The rural community care gerontologic nurse entrepreneur: role development strategies.

Science.gov (United States)

Caffrey, Rosalie A

2005-10-01

Rural elderly individuals are an underserved population with limited access to health care. There is an increasing need for independent community care nurses to provide assistance to home-based elderly individuals with chronic illnesses to prevent unnecessary medical and placement decisions and, thus, allow them to maintain independence and quality of life. This article describes the rural setting and why community care nurses are needed, and explores strategies for implementing the role of the independent nurse entrepreneur in caring for community-based elderly individuals in rural settings.

Striving to promote male involvement in maternal health care in rural and urban settings in Malawi - a qualitative study

Directory of Open Access Journals (Sweden)

Kululanga Lucy I

2011-12-01

Full Text Available Abstract Background Understanding the strategies that health care providers employ in order to invite men to participate in maternal health care is very vital especially in today's dynamic cultural environment. Effective utilization of such strategies is dependent on uncovering the salient issues that facilitate male participation in maternal health care. This paper examines and describes the strategies that were used by different health care facilities to invite husbands to participate in maternal health care in rural and urban settings of southern Malawi. Methods The data was collected through in-depth interviews from sixteen of the twenty health care providers from five different health facilities in rural and urban settings of Malawi. The health facilities comprised two health centres, one district hospital, one mission hospital, one private hospital and one central hospital. A semi-structured interview guide was used to collect data from health care providers with the aim of understanding strategies they used to invite men to participate in maternal health care. Results Four main strategies were used to invite men to participate in maternal health care. The strategies were; health care provider initiative, partner notification, couple initiative and community mobilization. The health care provider initiative and partner notification were at health facility level, while the couple initiative was at family level and community mobilization was at village (community level. The community mobilization had three sub-themes namely; male peer initiative, use of incentives and community sensitization. The sustainability of each strategy to significantly influence behaviour change for male participation in maternal health care is discussed. Conclusion Strategies to invite men to participate in maternal health care were at health facility, family and community levels. The couple strategy was most appropriate but was mostly used by educated and city

Mechanisms of power in participatory rural planning

DEFF Research Database (Denmark)

Johansen, Pia Heike; Chandler, Thomas Lund

2015-01-01

that in such an assessment of power it is needed also to drawn in the social context because different social contexts will be more or less vulnerable to different mechanisms of power. The paper takes the stand the rural settings are especially vulnerable to dis-engagement of local citizens, sub-ordination of the rural...... by the urban privilege to define the rural qualities and creation of local conflicts and that mechanisms of power that cause such unintended outcomes of rural planning projects should be uncovered. Inspired by Foucault's interpretation of power the paper carries out a grounded theory inspired analysis...

Ciclovia in a Rural Latino Community: Results and Lessons Learned.

Science.gov (United States)

Perry, Cynthia K; Ko, Linda K; Hernandez, Lidia; Ortiz, Rosa; Linde, Sandra

Ciclovias involve the temporary closure of roads to motorized vehicles, allowing for use by bicyclists, walkers, and runners and for other physical activity. Ciclovias have been held in urban and suburban communities in the United States and Latin America. We evaluated the first ciclovia held in a rural, predominantly Latino community in Washington State. Three blocks within a downtown area in a rural community were closed for 5 hours on a Saturday in July 2015. The evaluation included observation counts and participant intercept surveys. On average, 200 participants were present each hour. Fourteen percent of youth (younger than 18 years) were observed riding bikes. No adults were observed riding bikes. A total of 38 surveys were completed. Respondents reported spending on average 2 hours at the ciclovia. Seventy-nine percent reported that they would have been indoors at home involved in sedentary activities (such as watching TV, working on computer) if they had not been at the ciclovia. Regularly held ciclovias, which are free and open to anyone, could play an important role in creating safe, accessible, and affordable places for physical activity in rural areas. Broad community input is important for the success of a ciclovia.

Plasmodium falciparum genotypes diversity in symptomatic malaria of children living in an urban and a rural setting in Burkina Faso

Directory of Open Access Journals (Sweden)

Konaté Amadou T

2009-06-01

Full Text Available Abstract Background The clinical presentation of malaria, considered as the result of a complex interaction between parasite and human genetics, is described to be different between rural and urban areas. The analysis of the Plasmodium falciparum genetic diversity in children with uncomplicated malaria, living in these two different areas, may help to understand the effect of urbanization on the distribution of P. falciparum genotypes. Methods Isolates collected from 75 and 89 children with uncomplicated malaria infection living in a rural and an urban area of Burkina Faso, respectively, were analysed by a nested PCR amplification of msp1 and msp2 genes to compare P. falciparum diversity. Results The K1 allelic family was widespread in children living in the two sites, compared to other msp1 allelic families (frequency >90%. The MAD 20 allelic family of msp1 was more prevalent (p = 0.0001 in the urban (85.3% than the rural area (63.2%. In the urban area, the 3D7 alleles of msp2 were more prevalent compared to FC27 alleles, with a high frequency for the 3D7 300bp allele (>30%. The multiplicity of infection was in the range of one to six in the urban area and of one to seven in the rural area. There was no difference in the frequency of multiple infections (p = 0.6: 96.0% (95% C.I: 91.6–100 in urban versus 93.1% (95%C.I: 87.6–98.6 in rural areas. The complexity of infection increased with age [p = 0.04 (rural area, p = 0.06 (urban area]. Conclusion Urban-rural area differences were observed in some allelic families (MAD20, FC27, 3D7, suggesting a probable impact of urbanization on genetic variability of P. falciparum. This should be taken into account in the implementation of malaria control measures.

Rural:urban inequalities in post 2015 targets and indicators for drinking-water

Energy Technology Data Exchange (ETDEWEB)

Bain, R.E.S. [The Water Institute at UNC, University of North Carolina at Chapel Hill, NC (United States); Wright, J.A. [Geography and Environment, University of Southampton, Southampton (United Kingdom); Christenson, E. [The Water Institute at UNC, University of North Carolina at Chapel Hill, NC (United States); Bartram, J.K., E-mail: jbartram@unc.edu [The Water Institute at UNC, University of North Carolina at Chapel Hill, NC (United States)

2014-08-15

Disparities in access to drinking water between rural and urban areas are pronounced. Although use of improved sources has increased more rapidly in rural areas, rising from 62% in 1990 to 81% in 2011, the proportion of the rural population using an improved water source remains substantially lower than in urban areas. Inequalities in coverage are compounded by disparities in other aspects of water service. Not all improved sources are safe and evidence from a systematic review demonstrates that water is more likely to contain detectable fecal indicator bacteria in rural areas. Piped water on premises is a service enjoyed primarily by those living in urban areas so differentiating amongst improved sources would exacerbate rural:urban disparities yet further. We argue that an urban bias may have resulted due to apparent stagnation in urban coverage and the inequity observed between urban and peri-urban areas. The apparent stagnation at around 95% coverage in urban areas stems in part from relative population growth – over the last two decades more people gained access to improved water in urban areas. There are calls for setting higher standards in urban areas which would exacerbate the already extreme rural disadvantage. Instead of setting different targets, health, economic, and human rights perspectives, We suggest that the focus should be kept on achieving universal access to safe water (primarily in rural areas) while monitoring progress towards higher service levels, including greater water safety (both in rural and urban areas and among different economic strata)

Rural:urban inequalities in post 2015 targets and indicators for drinking-water.

Science.gov (United States)

Bain, R E S; Wright, J A; Christenson, E; Bartram, J K

2014-08-15

Disparities in access to drinking water between rural and urban areas are pronounced. Although use of improved sources has increased more rapidly in rural areas, rising from 62% in 1990 to 81% in 2011, the proportion of the rural population using an improved water source remains substantially lower than in urban areas. Inequalities in coverage are compounded by disparities in other aspects of water service. Not all improved sources are safe and evidence from a systematic review demonstrates that water is more likely to contain detectable fecal indicator bacteria in rural areas. Piped water on premises is a service enjoyed primarily by those living in urban areas so differentiating amongst improved sources would exacerbate rural:urban disparities yet further. We argue that an urban bias may have resulted due to apparent stagnation in urban coverage and the inequity observed between urban and peri-urban areas. The apparent stagnation at around 95% coverage in urban areas stems in part from relative population growth - over the last two decades more people gained access to improved water in urban areas. There are calls for setting higher standards in urban areas which would exacerbate the already extreme rural disadvantage. Instead of setting different targets, health, economic, and human rights perspectives, We suggest that the focus should be kept on achieving universal access to safe water (primarily in rural areas) while monitoring progress towards higher service levels, including greater water safety (both in rural and urban areas and among different economic strata). Copyright © 2014 Elsevier B.V. All rights reserved.

Rural:urban inequalities in post 2015 targets and indicators for drinking-water

International Nuclear Information System (INIS)

Bain, R.E.S.; Wright, J.A.; Christenson, E.; Bartram, J.K.

2014-01-01

Disparities in access to drinking water between rural and urban areas are pronounced. Although use of improved sources has increased more rapidly in rural areas, rising from 62% in 1990 to 81% in 2011, the proportion of the rural population using an improved water source remains substantially lower than in urban areas. Inequalities in coverage are compounded by disparities in other aspects of water service. Not all improved sources are safe and evidence from a systematic review demonstrates that water is more likely to contain detectable fecal indicator bacteria in rural areas. Piped water on premises is a service enjoyed primarily by those living in urban areas so differentiating amongst improved sources would exacerbate rural:urban disparities yet further. We argue that an urban bias may have resulted due to apparent stagnation in urban coverage and the inequity observed between urban and peri-urban areas. The apparent stagnation at around 95% coverage in urban areas stems in part from relative population growth – over the last two decades more people gained access to improved water in urban areas. There are calls for setting higher standards in urban areas which would exacerbate the already extreme rural disadvantage. Instead of setting different targets, health, economic, and human rights perspectives, We suggest that the focus should be kept on achieving universal access to safe water (primarily in rural areas) while monitoring progress towards higher service levels, including greater water safety (both in rural and urban areas and among different economic strata)

Do features of public open spaces vary between urban and rural areas?

Science.gov (United States)

Veitch, Jenny; Salmon, Jo; Ball, Kylie; Crawford, David; Timperio, Anna

2013-02-01

Parks are an important setting for physical activity and specific park features have been shown to be associated with park visitation and physical activity. Most park-based research has been conducted in urban settings with few studies examining rural parks. This study examined differences in features of parks in urban compared with rural areas. In 2009/10 a tool was developed to audit 433 urban and 195 rural parks located in disadvantaged areas of Victoria, Australia. Features assessed included: access; lighting/safety; aesthetics; amenities; paths; outdoor courts/ovals; informal play spaces; and playgrounds (number, diversity, age appropriateness and safety of play equipment). Rural parks scored higher for aesthetics compared with urban parks (5.08 vs 4.44). Urban parks scored higher for access (4.64 vs 3.89), lighting/safety (2.01 vs 1.76), and diversity of play equipment (7.37 vs 6.24), and were more likely to have paths suitable for walking/cycling (58.8% vs 40.9%) and play equipment for older children (68.2% vs 17.1%). Although the findings cannot be generalized to all urban and rural parks, the results may be used to inform advocacy for park development in rural areas to create parks that are more supportive of physical activity for children and adults. Copyright © 2012 Elsevier Inc. All rights reserved.

Theoretical Guidelines for a Psychology of Rural Development

NARCIS (Netherlands)

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

2014-01-01

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

Better Country: A Strategy for Rural Development in the 1980's.

Science.gov (United States)

Department of Agriculture, Washington, DC.

The report of the 25-member National Advisory Council on Rural Development, appointed by the Secretary of Agriculture, defines rural needs and sets forth strategies for rural development in the 1980's. A review of the decade between 1970 and 1980 discusses rapid economic growth of rural areas, social progress, and changes in public service, and…

Prevalence of pregnancy-relevant infections in a rural setting of Ghana.

Science.gov (United States)

Völker, Fabian; Cooper, Paul; Bader, Oliver; Uy, Angela; Zimmermann, Ortrud; Lugert, Raimond; Groß, Uwe

2017-06-06

Although infectious diseases still account for a high burden of morbidity and mortality in sub-Saharan Africa, simultaneous investigations on multiple infections affecting maternal and child health are missing. We conducted a cross-sectional, single-centre pilot study in a rural area of Ghana to assess the infectiological profile during pregnancy. Screening of 180 expectant mothers was done by vaginal swabs and serology to detect the most common pregnancy-relevant infections. They were also interviewed for potential risk factors, outcome of previous pregnancies, and socio-economic aspects. We found a high prevalence of infections caused by hepatitis B virus (16.7% HBs antigen positive). In contrast, infections caused by hepatitis C virus (1.1% anti-HCV) and HIV (0.6%) were rare. Maternal malaria was frequent (10.6%), despite increasing acceptance of intermittent preventive treatment during pregnancy (IPTp). Group B streptococci were present in 10.6% of all pregnant women. Absence of antibodies against varicella zoster virus in 43.2%, Toxoplasma gondii in 26.8%, parvovirus B19 in 20.0%, and rubella virus in 15.7% makes a significant proportion of pregnant women susceptible for acquiring primary infections. Whereas all study participants had specific IgG antibodies against human cytomegalovirus, infections with Listeria, Brucella, or Neisseria gonorrhoeae as well as active syphilis were absent. Our pilot study in a rural community in Ghana indicates an urgent need for action in dealing at least with high-prevalent pregnancy-relevant infections, such as hepatitis B, malaria and those caused by group B streptococci. In addition, the resulting prevalence rates of various other infections may offer guidance for health officials to prioritize possible future intervention schemes.

Progression of the epidemiological transition in a rural South African setting: findings from population surveillance in Agincourt, 1993–2013

Directory of Open Access Journals (Sweden)

Chodziwadziwa W. Kabudula

2017-05-01

Full Text Available Abstract Background Virtually all low- and middle-income countries are undergoing an epidemiological transition whose progression is more varied than experienced in high-income countries. Observed changes in mortality and disease patterns reveal that the transition in most low- and middle-income countries is characterized by reversals, partial changes and the simultaneous occurrence of different types of diseases of varying magnitude. Localized characterization of this shifting burden, frequently lacking, is essential to guide decentralised health and social systems on the effective targeting of limited resources. Based on a rigorous compilation of mortality data over two decades, this paper provides a comprehensive assessment of the epidemiological transition in a rural South African population. Methods We estimate overall and cause-specific hazards of death as functions of sex, age and time period from mortality data from the Agincourt Health and socio-Demographic Surveillance System and conduct statistical tests of changes and differentials to assess the progression of the epidemiological transition over the period 1993–2013. Results From the early 1990s until 2007 the population experienced a reversal in its epidemiological transition, driven mostly by increased HIV/AIDS and TB related mortality. In recent years, the transition is following a positive trajectory as a result of declining HIV/AIDS and TB related mortality. However, in most age groups the cause of death distribution is yet to reach the levels it occupied in the early 1990s. The transition is also characterized by persistent gender differences with more rapid positive progression in females than males. Conclusions This typical rural South African population is experiencing a protracted epidemiological transition. The intersection and interaction of HIV/AIDS and antiretroviral treatment, non-communicable disease risk factors and complex social and behavioral changes will impact

Epidemiological study of clinical characteristics of patients with PCOS attending infertility clinic and awareness of PCOS in a rural set up

OpenAIRE

Shubhada Jajoo; Riju Angik

2013-01-01

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age group. It is a common diagnosis in women presenting with infertility. All the dimensions of PCOS have not been completely explored. In this study we studied the clinical features of PCOS and comparing with non-PCOS infertility patients and simultaneously studied the prevalence of PCOS in infertility patients and its awareness in a rural set up. Methods: It is a prospect...

The buck stops here: midwives and maternity care in rural Scotland.

Science.gov (United States)

Harris, Fiona M; van Teijlingen, Edwin; Hundley, Vanora; Farmer, Jane; Bryers, Helen; Caldow, Jan; Ireland, Jillian; Kiger, Alice; Tucker, Janet

2011-06-01

To explore and understand what it means to provide midwifery care in remote and rural Scotland. Qualitative interviews with 72 staff from 10 maternity units, analysed via a case study approach. Remote and rural areas of Scotland. Predominantly midwives, with some additional interviews with paramedics, general surgeons, anaesthetists and GPs. Remote and rural maternity care includes a range of settings and models of care. However, the impact of rural geographies on decision-making and risk assessment is common to all settings. Making decisions and dealing with the implications of these decisions is, in many cases, done without onsite specialist support. This has implications for the skills and competencies that are needed to practice midwifery in remote and rural settings. Whereas most rural midwives reported that their skills in risk assessment and decisions to transfer were well developed and appropriate to practising in their particular settings, they perceived these decisions to be under scrutiny by urban-based colleagues and felt the need to stress their competence in the face of what they imagined to be stereotypes of rural incompetence. This study shows that skills in risk assessment and decision-making are central to high quality remote and rural midwifery care. However, linked to different perspectives on care, there is a risk that these skills can be undermined by contact with colleagues in large urban units, particularly when staff do not know each other well. There is a need to develop a professional understanding between midwives in different locations. It is important for the good working relationships between urban and rural maternity units that all midwives understand the importance of contextual knowledge in both decisions to transfer from rural locations and the position of midwives in receiving units. Multiprofessional CPD courses have been effective in bringing together teams around obstetric emergencies; we suggest that a similar format may be

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

Science.gov (United States)

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

2003-01-01

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

An Ethnographic Meta-Synthesis of Three Southwestern Rural Studies.

Science.gov (United States)

Averill, Jennifer B

2016-01-01

The objectives were to synthesize cumulative findings across three critical ethnographic, community-partnered studies in the southwestern United States and to describe the process of meta-ethnography for that analysis. The meta-ethnography followed the design of Noblit and Hare for constructing an analysis of composite data, informed by community-based participatory research and Stringer's ethnographic strategies of Look-Think-Act. The three studies occurred in rural settings of Colorado and New Mexico, engaging 129 total participants, along with community organizations and agencies as partners. Methods consisted of detailed review of each original study, mapping of major concepts and themes, and general analysis, interpretation, and synthesis across the studies. Overall themes were: health is the capacity to care for oneself and do work, meaningful relationships are key in health care interactions, patterns of discrimination persist in rural settings, poor literacy and health literacy are barriers, and food insecurity is a growing concern for older rural adults. Resolutions involve practice, policy, and research and must incorporate all stakeholder groups in rural settings; a participatory approach is critical to prioritize and impact existing inequities; and work is needed to extend education and understanding of multiple cultures, groups, customs, and rural contexts. © 2015 Wiley Periodicals, Inc.

Who is consuming the countryside? An activity-based segmentation analysis of the domestic rural tourism market in Portugal

NARCIS (Netherlands)

Eusébio, Celeste; Carneiro, Maria João; Kastenholz, Elisabeth; Figueiredo, Elisabete; Soares da Silva, Diogo

2017-01-01

As a result of a well-debated set of transformations, rural areas are increasingly perceived as consumption rather than productive places, mainly associated to leisure and tourism. This paper aims to analyse the heterogeneity of domestic tourism consumption of rural areas. Based on a cluster

Groebner basis, resultants and the generalized Mandelbrot set

Energy Technology Data Exchange (ETDEWEB)

Geum, Young Hee [Centre of Research for Computational Sciences and Informatics in Biology, Bioindustry, Environment, Agriculture and Healthcare, University of Malaya, 50603 Kuala Lumpur (Malaysia)], E-mail: conpana@empal.com; Hare, Kevin G. [Department of Pure Mathematics, University of Waterloo, Waterloo, Ont., N2L 3G1 (Canada)], E-mail: kghare@math.uwaterloo.ca

2009-10-30

This paper demonstrates how the Groebner basis algorithm can be used for finding the bifurcation points in the generalized Mandelbrot set. It also shows how resultants can be used to find components of the generalized Mandelbrot set.

Groebner basis, resultants and the generalized Mandelbrot set

International Nuclear Information System (INIS)

Geum, Young Hee; Hare, Kevin G.

2009-01-01

This paper demonstrates how the Groebner basis algorithm can be used for finding the bifurcation points in the generalized Mandelbrot set. It also shows how resultants can be used to find components of the generalized Mandelbrot set.

Area-level risk factors for adverse birth outcomes: trends in urban and rural settings

OpenAIRE

Kent, Shia T; McClure, Leslie A; Zaitchik, Ben F; Gohlke, Julia M

2013-01-01

Background Significant and persistent racial and income disparities in birth outcomes exist in the US. The analyses in this manuscript examine whether adverse birth outcome time trends and associations between area-level variables and adverse birth outcomes differ by urban?rural status. Methods Alabama births records were merged with ZIP code-level census measures of race, poverty, and rurality. B-splines were used to determine long-term preterm birth (PTB) and low birth weight (LBW) trends b...

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

Science.gov (United States)

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

2013-06-01

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

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

Science.gov (United States)

Roche, Ann; McEntee, Alice

2017-08-01

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

Rural Nonfarm Employment andIncomes in the Himalayas

OpenAIRE

Micevska, Maja; Rahut, Dil Bahadur

2008-01-01

Nonfarm activities generate on average about 60 percent of rural households' incomes in the Himalayas. This paper analyzes the determinants of participation in nonfarm activities and of nonfarm incomes across rural households. A unique data set collected in the Himalayan region of India allows us to deal with the heterogeneity of rural nonfarm activities by using aggregations into categories that are useful both analytically and for policy purposes. We conduct an empirical inquiry that reveal...

"Everybody Knows Everybody Else's Business"-Privacy in Rural Communities.

Science.gov (United States)

Leung, Janni; Smith, Annetta; Atherton, Iain; McLaughlin, Deirdre

2016-12-01

Patients have a right to privacy in a health care setting. This involves conversational discretion, security of medical records and physical privacy of remaining unnoticed or unidentified when using health care services other than by those who need to know or whom the patient wishes to know. However, the privacy of cancer patients who live in rural areas is more difficult to protect due to the characteristics of rural communities. The purpose of this article is to reflect on concerns relating to the lack of privacy experienced by cancer patients and health care professionals in the rural health care setting. In addition, this article suggests future research directions to provide much needed evidence for educating health care providers and guiding health care policies that can lead to better protection of privacy among cancer patients living in rural communities.

Telecommunications technology and rural education in the United States

Science.gov (United States)

Perrine, J. R.

1975-01-01

The rural sector of the US is examined from the point of view of whether telecommunications technology can augment the development of rural education. Migratory farm workers and American Indians were the target groups which were examined as examples of groups with special needs in rural areas. The general rural population and the target groups were examined to identify problems and to ascertain specific educational needs. Educational projects utilizing telecommunications technology in target group settings were discussed. Large scale regional ATS-6 satellite-based experimental educational telecommunications projects were described. Costs and organizational factors were also examined for large scale rural telecommunications projects.

Poverty in Rural and Semi-Urban Mexico during 1992-2002

OpenAIRE

Verner, Dorte

2005-01-01

This paper analyzes poverty in rural and semi-urban areas of Mexico (localities with less than 2,500 and 15,000 inhabitants, respectively) and provides guidance on a social agenda and poverty alleviation strategy for rural Mexico. The analyses are based on INIGH and ENE data sets for 1992-2002. Monetary extreme poverty affected 42 percent of the rural dwellers in dispersed rural areas and 21 percent in semi-urban areas in 2002, slightly less than one decade earlier. Most of the rural poor liv...

Factor Analysis on the Factors that Influencing Rural Environmental Pollution in the Hilly Area of Sichuan Province,China

Institute of Scientific and Technical Information of China (English)

2011-01-01

By using factor analysis method and establishing analysis indicator system from four aspects including crop production,poultry farming,rural life and township enterprises,the difference,features,and types of factors influencing the rural environmental pollution in the hilly area in Sichuan Province,China.Results prove that the major factor influencing rural environmental pollution in the study area is livestock and poultry breeding,flowed by crop planting,rural life,and township enterprises.Hence future pollution prevention and control should set about from livestock and poultry breeding.Meanwhile,attention should be paid to the prevention and control of rural environmental pollution caused by rural life and township enterprise production.

Body Mass Index and Self-Perception of Overweight and Obesity in Rural, Urban and Rural-to-Urban Migrants: PERU MIGRANT Study

OpenAIRE

Loret de Mola, Christian; Pillay, Timesh D.; Diez-Canseco, Francisco; Gilman, Robert H.; Smeeth, Liam; Miranda, J. Jaime

2012-01-01

Objective: This study aimed to compare self-reported weight and body mass index (BMI) in order to determine discrepancies between subjective and objective obesity-related markers, and possible explanatory factors of overweight and obesity underestimation, in urban, rural and migrant populations. Materials and Methods: Data from the PERU MIGRANT study, a cross-sectional study, in low-income settings, of urban, migrant (rural-to-urban), and rural groups, including BMI, self-reported weight and ...

Welfare service in rural areas

DEFF Research Database (Denmark)

Nørgaard, Helle

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

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

Directory of Open Access Journals (Sweden)

Andrew J. Ross

2014-12-01

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

SELCO: A model for solar rural electrification in India

Science.gov (United States)

Hande, H. Harish

1999-11-01

The following thesis presents the concept of a Rural Energy Service Company in India, known as SELCO. The model is being set up as a sustainable proposition for the implementation of solar photovoltaics as a viable alternative to provide reliable home lighting in the rural areas of India. The SELCO approach has already achieved noteworthy social and commercial results. Institutional, policy and operational problems have long plagued the rural electrification programs in India, resulting in thousands of villages without access to electricity. SELCO is a solar energy service company operating in Southern India since 1995, focusing on the enormous untapped market for home lighting where thousands of households have no access to electricity and severe power shortages face those already connected to the electric grid. The Company has installed nearly 2,000 solar home lighting systems. From a modest two employees company in 1995, it has grown to 35 in 1997 and from one office to eight. The hypothesis to be tested in this study is that in rural India, in a market not subsidized by the government, a solar service company with available loans from local banks and cooperatives and with sales, installation, and maintenance personnel in the villages can be successful in introducing photovoltaic systems to provide basic amenities such as lighting and water pumping for the improvement of the quality of life, public health, and the environment. The initial success of SELCO lends considerable evidence to the acceptance of the hypothesis. To accomplish its mission, SELCO works with commercial, retail, and rural development banks with large rural branch networks to stimulate loans to SELCO's customers based on a standard set of attractive financing terms. SELCO through its successful model has convinced the policy makers that a way to increase rural families' access to consumer financing for solar home lighting systems is through the existing financial network available in the

Understanding the strategies employed to cope with increased numbers of AIDS-orphaned children in families in rural settings: a case of Mbeya Rural District, Tanzania.

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Fauk, Nelsensius Klau; Mwakinyali, Silivano Edson; Putra, Sukma; Mwanri, Lillian

2017-02-07

NGO) and the local government respectively. The current study identified challenges that adoptive families as well as the AIDS-orphaned children themselves faced in Mbeya Rural District, Tanzania. Recognition of these issues highlights the need for targeted interventions to address the underlying social determinants of human immunodeficiency virus or HIV and AIDS in affected populations in order to prevent further imposition of social, cultural and economic disadvantages on families that provide care for AIDS-orphaned children and the children themselves. These findings may prove useful in provoking discussions that may lead to HIV/AIDS prevention and the development of broader mitigation strategies to alleviate the impact of this scourge on families and communities in rural Tanzania, and in similar settings across the world.

Urban-Rural Excellence Gaps: Features, Factors, and Implications

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Hernández-Torrano, Daniel

2018-01-01

The purpose of this study was to examine the presence of excellence gaps (i.e., differences between subgroups of students performing at the highest levels of achievement) in a sample of 563 students nominated as gifted by their teachers in urban, semi-urban, and rural settings in Spain. In general, the results suggested the existence of excellence…

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Results 391 - 400 of 8494 ... Integrated Rural-Urban Water Management for Climate Based Adaptation in ... Implementing effective simulation-based education to improve maternal newborn and child health in a resource-constrained setting.

Prevalence of anemia and associated factors in children living in urban and rural settings from Bata District, Equatorial Guinea, 2013.

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Ncogo, Policarpo; Romay-Barja, Maria; Benito, Agustin; Aparicio, Pilar; Nseng, Gloria; Berzosa, Pedro; Santana-Morales, Maria A; Riloha, Matilde; Valladares, Basilio; Herrador, Zaida

2017-01-01

Anemia in children under 5 years of age is a global public health problem. According to the World Health Organization the current rate of anemia among preschool aged children in Equatorial Guinea is 66%. No information is available above this age. The cross-sectional Prevamal Survey was conducted in 2013 aimed at providing baseline data on malaria prevalence in children aged 2 months-15 years old. Sampling was carried out with the use of a multistage, stratified cluster strategy in the district of Bata, Equatorial Guinea. The χ2 test and adjusted Poisson regression models were applied to assess the association between social-demographic and economic factors, malaria and anemia. A total of 1436 children were tested, out of which 1,421 children (99%) were tested for anemia. Over 85% were anemic; out of them, 284 (24%), 815 (67%) and 111 (9%) children had mild, moderate and severe anemia, respectively. Severe anemia was more frequent among children aged 2-12 months old and those living in rural sites. About 47% tested positive for malaria via a rapid diagnostic test (RDT). This rate was significantly higher in rural villages (66%; panemia and malaria was higher in rural settings (panemia in urban areas displayed a heterogeneity and complexity that differed from the rural environment: in urban neighbourhoods, children with concomitant malaria infection were more likely to be anemic (adjusted prevalence rate (aPR):1.19; CI 95%: 1.12-1.28). Moreover, the prevalence of anemia was higher in children aged above 13 months compared to younger children (pchildren' parents being employees (aPR: 0.86, 95% CI: 0.76-0.96) or self-employed (aPR: 0.86, 95% CI: 0.76-0.97) vs. working in agriculture and/or fishing negatively associated with anemia among urban children. This marked urban-rural variation indicates the importance of targeting specific areas or districts. Strategies aimed at reducing malaria are clearly paramount in this country. Prevention and treatment of other factors

Mental health literacy in rural Queensland: results of a community survey.

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Bartlett, Helen; Travers, Catherine; Cartwright, Colleen; Smith, Norman

2006-09-01

The aim of this study was to assess the awareness of, and attitudes to, mental health issues in rural dwelling Queensland residents. A secondary objective was to provide baseline data of mental health literacy prior to the implementation of Australian Integrated Mental Health Initiative--a health promotion strategy aimed at improving the health outcomes of people with chronic or recurring mental disorders. In 2004 a random sample of 2% (2132) of the estimated adult population in each of eight towns in rural Queensland was sent a postal survey and invited to participate in the project. A series of questions were asked based on a vignette describing a person suffering major depression. In addition, questions assessed respondents' awareness and perceptions of community mental health agencies. Approximately one-third (36%) of those surveyed completed and returned the questionnaire. While a higher proportion of respondents (81%) correctly identified and labelled the problem in the vignette as depression than previously reported in Australian community surveys, the majority of respondents (66%) underestimated the prevalence of mental health problems in the community. Furthermore, a substantial number of respondents (37%) were unaware of agencies in their community to assist people with mental health issues while a majority of respondents (57.6%) considered that the services offered by those agencies were poor. While mental health literacy in rural Queensland appears to be comparable to other Australian regions, several gaps in knowledge were identified. This is in spite of recent widespread coverage of depression in the media and thus, there is a continuing need for mental health education in rural Queensland.

Random blood glucose may be used to assess long-term glycaemic control among patients with type 2 diabetes mellitus in a rural African clinical setting.

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Rasmussen, Jon B; Nordin, Lovisa S; Rasmussen, Niclas S; Thomsen, Jakúp A; Street, Laura A; Bygbjerg, Ib C; Christensen, Dirk L

2014-12-01

To investigate the diagnostic accuracy of random blood glucose (RBG) on good glycaemic control among patients with diabetes mellitus (DM) in a rural African setting. Cross-sectional study at St. Francis' Hospital in eastern Zambia. RBG and HbA1c were measured during one clinical review only. Other information obtained was age, sex, body mass index, waist circumference, blood pressure, urine albumin-creatinine ratio, duration since diagnosis and medication. One hundred and one patients with DM (type 1 DM = 23, type 2 DM = 78) were included. Spearman's rank correlation coefficient revealed a significant correlation between RBG and HbA1c among the patients with type 2 DM (r = 0.73, P AUC = 0.80, SE = 0.05), RBG ≤7.5 mmol/l was determined as the optimal cut-off value for good glycaemic control (HbA1c blood glucose could possibly be used to assess glycaemic control among patients with type 2 DM in rural settings of sub-Saharan Africa. © 2014 John Wiley & Sons Ltd.

HIV testing service awareness and service uptake among female heads of household in rural Mozambique: results from a province-wide survey.

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Paulin, Heather N; Blevins, Meridith; Koethe, John R; Hinton, Nicole; Vaz, Lara M E; Vergara, Alfredo E; Mukolo, Abraham; Ndatimana, Elisée; Moon, Troy D; Vermund, Sten H; Wester, C William

2015-02-12

HIV voluntary counseling and testing (VCT) utilization remains low in many sub-Saharan African countries, particularly in remote rural settings. We sought to identify factors associated with service awareness and service uptake of VCT among female heads of household in rural Zambézia Province of north-central Mozambique which is characterized by high HIV prevalence (12.6%), poverty, and suboptimal health service access and utilization. Our population-based survey of female heads of household was administered to a representative two-stage cluster sample using a sampling frame created for use on all national surveys and based on census results. The data served as a baseline measure for the Ogumaniha project initiated in 2009. Survey domains included poverty, health, education, income, HIV stigma, health service access, and empowerment. Descriptive statistics and logistic regression were used to describe service awareness and service uptake of VCT. Of 3708 women surveyed, 2546 (69%) were unaware of available VCT services. Among 1162 women who were aware of VCT, 673 (58%) reported no prior testing. In the VCT aware group, VCT awareness was associated with higher education (aOR = 2.88; 95% CI = 1.61, 5.16), higher income (aOR = 1.41, 95% CI = 1.06, 1.86), higher numeracy (aOR = 1.05, CI 1.03, 1.08), more children mobile phone ownership (aOR = 1.37; 95% CI = 1.03, 1.84) (all p-values marketing of VCT are needed in rural Mozambique with special attention to issues of community-level stigma reduction.

Prevalence of diabetic complications in rural Goa, India

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Nafisa C Vaz

2011-01-01

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

Secondhand Smoke Exposure and Smoke-Free Policy Support Among Public Housing Authority Residents in Rural and Tribal Settings.

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Schmidt, Lisa M; Reidmohr, Alison A; Helgerson, Steven D; Harwell, Todd S

2016-12-01

Previous research has shown that multi-unit housing (MUH) residents are at risk of secondhand smoke (SHS) exposure, which can transfer between units. The purpose of this study was to determine SHS exposure and examine attitudes towards smoking policies among public housing authority (PHA) residents in rural and tribal settings. A self-administered questionnaire was completed by 895 adult tenants (41 % response rate) living in PHA multiunit buildings in Montana in 2013. Our primary outcome was tenant support of smoke-free policies; our secondary outcome was exacerbation of child asthma symptoms due to SHS exposure. In 2014, we used multiple logistic regression models to test associations between independent variables and outcomes of interest. The majority (80.6 %) of respondents supported having a smoke-free policy in their building, with support being significantly higher among nonsmokers [adjusted odds ratio (aOR) 4.2, 95 % confidence interval (CI) 1.5-11.6] and among residents living with children (aOR 2.9, 95 % CI 1.3-6.2). Tribal residents were as likely to support smoke-free policies as non-tribal residents (aOR 1.4; 95 % CI 0.5-4.0). Over half (56.5 %) of respondents reported SHS exposure in their home; residents in a building with no smoke-free policy in place were significantly more likely to report exposure (aOR 3.5, 95 % CI 2.2-5.5). SHS exposure was not significantly associated with asthma symptoms. There is a significant reduction in exposure to SHS in facilities with smoke-free policies and there is strong support for such policies by both tribal and non-tribal MUH residents. Opportunities exist for smoke-free policy initiatives in rural and tribal settings.

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

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Seshaiah, Manasi; Nagesh, Latha; Ramesh, Hemalatha

2017-01-01

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

Is Nonfarm Diversification a Way Out of Poverty for Rural Households? Evidence from Vietnam in 1993-2006

OpenAIRE

Pham Thai Hung; Bui Anh Tuan; Dao Le Thanh

2010-01-01

school. Using the four high quality household living standards surveys available to date this paper reveals that Vietnam’s rural labour force has been markedly diversifying toward nonfarm activities in the doi moi (renovation) reform period. The employment share of the rural nonfarm sector has increased from 23 percent to 58 percent between the years 1993 and 2006. At the individual level, the results indicate that participation in the rural nonfarm sector is determined by a set of individual...

Urban and rural population growth in a spatial panel of municipalities

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Costa da Silva, Diego Firmino; Elhorst, J. Paul; Silveira Neto, Raul da Mota

2017-01-01

Urban and rural population growth in a spatial panel of municipalities. Regional Studies. Using Bayesian posterior model probabilities and data pertaining to 3659 Brazilian minimum comparable areas (MCAs) over the period 1970-2010, two theoretical settings of population growth dynamics resulting in

Appropriate training and retention of community doctors in rural areas: a case study from Mali

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Coulibaly Seydou

2008-11-01

Full Text Available Abstract Background While attraction of doctors to rural settings is increasing in Mali, there is concern for their retention. An orientation course for young practicing rural doctors was set up in 2003 by a professional association and a NGO. The underlying assumption was that rurally relevant training would strengthen doctors' competences and self-confidence, improve job satisfaction, and consequently contribute to retention. Methods Programme evaluation distinguished trainees' opinions, competences and behaviour. Data were collected through participant observation, group discussions, satisfaction questionnaires, a monitoring tool of learning progress, and follow up visits. Retention was assessed for all 65 trainees between 2003 and 2007. Results and discussion The programme consisted of four classroom modules – clinical skills, community health, practice management and communication skills – and a practicum supervised by an experienced rural doctor. Out of the 65 trained doctors between 2003 and 2007, 55 were still engaged in rural practice end of 2007, suggesting high retention for the Malian context. Participants viewed the training as crucial to face technical and social problems related to rural practice. Discussing professional experience with senior rural doctors contributed to socialisation to novel professional roles. Mechanisms underlying training effects on retention include increased self confidence, self esteem as rural doctor, and sense of belonging to a professional group sharing a common professional identity. Retention can however not be attributed solely to the training intervention, as rural doctors benefit from other incentives and support mechanisms (follow up visits, continuing training, mentoring... affecting job satisfaction. Conclusion Training increasing self confidence and self esteem of rural practitioners may contribute to retention of skilled professionals in rural areas. While reorientations of curricula in

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

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

2017-05-02

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

Evaluation on Optimal Scale of Rural Fixed-asset Investment-Based on Microcosmic Perspective of Farmers’ Income Increase

Institute of Scientific and Technical Information of China (English)

Jinqian; DENG; Kangkang; SHAN; Yan; ZHANG

2014-01-01

The rural fundamental and productive fixed-asset investment not only makes active influence on the changes of farmers’ operational,wages and property income,but it also has an optimal scale range for farmers’ income increase. From the perspective of farmers’ income increase,this article evaluates the optimal scale of rural fixed-asset investment by setting up model with statistic data,and the results show that the optimal scale of per capita rural fixed-asset investment is 76. 35% of per capita net income of rural residents,which has been reached in China in 2009. Therefore,compared with the adding of rural fixed-asset investment,a better income increase effect can be achieved through the adjustment of rural fixed-asset investment structure.

Screening mammography uptake within Australia and Scotland in rural and urban populations.

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Leung, Janni; Macleod, Catriona; McLaughlin, Deirdre; Woods, Laura M; Henderson, Robert; Watson, Angus; Kyle, Richard G; Hubbard, Gill; Mullen, Russell; Atherton, Iain

2015-01-01

To test the hypothesis that rural populations had lower uptake of screening mammography than urban populations in the Scottish and Australian setting. Scottish data are based upon information from the Scottish Breast Screening Programme Information System describing uptake among women residing within the NHS Highland Health Board area who were invited to attend for screening during the 2008 to 2010 round (N = 27,416). Australian data were drawn from the 2010 survey of the 1946-51 cohort of the Australian Longitudinal Study on Women's Health (N = 9890 women). Contrary to our hypothesis, results indicated that women living in rural areas were not less likely to attend for screening mammography compared to women living in urban areas in both Scotland (OR for rural = 1.17, 95% CI = 1.06-1.29) and Australia (OR for rural = 1.15, 95% CI = 1.01-1.31). The absence of rural-urban differences in attendance at screening mammography demonstrates that rurality is not necessarily an insurmountable barrier to screening mammography.

Impact of community-based interventions on maternal and neonatal health indicators: Results from a community randomized trial in rural Balochistan, Pakistan

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Becker Stan

2010-11-01

Full Text Available Abstract Background Pakistan has high maternal mortality, particularly in the rural areas. The delay in decision making to seek medical care during obstetric emergencies remains a significant factor in maternal mortality. Methods We present results from an experimental study in rural Pakistan. Village clusters were randomly assigned to intervention and control arms (16 clusters each. In the intervention clusters, women were provided information on safe motherhood through pictorial booklets and audiocassettes; traditional birth attendants were trained in clean delivery and recognition of obstetric and newborn complications; and emergency transportation systems were set up. In eight of the 16 intervention clusters, husbands also received specially designed education materials on safe motherhood and family planning. Pre- and post-intervention surveys on selected maternal and neonatal health indicators were conducted in all 32 clusters. A district-wide survey was conducted two years after project completion to measure any residual impact of the interventions. Results Pregnant women in intervention clusters received prenatal care and prophylactic iron therapy more frequently than pregnant women in control clusters. Providing safe motherhood education to husbands resulted in further improvement of some indicators. There was a small but significant increase in percent of hospital deliveries but no impact on the use of skilled birth attendants. Perinatal mortality reduced significantly in clusters where only wives received information and education in safe motherhood. The survey to assess residual impact showed similar results. Conclusions We conclude that providing safe motherhood education increased the probability of pregnant women having prenatal care and utilization of health services for obstetric complications.

Advice from Rural Elders: What It Takes to Age in Place

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Dye, Cheryl J.; Willoughby, Deborah F.; Battisto, Dina G.

2011-01-01

Older adults prefer to age in place (AIP), and there are psychological, physiological, and economic benefits in doing so. However, it is especially challenging to AIP in rural communities. AIP models have been tested in urban settings and age-segregated communities, but they are not appropriate for rural communities. This paper presents rural AIP…

A Mixed Methods Comparison of Urban and Rural Retail Corner Stores

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Jared T McGuirt

2015-08-01

Full Text Available Efforts to transform corner stores to better meet community dietary needs have mostly occurred in urban areas but are also needed in rural areas. Given important contextual differences between urban and rural areas, it is important to increase our understanding of the elements that might translate successfully to similar interventions involving stores in more rural areas. Thus, an in-depth examination and comparison of corner stores in each setting is needed. A mixed methods approach, including windshield tours, spatial visualization with analysis of frequency distribution, and spatial regression techniques were used to compare a rural North Carolina and large urban (Los Angeles food environment. Important similarities and differences were seen between the two settings in regards to food environment context, spatial distribution of stores, food products available, and the factors predicting corner store density. Urban stores were more likely to have fresh fruits (Pearson chi2 = 27.0423; p < 0.001 and vegetables (Pearson chi2 = 27.0423; p < 0.001. In the urban setting, corner stores in high income areas were more likely to have fresh fruit (Pearson chi2 = 6.00; p = 0.014, while in the rural setting, there was no difference between high and low income area in terms of fresh fruit availability. For the urban area, total population, no vehicle and Hispanic population were significantly positively associated (p < 0.05, and median household income (p < 0.001 and Percent Minority (p < 0.05 were significantly negatively associated with corner store count. For the rural area, total population (p < 0.05 and supermarket count were positively associated (p < 0.001, and median household income negatively associated (P < 0.001, with corner store count. Translational efforts should be informed by these findings, which might influence the success of future interventions and policies in both rural and urban contexts.

Social Problems Of Aged In A Rural Population

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Singh Charan

1995-01-01

Full Text Available Research Question: What are the social problems of aged persons in a rural population? Objectives: i To study social problems of aged. ii To identify measures to eliminate them. Study design: Cross- sectional. Setting: Rural areas of Machhra Rural Health & Training Centre attached with Deptt. of SPM, Medical College, Meerut. Participants: Population above 60 years of age. Sample Size: 1000 households from 5 villages, which had 464 participants. Study Variables: Chi- square test. Results: In all, 259 (55.8% aged persons were engaged in productive work while 205 (44.2% were not doing any productive work. Of 376 aged persons living in joint families, 207 (55% were being respected, 71(18.9% were indifferently treated and 98 (26.1% were being neglected by family members. Recommendations: It is a strong case for proper planning to improve the lot of old age population especially for their social problems at the earliest.

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

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Walker, Lorraine; Cross, Merylin; Barnett, Tony

2018-05-01

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

Comparative Analysis of Households Solid Waste Management in Rural and Urban Ghana.

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Boateng, Simon; Amoako, Prince; Appiah, Divine Odame; Poku, Adjoa Afriyie; Garsonu, Emmanuel Kofi

2016-01-01

The comparative analysis of solid waste management between rural and urban Ghana is largely lacking. This study investigated the solid waste situation and the organisation of solid waste management in both urban and rural settings from the perspective of households. The study employed cross-sectional survey covering both rural and urban districts in the Ashanti and Greater Accra Regions of Ghana. The study systematically sampled houses from which 400 households and respondents were randomly selected. Pearson's Chi square test was used to compare demographic and socioeconomic variables in rural and urban areas. Multivariate Test, Tests of Between-Subjects Effects, and Pair-Wise Comparisons were performed through one-way MANOVA to determine whether or not solid waste situations in rural and urban areas are significantly different. The results revealed that location significantly affects solid waste management in Ghana. Urban communities had lower mean scores than rural communities for poor solid waste situation in homes. However, urban communities had higher mean scores than rural communities for poor solid waste situation in principal streets and dumping sites. The study recommends that the local government authorities implement very comprehensive policies (sanitary inspection, infrastructure development, and community participation) that will take into consideration the specific solid waste management needs of both urban and rural areas.

Comparative Analysis of Households Solid Waste Management in Rural and Urban Ghana

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Simon Boateng

2016-01-01

Full Text Available The comparative analysis of solid waste management between rural and urban Ghana is largely lacking. This study investigated the solid waste situation and the organisation of solid waste management in both urban and rural settings from the perspective of households. The study employed cross-sectional survey covering both rural and urban districts in the Ashanti and Greater Accra Regions of Ghana. The study systematically sampled houses from which 400 households and respondents were randomly selected. Pearson’s Chi square test was used to compare demographic and socioeconomic variables in rural and urban areas. Multivariate Test, Tests of Between-Subjects Effects, and Pair-Wise Comparisons were performed through one-way MANOVA to determine whether or not solid waste situations in rural and urban areas are significantly different. The results revealed that location significantly affects solid waste management in Ghana. Urban communities had lower mean scores than rural communities for poor solid waste situation in homes. However, urban communities had higher mean scores than rural communities for poor solid waste situation in principal streets and dumping sites. The study recommends that the local government authorities implement very comprehensive policies (sanitary inspection, infrastructure development, and community participation that will take into consideration the specific solid waste management needs of both urban and rural areas.

Comparative Analysis of Households Solid Waste Management in Rural and Urban Ghana

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Appiah, Divine Odame; Poku, Adjoa Afriyie; Garsonu, Emmanuel Kofi

2016-01-01

The comparative analysis of solid waste management between rural and urban Ghana is largely lacking. This study investigated the solid waste situation and the organisation of solid waste management in both urban and rural settings from the perspective of households. The study employed cross-sectional survey covering both rural and urban districts in the Ashanti and Greater Accra Regions of Ghana. The study systematically sampled houses from which 400 households and respondents were randomly selected. Pearson's Chi square test was used to compare demographic and socioeconomic variables in rural and urban areas. Multivariate Test, Tests of Between-Subjects Effects, and Pair-Wise Comparisons were performed through one-way MANOVA to determine whether or not solid waste situations in rural and urban areas are significantly different. The results revealed that location significantly affects solid waste management in Ghana. Urban communities had lower mean scores than rural communities for poor solid waste situation in homes. However, urban communities had higher mean scores than rural communities for poor solid waste situation in principal streets and dumping sites. The study recommends that the local government authorities implement very comprehensive policies (sanitary inspection, infrastructure development, and community participation) that will take into consideration the specific solid waste management needs of both urban and rural areas. PMID:27807453

The Effects of Rent Restructuring on Social Housing in English Rural Areas

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Walker, Bruce

2004-01-01

This paper discusses the impact of central government's rent restructuring policy on social housing in rural areas in England. It examines the effect that restructuring will have on the rents set by social landlords in a set of case study areas then considers some of the likely impacts on affordability and on new investment in rural social…

A quantitative day in the life of a Saskatchewan rural physician.

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Harrison, Emmett; Dhillon, Paul B A

2018-01-01

Rural family physicians are often required to meet a wide variety of medical service demands that are otherwise the responsibility of specialty physicians in urban centres. However, many rural physicians enjoy the practice variety and ability to meet patients' medical needs through this wider spectrum of care. We aimed to quantify and summarize the workload and clinical disorders seen by rural family physicians in Saskatchewan relative to urban family physicians. We used Saskatchewan Ministry of Health billing data for 2015/16 to compare rural and urban care provision. The data were summarized in a graphic 1-month format to portray a typical month in the life of a rural physician in the province. In the office setting, rural family physicians saw 16.8% more cardiac presentations in adults over 65 years of age than did urban family physicians; otherwise, there were no significant differences in the top office diagnosis categories seen by the 2 groups. Differences were apparent, however, in the hospital setting: urban family physicians saw more patients presenting with pain and, reflective of centralization of obstetric delivery services, performed more deliveries than did rural physicians. There are differences in the clinical presentations seen by rural and urban family physicians, and these need to be considered by new physicians considering rural practice. Our simple visual depiction of average workload, vacation and activity levels of rural physicians can further inform medical residents on the realities of working in rural Saskatchewan as a family physician. A more complete understanding of clinical workload expectations may promote recruitment of resident physicians.

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

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

2013-01-01

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

Providing high-quality HIV care in a deeply rural setting – the ...

African Journals Online (AJOL)

challenges are not unique, rural health facilities are often fragile entities. ... problems with procurement, an isolated work environment and lack of on-site ... The government has focused on expanding programmes across the country, with ... us over the years to design and implement this programme, including. Drs Karl and ...

Primary Maternity Units in rural and remote Australia: Results of a national survey.

Science.gov (United States)

Kruske, Sue; Kildea, Sue; Jenkinson, Bec; Pilcher, Jennifer; Robin, Sarah; Rolfe, Margaret; Kornelsen, Jude; Barclay, Lesley

2016-09-01

Primary Maternity Units (PMUs) offer less expensive and potentially more sustainable maternity care, with comparable or better perinatal outcomes for normal pregnancy and birth than higherlevel units. However, little is known about how these maternity services operate in rural and remote Australia, in regards to location, models of care, service structure, support mechanisms or sustainability. This study aimed to confirm and describe how they operate. a descriptive, cross-sectional study was undertaken, utilising a 35-item survey to explore current provision of maternity care in rural and remote PMUs across Australia. Data were subjected to simple descriptive statistics and thematic analysis for free text answers. Only 17 PMUs were identified in rural and remote areas of Australia. All 17 completed the survey. the PMUs were, on average, 56km or 49minutes from their referral service and provided care to an average of 59 birthing women per year. Periodic closures or downgrading of services was common. Low-risk eligibility criteria were universally used, but with some variability. Medically-led care was the most widely available model of care. In most PMUs midwives worked shift work involving both nursing and midwifery duties, with minimal uptake of recent midwifery workforce innovations. Perceived enablers of, and threats to, sustainability were reported. a small number of PMUs operate in rural Australia, and none in remote areas. Continuing overreliance on local medical support, and under-utilisation of the midwifery workforce constrain the restoration of maternity services to rural and remote Australia. Copyright © 2016 Elsevier Ltd. All rights reserved.

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.

Una escuela ¿Para qué idea de lo rural?

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Nidia Yolive Vera-Angarita

2016-02-01

Full Text Available Starting from the assumption of a nonexistent rural school given that the current educational institution, which performs in that context, assumes an inappropriate vision of its reality which is identified by the possession of a set of economical and socio-cultural characteristics and defined as a form of existence both distinct and differentiable. This, therefore, brings forward the fact that rural schools need to adopt a rediscovery of the nature of the countryside realm as a basic condition for the elaboration of a suitable educational proposal able to cope with particularities, issues and expectations of the rural sphere, particularly, capable of facing the challenges that globalization processes set out to this form of existence.

Issues and prospects for coal utilization in Zimbabwe's rural households

International Nuclear Information System (INIS)

Maya, R.S.

1990-01-01

The increasing shortage of traditional fuels in Zimbabwe has prompted government to consider seriously the use of coal in rural households. In this regard, both government and the privately owned coal industry have begun pilot projects in selected rural areas to initiate the introduction of coal stoves and coal fuels. These efforts by government and the coal industry need to be informed by knowledge of the financial and economic dimensions of coal diffusion to rural economies, the environmental implications of widespread coal use in rural households, and the general acceptability of coal as a fuel to households with a long tradition of free fuels. This paper summarizes the results of a study undertaken to provide such background information. Conducted over six months during 1988, the study included field surveys of four districts in Zimbabwe: Murewa, Shurugwi, Mberengwa, and Mazoe Citrus Estates. All but the Mazoe district are rural settings with severe shortages of fuelwood. Mazoe Citrus Estates is a semi-urban plantation community which has had over twenty years' experience with coal use in households under a company-sponsored programme which supplies both fuels and stoves free of charge

Effectiveness of Botswana's policy on rural electrification

International Nuclear Information System (INIS)

Ketlogetswe, C.; Mothudi, T.H.; Mothibi, J.

2007-01-01

Rural areas, the world over, are characterised by low levels of connectivity to electrical energy, despite the fact that electricity has been universally acknowledged as one of the most important propellant for community and national development. Botswana is not immune to this trend. Consequently, available evidence puts the overall level of electrical connectivity in Botswana rural areas to just 12%. A plethora of factors are responsible for inhibiting high levels of access to electrical energy by rural communities. Some major impediments often cited as causing ineffective energy provision to rural-based communities include, among others, the following: (a)geographical set-ups of the concerned communities; (b)inappropriately conceived energy policies; (c)low-income status of most rural inhabitants. This paper, therefore, examines Botswana's policy on energy supply with the view to confirm or deny any correlation between the above factors and the low-levels of electrical connectivity in the country's rural communities, as well as many others that may have impacted on this state of affairs. The policy is evaluated by undertaking a comparative study of its implementation on two seemingly geographical contrasting rural communities within the country

A Curriculum Infusion Approach to Preservice Rural Teacher Preparation: Strategies and Resources.

Science.gov (United States)

Sarachan-Deily, Ann Beth; And Others

Collaborative strategies were used by The College of Saint Rose (CSR) and 15 rural school districts in upstate New York to implement preservice teacher training and programming to better meet the needs of handicapped learners in rural settings. Through meetings and questionnaires, rural administrative teams identified relevant skills and issues…

Instrumental and socioemotional communications in doctor-patient interactions in urban and rural clinics

Science.gov (United States)

2013-01-01

Background Location of practice, such as working in a rural or urban clinic, may influence how physicians communicate with their patients. This exploratory pilot study examines the communication styles used during doctor-patient interactions in urban and rural family practice settings in Western Canada. Methods We analyzed observation and interview data from four physicians practicing in these different locations. Using a grounded theory approach, communications were categorized as either instrumental or socioemotional. Instrumental communication refers to “cure-oriented interactions” and tends to be more task-oriented focusing on the patient’s health concerns and reason for the appointment. In contrast, socioemotional communication refers to more “care-oriented interactions” that may make the patient feel comfortable, relieve patient anxiety and build a trusting relationship. Results The physicians in small, rural towns appear to know their patients and their families on a more personal level and outside of their office, and engage in more socioemotional communications compared to those practicing in suburban clinics in a large urban centre. Knowing patients outside the clinic seems to change the nature of the doctor-patient interaction, and, in turn, the doctor-patient relationship itself. Interactions between urban doctors and their patients had a mixture of instrumental and socioemotional communications, while interactions between rural doctors and their patients tended to be highly interpersonal, often involving considerable socioemotional communication and relationship-building. Conclusions Despite the different ways that doctors and patients communicate with each other in the two settings, rural and urban doctors spend approximately the same amount of time with their patients. Thus, greater use of socioemotional communication by rural doctors, which may ease patient anxiety and increase patient trust, did not appear to add extra time to the patient

Prevalence of anemia and associated factors in children living in urban and rural settings from Bata District, Equatorial Guinea, 2013.

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Policarpo Ncogo

Full Text Available Anemia in children under 5 years of age is a global public health problem. According to the World Health Organization the current rate of anemia among preschool aged children in Equatorial Guinea is 66%. No information is available above this age. The cross-sectional Prevamal Survey was conducted in 2013 aimed at providing baseline data on malaria prevalence in children aged 2 months-15 years old. Sampling was carried out with the use of a multistage, stratified cluster strategy in the district of Bata, Equatorial Guinea. The χ2 test and adjusted Poisson regression models were applied to assess the association between social-demographic and economic factors, malaria and anemia. A total of 1436 children were tested, out of which 1,421 children (99% were tested for anemia. Over 85% were anemic; out of them, 284 (24%, 815 (67% and 111 (9% children had mild, moderate and severe anemia, respectively. Severe anemia was more frequent among children aged 2-12 months old and those living in rural sites. About 47% tested positive for malaria via a rapid diagnostic test (RDT. This rate was significantly higher in rural villages (66%; p<0.001. The prevalence of anemia and malaria was higher in rural settings (p<0.001. On the other hand, anemia in urban areas displayed a heterogeneity and complexity that differed from the rural environment: in urban neighbourhoods, children with concomitant malaria infection were more likely to be anemic (adjusted prevalence rate (aPR:1.19; CI 95%: 1.12-1.28. Moreover, the prevalence of anemia was higher in children aged above 13 months compared to younger children (p<0.005. Belonging to the poorest wealth tertile were positively (aPR: 1.14, 95% CI: 1.05-1.24 and children' parents being employees (aPR: 0.86, 95% CI: 0.76-0.96 or self-employed (aPR: 0.86, 95% CI: 0.76-0.97 vs. working in agriculture and/or fishing negatively associated with anemia among urban children. This marked urban-rural variation indicates the

Rural Trends in Diagnosis and Services for Autism Spectrum Disorder

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Ligia Antezana

2017-04-01

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

Patent Medicine Vendors in Rural Areas of Lagos Nigeria ...

African Journals Online (AJOL)

Purpose: To determine the compliance of patent medicine vendors (PMVs) in rural areas of Lagos State, Nigeria with set guidelines to regulate their practice and its implications for malaria control. Methods: A baseline cross-sectional study was conducted as part of an intervention study in two rural local government areas ...

Rural development--national improvement.

Science.gov (United States)

Malhotra, R C

1984-05-01

Rural development should be viewed as the core of any viable strategy for national development in developing countries where an average 2/3 of the population live in rural areas. Rural development is multisectoral, including economic, sociopolitical, environmental, and cultural aspects of rural life. Initially, the focus is on the provision of basic minimum needs in food, shelter, clothing, health, and education, through optimum use and employment of all available resources, including human labor. The development goal is the total development of the human potential. The hierarchy of goals of development may be shown in the form of an inverted pyramid. At the base are basic minimum needs for subsistence whose fulfillment leads to a higher set of sociopolitical needs and ultimately to the goal of total developmentand the release of creative energies of every individual. If development, as outlined, were to benefit the majority of the people then they would have to participate in decision making which affects their lives. This would require that the people mobilize themselves in the people'ssector. The majority can equitably benefit from development only if they are mobilized effectively. Such mobilization requires raising the consciousness of the people concerning their rights and obligations. All development with the twin objectives of growth with equity could be reduced to restructuring the socioeconomic, and hence political relationships. Desinging and implementing an intergrated approach to rural development is the 1st and fundamental issue of rural development management. The commonly accepted goals and objectives of a target group oriented antipoverty development strategy include: higher productivity and growth in gross national product (GNP); equitable distribution of the benefits of development; provision of basic minimum needs for all; gainful employment; participation in development; self reliance or self sustaining growth and development; maintenance of

Suicide in Castellon, 2009-2015: Do sociodemographic and psychiatric factors help understand urban-rural differences?

Science.gov (United States)

Suso-Ribera, Carlos; Mora-Marín, Rafael; Hernández-Gaspar, Carmen; Pardo-Guerra, Lidón; Pardo-Guerra, María; Belda-Martínez, Adela; Palmer-Viciedo, Ramón

Studies have pointed to rurality as an important factor influencing suicide. Research so far suggests that several sociodemograpic and psychiatric factors might influence urban-rural differences in suicide. Also, their contribution appears to depend on sex and age. Unfortunately, studies including a comprehensive set of explanatory variables altogether are still scare and most studies have failed to present their analyses split by sex and age groups. Also, urban-rural differences in suicide in Spain have been rarely investigated. The present study aimed at explaining rural-urban differences in suicidality in the province of Castellon (Spain). A comprehensive set of sociodemographic and psychiatric factors was investigated and analyses were split by sex and age. The sample comprised all suicides recorded in the province of Castellon from January 2009 to December 2015 (n=343). Sociodemographic data included sex, age, and suicide method. Psychiatric data included the history of mental health service utilization, psychiatric diagnosis, suicide attempts, and psychiatric hospitalization. Consistent with past research, suicide rates were highest in rural areas, especially in men and older people. We also found that urban-rural differences in sociodemographic and psychiatric variables were sensitive to sex and age. Our results indicated that specialized mental health service use and accessibility to suicide means might help understand urban-rural differences in suicide, especially in men. When exploring urban-rural differences as a function of age, general practitioner visits for psychiatric reasons were more frequent in the older age group in rural areas. Study implications for suicide prevention strategies in Spain are discussed. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

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

Science.gov (United States)

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

2015-01-01

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

The efficacy of staff training on improving internal customer satisfaction in a rural health setting.

Science.gov (United States)

Hartley, R; Turner, R

1995-09-01

The NSW Health Department is 3 years into its customer satisfaction initiative. North West Health Service, one of the largest rural health districts, was among the first centres to embrace the customer satisfaction philosophy starting with compulsory training of all staff. This paper reports on changes in staff morale (internal satisfaction) as a result of that training. The data suggest that training per se has had minimal effect and argues for management development, particularly regarding leadership, rather than fiscal skills.

AN ANALYSIS OF THE ROUMANIAN RURAL TOURISTIC PHENOMENON

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Marius BOIŢĂ

2014-04-01

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

Schoolchildren affected by HIV in rural South Africa: Schools as ...

African Journals Online (AJOL)

This article explores how schoolchildren made vulnerable due to HIV and AIDS might cope and even thrive in a rural school environment in South Africa. I argue that ... Keywords: appreciative inquiry, assets, coping, PhotoVoice, psychosocial aspects, research methods, rural settings, visual participatory methods

Positive body image: inter-ethnic and rural-urban differences among an indigenous sample from Malaysian Borneo.

Science.gov (United States)

Swami, Viren; Kannan, Kumaraswami; Furnham, Adrian

2012-11-01

Previous studies examining body image from a cross-cultural perspective have tended to neglect samples from different ethnic groups or along a rural-urban continuum. To overcome this limitation, the present study examined positive body image among rural and urban women from three major indigenous ethnic groups in Sabah, Malaysia. A total of 202 women completed the Body Appreciation Scale, as well as measures of media exposure and financial security, and provided their demographic details. s showed that there were significant rural-urban differences in body appreciation, with rural participants having significantly higher body appreciation than urban participants. A comparison with a previous data set of West Malaysian women (Swami & Chamorro-Premuzic, 2008) showed that the current urban sample had significantly lower body appreciation and that the rural group had significantly higher body appreciation. Further results showed that research site (urban vs rural) explained 11.0% of the variance in body appreciation. Participant body mass index and exposure to western forms of media explained an additional 2.0% of the variance. These results suggest that there are differences in body image between rural and urban women. Results are discussed in relation to the promotion of positive body image, particularly in developing societies where health care resources may be limited.

Paediatric case mix in a rural clinical school is relevant to future practice.

Science.gov (United States)

Wright, Helen M; Maley, Moira A L; Playford, Denese E; Nicol, Pam; Evans, Sharon F

2017-11-29

Exposure to a representative case mix is essential for clinical learning, with logbooks established as a way of demonstrating patient contacts. Few studies have reported the paediatric case mix available to geographically distributed students within the same medical school. Given international interest in expanding medical teaching locations to rural contexts, equitable case exposure in rural relative to urban settings is topical. The Rural Clinical School of Western Australia locates students up to 3500 km from the urban university for an academic year. There is particular need to examine paediatric case mix as a study reported Australian graduates felt unprepared for paediatric rotations. We asked: Does a rural clinical school provide a paediatric case mix relevant to future practice? How does the paediatric case mix as logged by rural students compare with that by urban students? The 3745 logs of 76 urban and 76 rural consenting medical students were categorised by presenting symptoms and compared to the Australian Institute of Health and Welfare (AIHW) database Major Diagnostic Categories (MDCs). Rural and urban students logged core paediatric cases, in similar order, despite the striking difference in geographic locations. The pattern of overall presenting problems closely corresponded to Australian paediatric hospital admissions. Rural students logged 91% of cases in secondary healthcare settings; urban students logged 90% of cases in tertiary settings. The top four presenting problems were ENT/respiratory, gastrointestinal/urogenital, neurodevelopmental and musculoskeletal; these made up 60% of all cases. Rural and urban students logged similar proportions of infants, children and adolescents, with a variety of case morbidity. Rural clinical school students logged a mix of core paediatric cases relevant to illnesses of Australian children admitted to public hospitals, with similar order and pattern by age group to urban students, despite major differences

ROLE OF RURAL TOURISM FOR DEVELOPMENT OF RURAL AREAS

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Andrej Udovč

2001-09-01

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

From the associative companies to the nuclei of rural entrepreneurs

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Álvaro Parrado

2010-12-01

Full Text Available Since the second half of the twentieth century, the impulse to the creation of Rural Associative Organizations (RAOs has become one of the main tools to implement rural development policies. However, most of these efforts have ended in failure, and have been marked by both the paternalism of the institutions and the lack of active participation from the rural communities. Faced with this situation, other methodologies and approaches have started to emerge. These new views have provided rural people with tools to participate in their own development processes and recognize that rural issues go beyond agricultural production. The Rural Management and Development Research Group in the Department of Agronomy at Colombia's Universidad Nacional has been working within this conceptual framework that tends to focus not only on participatory methodologies, but also on gender focus, the new rural setting and the territorial development. The research group has been involved in rural areas of Bogotá and Cundinamarca, building proposals with the active participation from the Nuclei of Rural Entrepreneurs as an alternative model to the conventional rural associative enterprise

Electronic data capture in a rural African setting: evaluating experiences with different systems in Malawi

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Carina King

2014-10-01

Full Text Available Background: As hardware for electronic data capture (EDC, such as smartphones or tablets, becomes cheaper and more widely available, the potential for using such hardware as data capture tools in routine healthcare and research is increasing. Objective: We aim to highlight the advantages and disadvantages of four EDC systems being used simultaneously in rural Malawi: two for Android devices (CommCare and ODK Collect, one for PALM and Windows OS (Pendragon, and a custom-built application for Android (Mobile InterVA – MIVA. Design: We report on the personal field and development experience of fieldworkers, project managers, and EDC system developers. Results: Fieldworkers preferred using EDC to paper-based systems, although some struggled with the technology at first. Highlighted features include in-built skip patterns for all systems, and specifically the ‘case’ function that CommCare offers. MIVA as a standalone app required considerably more time and expertise than the other systems to create and could not be customised for our specific research needs; however, it facilitates standardised routine data collection. CommCare and ODK Collect both have user-friendly web-interfaces for form development and good technical support. CommCare requires Internet to build an application and download it to a device, whereas all steps can be done offline with ODK Collect, a desirable feature in low connectivity settings. Pendragon required more complex programming of logic, using a Microsoft Access application, and generally had less technical support. Start-up costs varied between systems, and all were considered more expensive than setting up a paper-based system; however running costs were generally low and therefore thought to be cost-effective over the course of our projects. Conclusions: EDC offers many opportunities for efficient data collection, but brings some issues requiring consideration when designing a study; the decision of which hardware

Rural women in the wired world | IDRC - International Development ...

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

2011-01-31

Jan 31, 2011 ... Other times, it refers to the disparity between people in rural and urban settings. ... down those barriers separating rural women from the benefits of ICTs. ... to become increasingly useful to other women, and our whole community.” ... women living on Tonga's outer islands, and also by their lack of access to ...

Comparing Costs of Telephone versus Face-to-Face Extended Care Programs for the Management of Obesity in Rural Settings

Science.gov (United States)

Radcliff, Tiffany A.; Bobroff, Linda B.; Lutes, Lesley D.; Durning, Patricia E.; Daniels, Michael J.; Limacher, Marian C.; Janicke, David M.; Martin, A. Daniel; Perri, Michael G.

2012-01-01

Background A major challenge following successful weight loss is continuing the behaviors required for long-term weight maintenance. This challenge may be exacerbated in rural areas with limited local support resources. Objective This study describes and compares program costs and cost-effectiveness for 12-month extended care lifestyle maintenance programs following an initial 6-month weight loss program. Design A 1-year prospective controlled randomized clinical trial. Participants/Setting The study included 215 female participants age 50 or older from rural areas who completed an initial 6-month lifestyle program for weight loss. The study was conducted from June 1, 2003, to May 31, 2007. Intervention The intervention was delivered through local Cooperative Extension Service offices in rural Florida. Participants were randomly-assigned to a 12-month extended care program using either individual telephone counseling (n=67), group face-to-face counseling (n=74), or a mail/control group (n=74). Main Outcome Measures Program delivery costs, weight loss, and self-reported health status were directly assessed through questionnaires and program activity logs. Costs were estimated across a range of enrollment sizes to allow inferences beyond the study sample. Statistical Analyses Performed Non-parametric and parametric tests of differences across groups for program outcomes were combined with direct program cost estimates and expected value calculations to determine which scales of operation favored alternative formats for lifestyle maintenance. Results Median weight regain during the intervention year was 1.7 kg for participants in the face-to-face format, 2.1 kg for the telephone format, and 3.1 kg for the mail/control format. For a typical group size of 13 participants, the face-to-face format had higher fixed costs, which translated into higher overall program costs ($420 per participant) when compared to individual telephone counseling ($268 per participant) and

The Impact of Rural Electrification. Challenges and Ways Forward

International Nuclear Information System (INIS)

Torero, Maximo; Vincent, Nicolas

2015-05-01

Rigorous impact evaluation that includes appropriately selected control groups must be a part of rural electrification program designs. Budgeting evaluation activities and engaging with evaluators at an early stage improves to likelihood of having a high quality evaluation design; plus, if deviations occur after the design stage, the evaluators are better prepared to adjust the design so that the impact results remain informative to policy makers and future program designers. Another take-away is to use unified framework to specify the expected outcomes and the plausible sizes of impacts. If done at the beginning of the program, this will provide context to the kind of discussion that policy makers should engage in (e.g. if they should focus on health benefits or the potential to diffuse information campaigns to rural households). These points focus mostly on internal validity, but we also need to focus on external validity as well. Large scale rural electrification programs will provide an opportunity to test if the results from small scale impact evaluations translate to other settings. Something we have not stressed so far but that is important to keep in mind are the complementarities in the provision of different type of infrastructure. Large projects can provide an opportunity to explore complementarities with other infrastructure programs, such as mobile telephony, road access, and improved water and sanitation access. They can shed light on what are the most welfare-enhancing policy options when deciding what types of infrastructure to provide in rural areas, and especially to poor rural households. Finally, we reiterate the need to use an objective function that casts a wider net when deciding where to place electrification programs. Focusing solely on cost minimization can result in missed opportunities. When deciding where to deploy the electric grid in rural areas it is imperative to take into account the potential profits, specifically the agricultural

Random blood glucose may be used to assess long-term glycaemic control among patients with type 2 diabetes mellitus in a rural African clinical setting

DEFF Research Database (Denmark)

Rasmussen, Jon B; Nordin, Lovisa S; Rasmussen, Niclas S

2014-01-01

clinical review only. Other information obtained was age, sex, body mass index, waist circumference, blood pressure, urine albumin-creatinine ratio, duration since diagnosis and medication. RESULTS: One hundred and one patients with DM (type 1 DM = 23, type 2 DM = 78) were included. Spearman's rank......OBJECTIVES: To investigate the diagnostic accuracy of random blood glucose (RBG) on good glycaemic control among patients with diabetes mellitus (DM) in a rural African setting. METHODS: Cross-sectional study at St. Francis' Hospital in eastern Zambia. RBG and HbA1c were measured during one.......24-0.32, P AUC = 0.80, SE = 0.05), RBG ≤7.5 mmol/l was determined as the optimal cut-off value for good glycaemic control (HbA1c

Risk aversion and willingness to pay for water quality: The case of non-farm rural residents.

Science.gov (United States)

Larue, Bruno; West, Gale E; Singbo, Alphonse; Tamini, Lota Dabio

2017-07-15

Stated choice experiments are used to investigate the economic valuation of rural residents living in the province of Quebec for water quality improvements. In Quebec, rural residents played an important role in the setting of stricter environmental regulations. Unlike most stated choice experiments about the valuation of improvements in water quality, this study explicitly accounts for risk in the design and analysis of choice experiments. Risk in phosphorus and coliform reductions is introduced through a three-point uniform distribution in the choice sets. The results show greater support for constant absolute risk aversion preferences than for constant relative risk aversion. Rural residents value coliform and phosphorus reductions and the more educated ones are particularly willing to see the government tax farmers and taxpayers to secure such reductions. As the science improves and risk in water quality outcomes decrease and as the political weight of non-farm rural residents increase, it should be easier for governments to replace voluntary cost-share programs by polluter-payer programs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Graduate Teacher Preparation for Rural Schools in Victoria and Queensland

Science.gov (United States)

Kline, Jodie; Walker-Gibbs, Bernadette

2015-01-01

Graduate teachers' preparedness for working in rural settings are mediated by the development of pedagogical expertise, professional engagement with parents and the community, and broader notions of preparation to teach in rural contexts. The Studying the Effectiveness of Teacher Education (SETE) project is a four-year longitudinal study tracking…

Autonomy and infant feeding decision-making among teenage mothers in a rural and urban setting in KwaZulu-Natal, South Africa.

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Jama, Ngcwalisa Amanda; Wilford, Aurene; Haskins, Lyn; Coutsoudis, Anna; Spies, Lenore; Horwood, Christiane

2018-02-17

The nutritional status of infants born to teenage mothers can be sub-optimal compared to those born to older mothers. One contributing factor is inappropriate feeding practices adopted by teenage mothers. Little is known about how infant feeding decisions are made among teenage mothers, particularly in under resourced settings. In this study we prospectively explored autonomy and infant feeding decision-making among teenage mothers in a rural and urban setting in KwaZulu-Natal, South Africa. This study adopted a qualitative longitudinal design. Thirty pregnant participants were recruited to the study cohort, from the catchment area of two hospitals (one urban and one rural). Participants were purposively selected to include teenagers, HIV positive, and working pregnant women. We report findings from ten teenage mothers, aged between 15 and 19 years, who participated in the larger cohort (n = 5 rural; n = 5 urban). Monthly in-depth interviews were conducted with participating mothers for 6 months starting 2 weeks after delivery. All interviews were conducted in the local language, transcribed verbatim and translated into English. Data was coded using NVivo v10 and framework analysis was used. Findings from this study showed that teenage mothers had knowledge about recommended feeding practices. However, our findings suggest that these mothers were not involved in infant feeding decisions once they were at home, because infant feeding decision-making was a role largely assumed by older mothers in the family. Further, the age of the mother and financial dependency diminished her autonomy and ability to influence feeding practices or challenge incorrect advice given at home. Most feeding advice shared by family members was inappropriate, leading to poor infant feeding practices among teenage mothers. Returning to school and fear of breastfeeding in public were also barriers to exclusive breastfeeding. Teenage mothers had a limited role in the infant feeding

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

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Ali Ghasemi Ardahaee

2017-07-01

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

Women Managing/Managing Women: The Marginalization of Female Leadership in Rural School Settings.

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Sherman, Ann

2000-01-01

Examines 21 female administrators' accounts of their experience in a rural Nova Scotia school district. Presents preliminary findings of these women's own responses, resistances, and initiatives while attempting to legitimize and implement their preferred leadership styles, which stressed relationships, instructional leadership, communication, and…

Unregulated Autonomy: Uncredentialed Educational Interpreters in Rural Schools.

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Fitzmaurice, Stephen

2017-01-01

Although many rural Deaf and Hard of Hearing students attend public schools most of the day and use the services of educational interpreters to gain access to the school environment, little information exists on what interpreters are doing in rural school systems in the absence of credentialing requirements. The researcher used ethnographic interviews and field observations of three educational interpreters with no certification or professional assessment to explore how uncredentialed interpreters were enacting their role in a rural high school. The findings indicate that uncredentialed interpreters in rural settings perform four major functions during their school day: preparing the environment, staff, and materials; interpreting a variety of content; interacting with numerous stakeholders; and directly instructing Deaf and Hard of Hearing students. Generally, educational interpreters in rural districts operate with unregulated autonomy, a situation that warrants further research and a national standard for all educational interpreters.

Sex Education in Rural Churches.

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Isberner, Fred R.; And Others

1990-01-01

Describes Open Communication Teens or Parents Understanding Sexuality (OCTOPUS), rural teenage pregnancy prevention program. Program presented in religious setting to improve sexual attitudes and parent-child communication. Finds that participants generally gained in knowledge and self-assessment, but teenagers showed no improvement in attitude…

Urban and Rural MSW Stream Characterization for Separate Collection Improvement

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Simona Ciuta

2015-01-01

Full Text Available In the new legislation framework enacted by new member countries of the European Union (EU, the characterization of municipal solid waste (MSW represents an important instrument for local governments and sanitation operators in setting and achieving targets for waste recycling and recovery. This paper presents the results of a study conducted in accordance with the Romanian methodology for domestic wastes characterization ROMECOM, aiming to provide a proper basis for developing clear and realistic forecasts in current municipal waste management, based on MSW composition and generation rate. The analyzed MSW came both from areas where the waste is collected in mixed and separate ways, in urban and rural areas. The MSW composition by fraction is detailed for dense urban areas, urban areas, rural and touristic areas from Romania. Based on these results, the MSW composition was determined for the eight development regions in Romania, and a generation rate of 0.9·kgMSW inhabitant−1·day−1 for the urban region and 0.4·kgMSW inh−1·day−1 for the rural region was established. The calorific values of urban and rural areas were determined as 6801 kJ·kg−1 and 5613 kJ·kg−1, respectively. In the perspective of sustainable development in this technical area, based on the obtained results and on the prognosis made for the following years, two proposals for urban and rural areas were developed for MSW treating options improvement. The two systems are characterized by selective collection (different efficiencies for urban and rural areas with subsequent recovery of the separated materials and energy recovery of the residual waste in a large-scale waste to energy (WTE plant.

Fasting capillary blood glucose: an appropriate measurement in screening for diabetes and pre-diabetes in low-resource rural settings.

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Zhao, X; Zhao, W; Zhang, H; Li, J; Shu, Y; Li, S; Cai, L; Zhou, J; Li, Y; Hu, R

2013-01-01

To evaluate the efficiency of fasting capillary blood glucose (FCG) measurement as compared with fasting venous plasma glucose (FPG) measurement in screening diabetes and pre-diabetes in low-resource rural settings. In 2010, 993 participants were randomly selected from 9 villages in Yunnan province using cluster sampling method. Samples for FCG and FPG test were obtained after demographics and physical examination. The oral glucose tolerance test was performed in parallel as gold standard for diagnosis. Diagnostic capacities of the FCG measurement in predicting undiagnosed diabetes and pre-diabetes were assessed. The performance of FCG and FPG tests was compared. Fifty-seven individuals with undiagnosed diabetes and 145 subjects with pre-diabetes were detected. The concordance between FCG and FPG levels was high (r = 0.75, p curve (AUC) for FCG test in predicting diabetes was 0.88 [95% confidence interval (CI) 0.82-0.93] with the optimal cutoff value of 5.65 mmol/l, sensitivity of 84.2%, and specificity of 79.3%. The corresponding values in FPG tests were 0.92 (95% CI 0.88-0.97) (AUC), 6.51 mmol/l (optimal cutoff point), 82.5% (sensitivity) and 98.3% (specificity), respectively. No significant difference was found in the AUC for the two screening strategies. FCG measurement is considered to be a convenient, practicable screening method in low-resource rural communities with acceptable test properties.

RURAL AREA – AN UNTAPPED OPPORTUNITY FOR ENTREPRENEURSHIP DEVELOPMENT ?

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Alexandru Costin CÎRSTEA

2013-01-01

Full Text Available Romanian rural area faces a violent lack of entrepreneurship initiatives, which can generate negative economic and social phenomena, with medium and long-term effects, such as: the decreased living standards of people in rural areas, the migration of young people from rural areas, which generates psychosocial problems among children who have to stay with their grandparents, the sharp decrease of interest for agriculture and, thus, the decrease of GDP ratio from agricultural activities, the lack of education among rural people etc. Under these circumstances, thepaper tries, through documentation, analysis and processing statistical data, to quantify the development level of entrepreneurship in rural areas in Romania, compared with developed EU countries (such as: Germany, Great Britain, France etc., in order to reveal the gaps in this sector. To increase the relevance of the analysis, the paper also analyzes the possible causes that can stimulate or repress the expression of entrepreneurship and its implementation in Romanian and European rural areas, such as: different levels of fiscal pressure, the existence, effectiveness and efficiency of programs implementation for stimulating and supporting entrepreneurship in general and in rural areas, in particular, the different business culture etc. These results generated from the research will finally create a set of premises for adopting international best practices and develop pragmatic solutions and programs to increase entrepreneurship, which can leads to new business initiatives in the Romanian rural area.In conclusion, for a quality of life growth and a decrease of negative social and economic phenomena with medium and long-term impact, it is necessary an increase of the living standards, done by increasing the opportunities for entrepreneurship in agriculture and rural areas. Specifically, there are needed investments in the development of human resources in rural areas and in supporting its

Training and experience of nurses in responding to alcohol misuse in rural communities.

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Kennedy, Alison J; Mellor, David; McCabe, Marita P; Ricciardelli, Lina A; Brumby, Susan A; Head, Alexandra; Mercer-Grant, Catherine

2013-07-01

Alcohol misuse by farmers continues to challenge rural nurses. This article reports on the experiences of Australian nurses participating in the Alcohol Intervention Training Program (AITP). Qualitative interviews of 15 rural and remote nurses. Semi-structured phone interviews were utilized to assess the response to and implementation of the AITP-an intervention designed to build nurses' knowledge, confidence and skills when responding to alcohol misuse. It comprises practical and theoretical components and was designed for rural and remote settings where nurses encounter alcohol misuse. Nurses found the training provided new-or built on existing-knowledge of alcohol misuse and offered practical hands-on "real life" skills. A range of workplace and personal situations where the content of the training was now being utilized were identified, and future use anticipated. Barriers to using the new knowledge and skills included both rural and generic issues. Constructive feedback to increasingly target the training to rural settings was recommended. The AITP is an effective training program. It can be further tailored to meet common needs of rural and remote nurses working with farmers who misuse alcohol, while recognizing diversity in rural practice. © 2013 Wiley Periodicals, Inc.

Quality and rural-urban comparison of tuberculosis care in Rivers State, Nigeria.

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Tobin-West, Charles Ibiene; Isodje, Anastasia

2016-01-01

Nigeria ranks among countries with the highest burden of tuberculosis. Yet evidence continues to indicate poor treatment outcomes which have been attributed to poor quality of care. This study aims to identify some of the systemic problems in order to inform policy decisions for improved quality of services and treatment outcomes in Nigeria. A comparative assessment of the quality of TB care in rural and urban health facilities was carried out between May and June 2013, employing the Donabedian model of quality assessment. Data was analysed using the SPSS software package version 20.0. The level of significance was set at p facility infrastructures were more constrained in the urban than rural settings. Both the urban and rural facilities lacked adequate facilities for infection control such as, running water, air filter respirators, hand gloves and extractor fans. Health education and HIV counselling and testing (HCT) were limited in rural facilities compared to urban facilities. Although anti-TB drugs were generally available in both settings, the DOTS strategy in patient care was completely ignored. Finally, laboratory support for diagnosis and patient monitoring was limited in the rural facilities. The study highlights suboptimal quality of TB care in Rivers State with limitations in health education and HCT of patients for HIV as well as laboratory support for TB care in rural health facilities. We, therefore, recommend that adequate infection control measures, strict observance of the DOTS strategy and sufficient laboratory support be provided to TB clinics in the State.

Balancing Rural and Urban Development: Applying Coordinated Urban–Rural Development (CURD Strategy to Achieve Sustainable Urbanisation in China

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Ling-Hin Li

2017-10-01

Full Text Available Land in rural China has been under a separate and closed management system for decades even after the urban land reform that started in the late 1980s. The blurred property rights over rural land have been hindering the rural welfare as surplus rural land in sub-urban areas cannot be circulated into more economic use without first being requisitioned by the state. This traditional conversion process creates a lot of problems, among them are the compensation standard as well as displacement of rural residents to the city, where they cannot find adequate welfare protection. The prolonged disparity in economic outcomes for rural and urban residents in China in the process of urbanisation has made the authority realise that land-based local finance is no longer an option. Coordinated Urban and Rural Development (CURD ideology arises to set a level playing field by giving the rural residents comparable welfare status as their urban counterparts’ one. The CURD ideology is basically linked to the strategic development of the three main issues in the rural area of China, or in the Chinese terminology: San Nong. These three issues are rural villages, rural enterprises and rural farmers (nong cun, nong ye, nong min. CURD ideology is to preserve the livelihood of rural villages, facilitate and promote rural enterprises and increase the living standard of rural farmers. Most importantly, however, CURD policy package bestows rural residents with property rights over their farmland so that they could sub-co1ntract the user-rights to other urban commercial entities for higher benefits. While CURD policies are applied in a lot of different regions in China including Chongqing in the West, Qingdao in the North, Zhongshan in the South and Wuhan in the middle, we focus our examination in Chengdu as the Chengdu model has been widely documented and highly regarded as the most successful model in implementing the CURD strategies. From our case study, we find that

Rural-Urban Differences in Late-Stage Breast Cancer: Do Associations Differ by Rural-Urban Classification System?

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Pruitt, Sandi L; Eberth, Jan M; Morris, E Scott; Grinsfelder, David B; Cuate, Erica L

2016-01-01

Introduction Rural residence is associated with later stage of breast cancer diagnosis in some but not all prior studies. The lack of a standardized definition of rural residence may contribute to these mixed findings. We characterize and compare multiple definitions of rural vs. non-rural residence to provide guidance regarding choice of measures and to further elucidate rural disparities in breast cancer stage at diagnosis. Methods We used Texas Cancer Registry data of 120,738 female breast cancer patients ≥50 years old diagnosed between 1995–2009. We defined rural vs. non-rural residence using 7 different measures and examined their agreement using Kappa statistics. Measures were defined at various geographic levels: county, ZIP code, census tract, and census block group. Late-stage was defined as regional or distant disease. For each measure, we tested the association of rural residence and late-stage cancer with unadjusted and adjusted logistic regression. Covariates included: age; patient race/ethnicity; diagnosis year; census block group-level mammography capacity; and census tract-level percent poverty, percent Hispanic, and percent Black. Results We found moderate to high levels of agreement between measures of rural vs. non-rural residence. For 72.9% of all patients, all 7 definitions agreed as to rural vs. non-rural residence. Overall, 6 of 7 definitions demonstrated an adverse association between rural residence and late-stage disease in unadjusted and adjusted models (Adjusted OR Range = 1.09–1.14). Discussion Our results document a clear rural disadvantage in late-stage breast cancer. We contribute to the heterogeneous literature by comparing varied measures of rural residence. We recommend use of the census tract-level Rural Urban Commuting Area Codes in future cancer outcomes research where small area data are available. PMID:27158685

Hearing loss and social support in urban and rural communities.

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Hay-McCutcheon, Marcia J; Hyams, Adriana; Yang, Xin; Parton, Jason

2018-04-19

Perceived social support and hearing handicap were assessed in adults with and without hearing loss who lived in different geographical regions of Alabama. The Hearing Handicap Inventory for Adults (HHIA) assessed emotional and social consequences of hearing loss. The Medical Outcomes Study (MOS) Social Support Survey and the Social Functioning, Role Emotional and Mental Health scales of the SF-36 were administered. Data were collected from 71 study participants with hearing loss and from 45 adults without hearing loss. Degree of hearing loss and outcomes from the HHIA did not differ between adults who lived in rural or urban settings. Tangible support was poorer for adults with hearing loss who lived in rural settings compared to those who lived in urban settings. For adults without hearing loss, residency was not associated with tangible support. For these adults, income was associated with other types of social support (i.e. informational support, affection, positive social interaction). Adults with hearing loss living in rural areas had poor perceived tangible support. The provision of support to address a hearing loss could be worse for these adults compared to adults who lived in urban settings.

Guidelines for Becoming a Teacher Leader in Rural Special Education

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Collins, Belva C.; Leahy, Maria Marsella; Ault, Melinda Jones

2017-01-01

Special education teachers have a unique set of skills and opportunities to become leaders in the field of education. Some rural special education teachers, however, may not see themselves as potential leaders or believe they have opportunities to be leaders. This article provides guidelines for rural special education teachers to consider in…

Personality and Personality Disorders in Urban and Rural Africa: Results from a Field Trial in Burkina Faso

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Jérôme eRossier

2013-03-01

Full Text Available Several studies have observed that the structure underlying both normal personality and personality disorders is stable across cultures. Most of this cross-cultural research was conducted in Western and Asian cultures. In Africa, the few studies were conducted with well-educated participants using French or English instruments. No research was conducted in Africa with less privileged or preliterate samples. The aim of this research was to study the structure and expression of normal and abnormal personality in an urban and a rural sample in Burkina Faso. The sample included 1750 participants, with a sub-sample from the urban area of Ouagadougou (n = 1249 and another sub-sample from a rural village, Soumiaga (n = 501. Most participants answered an interview consisting of a Mooré language adaptation of the Revised NEO Personality Inventory and of the International Personality Disorders Examination. A sub-sample completed the same instruments in French. Demographic variables only have a small impact on normal and abnormal personality traits. The structure underlying normal personality was unstable across regions and languages, illustrating that translating a complex psychological inventory into a native African language is a very difficult task. The structure underlying abnormal personality was stable across regions, scales reaching even metric equivalence. As scalar equivalence was not reached, mean differences cannot be interpreted. Nevertheless, these differences could be due to an exaggerated expression of abnormal traits valued in the two cultural settings. Our results suggest that studies using a different methodology should be conducted to understand what is considered, in different cultures, as deviating from the expectations of the individual’s culture, and as a significant impairment in self and interpersonal functioning, as defined by the DSM-5.

Unhealthy Fat in Street and Snack Foods in Low-Socioeconomic Settings in India: A Case Study of the Food Environments of Rural Villages and an Urban Slum.

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Gupta, Vidhu; Downs, Shauna M; Ghosh-Jerath, Suparna; Lock, Karen; Singh, Archna

2016-04-01

To describe the food environment in rural villages and an urban slum setting in India with reference to commercially available unbranded packaged snacks and street foods sold by vendors, and to analyze the type and quantity of fat in these foods. Cross-sectional. Two low-income villages in Haryana and an urban slum in Delhi. Street vendors (n = 44) were surveyed and the nutritional content of snacks (n = 49) sold by vendors was analyzed. Vendors' awareness and perception of fats and oils, as well as the type of snacks sold, along with the content and quality of fat present in the snacks. Descriptive statistics of vendor survey and gas chromatography to measure fatty acid content in snacks. A variety of snacks were sold, including those in unlabeled transparent packages and open glass jars. Mean fat content in snacks was 28.8 g per 100-g serving in rural settings and 29.6 g per 100-g serving in urban settings. Sampled oils contained high levels of saturated fats (25% to 69% total fatty acids) and trans fats (0.1% to 30% of total fatty acids). Interventions need to target the manufacturers of oils and fats used in freshly prepared products to improve the quality of foods available in the food environment of low-socioeconomic groups in India. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

The use of traditional medicines to lower blood pressure: A survey in rural areas in Yogyakarta province, Indonesia

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Riana Rahmawati; Beata Bajorek

2018-01-01

Background Despite common usage of traditional medicines in rural populations, the data of their uses along with hypertension medications are limited. Aims To quantify the use of traditional medicines and to identify factors associated with its use among people with hypertension in a low-resource setting. Methods Data were collected using a researcher-administered questionnaire from people with hypertension in rural underdeveloped villages in Indonesia. Result...

Nonlinear Differential Equations and Feedback Control Design for the Urban-Rural Resident Pension Insurance in China

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Wang, Lijian

2015-12-01

Facing many problems of the urban-rural resident pension insurance system in China, one should firstly make sure that this system can be optimized. This paper, based on the modern control theory, sets up differential equations as models to describe the urban-rural resident pension insurance system, and discusses the globally asymptotic stability in the sense of Liapunov for the urban-rural resident pension insurance system in the new equilibrium point. This research sets the stage for our further discussion, and it is theoretically important and convenient for optimizing the urban-rural resident pension insurance system.

Planning for rural energy system: Part 2

International Nuclear Information System (INIS)

Devadas, V.

2001-01-01

This paper discusses the central importance of energy inputs in development, and presents the complex interactions within subsystems that contribute a Rural Energy System. This paper also brings about the importance of the primary data for realistic renewable energy planning at the micro level in a given rural system. Factors that render secondary data somewhat inadequate for such applications are discussed. The differences between energy related data from secondary and primary sources in respect of representative villages in Kanyakumari District of Tamil Nadu, India, are detailed. A rural system model for computing the output from various components of a rural system is also presented. This projection is made by making use of a set of technical coefficients, which relate the inputs to the outputs from individual segments of the rural production system. While some of the technical coefficients are developed based on previously published data, a large number have been quantified on the basis of careful survey. The usefulness of the model is discussed. The paper also presents a Linear Programming Model for optimum resource allocation in a rural system. The objective function of the Linear Programming Model is maximizing the revenue of the rural system where in optimum resource allocation is made subject to a number of energy and non-energy related relevant constraints. The model also quantifies the major yields as well as the byproducts of different sectors of the rural economic system. (Author)

Setting Priorities: Personal Values, Organizational Results. Ideas into Action Guidebooks

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Cartwright, Talula

2007-01-01

Successful leaders get results. To get results, you need to set priorities. This book can help you do a better job of setting priorities, recognizing the personal values that motivate your decision making, the probable trade-offs and consequences of your decisions, and the importance of aligning your priorities with your organization's…

Retrospective study of antibiotic resistance among uropathogens from rural teaching hospital, Tamilnadu, India

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Kasi Murugan

2012-10-01

Full Text Available Objective: To determine the community associated urinary tract infection (UTI causing uropathogen's prevalence, antibiotic resistance pattern and the risk factors predisposing infection in Indian rural settings. Methods: A pilot study was conducted between January and December 201 0 among out patients attending rural teaching medical college hospital at Tamilnadu, India. The demographic details, culture, common antibiotic Kirby-Bauer disc diffusion assay susceptibility profiles of the isolates and the resistance analysis by WHONET 5.6 software were performed. Results: During this surveillance study, a total number of 1 359 urinary samples were collected, among which 309 (22.78% gave positive culture. The common uropathogens encountered were Escherichia coli (66.02%, Staphylococcus sp. (12.62%, Klebsiella sp. (5.83%, Streptococcus sp. (5.1 8%, Enterococcus sp. (2.59% and Proteus sp., (2.26%. Antibiotic resistance analysis revealed the multiple drug resistance nature of the isolates to the commonly used antibiotics. It is also found that both genders at the specific age group of 40-50 were more prone to infection and seasonal variations also play an important role in their establishment. Conclusions: The obtained results suggest that antibiotic selection for empirical treatment should be based on individual drug-sensitive test results. There is also an urgent need to develop a new combination of chemotherapeutic agents and awareness on antibiotic use for the effective UTI management in rural settings.

Rural youth in northern Zambia: straddling the rural-urban divide

DEFF Research Database (Denmark)

Birch-Thomsen, Torben

2016-01-01

reported for sub-Saharan Africa, young people are increasingly turning their backs on agriculture, seeing it as an occupation that is back-breaking and only fit for old people (FAO, 2014). The aim of this chapter is to explore the livelihood strategies and aspirations of young people living in a rural area...... how, contrary to the trend in much of sub-Saharan Africa, many young people are choosing to stay in their rural villages and engage in farming. This is partly due to the availability of land and government programmes that have been introduced to stimulate agriculture. Increasingly, however, young...... people are not relying solely on farming, but are also engaging in nonfarm activities. Some young people are shown to be highly entrepreneurial, managing to set up and run businesses despite facing constant and changing challenges. Whether they are based in the village or in the nearby small town, most...

Medicaid managed care for mental health services: the survival of safety net institutions in rural settings.

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Willging, Cathleen E; Waitzkin, Howard; Nicdao, Ethel

2008-09-01

Few accounts document the rural context of mental health safety net institutions (SNIs), especially as they respond to changing public policies. Embedded in wider processes of welfare state restructuring, privatization has transformed state Medicaid systems nationwide. We carried out an ethnographic study in two rural, culturally distinct regions of New Mexico to assess the effects of Medicaid managed care (MMC) and the implications for future reform. After 160 interviews and participant observation at SNIs, we analyzed data through iterative coding procedures. SNIs responded to MMC by nonparticipation, partnering, downsizing, and tapping into alternative funding sources. Numerous barriers impaired access under MMC: service fragmentation, transportation, lack of cultural and linguistic competency, Medicaid enrollment, stigma, and immigration status. By privatizing Medicaid and contracting with for-profit managed care organizations, the state placed additional responsibilities on "disciplined" providers and clients. Managed care models might compromise the rural mental health safety net unless the serious gaps and limitations are addressed in existing services and funding.

Clinical decision-making of rural novice nurses.

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Seright, T J

2011-01-01

Nurses in rural settings are often the first to assess and interpret the patient's clinical presentations. Therefore, an understanding of how nurses experience decision-making is important in terms of educational preparation, resource allocation to rural areas, institutional cultures, and patient outcomes. Theory development was based on the in-depth investigation of 12 novice nurses practicing in rural critical access hospitals in a north central state. This grounded theory study consisted of face-to-face interviews with 12 registered nurses, nine of whom were observed during their work day. The participants were interviewed a second time, as a method of member checking, and during this interview they reviewed their transcripts, the emerging themes and categories. Directors of nursing from both the research sites and rural hospitals not involved in the study, experienced researchers, and nurse educators facilitated triangulation of the findings. 'Sociocentric rationalizing' emerged as the central phenomenon and referred to the sense of belonging and agency which impacted the decision-making in this small group of novice nurses in rural critical access hospitals. The observed consequences, which were conceptualized during the axial coding process and were derived from observations and interviews of the 12 novice nurses in this study include: (1) gathering information before making a decision included assessment of: the credibility of co-workers, patients' subjective and objective data, and one's own past and current experiences; (2) conferring with co-workers as a direct method of confirming/denying decisions being made was considered more realistic and expedient than policy books and decision trees; (3) rural practicum clinical experiences, along with support after orientation, provide for transition to the rural nurse role; (4) involved directors of nursing served as both models and protectors of novice nurses placed in high accountability positions early in

Body mass index and self-perception of overweight and obesity in rural, urban and rural-to-urban migrants: PERU MIGRANT study.

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Loret de Mola, Christian; Pillay, Timesh D; Diez-Canseco, Francisco; Gilman, Robert H; Smeeth, Liam; Miranda, J Jaime

2012-01-01

This study aimed to compare self-reported weight and body mass index (BMI) in order to determine discrepancies between subjective and objective obesity-related markers, and possible explanatory factors of overweight and obesity underestimation, in urban, rural and migrant populations. Data from the PERU MIGRANT study, a cross-sectional study, in low-income settings, of urban, migrant (rural-to-urban), and rural groups, including BMI, self-reported weight and socio-demographic indicators were analyzed. Percentage of concurrences between BMI and self-reported weight and Kappa coefficients for inter-rater agreement were calculated. Univariate and standardized descriptive analyses were performed to identify potential explanatory variables for weight underestimation in only overweight and obese individuals, using established BMI and waist circumference cut offs. 983 Participants-199 urban, 583 migrants and 201 rural-were analyzed. Based on BMI, overall prevalence of obesity was 20.1% (95% CI 17.6%-22.6%), and overweight was 38.3% (95% CI 35.2%-41.2%), with differences between study groups (poverweight category. In overweight and obese individuals, deprivation index (p = 0.016), age (p = 0.014) and waist circumference (poverweight, obesity, and underestimation of BMI status were found, with poor agreement between BMI and self-reported weight, showing the unawareness of weight status severity in this low-income setting.

Cost of microbial larviciding for malaria control in rural Tanzania.

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Rahman, Rifat; Lesser, Adriane; Mboera, Leonard; Kramer, Randall

2016-11-01

Microbial larviciding may be a potential supplement to conventional malaria vector control measures, but scant information on its relative implementation costs and effectiveness, especially in rural areas, is an impediment to expanding its uptake. We perform a costing analysis of a seasonal microbial larviciding programme in rural Tanzania. We evaluated the financial and economic costs from the perspective of the public provider of a 3-month, community-based larviciding intervention implemented in twelve villages in the Mvomero District of Tanzania in 2012-2013. Cost data were collected from financial reports and invoices and through discussion with programme administrators. Sensitivity analysis explored the robustness of our results to varying key parameters. Over the 2-year study period, approximately 6873 breeding sites were treated with larvicide. The average annual economic costs of the larviciding intervention in rural Tanzania are estimated at 2014 US$ 1.44 per person protected per year (pppy), US$ 6.18 per household and US$ 4481.88 per village, with the larvicide and staffing accounting for 14% and 58% of total costs, respectively. We found the costs pppy of implementing a seasonal larviciding programme in rural Tanzania to be comparable to the costs of other larviciding programmes in urban Tanzania and rural Kenya. Further research should evaluate the cost-effectiveness of larviciding relative to, and in combination with, other vector control strategies in rural settings. © 2016 John Wiley & Sons Ltd.

Universal Prevention Program Outcomes: Safe Schools Healthy Students in a Rural, Multicultural Setting

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Harris, Elizabeth; McFarland, Joyce; Siebold, Wendi; Aguilar, Rafael; Sarmiento, Ana

2007-01-01

The Idaho Consortium for Safe Schools Healthy Students consists of three school districts in rural North Central Idaho and the Nez Perce Tribe's Students for Success Program. Universal prevention programs implemented in the elementary schools include Second Step and the middle schools implemented the Life Skills program. Each of the three…

Rural School In The Context Of Community-Led Local Development*

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Hudečková H.

2015-03-01

Full Text Available The paper is based on the general concept of knowledge society and deals with regional development theories which emphasize local environment as an important part of rural development. The following two questions were studied: (1 What is the early experience of municipalities when establishing a Community School? (2 In which other municipalities would it be possible and appropriate to build such a school? For this purpose, both secondary and primary research methods were combined with data collection techniques – document study, observation, and questioning. Because the examined problem is set in the context of community-led local development (CLLD, violation of the ‘bottom-up’ approach principle is also highlighted. The paper presents the first experiences in the establishment of seven Community Schools within the Pilsen region and based on them also recommendations for the feasibility and suitability of establishing this type of school in other rural municipalities. The results show that the educational sector is not assisting in the modernization of rural schools with regard to community education and that the possibility of the contemporary and meaningful existence of schools in small rural municipalities remains ignored.

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

Directory of Open Access Journals (Sweden)

Rosa Gallardo-Cobos

2010-12-01

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

Availability of thrombolytic therapy in rural Newfoundland and Labrador.

OpenAIRE

Marshall, S; Godwin, M; Miller, R

1995-01-01

OBJECTIVE: To determine the availability of thrombolytic therapy in rural Newfoundland and Labrador. DESIGN: Self-administered questionnaire mailed to staff at health care facilities. Respondents were sent two reminders by mail, and questionnaires not returned were completed through telephone interviews. SETTING: Rural health care facilities, including hospitals, 24-hour clinics and satellite clinics. PARTICIPANTS: All chief medical officers, nursing supervisors and administrators in the 34 g...

Leadership development for rural health.

Science.gov (United States)

Size, Tim

2006-01-01

Leadership is the capacity to help transform a vision of the future into reality. Individuals who can and will exercise leadership are like a river's current--a part past where we now stand, a part yet to come. We have an ongoing need to remember and to look toward the next "generation." A key responsibility of those here now, is to mentor and to create structures for mentoring, in order to maximize the flow and effectiveness of tomorrow's leaders. When recruiting organizational leaders, the recruitment and interview process must seek individuals who in addition to technical competence, also have demonstrated leadership in their prior work and activities. To exercise effective leadership, we must work to know who we are, how we relate to others, and the environment around us. "Servant leadership" is a perspective held by many throughout the rural health community and offers a key set attributes of leadership useful to rural health. To implement the Institute of Medicine's recommendations in Through Collaboration: the Future of Rural Health, we must develop leaders skilled in collaboration, both internal to their organization and across organizations. The National Advisory Committee on Rural Health and Human Services had it right when they said to the Secretary and to the rest of us, "the best way to honor Jim is to consciously work to help develop the next generation of rural health leaders." There are, of course, a multitude of leadership institutes, programs, and courses throughout America; this is not a call for yet another separate entity. But it is a call to each of us in rural health to assure that we are deliberate in how we identify "emerging leaders from and for rural communities and provide them with the training and resources to play a lead role in ensuring access to quality healthcare in their states and communities." Let's get started.

Impact of new information technologies on training and continuing education for rural health professionals.

Science.gov (United States)

Crandall, L A; Coggan, J M

1994-01-01

Recently developed and emerging information and communications technologies offer the potential to move the clinical training of physicians and other health professionals away from the resource intensive urban academic health center, with its emphasis on tertiary care, and into rural settings that may be better able to place emphasis on the production of badly needed primary care providers. These same technologies also offer myriad opportunities to enhance the continuing education of health professionals in rural settings. This article explores the effect of new technologies for rural tele-education by briefly reviewing the effect of technology on health professionals' education, describing ongoing applications of tele-education, and discussing the likely effect of new technological developments on the future of tele-education. Tele-education has tremendous potential for improving the health care of rural Americans, and policy-makers must direct resources to its priority development in rural communities.

Striving to promote male involvement in maternal health care in rural and urban settings in Malawi - a qualitative study.

Science.gov (United States)

Kululanga, Lucy I; Sundby, Johanne; Malata, Address; Chirwa, Ellen

2011-12-02

Understanding the strategies that health care providers employ in order to invite men to participate in maternal health care is very vital especially in today's dynamic cultural environment. Effective utilization of such strategies is dependent on uncovering the salient issues that facilitate male participation in maternal health care. This paper examines and describes the strategies that were used by different health care facilities to invite husbands to participate in maternal health care in rural and urban settings of southern Malawi. The data was collected through in-depth interviews from sixteen of the twenty health care providers from five different health facilities in rural and urban settings of Malawi. The health facilities comprised two health centres, one district hospital, one mission hospital, one private hospital and one central hospital. A semi-structured interview guide was used to collect data from health care providers with the aim of understanding strategies they used to invite men to participate in maternal health care. Four main strategies were used to invite men to participate in maternal health care. The strategies were; health care provider initiative, partner notification, couple initiative and community mobilization. The health care provider initiative and partner notification were at health facility level, while the couple initiative was at family level and community mobilization was at village (community) level. The community mobilization had three sub-themes namely; male peer initiative, use of incentives and community sensitization. The sustainability of each strategy to significantly influence behaviour change for male participation in maternal health care is discussed. Strategies to invite men to participate in maternal health care were at health facility, family and community levels. The couple strategy was most appropriate but was mostly used by educated and city residents. The male peer strategy was effective and sustainable at

Quantification of Gravel Rural Road Sediment Production

Science.gov (United States)

Silliman, B. A.; Myers Toman, E.

2014-12-01

Unbound rural roads are thought to be one of the largest anthropogenic sources of sediment reaching stream channels in small watersheds. This sediment deposition can reduce water quality in the streams negatively impacting aquatic habitat as well as impacting municipal drinking water sources. These roads are thought to see an increase in construction and use in southeast Ohio due to the expansion of shale gas development in the region. This study set out to quantify the amount of sediment these rural roads are able to produce. A controlled rain event of 12.7 millimeters of rain over a half hour period was used to drive sediment production over a 0.03 kilometer section of gravel rural road. These 8 segments varied in many characteristics and produced from 2.0 to 8.4 kilograms of sediment per 0.03 kilometers of road with the average production over the 8 segments being 5.5 kilograms of sediment. Sediment production was not strongly correlated with road segment slope but traffic was found to increase sediment production from 1.1 to 3.9 times as much sediment after traffic use. These results will help inform watershed scale sediment budgeting, and inform best management practices for road maintenance and construction. This study also adds to the understanding of the impacts of rural road use and construction associated with the changing land use from agricultural to natural gas extraction.

Rural youth and violence: a gender perspective.

Science.gov (United States)

Hall, Barry L; Kulig, Judith; Grant Kalischuk, Ruth

2011-01-01

The public health system must consider violence as an all too common reality in modern life. Violence can contribute to long-lasting negative consequences for individuals and communities. Research on violence has primarily focused on urban environments. Research examining youth violence within rural communities is limited. This is particularly the case for the links between gender and violence in small rural settings. The purpose of this study was to examine rural violence from a gender perspective by examining four variables: meaning, causes, consequences and solutions. A survey was completed in Central Alberta, Canada with 178 students from grades 6 to 12. The schools' geographic locations represented two distinct economic settings: one natural resources and the other agriculture. The mean age of the participants was 16 years with 60% of the youth female and 40% male. The survey instrument was composed of demographic questions and 70 questions that focused on violence. Violence was a concern for all youth, but there were gender differences. Females viewed the meaning of violence as having the intent to harm others and causes contributing to violence included television, movies, video games and the internet. Females were more concerned than males about the emotional consequences of violence. For solutions, females were more accepting of intrusive means to control violence such as increased security and stricter school rules, and involving non-peer helpers such as teachers and community based agencies as a means to help combat violence. The results of this study indicate that violence exists among rural youth and causes a great deal of concern. In particular, the study underscores the fact that there are potential gender differences in relation to causes, meaning, impact and solutions to violence. All the youth believed that violence in their lives needs to be addressed and want to develop anti-violence strategies. Females in particular see the development of such

Gender Inequalities in Remote Settings: Analysis of 105,025 Medical Records of a Rural Hospital in Ethiopia (2005-2015).

Science.gov (United States)

Accorsi, Sandro; Somigliana, Edgardo; Farese, Pasquale; Ademe, Tsegaye; Desta, Yonas; Putoto, Giovanni; Manenti, Fabio

2017-08-01

Gender inequalities in Sub-Saharan Africa are deemed relevant but data to support this view are scanty. Retrospective analysis of a large dataset of 105,025 patients admitted to an Ethiopian rural private, non-for-profit hospital over a 11 years period (2005-2015). Since 2001, the hospital and the local community are involved in a long-term, comprehensive and externally-supported health care intervention. The total number of admissions was higher for females (61.9% of the total) mainly because of the high frequency of admissions for obstetrics conditions. The total male-to-female ratio (M:F) was 0.6. Except for malaria, men had more admissions for the other leading causes, with the highest M:F being found for injuries (2.7) and musculoskeletal diseases (1.7). Overall, excluding admissions for pregnancy-related issues, the M:F was 1.4. The frequency of admissions changed with age and gender. Female admissions prevailed in the reproductive age period (from 15 to 44 years of age) while males admissions prevailed in the younger and older age groups. The case fatality rate was higher for men (M:F = 2.0). The total M:F and the M:F excluding pregnancy-related admissions did not change during the study period. Gender inequalities do exist in rural remote setting but tend to affect women differently during their lifespan. Even if gender inequalities generally favor males, the substantial proportion of admissions for pregnancy-related situations is encouraging.

Exploring rural high school learners' experience of mathematics ...

African Journals Online (AJOL)

times, often, or always experience mathematics anxiety in academic settings. It is therefore ... South African Journal of Education, Volume 32(3), August 2012 in education and ... This study was conducted in rural school settings owing to the reality that I face as ..... European Journal of Social Sciences, 16:75-86. Leppavirta J ...

Measures of Implicit Gender Attitudes May Exaggerate Differences in Underlying Associations among Chinese Urban and Rural Women

Directory of Open Access Journals (Sweden)

Zhen Jin

2016-01-01

Full Text Available The oppression of women in rural China is more severe than in urban China, not only because the two areas differ in terms of social hierarchy, but also because urban women are more likely to fight against their subordination, which is endorsed by conventional social views on gender. To independently assess these relationships, we applied the Quadruple Process model to measure the processes underlying implicit gender attitudes in a sample of urban and rural females. The results indicated that the urban women had higher in-group favoritism than did the rural women. Application of the Quad model, however, showed that pro-women associations were similarly activated among urban and rural women, but that women in rural settings more effectively inhibited activated associations. Differences in inhibition, rather than in activated associations, appear to account for the less favorable attitudes among rural women. Thus, the differences in attitudinal responses among urban and rural women exaggerate the differences in underlying evaluative associations with respect to gender and conceal differences in self-regulating the expression of those associations.

The current state of rural neurosurgical practice: An international perspective

Directory of Open Access Journals (Sweden)

Pavan S Upadhyayula

2018-01-01

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

The Current State of Rural Neurosurgical Practice: An International Perspective

Science.gov (United States)

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

2018-01-01

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

Environmental barriers and enablers to physical activity participation among rural adults: a qualitative study.

Science.gov (United States)

Cleland, Verity; Hughes, Clarissa; Thornton, Lukar; Squibb, Kathryn; Venn, Alison; Ball, Kylie

2015-08-01

Social-ecological models of health behaviour acknowledge environmental influences, but research examining how the environment shapes physical activity in rural settings is limited. This study aimed to explore the environmental factors that act as barriers or facilitators to physical activity participation among rural adults. Forty-nine adults from three regions of rural Tasmania, Australia, participated in semi-structured interviews that explored features of the environment that supported or hindered physical activity. Interviews were digitally recorded, transcribed verbatim and analysed thematically. Four key themes emerged: functionality, diversity, spaces and places for all and realistic expectations. 'Functionality' included connectivity with other destinations, distance, safety, continuity, supporting infrastructure and surfacing. While there was limited 'diversity' of structured activities and recreational facilities, the importance of easy and convenient access to a natural environment that accommodated physical activity was highlighted. 'Spaces and places for all' highlighted the importance of shared-use areas, particularly those that were family- and dog-friendly. Despite desires for more physical activity opportunities, many participants had 'realistic expectations' of what was feasible in rural settings. Functionality, diversity, spaces and places for all and realistic expectations were identified as considerations important for physical activity among rural adults. Further research using quantitative approaches in larger samples is needed to confirm these findings. SO WHAT? Urban-centric views of environmental influences on physical activity are unlikely to be entirely appropriate for rural areas. Evidence-based recommendations are provided for creating new or modifying existing infrastructure to support active living in rural settings.

Prevention of Clostridium difficile infection in rural hospitals.

Science.gov (United States)

Haun, Nicholas; Hofer, Adam; Greene, M Todd; Borlaug, Gwen; Pritchett, Jenny; Scallon, Tina; Safdar, Nasia

2014-03-01

Prevention of Clostridium difficile infection (CDI) remains challenging across the spectrum of health care. There are limited data on prevention practices for CDI in the rural health care setting. An electronic survey was administered to 21 rural facilities in Wisconsin, part of the Rural Wisconsin Health Cooperative. Data were collected on hospital characteristics and practices to prevent endemic CDI. Fifteen facilities responded (71%). Nearly all respondent facilities reported regular use of dedicated patient care items, use of gown and gloves, private patient rooms, hand hygiene, and room cleaning. Facilities in which the infection preventionist thought the support of his/her leadership to be "Very good" or "Excellent" employed significantly more CDI practices (13.3 ± 2.4 [standard deviation]) compared with infection preventionists who thought there was less support from leadership (9.8 ± 3.0, P = .033). Surveillance for CDI was highly variable. The most frequent barriers to implementation of CDI prevention practices included lack of adequate resources, lack of a physician champion, and difficulty keeping up with new recommendations. Although most rural facilities in our survey reported using evidence-based practices for prevention of CDI, surveillance practices were highly variable, and data regarding the impact of these practices on CDI rates were limited. Future efforts that correlate CDI prevention initiatives and CDI incidence will help develop evidence-based practices in these resource-limited settings. Published by Mosby, Inc.

Body Mass Index and Self-Perception of Overweight and Obesity in Rural, Urban and Rural-to-Urban Migrants: PERU MIGRANT Study

Science.gov (United States)

Loret de Mola, Christian; Pillay, Timesh D.; Diez-Canseco, Francisco; Gilman, Robert H.; Smeeth, Liam; Miranda, J. Jaime

2012-01-01

Objective This study aimed to compare self-reported weight and body mass index (BMI) in order to determine discrepancies between subjective and objective obesity-related markers, and possible explanatory factors of overweight and obesity underestimation, in urban, rural and migrant populations. Materials and Methods Data from the PERU MIGRANT study, a cross-sectional study, in low-income settings, of urban, migrant (rural-to-urban), and rural groups, including BMI, self-reported weight and socio-demographic indicators were analyzed. Percentage of concurrences between BMI and self-reported weight and Kappa coefficients for inter-rater agreement were calculated. Univariate and standardized descriptive analyses were performed to identify potential explanatory variables for weight underestimation in only overweight and obese individuals, using established BMI and waist circumference cut offs. Results 983 Participants–199 urban, 583 migrants and 201 rural–were analyzed. Based on BMI, overall prevalence of obesity was 20.1% (95% CI 17.6%–22.6%), and overweight was 38.3% (95% CI 35.2%–41.2%), with differences between study groups (prural residents had the lowest coefficient (0.01) and the most underestimation, especially in the overweight category. In overweight and obese individuals, deprivation index (p = 0.016), age (p = 0.014) and waist circumference (p<0.001) were associated with weight underestimation. Discussion Overall, high levels of overweight, obesity, and underestimation of BMI status were found, with poor agreement between BMI and self-reported weight, showing the unawareness of weight status severity in this low-income setting. PMID:23209688

A comparison of mental health, substance use, and sexual risk behaviors between rural and non-rural transgender persons.

Science.gov (United States)

Horvath, Keith J; Iantaffi, Alex; Swinburne-Romine, Rebecca; Bockting, Walter

2014-01-01

The aim of this study was to compare the mental health, substance use, and sexual risk behaviors of rural and non-rural transgender persons. Online banner advertisements were used to recruit 1,229 self-identified rural and non-rural transgender adults (18+ years) residing in the United States. Primary findings include significant differences in mental health between rural and non-rural transmen; relatively low levels of binge drinking across groups, although high levels of marijuana use; and high levels of unprotected sex among transwomen. The results confirm that mental and physical health services for transgender persons residing in rural areas are urgently needed.

Effects of Rural Medical Insurance on Chronically Ill Patients' Choice of the Same Hospital Again in Rural Northern China.

Science.gov (United States)

Jiang, Ke; You, Daming; Li, Zhendong; Wei, Wei; Mainstone, Mitchell

2018-04-12

The emergence of rural health insurance plays a crucial role in alleviating the pressure on rural medical expenditure. Under the current medical system in northern China, rural medical insurance may reduce the free referral of patients with chronic diseases among hospitals. This study was carried out based on the results of an investigation of rural chronically-ill patients in eight county hospitals in northern China, as well as through the comparison and analysis of patients with chronic diseases, considering whether they were with or without rural health insurance. The main results showed that both age ( χ 2 = 22.9, p rural peoples' willingness to buy health insurance. Meanwhile, both the quality of the hospital's treatment ( B = 0.555, p rural health insurance had weakened the three relationships upon which the aforementioned correlations were based.

Youth alcohol and drug use in rural Ireland--parents' views.

LENUS (Irish Health Repository)

Van Hout, Marie Claire A

2009-08-27

INTRODUCTION: Drug availability is increasing throughout Ireland due to a convergence of rural and urban cultures during the last decade of economic growth and prosperity. Rural Irish youth may now have a heightened risk for problematic alcohol and drug use due to increased exposure to drugs, urban contact with peer drug users, unstructured recreation time and poor parental monitoring. Rural parents may perceive their children to be less at risk, and often struggle more than their urban counterparts to identify and respond to their children\\'s alcohol and drug use. The aim of this research was to provide an exploratory account of rural parents\\' perspectives on alcohol and illicit drug use among youth in Ireland. METHODS: A convenience sample of parents with adolescent children was selected at a parent-teacher evening at 3 rural schools, with the facilitation of school completion officers (34 mothers and 21 fathers, n = 55). Semi-structured interviews were conducted which included questions relating to the parents\\' perceptions of youth drug and alcohol use, both in terms of recreational and problematic use in their communities, levels of drug availability, risk perceptions, settings of adolescent substance use, service provision and drug information; and not necessarily with regard to their own children. Following transcription of the interviews, a content and thematic analysis was conducted in order to identify areas of similar and contrasting opinions, and various formulations were compared and contrasted in order to ground the information firmly in the data garnered. RESULTS: The results suggested parental concern with regard to increased rural drug exposure for youth in local rural communities. The majority of parents were aware of youth alcohol use but were concerned about all drugs, not aware of specific differences in drug-related risk, and had difficulty comprehending harm-reduction principles. Most parents recognised the need for greater parental

A Profile of Food Insecurity Dynamics in Rural and Small Town ...

African Journals Online (AJOL)

Optiplex 7010 Pro

design and for estimating the total food insecurity count over time. ... both 2012 and 2014, but the panel data reveal that 46 percent of the rural .... the FAO sets out 30 indicators that capture various dimensions of food ... of poverty – which is closely related to food insecurity – in rural Ethiopia, ..... Indicator (Female headed.

Scottish urban versus rural trauma outcome study.

Science.gov (United States)

McGuffie, A Crawford; Graham, Colin A; Beard, Diana; Henry, Jennifer M; Fitzpatrick, Michael O; Wilkie, Stewart C; Kerr, Gary W; Parke, Timothy R J

2005-09-01

Outcome following trauma and health care access are important components of health care planning. Resources are limited and quality information is required. We set the objective of comparing the outcomes for patients suffering significant trauma in urban and rural environments in Scotland. The study was designed as a 2 year prospective observational study set in the west of Scotland, which has a population of 2.58 million persons. Primary outcome measures were defined as the total number of inpatient days, total number of intensive care unit days, and mortality. The participants were patients suffering moderate (ISS 9-15) and major (ISS>15) trauma within the region. The statistical analysis consisted of chi square test for categorical data and Mann Whitney U test for comparison of medians. There were 3,962 urban (85%) and 674 rural patients (15%). Urban patients were older (50 versus 46 years, p = 0.02), were largely male (62% versus 57%, p = 0.02), and suffered more penetrating traumas (9.9% versus 1.9%, p rural patients (p rural major trauma group (p = 0.002). There were more serious head injuries in the urban group (p = 0.04), and also a higher proportion of urban patients with head injuries transferred to the regional neurosurgical unit (p = 0.037). There were no differences in length of total inpatient stay (median 8 days, p = 0.7), total length of stay in the intensive care unit (median two days, p = 0.4), or mortality (324 deaths, moderate trauma, p = 0.13; major trauma, p = 0.8). Long prehospital times in the rural environment were not associated with differences in mortality or length of stay in moderately and severely injured patients in the west of Scotland. This may lend support to a policy of rationalization of trauma services in Scotland.

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

Science.gov (United States)

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

2017-03-01

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

Sustainable Development of Rural Areas in the EU and China: A Common Strategy for Architectural Design, Research Practice and Decision-Making

Directory of Open Access Journals (Sweden)

Tiziano Cattaneo

2016-10-01

Full Text Available This paper describes the results of a research project to develop a set of goals and strategies aimed at policymakers, stakeholders, researchers, designers and/or some other groups of citizens’ communities whose development actions are undertaken in a specific rural context. The aim of the project was to move beyond the knowledge of the articulated architectural and social evolution of the rural areas in both the EU and China, looking at the local and global challenges, at the need for continuous adaptation and at the experiences of resilience that the countryside faces today. The paper shows, through two-pronged methods, such as semantic analysis and a meta-project design, that a common strategy can be set to support actions for the development of rural areas both in China and the EU. In doing so, this study has defined a strategy system tool that is a type of interactive and generative key-checklist that can be used by stakeholders in specific contexts, becoming a reading tool, a set of design guidelines or a decision facilitator support system. The results achieved have been tested through design application in two meta-projects that confirm the validity of the whole research framework with the aim of promoting a sustainable development and enhancement of places and rural communities.

Evaluation of blood pressure and indices of obesity in a typical rural ...

African Journals Online (AJOL)

Aim: With increasing urbanization of lifestyle, cardiovascular morbidity and mortality have been on the increase in Africans. Studies on cardiovascular risk factors in rural communities in South East Nigeria are scarce. This study focused on hypertension and obesity in adult Nigerians dwelling in a rural setting in Eastern ...

E-branding of rural tourism in Carinthia, Austria

OpenAIRE

Kavoura, Androniki; Bitsani, Evgenia

2013-01-01

The aim of this paper is to create an e-branding model which could also be applied for place branding in small central rural regions of Central Europe based on the innovative methodology of rural tour marketing. It was based and went beyond the European program of transnational cooperation, INTERREG IIIB CADSES. The region of Carinthia, Austria was set as a case study for the application of interrelating scientific theories of marketing, place branding and place identity in relation to and in...

China's rural energy system and management

International Nuclear Information System (INIS)

Catania, Peter

1999-01-01

The issues related to rural energy development and the corresponding escalating economic activities have given rise to a complex, interrelationship among societal, economics, energy, environment and rural policies. With 7% of the world's farm land to produce food for 23% of the world's population, combined with the increasing energy demands for modernised farming has resulted in a dynamic rural energy policy for China. This paper discusses the characteristics of a rural society, outlines the relationship for rural energy supply and demand management, and discusses the interrelationship between energy and the environment utilisation. An illustration of the diffusion of biomass as a success story highlights some of the policies related to self-building, self-managing and self-using. Also discussed in this paper are the results of the integrated rural energy-policy, that is, the social benefits to farmers and the decrease of energy consumption per unit of output. Emerging nations must undertake a comprehensive analysis and synthesis of their respective rural energy developments and the corresponding interrelationships between technology, economics and the environment. (Author)

Conducting a randomized trial in rural and urban safety-net health centers: Added value of community-based participatory research

Directory of Open Access Journals (Sweden)

Meera Muthukrishnan

2018-06-01

Full Text Available Background: Colorectal cancer (CRC is the second most common cancer in the US. Despite evidence that screening reduces CRC incidence and mortality, screening rates are sub-optimal with disparities by race/ethnicity, income, and geography. Rural-urban differences in CRC screening are understudied even though approximately one-fifth of the US population lives in rural areas. This focus on urban populations limits the generalizability and dissemination potential of screening interventions. Methods: Using community-based participatory research (CBPR principles, we designed a cluster-randomized trial, adaptable to a range of settings, including rural and urban health centers. We enrolled 483 participants across 11 health centers representing 2 separate networks. Both networks serve medically-underserved communities; however one is primarily rural and one primarily urban. Results: Our goal in this analysis is to describe baseline characteristics of participants and examine setting-level differences. CBPR was a critical for recruiting networks to the trial. Patient respondents were predominately female (61.3%, African-American (66.5%, and earned <$1200 per month (87.1%. The rural network sample was older; more likely to be female, white, disabled or retired, and have a higher income, but fewer years of education. Conclusions: Variation in the samples partly reflects the CBPR process and partly reflects inherent differences in the communities. This confirmed the importance of using CBPR when planning for eventual dissemination, as it enhanced our ability to work within diverse settings. These baseline findings indicate that using a uniform approach to implementing a trial or intervention across diverse settings might not be effective or efficient. Keywords: Colorectal cancer screening, Community-based participatory research, Health disparities, Medically underserved populations, Dissemination and implementation, Randomized trial

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.

Sustainable Energy Solutions for Rural Alaska

Energy Technology Data Exchange (ETDEWEB)

Allen, Riley [Regulatory Assistance Project, Montpelier, VT (United States); Brutkoski, Donna [Regulatory Assistance Project, Montpelier, VT (United States); Farnsworth, David [Regulatory Assistance Project, Montpelier, VT (United States); Larsen, Peter [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2016-04-22

The state of Alaska recognizes the challenges these rural communities face and provides financial support via the Power Cost Equalization (PCE) program. The PCE subsidizes the electricity prices paid by customers of these high-cost utilities. The PCE program is designed to spread the benefits of Alaska’s natural resources more evenly throughout the state. Yet even with this subsidy, electricity is still much more expensive for these rural customers. And beyond the PCE, other forms of assistance to rural utilities are becoming scarce given the state’s current fiscal environment. Nearly 90 percent of Alaska’s unrestricted budget funds in recent years have been tied to oil royalties—a sector experiencing significant declines in production and oil prices. Consequently, as Alaska looks to tighten budgets, the challenge of lowering rural utility costs, while encouraging self-sufficiency, has become more urgent.This study examines reliability, capital and strategic planning, management, workforce development, governance, financial performance and system efficiency in the various communities visited by the research team. Using those attributes, a tier system was developed to categorize rural Alaska utilities into Leading and Innovating Systems (Tier I), Advanced Diesel Systems (Tier II), Basic Systems (Tier III), and Underperforming Systems (Tier IV). The tier approach is not meant to label specific utilities, but rather to provide a general set of benchmarks and guideposts for improvement.

A telecommunications journey rural health network.

Science.gov (United States)

Moore, Joe

2012-01-01

Utilizing a multi-gigabit statewide fiber healthcare network, Radiology Consultants of Iowa (RCI) set out to provide instantaneous service to their rural, critical access, hospital partners. RCIs idea was to assemble a collection of technologies and services that would even out workflow, reduce time on the road, and provide superior service. These technologies included PACS, voice recognition enabled dictation, HL7 interface technology, an imaging system for digitizing paper and prior films, and modern communication networks. The Iowa Rural Health Telecommunication Project was undertaken to form a system that all critical access hospitals would participate in, allowing RCI radiologists the efficiency of "any image, anywhere, anytime".

School Absenteeism during Menstruation among Rural Adolescent Girls in Pune

OpenAIRE

Suman Bodat, Mrunalini M Ghate, Jyoti R Majumdar

2013-01-01

Background: Menstrual related problems and inadequate school sanitation facilities have an adverse effect on adolescent girl?s academic performance and school attendance especially in rural setting. The following study was undertaken to determine school absenteeism during menstruation period. Objective: To assess the impact of menstruation on school attendance and factors affecting menstruation management. Methods: This cross sectional study was conducted in rural field practice area o...

Who meets their intentions to stop childbearing? Results of a longitudinal study in rural eastern Bali, Indonesia.

Science.gov (United States)

Withers, Mellissa; Tavrow, Paula; Abe, Denise

2012-01-01

In this longitudinal study from rural Bali, Indonesia, we sought to identify the predictors of birth avoidance among 665 married women of reproductive age who reported the intention to stop childbearing. We found that almost 30% of women who wanted no more children had a subsequent birth during the 4-year study period. Women at highest risk for an unwanted birth were younger, had fewer children, and did not use a long-term contraceptive method. The ability to meet intentions to stop childbearing depended on women's motivation (family size), fecundity (proxied by age), and their use of long-term contraceptive methods. Our results suggest that to reduce unwanted births among rural women, family planning providers should recommend long-term methods to younger women with smaller family sizes who express clear intentions to stop childbearing.

Panic disorder in rural Tanzania: an explorative study | Nordgreen ...

African Journals Online (AJOL)

This article examines cultural based interpretations of the diagnosis of panic disorder (PD) in a rural Tanzanian hospital setting through clinical work. It also examines how to adapt and apply brief cognitive behaviour therapy (CBT) interventions to this setting. Method: A qualitative analysis of clinical data from ten participants ...

Low Impact Development Intensive Rural Construction Planning in Xu Fu Village Ningbo, China: Planning Review through Rural Resilience Perspective

Directory of Open Access Journals (Sweden)

Roosmayri Lovina Hermaputi

2017-08-01

Full Text Available Xu Fu Village Ningbo LID Intensive Rural Construction Planning is a cooperation project between Zhejiang University and Ningbo Institute of Technology which named "12th Five-Year National Science and Technology support program-the comprehensive demonstration of the key technology of the beautiful rural construction in the rapid urbanization area of the Yangtze River Delta". This plan focuses on intensive rural construction as part of rural development and construction project that applies the principles of low impact development. Xu Fu Village located in the Yangtze River Delta Region. Currently, the rural growth brings the high impact of development, as a result of rapid urbanization growth arising several issues, such as low land use efficiency, dispersed rural residence, homestead occupies more, rural roads covering over, etc. Meanwhile, Xu Fu village wishes to develop its tourism potential. Thus, the intensive rural construction should be done to avoid the severe effect. The project result hopefully can improve the quality and level of rural residential planning, design, and construction; improve their living environment; save construction land and water use; and improve energy efficiency. The aim of this study is to review the Low Impact Development (LID Intensive Rural Construction in Xu Fu Village, Ningbo City through the rural resilience perspective. This paper will describe the project plan first, then review it through rural resilience perspective. This paper will elaborate the rural resilience theory and then review the rural resiliency through two parts; the first part is identifying rural resilience in rural infrastructure development based on the criteria created by Ayyob S. and Yoshiki Y. (2014, about urban resiliency criteria, and then the second part is reviewing Xu Fu Village resilience through Arup Resilience Qualities (2012, considering three rural resilience domain (economy, ecology, and cultural.

Sociodemographic and environmental correlates of active commuting in rural America.

Science.gov (United States)

Fan, Jessie X; Wen, Ming; Kowaleski-Jones, Lori

2015-01-01

This research investigated participation rates in 3 modes of active commuting (AC) and their sociodemographic and physical environmental correlates in rural America. The 2000 Census supplemented with other data sets were used to analyze AC rates in percentage of workers walking, biking, and taking public transportation to work in 14,209 nonmetropolitan rural tracts identified by RUCA codes, including 4,067 small rural and 10,142 town-micropolitan rural tracts. Sociodemographic and physical environmental variables were correlated with 3 AC modes simultaneously using Seemingly Unrelated Regression for nonmetro rural, and for small rural and town-micropolitan rural separately. The average AC rates in rural tracts were 3.63%, 0.26%, and 0.56% for walking, biking, and public transportation to work, respectively, with small rural tracts having a higher rate of walking but lower rates of biking and public transportation to work than town-micropolitan tracts. In general, better economic well-being was negatively associated with AC but percentage of college-educated was a positive correlate. Population density was positively associated with AC but greenness and proximity to parks were negative correlates. However, significant differences existed for different AC modes, and between small rural and town-micropolitan rural tracts. Sociodemographic factors explained more variance in AC than physical environmental factors but the detailed relationships were complex, varying by AC mode and by degree of rurality. Any strategy to promote AC in rural America needs to be sensitive to the population size of the area and assessed in a comprehensive manner to avoid a "one size fits all" approach. © 2014 National Rural Health Association.

Rural health workers and their work environment: the role of inter-personal factors on job satisfaction of nurses in rural Papua New Guinea

Directory of Open Access Journals (Sweden)

Jayasuriya Rohan

2012-06-01

Full Text Available Abstract Background Job satisfaction is an important focal attitude towards work. Understanding factors that relate to job satisfaction allows interventions to be developed to enhance work performance. Most research on job satisfaction among nurses has been conducted in acute care settings in industrialized countries. Factors that relate to rural nurses are different. This study examined inter-personal, intra-personal and extra-personal factors that influence job satisfaction among rural primary care nurses in a Low and Middle Income country (LMIC, Papua New Guinea. Methods Data was collected using self administered questionnaire from rural nurses attending a training program from 15 of the 20 provinces. Results of a total of 344 nurses were available for analysis. A measure of overall job satisfaction and measures for facets of job satisfaction was developed in the study based on literature and a qualitative study. Multi-variate analysis was used to test prediction models. Results There was significant difference in the level of job satisfaction by age and years in the profession. Higher levels of overall job satisfaction and intrinsic satisfaction were seen in nurses employed by Church facilities compared to government facilities (P Conclusions This study provides empirical evidence that inter-personal relationships: work climate and supportive supervision are the most important influences of job satisfaction for rural nurses in a LMIC. These findings highlight that the provision of a conducive environment requires attention to human relations aspects. For PNG this is very important as this critical cadre provide the frontline of primary health care for more than 70% of the population of the country. Many LMIC are focusing on rural health, with most of the attention given to aspects of workforce numbers and distribution. Much less attention is given to improving the aspects of the working environment that enhances intrinsic satisfaction and

Urban bound migration and rural investment: the case of Mexico.

Science.gov (United States)

Silvers, A L; Crosson, P

1983-02-01

The authors investigate an agriculturally based policy for improving rural incomes and for retarding the rural-urban migration flow. The production of agricultural goods is characterized by a production function in which output increases with increases in agricultural labor inputs, capital, public infrastructure, land, and technology. Differences among regions in agricultural technology will reflect regional differences in education, the institutionalized form of productive organization, and differences in access to technological information channeled through more technically advanced cities. To pick up the effect of out-migration changes in state agricultural labor supply and upon agricultural output, the state's agricultural out-migration rate is included together with the agricultural labor force. The gross migrant flow between 2 locations is hypothesized to depend upon a set of variables influencing the individual's perception of the economic rate of return to be gained by moving, a set of variables reflecting the individual's propensity to relocate, the labor displacement effects of investments, and the at risk population at 1 location available to migrate. It is also taken into account that individuals differ in their response to information about origin and destination wage differentials and that individuals may or may not perceive a new ecnomic gain from migration but may base the decision on other considerations. Results of a statistical analysis using data from the Mexican census of population for 1960 and 1970 are: 1) size of the rural labor force was negatively associated with agricultural wages, contrary to expectations; 2) small farmers have benefited from the expansion of irrigation in Mexico; and 3) higher urban wages attract migration, and higher growth rate of agricultural income retards rural-urban migration. With respect to the 1950-60 decade both agricultural income and rural out-migration impacts could have been substantial but both the impact

Tourism in rural Alaska

Science.gov (United States)

Katrina Church-Chmielowski

2007-01-01

Tourism in rural Alaska is an education curriculum with worldwide relevance. Students have started small businesses, obtained employment in the tourism industry and gotten in touch with their people. The Developing Alaska Rural Tourism collaborative project has resulted in student scholarships, workshops on website development, marketing, small...

Seizures, cysticercosis and rural-to-urban migration: the PERU MIGRANT study

Science.gov (United States)

Gonzales, Isidro; Miranda, J Jaime; Rodriguez, Silvia; Vargas, Victor; Cjuno, Alfredo; Smeeth, Liam; Gonzalez, Armando E; Tsang, Victor C W; Gilman, Robert H; Garcia, Hector H

2015-01-01

Objectives To examine the prevalence of seizures, epilepsy and seropositivity to cysticercosis in rural villagers (cysticercosis-endemic setting), rural-to-urban migrants into a non-endemic urban shanty town and urban inhabitants of the same non-endemic shanty town. Methods Three Peruvian populations (n = 985) originally recruited into a study about chronic diseases and migration were studied. These groups included rural inhabitants from an endemic region (n = 200), long-term rural-to-urban migrants (n = 589) and individuals living in the same urban setting (n = 196). Seizure disorders were detected by a survey, and a neurologist examined positive respondents. Serum samples from 981/985 individuals were processed for cysticercosis antibodies on immunoblot. Results Epilepsy prevalence (per 1000 people) was 15.3 in the urban group, 35.6 in migrants and 25 in rural inhabitants. A gradient in cysticercosis antibody seroprevalence was observed: urban 2%, migrant 13.5% and rural group 18% (P grupos incluían habitantes rurales de una región endémica (n=200), inmigrantes de larga duración de zonas rurales a urbanas (n=589), e individuos que vivían en la misma zona urbana (n=196). Las convulsiones se detectaron mediante una encuesta y un neurólogo examinó a quienes habían respondido positivamente. Se procesaron muestras de suero de 981/985 individuos en busca de anticuerpos para cisticercosis mediante inmunoblot. Resultados La prevalencia de epilepsia (por 1,000 personas) era de 15.3 en el grupo urbano, 35.6 en inmigrantes y 25 en habitantes rurales. Se observó un gradiente en la seroprevalencia de los anticuerpos para cisticercosis: grupos urbano 2%, inmigrante 13.5% y rural 18% (p<0.05). Se observó un patrón de aumento similar de mayor seroprevalencia entre inmigrantes según la edad que tenían en el momento de emigrar. En pobladores rurales, había una evidencia importante de asociación entre tener una serología positiva y sufrir convulsiones (p=0

Seizures, cysticercosis and rural-to-urban migration: the PERU MIGRANT study.

Science.gov (United States)

Gonzales, Isidro; Miranda, J Jaime; Rodriguez, Silvia; Vargas, Victor; Cjuno, Alfredo; Smeeth, Liam; Gonzalez, Armando E; Tsang, Victor C W; Gilman, Robert H; Garcia, Hector H

2015-04-01

To examine the prevalence of seizures, epilepsy and seropositivity to cysticercosis in rural villagers (cysticercosis-endemic setting), rural-to-urban migrants into a non-endemic urban shanty town and urban inhabitants of the same non-endemic shanty town. Three Peruvian populations (n = 985) originally recruited into a study about chronic diseases and migration were studied. These groups included rural inhabitants from an endemic region (n = 200), long-term rural-to-urban migrants (n = 589) and individuals living in the same urban setting (n = 196). Seizure disorders were detected by a survey, and a neurologist examined positive respondents. Serum samples from 981/985 individuals were processed for cysticercosis antibodies on immunoblot. Epilepsy prevalence (per 1000 people) was 15.3 in the urban group, 35.6 in migrants and 25 in rural inhabitants. A gradient in cysticercosis antibody seroprevalence was observed: urban 2%, migrant 13.5% and rural group 18% (P < 0.05). A similarly increasing pattern of higher seroprevalence was observed among migrants by age at migration. In rural villagers, there was strong evidence of an association between positive serology and having seizures (P = 0.011) but such an association was not observed in long-term migrants or in urban residents. In the entire study population, compared with seronegative participants, those with strong antibody reactions (≥ 4 antibody bands) were more likely to have epilepsy (P < 0.001). It is not only international migration that affects cysticercosis endemicity; internal migration can also affect patterns of endemicity within an endemic country. The neurological consequences of cysticercosis infection likely outlast the antibody response for years after rural-to-urban migration. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

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

Institute of Scientific and Technical Information of China (English)

2012-01-01

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

Managerial Strategies for the Conservation of Rurality in Rural Tourism

Directory of Open Access Journals (Sweden)

Cornelia Petroman

2010-10-01

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

DISTANCE EDUCATION POTENTIAL FOR A CANADIAN RURAL ISLAND COMMUNITY

Directory of Open Access Journals (Sweden)

Tom JONES

2009-04-01

Full Text Available The purpose of the study was to investigate the potential impact of distance education on a small, rural, Canadian island community. Presently, the population of small, rural island communities on the west coast of Canada are facing numerous challenges to retain and to attract permanent residents and families and to provide support and direction for those residents who wish to pursue K-12 accreditation, post-secondary education, vocational/trades training and up-grading or life-long learning. A unique set of considerations confront many of these isolated communities if they wish to engage in distance education and training. This set ranges from internet access to excessive travel by secondary students to the lack of centralized facility. For this study, a group of 48 participants were interviewed to determine their perceptions of the potential for distance education to impact on the community's educational, both academic and vocational, life-long learning and economic needs. The results indicated that there were four general areas of purported benefit: academic advancement, an improved quality of life, support for young families and a stabilizing affect on the local economy. Suggestions for the implementation of a suitable distance education resource are noted.

RURAL TOURISM IN DOBRUDGEA

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Elena, SIMA

2014-11-01

Full Text Available The natural and anthropic tourism resources of a certain area generate specific tourism forms, which complete each other within the different destination categories.The rural area in Dobrudja has diversified tourism potential, provided by the contrast of natural environment factors, ranging from the oldest and to the youngest relief units, natural protected areas, spa resources and cultural, historical, religious sites, as well as multicultural local customs and traditions of the rural area. This potential can be used under various kinds in the rural area: cultural tourism, historical tourism, religious tourism, ecotourism, fishing tourism or bird-watching tourism, and other kinds of rural tourism. By linking these tourism resources and tourism forms, tourism routes can result, which together with the local customs, traditions and cuisine may contribute to the social and economic development of Dobrudja's rural area, through sustainable tourism as alternative to seasonal seashore tourism.

A Persistent Disparity: Smoking in Rural Sexual and Gender Minorities.

Science.gov (United States)

Bennett, Keisa; McElroy, Jane A; Johnson, Andrew O; Munk, Niki; Everett, Kevin D

2015-03-01

Sexual and gender minorities (SGM) smoke cigarettes at higher rates than the general population. Historically, research in SGM health issues was conducted in urban populations and recent population-based studies seldom have sufficient SGM participants to distinguish urban from rural. Given that rural populations also tend to have a smoking disparity, and that many SGM live in rural areas, it is vitally important to understand the intersection of rural residence, SGM identity, and smoking. This study analyzes the patterns of smoking in urban and rural SGM in a large sample. We conducted an analysis of 4280 adult participants in the Out, Proud, and Healthy project with complete data on SGM status, smoking status, and zip code. Surveys were conducted at 6 Missouri Pride Festivals and online in 2012. Analysis involved descriptive and bivariate methods, and multivariable logistic regression. We used GIS mapping to demonstrate the dispersion of rural SGM participants. SGM had higher smoking proportion than the non-SGM recruited from these settings. In the multivariable model, SGM identity conferred 1.35 times the odds of being a current smoker when controlled for covariates. Rural residence was not independently significant, demonstrating the persistence of the smoking disparity in rural SGM. Mapping revealed widespread distribution of SGM in rural areas. The SGM smoking disparity persists among rural SGM. These communities would benefit from continued research into interventions targeting both SGM and rural tobacco control measures. Recruitment at Pride Festivals may provide a venue for reaching rural SGM for intervention.

Impact and management of dual relationships in metropolitan, regional and rural mental health practice.

Science.gov (United States)

Endacott, Ruth; Wood, Anita; Judd, Fiona; Hulbert, Carol; Thomas, Ben; Grigg, Margaret

2006-01-01

To explore the extent and impact of professional boundary crossings in metropolitan, regional and rural mental health practice in Victoria and identify strategies mental health clinicians use to manage dual relationships. Nine geographically located focus groups consisting of mental health clinicians: four focus groups in rural settings; three in a regional city and two in a metropolitan mental health service. A total of 52 participants were interviewed. Data revealed that professional boundaries were frequently breached in regional and rural settings and on occasions these breaches had a significantly negative impact. Factors influencing the impact were: longevity of the clinician's relationship with the community, expectations of the community, exposure to community 'gossip' and size of the community. Participants reported greater stress when the boundary crossing affected their partner and/or children. Clinicians used a range of proactive and reactive strategies, such as private telephone number, avoidance of social community activities, when faced with a potential boundary crossing. The feasibility of reactive strategies depended on the service configuration: availability of an alternative case manager, requirement for either patient or clinician to travel. The greater challenges faced by rural and regional clinicians were validated by metropolitan participants with rural experience and rural participants with metropolitan experience. No single strategy is used or appropriate for managing dual relationships in rural settings. Employers and professional bodies should provide clearer guidance for clinicians both in the management of dual relationships and the distinction between boundary crossings and boundary violation. Clinicians are clearly seeking to represent and protect the patients' interests; consideration should be given by consumer groups to steps that can be taken by patients to reciprocate.

Rural Tourism Accommodation Prices by Land Use-Based Hedonic Approach: First Results from the Case Study of the Self-Catering Cottages in Asturias

Directory of Open Access Journals (Sweden)

Celia Bilbao-Terol

2017-09-01

Full Text Available This study analyses the impacts of environmental amenities associated with agricultural and silvicultural land use on the price of rural tourism accommodation in Asturias (Spain. A hedonic price model that relates the price of rural accommodation to environmental amenities as well as equipment, services offered, and the locational characteristics of the accommodation is estimated. The rural accommodations in the study are the self-catering cottages, the intrinsic features of which promote the development of rural tourism sustainability. Geographic information systems (GIS data are used to measure the location and the proximity to amenities of these self-catering cottages. The main results indicate that agricultural land use has an important impact on the price of accommodation in self-catering cottages. Specifically, a high percentage of grassland in the municipality where the self-catering cottage is sited has a positive effect on rental prices, while a high percentage of arable crops has the opposite effect. The analysis is interesting for decision-making in the context of environmental policies, land use conflict resolution, and rural tourism sustainability.

Rural Elementary Teachers and Place-Based Connections to Text during Reading Instruction

Science.gov (United States)

Waller, Rachael; Barrentine, Shelby J.

2015-01-01

Schooling can play a role in bolstering a sense of community, but research suggests that curriculum may serve to isolate teachers and students from their rural surroundings. In this qualitative case study, we asked if the literacy curriculum and instruction supported readers to make connections to their rural setting. We analyzed curriculum…

Rural public acceptance of renewable energy deployment: The case of Shandong in China

NARCIS (Netherlands)

Liu Wenling, Wenling; Wang Can,; Mol, A.P.J.

2013-01-01

China has set ambitious goals to increase the use of renewable energy. Developing renewables in rural areas is also one of the most important energy strategies. This paper examines rural social acceptance of renewable energy deployment taking Shandong as a case study via a field questionnaire

Electronic data capture in a rural African setting: evaluating experiences with different systems in Malawi.

Science.gov (United States)

King, Carina; Hall, Jenny; Banda, Masford; Beard, James; Bird, Jon; Kazembe, Peter; Fottrell, Ed

2014-01-01

As hardware for electronic data capture (EDC), such as smartphones or tablets, becomes cheaper and more widely available, the potential for using such hardware as data capture tools in routine healthcare and research is increasing. We aim to highlight the advantages and disadvantages of four EDC systems being used simultaneously in rural Malawi: two for Android devices (CommCare and ODK Collect), one for PALM and Windows OS (Pendragon), and a custom-built application for Android (Mobile InterVA--MIVA). We report on the personal field and development experience of fieldworkers, project managers, and EDC system developers. Fieldworkers preferred using EDC to paper-based systems, although some struggled with the technology at first. Highlighted features include in-built skip patterns for all systems, and specifically the 'case' function that CommCare offers. MIVA as a standalone app required considerably more time and expertise than the other systems to create and could not be customised for our specific research needs; however, it facilitates standardised routine data collection. CommCare and ODK Collect both have user-friendly web-interfaces for form development and good technical support. CommCare requires Internet to build an application and download it to a device, whereas all steps can be done offline with ODK Collect, a desirable feature in low connectivity settings. Pendragon required more complex programming of logic, using a Microsoft Access application, and generally had less technical support. Start-up costs varied between systems, and all were considered more expensive than setting up a paper-based system; however running costs were generally low and therefore thought to be cost-effective over the course of our projects. EDC offers many opportunities for efficient data collection, but brings some issues requiring consideration when designing a study; the decision of which hardware and software to use should be informed by the aim of data collection

Interface between urban and rural

DEFF Research Database (Denmark)

Brandt, Jesper

2007-01-01

  Counterurbanisation combined with recent trends in agricultural technology has resulted in a ‘multifunctional countryside regime', raising new questions on the relation between nature and land use in rural areas and between very different values and interests developing in these areas. Indicators...... for new trends in rural landscapes have been related to a model for urban pressure on rural areas in Denmark however without any convincing results. A model for the historical development of a typical Danish village has been made, to see if the socially differentiated process of counterurbanisation can...... be related to the differentiation in the development of different types of village developments. Such a model can elucidate the potentials of a multifunctional landscape as a basis for a varied and and attractive fulfilment of human needs in an urban-rural continuum....

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

Science.gov (United States)

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

2016-05-01

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

Dietary Diversity is a Predictor of Acute Malnutrition in Rural but Not in Urban Settings: Evidence from Ghana

OpenAIRE

Amugsi, Dickson Abanimi; Mittelmark, Maurice B.; Lartey, Anna

2014-01-01

Aims: To document the relationships between child dietary diversity and acute malnutrition (wasting) in urban and rural Ghana, controlling for maternal, child and household socio-demographic characteristics. Study Design: Cross sectional survey Place and Duration of Study: Urban and rural Ghana, between September and November 2008. Methodology: The analysis uses data from the 2008 Ghana Demographic and Health Survey. Data on children aged 6-36 months (n = 1,187) and their...

The Adoption and Use of Health Information Technology in Rural Areas: Results of a National Survey

Science.gov (United States)

Singh, Ranjit; Lichter, Michael I.; Danzo, Andrew; Taylor, John; Rosenthal, Thomas

2012-01-01

Context: Health information technology (HIT) is a national policy priority. Knowledge about the special needs, if any, of rural health care providers should be taken into account as policy is put into action. Little is known, however, about rural-urban differences in HIT adoption at the national level. Purpose: To conduct the first national…

Serving an Indigenous community: Exploring the cultural competence of medical students in a rural setting

Directory of Open Access Journals (Sweden)

Chin Hoong Wong

2017-06-01

Full Text Available Since 2013, medical students from the International Medical University (IMU in Malaysia have been providing primary healthcare services, under the supervision of faculty members, to the indigenous people living in Kampung Sebir. The project has allowed the students to learn experientially within a rural setting. This study aims to examine the cultural competence of IMU medical students through an examination of their perspective of the indigenous people who they serve and the role of this community service in their personal and professional development. Students who participated in the project were required to complete a questionnaire after each community engagement activity to help them reflect on the above areas. We analysed the responses of students from January to December 2015 using a thematic analysis approach to identify overarching themes in the students’ responses. Students had differing perceptions of culture and worldviews when compared to the indigenous people. However, they lacked the self-reflection skills necessary to understand how such differences can affect their relationship with the indigenous people. Because of this, the basis of their engagement with the indigenous community (as demonstrated by their views of community service is focused on their agenda of promoting health from a student’s perspective rather than connecting and building relationships first. Students also lacked the appreciation that building cultural competency is a continuous process. The results show that the medical students have a developing cultural competence. The project in Kampung Sebir is an experiential learning platform of great value to provide insights into and develop the cultural competency of participating students. This study also reflects on the project itself, and how the relationship with stakeholders, the competence and diversity of academic staff, and the support of the university can contribute toward training in cultural

Organization of public services in remote rural areas in developing countries: application to decentralized rural electrification

International Nuclear Information System (INIS)

Bui, D.N.

2005-01-01

The electrical sector has traditionally been organized as a natural monopoly. The intensity in capital of the grid and the public service obligation of electrical distribution led to the creation of electrical companies with exclusive territorial concessions. This approach has recently been challenged because of its failure to electrify remote rural villages in developing countries. A new set of solutions appeared under the umbrella of Decentralized Rural Electrification (DRE) thanks to technological innovations that replace collective infrastructures with individual systems. However, the widespread deployment of decentralized technologies remains impaired by numerous obstacles at various levels: institutional, legal, organizational, social, financial... New models that take into account the specificities of DRE must now be imagined. The study of two case studies in Morocco and India provide insightful examples of possible strategies to accelerate the deployment of DRE and therefore attain the objectives of rural electrification. Two major policies stand out: public service delegation and the approach of delivering equipment by the public market. Even though these models are too recent to conclude on their viability and permanence, they provide guidelines for the public and private players of the sector to generalize the access to electrical services to rural populations in developing countries, and contribute to their development. (author)

Rural Depopulation Pattern at Yogyakarta Special Province (DIY

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M Baiquni

2004-01-01

This paper is based on a secondary data research i.e. statistical data at rural levels in Yogyakarta, thematics maps and other documents. Statistical methodes and map pattern analysis are employed to analysis data. The result of this research are as follows: a the rural depopulation in DIY can be found in 189 rural areas of 393 rural areas (48.09%; b the spatial distribution of the rural depopulation are in Gunung Kidul District (80 rural areas, Kulon Progo District (59 rural areas Sleman District (33 rural areas, and Bantul District (17 rural areas; c the rural depopulation in Yogyakarta at least related to six factors whih have been identified as out – migration, local resources, carrying capacity, geographycal location or accessibility, rural infrastructure, and service availability.

Childhood obesity prevention in rural settings: background, rationale, and study design of ‘4-Health,’ a parent-only intervention

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Lynch Wesley C

2012-04-01

Full Text Available Abstract Background Childhood obesity in rural communities is a serious but understudied problem. The current experiment aims to assess a wide range of obesity risk factors among rural youth and to offer an 8-month intervention program for parents to reduce obesity risk in their preteen child. Methods/Design A two-group, repeated measures design is used to assess the effectiveness of the 4-Health intervention program. Assessments include anthropometric measures, child self-evaluations, parent self-evaluations, and parent evaluations of child. County Extension agents from 21 rural Montana counties recruit approximately 150 parent–child dyads and counties are semi-randomly assigned to the active intervention group (4-Health Educational Program or a “best-practices” (Healthy Living Information control group. Discussion This study will shed light on the effectiveness of this parent-only intervention strategy in reducing obesity risk factors among rural preteens. The 4-Health program is designed to provide information and skills development for busy rural parents that will increase healthy lifestyles of their preteen children and improve the parents’ ability to intervene effectively in the lives of their families during this critical developmental period. Trial registration ClinicalTrials.gov ID: NCT01510587

Exploring the condom gap: is supply or demand the limiting factor - condom access and use in an urban and a rural setting in Kilifi district, Kenya.

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Papo, Jacqueline K; Bauni, Evasius K; Sanders, Eduard J; Brocklehurst, Peter; Jaffe, Harold W

2011-01-14

to explore the extent of the condom gap, investigating the relative roles of supply-side and demand-side factors in determining condom use. GPS mapping of condom outlets, and population-based survey. an urban and a rural site were selected within the Epidemiological and Demographic Surveillance Site in Kilifi district, Kenya. Potential condom outlets (n = 281) were mapped and surveyed, and questionnaires on condom access and use (n = 630) were administered to a random sample of men and women aged 15-49. Multivariate logistic regression was performed to assess the relative roles of supply-side and demand-side barriers on condom use. the median straight-line distance to free condoms was 18-fold higher in the rural versus urban site. Among sexually active respondents, 42% had ever used a condom, and 23% had used a condom over the past 12 months, with lower levels among rural versus urban respondents (P supply-side or demand-side barriers, compared with individuals experiencing both types of barriers. Despite low levels of usage and the presence of supply-side and demand-side barriers, reported unmet need for condoms was low. there is an urgent need for renewed condom promotion efforts aimed at building demand, in addition to improving physical access, in resource-limited settings with generalized HIV epidemics in sub-Saharan Africa. 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Ruralization of students’ horizons: insights into Australian health professional students’ rural and remote placements

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Cross, Merylin; Waller, Susan; Chambers, Helen; Farthing, Annie; Barraclough, Frances; Pit, Sabrina W; Sutton, Keith; Muyambi, Kuda; King, Stephanie; Anderson, Jessie

2018-01-01

Introduction Health workforce shortages have driven the Australian and other Western governments to invest in engaging more health professional students in rural and remote placements. The aim of this qualitative study was to provide an understanding of the lived experiences of students undertaking placements in various nonmetropolitan locations across Australia. In addition to providing their suggestions to improve rural placements, the study provides insight into factors contributing to positive and negative experiences that influence students’ future rural practice intentions. Methods Responses to open-ended survey questions from 3,204 students from multiple health professions and universities were analyzed using two independent methods applied concurrently: manual thematic analysis and computerized content analysis using Leximancer software. Results The core concept identified from the thematic analysis was “ruralization of students’ horizons,” a construct representing the importance of preparing health professional students for practice in nonmetropolitan locations. Ruralization embodies three interrelated themes, “preparation and support,” “rural or remote health experience,” and “rural lifestyle and socialization,” each of which includes multiple subthemes. From the content analysis, factors that promoted students’ rural practice intentions were having a “positive” practice experience, interactions with “supportive staff,” and interactions with the “community” in general. It was apparent that “difficulties,” eg, with “accommodation,” “Internet” access, “transport,” and “financial” support, negatively impacted students’ placement experience and rural practice intentions. Conclusions The study findings have policy and practice implications for continuing to support students undertaking regional, rural, and remote placements and preparing them for future practice in nonmetropolitan locations. This study

Women's decision-making autonomy and children's schooling in rural Mozambique.

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Luz, Luciana; Agadjanian, Victor

2015-03-24

Women's decision-making autonomy in developing settings has been shown to improve child survival and health outcomes. However, little research has addressed possible connections between women's autonomy and children's schooling. To examine the relationship between rural women's decision-making autonomy and enrollment status of primary school-age children living in their households and how this relationship differs by child's gender. The analysis uses data from a 2009 survey of rural households in four districts of Gaza province in southern Mozambique. Multilevel logistic models predict the probability of being in school for children between 6 and 14 years old. The results show a positive association of women's decision-making autonomy with the probability of being enrolled in primary school for daughters, but not for sons. The effect of women's autonomy is net of other women's characteristics typically associated with enrollment and does not mediate the effects of those characteristics. Based on the results, we argue that women with higher levels of decision-making autonomy may have a stronger preference for daughters' schooling and may have a greater say in making and implementing decisions regarding daughters' education, compared to women with lower autonomy levels. Results also illustrate a need for considering a broader set of autonomy-related characteristics when examining the effects of women's status on children's educational outcomes.

Occupational Therapy and Physiotherapy in Acute Stroke: Do Rural Patients Receive Less Therapy?

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Josie Merchant

2016-01-01

Full Text Available Objective. To assess whether acute stroke patients in rural hospitals receive less occupational therapy and physiotherapy than those in metropolitan hospitals. Design. Retrospective case-control study of health data in patients ≤10 days after stroke. Setting. Occupational therapy and physiotherapy services in four rural hospitals and one metropolitan hospital. Participants. Acute stroke patients admitted in one health district. Main Outcome Measures. Frequency and duration of face-to-face and indirect therapy sessions. Results. Rural hospitals admitted 363 patients and metropolitan hospital admitted 378 patients. Mean age was 73 years. Those in rural hospitals received more face-to-face (p>0.0014 and indirect (p=0.001 occupational therapy when compared to those in the metropolitan hospital. Face-to-face sessions lasted longer (p=0.001. Patients admitted to the metropolitan hospital received more face-to-face (p>0.000 and indirect (p>0.000 physiotherapy when compared to those admitted to rural hospitals. Face-to-face sessions were shorter (p>0.000. Almost all were seen within 24 hours of referral. Conclusions. Acute stroke patients in Australian rural hospital may receive more occupational therapy and less physiotherapy than those in metropolitan hospitals. The dose of therapy was lower than recommended, and the referral process may unnecessarily delay the time from admission to a patient’s first therapy session.

Helping rural women in Pakistan to prevent postpartum hemorrhage: A quasi experimental study

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Mir Ali

2012-10-01

Full Text Available Abstract Background According to the Pakistan Demographic and Health Survey from 2006–2007, the maternal mortality ratio in rural areas is 319 per 100,000 live births. Postpartum hemorrhage is the leading cause of maternal deaths in Pakistan. The objectives of the study were to document the feasibility of distribution of misoprostol tablets by community-based providers mainly traditional birth attendants and acceptability and use of misoprostol by women who gave birth at home. Methods A quasi-experimental design, comprising intervention and comparison areas, was used to document the acceptability of providing misoprostol tablets to pregnant women to prevent postpartum hemorrhage in the rural community setting in Pakistan. Data were collected using structured questionnaires administered to women before and after delivery at home and their birth attendants. Results Out of 770 women who delivered at home, 678 (88% ingested misoprostol tablets and 647 (84% ingested the tablets after the birth of the neonate but prior to the delivery of the placenta. The remaining women took misoprostol tablets after delivery of the placenta. Side effects were experienced by 40% of women and were transitory in nature. Among women who delivered at home, 80% said that they would use misoprostol tablets in the future and 74% were willing to purchase them in the future. Conclusions Self-administration of misoprostol in the home setting is feasible. Community-based providers, such as traditional birth attendants and community midwives with proper training and counseling, play an important role in reducing postpartum hemorrhage. Proper counseling and information exchange are helpful for introducing new practices in resource-constrained rural communities. Until such a time that skilled birth attendance is made more universally available in the rural setting, alternative strategies, such as training and using the services of traditional birth attendants to provide safe

Prioritizing Nutrition in Agriculture and Rural Development : Guiding Principles for Operational Investments

OpenAIRE

Herforth, Anna; Jones, Andrew; Pinstrup-Andersen, Per

2012-01-01

Agricultural and rural development provides a critically important opportunity for reducing malnutrition. The purpose of this paper is to provide a set of guiding principles for incorporating nutrition goals into the design and implementation of agricultural and rural development projects, and to provide examples of current best evidence options for operational investments. Several princip...

Rural adolescents' access to adolescent friendly health services.

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Secor-Turner, Molly A; Randall, Brandy A; Brennan, Alison L; Anderson, Melinda K; Gross, Dean A

2014-01-01

The purpose of this study was to assess rural North Dakota adolescents' experiences in accessing adolescent-friendly health services and to examine the relationship between rural adolescents' communication with health care providers and risk behaviors. Data are from the Rural Adolescent Health Survey (RAHS), an anonymous survey of 14- to 19-year-olds (n = 322) attending secondary schools in four frontier counties of North Dakota. Descriptive statistics were used to assess participants' access to adolescent-friendly health services characterized as accessible, acceptable, and appropriate. Logistic regressions were used to examine whether participant-reported risk behaviors predicted communication with health care providers about individual health risk behaviors. Rural adolescents reported high access to acceptable primary health care services but low levels of effective health care services. Participant report of engaging in high-risk behaviors was associated with having received information from health care providers about the leading causes of morbidity and mortality. These findings reveal missed opportunities for primary care providers in rural settings to provide fundamental health promotion to adolescents. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

ASSESSMENT OF THE RURAL POPULATION TO THE RESULTS OF NATIONAL CENSUS 2002, 2010. IN THE REPUBLICS OF THE NORTH CAUCASUS: GIS APPROACHES AND METHODS

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P. P. Turun

2016-01-01

Full Text Available The article describes the dynamics of the rural population of the North Caucasus republics in 1989–2010 analyzes the differences of census data with the results of the current account of the population over two intercensal period. For obtaining the most accurate data in the rural population applies a correction factor the results of the census are considered critical, given the problems of its implementation.

Injury morbidity in an urban and a rural area in Tanzania: an epidemiological survey

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Setel Philip

2005-01-01

Full Text Available Abstract Background Injuries are becoming a major health problem in developing countries. Few population based studies have been carried out in African countries. We examined the pattern of nonfatal injuries and associated risk factors in an urban and rural setting of Tanzania. Methods A population-based household survey was conducted in 2002. Participants were selected by cluster sampling. A total of 8,188 urban and 7,035 rural residents of all ages participated in the survey. All injuries reported among all household members in the year preceding the interview and resulting in one or more days of restricted activity were included in the analyis. Results A total of 206 (2.5% and 303 (4.3% persons reported to have been injured in the urban and rural area respectively. Although the overall incidence was higher in the rural area, the incidence of major injuries (≥ 30 disability days was similar in both areas. Males were at a higher risk of having an injury than females. Rural residents were more likely to experience injuries due to falls (OR = 1.6; 95% CI = 1.1 – 2.3 and cuts (OR = 4.3; 95% CI = 3.0 – 6.2 but had a lower risk of transport injuries. The most common causes of injury in the urban area were transport injuries and falls. In the rural area, cuts and stabs, of which two thirds were related to agriculture, formed the most common cause. Age was an important risk factor for certain types of injuries. Poverty levels were not significantly associated with experiencing a nonfatal injury. Conclusion The patterns of injury differ in urban and rural areas partly as a reflection of livelihoods and infrastructure. Rural residents are at a higher overall injury risk than urban residents. This may be important in the development of injury prevention strategies.

Rural/Urban Disparities in Science Achievement in Post-Socialist Countries: The Evolving Influence of Socioeconomic Status

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Kryst, Erica L.; Kotok, Stephen; Bodovski, Katerina

2015-01-01

Disparities in educational outcomes exist between students in rural areas as compared to students in urban settings. While there is some evidence that these rural disparities are present in eastern Europe, little is known about young peoples' lives in the rural areas of this region. This paper presents an analysis of science achievement by…

Panic disorder in rural Tanzania: an explorative study

African Journals Online (AJOL)

research from low-income countries on the relevance of diagnoses ... study examines cultural based interpretations of the PD diagnose ... for PD may be adapted to a rural Tanzanian setting, also taking into consideration the limited financial ...

A new inter-professional course preparing learners for life in rural communities.

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Medves, Jennifer; Paterson, Margo; Chapman, Christine Y; Young, John H; Tata, Elizabeth; Bowes, Denise; Hobbs, Neil; McAndrews, Brian; O'Riordan, Anne

2008-01-01

The 'Professionals in Rural Practice' course was developed with the aim of preparing students enrolled in professional programs in Canada to become better equipped for the possible eventuality of professional work in a rural setting. To match the reality of living and working in a rural community, which by nature is interprofessional, the course designers were an interprofessional teaching team. In order to promote group cohesiveness the course included the participation of an interprofessional group of students and instructors from the disciplines of medicine, nursing, occupational therapy, physical therapy, teacher education, and theology. The format of the course included three-hour classes over an eight-week period and a two-day field experience in a rural community. The course utilized various experiential and interactive teaching and learning methods, along with a variety of assessment methods. Data were collected from student participants over two iterations of the course using a mixed methods approach. Results demonstrate that students value the interprofessional and experiential approach to learning and viewed this course as indispensable for gaining knowledge of other professions and preparation for rural practice. The data reveal important organizational and pedagogical considerations specific to interprofessional education, community based action research, and the unique interprofessional nature of training for life and work in a rural community. This study also indicates the potential value of further longitudinal study of participants in this course. Key words: Canada, community based action research, education, interdisciplinary, interprofessional.

Tourism as a factor of sustainable development of rural areas belonging to Rudnička Morava

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Ristić Lela

2016-01-01

Full Text Available The paper looks at tourism as an essential component of sustainable development of rural areas belonging to Rudnička Morava territory. The aim of the paper is to point to the role of tourism in the integration of rural areas into the national and international economy based on the analysis of the relevant rural development model and in terms of more efficient endogenous development. The main hypothesis is that rural areas belonging to Rudnička Morava territory have significant natural and anthropogenic resources for tourism development. However, what lacks is an integrated strategy that would contribute to sustainability and strengthening of the competitiveness of the rural economy. In accordance with the subject of the paper, its aim and the set hypotheses, qualitative, quantitative and SWOT analysis were applied during the research. A survey was conducted in order to obtain positions and feedback from the key actors involved in tourism development. The paper is organized in eight sections. The main result of the research points to the necessity of giving priority to rural tourism development as an essential component of the revitalization of villages and local communities.

Engaging rural women in healthy lifestyle programs: insights from a randomized controlled trial.

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Kozica, Samantha L; Harrison, Cheryce L; Teede, Helena J; Ng, Sze; Moran, Lisa J; Lombard, Catherine B

2015-09-16

The obesity epidemic is well established, particularly in rural settings. Programs promoting healthy lifestyles for rural women are urgently needed; however, participant engagement is challenging. In the context of a large randomized controlled trial targeting the prevention of weight gain in rural women, we explored successful recruitment strategies and aimed to understand participants' barriers, enablers and reasons for program participation. We recruited women (aged 18-55 years) from the general rural Australian population. A mixed-methods approach was applied to explore factors that influenced program participation, including quantitative questionnaires for all participants (n = 649) and qualitative semi-structured interviews conducted for a subgroup of participants (n = 45). Data were collected at three time points: baseline, 6 and 12 months post program commencement. We recruited 649 rural women through a community communication and partnering strategy, a program marketing campaign and mobilization of social networks. Program participants were diverse across education and income levels and were representative of the wider Australian regional population. Factors that influenced program engagement were divided into personal (perceived program benefits and program accessibility) and social (peer persuasion and support). Identified enablers included convenience of the program location, perceived program utility, such as weight management and optimization of lifestyle choices, as well as attending the program with peer support. Barriers to engagement, which are likely exacerbated in rural communities included lack of anonymity, self-consciousness and segregated social networks in rural settings. Participants reported that eliciting local support and maximizing publicity is fundamental to improving future program engagement. Multiple program promotion strategies including communication, marketing and partnering, as well as mobilization of social networks and peer

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

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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

The Need and Use the Rural ICT Services in Iranian Rural Areas

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Amir Mozafar Amini

2015-11-01

Full Text Available Nowadays, Internet access and use of information resources in all human societies are experiencing a rising trend, and different communities are used each with multiple infrastructures due to the benefits of ICT. The present study was based on applied research. In this research, a hybrid approach involving quantitative methods (survey and qualitative (observation, interviews was used. Statistical population of this study consists of two parts, the first part responsible for rural ICT offices, with a population of 125 people using Cochran Formula 80 subjects were selected as first sample, and the second part of the rural of first sample villages with a population of 84,836 people using Cochran formula and randomized-comparative method were studied as second sample. The questionnaire was subjected to reliability testing by using data collection in the pilot study with Cronbach’s Alpha value 0.73 to 0.95 for all variables. SPSS statistical software was used to analysis the data. The results of the study indicate that the overall performance of the agencies providing services to the rural was lower-middle in the offices in banking services has received first place, and the final ranking in the provision of health services. The results of study showed that rural employment, level education and family size effect on the rate of rural ICT offices.

The impact of micro financing on poverty levels of rural women farm households in Abia state, Nigeria; implication for policy intervention

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EZEH Innocent

2013-06-01

Full Text Available This study determined the impact of micro-finance on poverty level of rural women farm households in Abia State, Nigeria: Implication for policy intervention. A multi-stage random sampling technique was used to +select the local government areas, communities and respondents in the three (Aba, Ohafia and Umuahia agricultural zones of the State. The sample size was 240 (120 a piece for rural women farmer borrowers and non borrowers. Instrument of data collection was a set of structured and pre-tested questionnaire administered on both groups of rural women farmers. The result indicated that incidence of poverty or head count ratio was 0.558 for the rural women farmers borrowers and 0.933 for the rural women farmer non borrowers; poverty gap otherwise known as income short fall was 0.4547 for the rural women farmer borrowers and 0.6995 for the rural women farmer non borrowers. The result of the paired t-test showed that micro-finance impacted significantly on annual farm income, farm size and fertilizer use level of rural women farmer borrowers at given levels of significance. It was however, recommended that increased subsidy policy on agro-inputs and increased funding by the micro-finance will significantly aim at reducing the poverty levels of these women.

Food insecurity among people with severe mental disorder in a rural Ethiopian setting: a comparative, population-based study.

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Tirfessa, K; Lund, C; Medhin, G; Hailemichael, Y; Fekadu, A; Hanlon, C

2017-11-16

In low-income African countries, ensuring food security for all segments of the population is a high priority. Mental illness is associated consistently with poverty, but there is little evidence regarding the association with food insecurity. The aim of this study was to compare the levels of food insecurity in people with severe mental disorders (SMD) with the general population in a rural African setting with a high burden of food insecurity. Households of 292 community-ascertained people with a specialist-confirmed diagnosis of SMD (including schizophrenia and bipolar disorder) were compared with 284 households without a person with SMD in a rural district in south Ethiopia. At the time of the study, no mental health services were available within the district. Food insecurity was measured using a validated version of the Household Food Insecurity Access Scale. Disability was measured using the World Health Organisation Disability Assessment Schedule 2.0. Severe household food insecurity was reported by 32.5% of people with SMD and 15.9% of respondents from comparison households: adjusted odds ratio 2.82 (95% confidence interval 1.62 to 4.91). Higher annual income was associated independently with lower odds of severe food insecurity. When total disability scores were added into the model, the association between SMD and food insecurity became non-significant, indicating a possible mediating role of disability. Efforts to alleviate food insecurity need to target people with SMD as a vulnerable group. Addressing the disabling effects of SMD would also be expected to reduce food insecurity. Access to mental health care integrated into primary care is being expanded in this district as part of the Programme for Improving Mental health carE (PRIME). The impact of treatment on disability and food insecurity will be evaluated.

The Eco-Behavioral Approach to Surveys and Social Accounts for Rural Communities: Exploratory Analyses and Interpretations of Roger G. Barker's Microdata from the Behavior Setting Survey of Midwest, Kansas in 1963-64.

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Fox, Karl A.

The concept of behavior settings--the environments shaping individual behavior--was originated by Roger Barker in 1950 in connection with his community surveys in a small Kansas town, code-named Midwest. This book seeks to provide rural social scientists with an understanding of Barker's eco-behavioral approach and proposed adaptations of it to…

Appropriate training and retention of community doctors in rural areas: a case study from Mali.

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Van Dormael, Monique; Dugas, Sylvie; Kone, Yacouba; Coulibaly, Seydou; Sy, Mansour; Marchal, Bruno; Desplats, Dominique

2008-11-18

While attraction of doctors to rural settings is increasing in Mali, there is concern for their retention. An orientation course for young practicing rural doctors was set up in 2003 by a professional association and a NGO. The underlying assumption was that rurally relevant training would strengthen doctors' competences and self-confidence, improve job satisfaction, and consequently contribute to retention. Programme evaluation distinguished trainees' opinions, competences and behaviour. Data were collected through participant observation, group discussions, satisfaction questionnaires, a monitoring tool of learning progress, and follow up visits. Retention was assessed for all 65 trainees between 2003 and 2007. The programme consisted of four classroom modules--clinical skills, community health, practice management and communication skills--and a practicum supervised by an experienced rural doctor. Out of the 65 trained doctors between 2003 and 2007, 55 were still engaged in rural practice end of 2007, suggesting high retention for the Malian context. Participants viewed the training as crucial to face technical and social problems related to rural practice. Discussing professional experience with senior rural doctors contributed to socialisation to novel professional roles. Mechanisms underlying training effects on retention include increased self confidence, self esteem as rural doctor, and sense of belonging to a professional group sharing a common professional identity. Retention can however not be attributed solely to the training intervention, as rural doctors benefit from other incentives and support mechanisms (follow up visits, continuing training, mentoring...) affecting job satisfaction. Training increasing self confidence and self esteem of rural practitioners may contribute to retention of skilled professionals in rural areas. While reorientations of curricula in training institutions are necessary, other types of professional support are needed

Energy for rural India

International Nuclear Information System (INIS)

Urban, Frauke; Benders, Rene M.J.; Moll, Henri C.

2009-01-01

About 72 million households in rural India do not have access to electricity and rely primarily on traditional biofuels. This research investigates how rural electrification could be achieved in India using different energy sources and what the effects for climate change mitigation could be. We use the Regional Energy Model (REM) to develop scenarios for rural electrification for the period 2005-2030 and to assess the effects on greenhouse gas emissions, primary energy use and costs. We compare the business-as-usual scenario (BAU) with different electrification scenarios based on electricity from renewable energy, diesel and the grid. Our results indicate that diesel systems tend to have the highest CO 2 emissions, followed by grid systems. Rural electrification with primarily renewable energy-based end-uses could save up to 99% of total CO 2 emissions and 35% of primary energy use in 2030 compared to BAU. Our research indicates that electrification with decentralised diesel systems is likely to be the most expensive option. Rural electrification with renewable energy tends to be the most cost-effective option when end-uses are predominantly based on renewable energy, but turns out to be more costly than grid extensions when electric end-use devices are predominantly used. This research therefore elaborates whether renewable energy is a viable option for rural electrification and climate change mitigation in rural India and gives policy recommendations.

Local management of rural power supply. A new approach in Tanzania

Energy Technology Data Exchange (ETDEWEB)

Gullberg, Monica; Katyega, Maneno; Kjellstroem, Bjoern

1999-07-01

The rural electrification program in Tanzania has been on going since independence in 1961, with the national utility, Tanzania Electric Supply Company Ltd. (TANESCO) being responsible for its implementation. By 1992, 14 townships and 37 villages had been electrified as a result of this program. This covers only a small fraction of rural Tanzania. It is estimated that in 1998, less than 1% of the rural households in Tanzania had access to electricity. Electricity constitutes only 1% of Tanzania's final energy consumption. Except for the few latest years, electricity generation and distribution in Tanzania has been the full responsibility of TANESCO. The national electricity grid is mainly supplied by large-scale hydro power plants (391 MW), and thermal power plants (148 MW). Rural areas are supplied either by a transmission line from the national grid or by diesel generator sets. The isolated branches run by TANESCO have an installed capacity amounting to a total of 23 MW. Electric lighting is the dominating use of electricity in rural areas. Industrial use in these areas is marginal. Very few rural households use electricity for cooking. Cooking is made with fuelwood and to some extent charcoal and kerosene. Where electricity is not available, kerosene in simple wick lamps is used for lighting. As part of the research co-operation between TANESCO and the Stockholm Environment Institute, SEI, an extensive evaluation of the experiences from the rural electrification program in Tanzania was carried out in 1989 - 1991. The four main conclusions from this evaluation were in summary: The rural people appreciate electrification. Rural electrification is a large financial burden on TANESCO. The quality of the service, in particular the supply reliability, is low in rural areas. Many of the perceived benefits of rural electrification, like the creation of small scale industries or reduced use of fuel wood for cooking, have not materialised to a significant degree. As

Factors Influencing Livelihood Diversification among Rural Farmers ...

African Journals Online (AJOL)

This research study was set out to analyze factors influencing rural farmer's engagement in livelihood diversification in the study area. The specific objectives were; to identify the different levels of farmers' engagement in livelihood diversification, determine the socio-demographic factors or forces that influence farmers' ...

Body mass index and self-perception of overweight and obesity in rural, urban and rural-to-urban migrants: PERU MIGRANT study.

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Christian Loret de Mola

Full Text Available This study aimed to compare self-reported weight and body mass index (BMI in order to determine discrepancies between subjective and objective obesity-related markers, and possible explanatory factors of overweight and obesity underestimation, in urban, rural and migrant populations.Data from the PERU MIGRANT study, a cross-sectional study, in low-income settings, of urban, migrant (rural-to-urban, and rural groups, including BMI, self-reported weight and socio-demographic indicators were analyzed. Percentage of concurrences between BMI and self-reported weight and Kappa coefficients for inter-rater agreement were calculated. Univariate and standardized descriptive analyses were performed to identify potential explanatory variables for weight underestimation in only overweight and obese individuals, using established BMI and waist circumference cut offs.983 Participants-199 urban, 583 migrants and 201 rural-were analyzed. Based on BMI, overall prevalence of obesity was 20.1% (95% CI 17.6%-22.6%, and overweight was 38.3% (95% CI 35.2%-41.2%, with differences between study groups (p<0.001. Only 43% of the whole sample had matching self-reported weight and BMI status, whereas 54% underestimated and 3% overestimated their BMI category. Kappa coefficient, between BMI and self-reported weight, for the entire sample was 0.16, rural residents had the lowest coefficient (0.01 and the most underestimation, especially in the overweight category. In overweight and obese individuals, deprivation index (p = 0.016, age (p = 0.014 and waist circumference (p<0.001 were associated with weight underestimation.Overall, high levels of overweight, obesity, and underestimation of BMI status were found, with poor agreement between BMI and self-reported weight, showing the unawareness of weight status severity in this low-income setting.

Smoking and heavy drinking patterns in rural, urban and rural-to-urban migrants: the PERU MIGRANT Study

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Alvaro Taype-Rondan

2017-02-01

Full Text Available Abstract Background Previous studies have found mixed results about cigarette and alcohol consumption patterns among rural-to-urban migrants. Moreover, there are limited longitudinal data about consumption patterns in this population. As such, this study aimed to compare the smoking and heavy drinking prevalence among rural, urban, and rural-to-urban migrants in Peru, as well as the smoking and heavy drinking incidence in a 5-year follow-up. Methods We analyzed the PERU MIGRANT Study data from rural, urban, and rural-to-urban migrant populations in Peru. The baseline study was carried out in 2006–2007 and follow-up was performed five years later. For the baseline data analysis, the prevalence of lifetime smoking, current smokers, and heavy drinking was compared by population group using prevalence ratios (PR and 95% confidence intervals (95% CI. For the longitudinal analysis, the incidence of smoking and heavy drinking was compared by population group with risk ratios (RR and 95% CI. Poisson regression with robust variance was used to calculate both PRs and RRs. Results We analyzed data from 988 participants: 200 rural dwellers, 589 migrants, and 199 urban dwellers. Compared with migrants, lifetime smoking prevalence was higher in the urban group (PR = 2.29, 95% CI = 1.64–3.20, but lower in the rural group (PR = 0.55, 95% CI = 0.31–0.99. Compared with migrants, the urban group had a higher current smoking prevalence (PR = 2.29, 95% CI = 1.26–4.16, and a higher smoking incidence (RR = 2.75, 95% CI = 1.03–7.34. Current smoking prevalence and smoking incidence showed no significant difference between rural and migrant groups. The prevalence and incidence of heavy drinking was similar across the three population groups. Conclusions Our results show a trend in lifetime smoking prevalence (urban > migrant > rural, while smoking incidence was similar between migrant and rural groups, but higher in the

THE RURAL TOURISM IN DANUBE DELTA

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Ionica SOARE

2014-06-01

Full Text Available Purpose - the purpose of this paper is to evaluate the rural areas has market size and forecast its development as an economic activity. The present paper aims at analyzing the rural areas has in Danube Delta. In an enviable BAs which have responsibility for their particular isolated, such as the Danube Delta and the Danube that used, fishing and rural areas has the main activities that provide jobs and income sources for local populations. Design/methodology/approach - A survey was administered to customers’ rural hostel accommodation in Danube Delta. Descriptive statistics method was mainly adopted to calculate the mean with standard deviation of entry assumes variable, and to examine the different levels of consumers' awareness. The index values of product familiarity, the ratio between entries assumes product's familiarity value and the average value. Findings - the research results show hash has rural consumers have different perception and accomplished through behaviour. The information channels of brand hash mainly from friends, relatives and neighbours, so word of mouth spreading is very important for a brand. Women show a higher sensitivity in health and are currently operating the propensity than referred to follow the recommendations for nutrition. Research limitations/implications - This item is intended to synthesize developments and challenges," on June 13th rural market growth has. The results of this paper should be considered tentatively until has also features replicated by larger has rural consumers. Originality/value - members of rural areas has consumer's behavior would improve marketing and the development of rural areas has products, in order to reduce consumer confusion.

Critical reflections on the New Rurality and the rural territorial development approaches in Latin America

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César Ramírez-Miranda

2014-04-01

Full Text Available This paper presents a critical approach to the New Rurality and the Rural Territorial Development (RTD perspectives, which nowadays are hegemonic for governmental organizations and Latin American academies. RTD's core requirements, which are functional for neoliberal policies resulting in the loss of food sovereignty, the globalization of agribusinesses, and migration as a consequence of peasant agricultural weakening, were critically reviewed on the basis of the principal challenges faced by Latin American rural areas. In light of the above consequences, it is thought that changes in such areas are based on neoliberal rurality rather than on the purported New Rurality. By stressing the need for a global historical view that reintroduces the Latin American critical thinking tradition, the urgency for public policies that stop neoliberal prescriptions and seek to strengthen peasant and indigenous agriculture in order to encourage rural development based on food sovereignty, democracy, equity and sustainability were established.

Evaluation on Optimal Scale of Rural Fixed-asset Investment – Based on Microcosmic Perspective of Farmers’ Income Increase

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DENG, Jinqian; SHAN, Kangkang; ZHANG, Yan

2014-01-01

The rural fundamental and productive fixed-asset investment not only makes active influence on the changes of farmers’ operational, wages and property income, but it also has an optimal scale range for farmers’ income increase. From the perspective of farmers’ income increase, this article evaluates the optimal scale of rural fixed-asset investment by setting up model with statistic data, and the results show that the optimal scale of per capita rural fixed-asset investment is 76.35% of...

Application of Greenhouse Gas Inventory to Urban Rural Planning in China

Institute of Scientific and Technical Information of China (English)

Stanley; C.; T.; YIP

2013-01-01

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

Detecting the changes in rural communities in Taiwan by applying multiphase segmentation on FORMOSA-2 satellite imagery

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Huang, Yishuo

2015-09-01

regions containing roads, buildings, and other manmade construction works and the class with high values of NDVI indicates that those regions contain vegetation in good health. In order to verify the processed results, the regional boundaries were extracted and laid down on the given images to check whether the extracted boundaries were laid down on buildings, roads, or other artificial constructions. In addition to the proposed approach, another approach called statistical region merging was employed by grouping sets of pixels with homogeneous properties such that those sets are iteratively grown by combining smaller regions or pixels. In doing so, the segmented NDVI map can be generated. By comparing the areas of the merged classes in different years, the changes occurring in the rural communities of Taiwan can be detected. The satellite imagery of FORMOSA-2 with 2-m ground resolution is employed to evaluate the performance of the proposed approach. The satellite imagery of two rural communities (Jhumen and Taomi communities) is chosen to evaluate environmental changes between 2005 and 2010. The change maps of 2005-2010 show that a high density of green on a patch of land is increased by 19.62 ha in Jhumen community and conversely a similar patch of land is significantly decreased by 236.59 ha in Taomi community. Furthermore, the change maps created by another image segmentation method called statistical region merging generate similar processed results to multiphase segmentation.

Rurality study of restricted areas

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Sergio Rivaroli

2011-02-01

Full Text Available Two main perspectives of investigation emerge from the study of a territory’s rurality: a geographical approach and a sociological approach. The research examines the sub-regional study case of ‘Nuovo circondario imolese’. The analysis shows that the combination of traditional institutional criteria with detailed informations about the territory, generates more accurate results which determine a better comprehension of the characteristics of restricted areas’ rurality. Over the period 1991-2001, the study highlights an increase in rural areas. This result could be interpreted as an effect of urban sprawl’s intensification, that increases the competition between non-farm residences and agricultural activities.

Role of Papanicolaou Smear in the Diagnosis of Pathologic Flora in Asymptomatic Patients in Rural Health Care Set-Up

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Siona Sabu

2017-10-01

Full Text Available Introduction: The infections of female genital tract, especially the cervix are asymptomatic in presentation and pose a diagnostic challenge. Vaginal infections can lead to cytoplasmic and nuclear abnormalities in the epithelial cells. Additionally, these infections could augur an inflammatory response of varying nature. The most common flora include Candida albicans, Gardnerella vaginalis, Trichomonas vaginalis, Human Papilloma Virus (HPV, Human Herpes Virus (HHV and Actinomyces sp. Aim: This study seeks to measure the role of Papanicolaou smear in detection of pathologic flora: Candida albicans, Gardnerella vaginalis, Trichomonas vaginalis, HPV, HHV and Actinomyces; in a rural health care set up amongst women in the reproductive and menopausal age group. Materials and Methods: A retrospective study of cervical smears by Papanicolaou method, over a 14 month period was carried out in a tertiary care centre including a total number of 150 patients. Results: Of the total of 150 samples examined, Candida species was the most frequently detected (8.7% followed by Trichomonas vaginalis (5.3% and Gardnerella vaginalis species (4.7%. HPV-induced changes were noted in a mere 2% of cases. Actinomyces species was noted in less than 1% of cases. Conclusion: The Papanicolaou test for examining cervical smear has definite uses in detecting vaginal microorganisms. Apart from detection of the usual pathogenic flora, the test has utility in defining the degree of inflammation and additional reparative changes.

Leading the rebirth of the rural obstetrician.

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Campbell, Alison M; Brown, James; Simon, David R; Young, Sari; Kinsman, Leigh

2014-12-11

To understand the factors influencing the decisions of rural general practitioners and GP registrars to practise obstetrics, and to understand the impact on these decisions of an innovative obstetric training and support program in the Gippsland region of Victoria. Qualitative approach using semistructured interviews conducted in July and August 2013 and inductive content analysis. Participants were identified from training records over the previous 5 years for the Gippsland GP obstetric training and support program. Two questions were posed during interviews: What challenges face rural GPs in practising obstetrics? What impact has the Gippsland GP obstetric program had on GP obstetric career decisions? Of 60 people invited to participate, 22 agreed. Interviews ranged in duration from 40 to 90 minutes. The major themes that emerged on the challenges facing rural GPs in practising obstetrics were isolation, work-life balance and safety. The major themes that emerged on the impact of the Gippsland GP obstetric program were professional support, structured training and effective leadership. Rural GP obstetricians are challenged by isolation, the impact of their job on work-life balance, and safety. The support, training and leadership offered by the Gippsland expanded obstetric training program helped doctors to deal with these challenges. The Gippsland model of training offers a template for GP obstetric procedural training programs for other rural settings.

An evaluation of the impact of a restrictive retail food environment intervention in a rural community pharmacy setting

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Leia M. Minaker

2016-07-01

Full Text Available Abstract Background Sugar-sweetened beverage consumption is associated with morbidity and mortality. The retail food environment influences food and beverage purchasing and consumption. This study assesses the impact of a community pharmacy’s removal of sweet beverages on overall community sales of carbonated soft drinks (CSD in a rural setting. We also examined whether the pharmacy intervention affected CSD sales in the town’s other food stores. Methods Weekly CSD sales data were acquired from the three food retailers in the town of Baddeck, Nova Scotia (January 1, 2013 to May 8, 2015, n = 123 weeks. Autoregressive integrated moving average (ARIMA analysis was used to analyse the interrupted time series data and estimate the impact of the pharmacy intervention (September 11, 2014 on overall CSD sales at the community level. Data were analysed in 2015. Results Before the intervention, the pharmacy accounted for approximately 6 % of CSD sales in the community. After the intervention, declines in total weekly average community CSD sales were not statistically significantly. CSD sales at the other food stores did not increase after the pharmacy intervention. Conclusions This study was among the first to examine the impact of a restrictive retail food environment intervention, and found a non-significant decline in CSD sales at the community level. It is the first study to examine a retail food environment intervention in a community pharmacy. Pharmacies may have an important role to play in creating healthy retail food environments.

Aproximación a las percepciones y orientaciones de los jóvenes ante el futuro del medio rural en Extremadura Aproximación a las percepciones y orientaciones de los jóvenes ante el futuro del medio rural en Extremadura

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Marcelo Sánchez-oro Sánchez

2008-04-01

Full Text Available In this essay, we will try a certain approach to the intangible aspects of rural development, a contribution to the knowledge of idiosyncrasy of people living in rural areas, studying the perceptions and bearings of young people that live or dwell in rural areas in Extremadura. Deep changes taking place in rural environment bring about a new set of values and beliefs towards the future. We would like to find out whether the apprehension of life that young people of rural extraction show is turning to a fresh set of values apprising non-material advantages of the rural environment. In fact, our target is to find out their spirits and their perception of the possibility that, regardless of the demographic decline in rural areas, villages would come up again. In short, we state in this essay some approaches to the following topics: the level of concern about the problems regarding rural environment, the symbolic insight into rural life, the upbringing of youngsters under a new set of values, their labour and carrier expectancies and life prospects for young students of rural extraction.Este artículo trata de exponer una manera de abordar los aspectos intangibles en el desarrollo rural, es decir, una contribución al conocimiento de la mentalidad de los que habitan en el medio rural a través de las percepciones y orientaciones de los jóvenes estudiantes rurales de Extremadura. Las transformaciones que afectan al medio rural introducen nuevos órdenes de valores y creencias de cara al futuro. Se trata de saber si las valoraciones de los jóvenes de los pueblos están girando hacia el nuevo paradigma de la funcionalidad no material del medio rural. En última instancia, se trata de conocer su estado de ánimo de cara al futuro y si comienza a valorarse la posibilidad de recuperación de los pueblos pese al declive de las zonas rurales de las últimas décadas (González J. J y Gómez Benito. 2002b:201. En concreto, en este trabajo se desarrollan

Degradation of rural and urban great tit song: testing transmission efficiency.

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Emily J Mockford

Full Text Available Acoustic signals play a fundamental role in avian territory defence and mate attraction. Several studies have now shown that spectral properties of bird song differ between urban and rural environments. Previously this has been attributed to competition for acoustic space as a result of low-frequency noise present in cities. However, the physical structure of urban areas may have a contributory effect. Here we investigate the sound degradation properties of woodland and city environments using both urban and rural great tit song. We show that although urban surroundings caused significantly less degradation to both songs, the transmission efficiency of rural song compared to urban song was significantly lower in the city. While differences between the two songs in woodland were generally minimal, some measures of the transmission efficiency of rural song were significantly lower than those of urban song, suggesting additional benefits to singing rural songs in this setting. In an attempt to create artificial urban song, we mimicked the increase in minimum frequency found several times previously in urban song. However, this did not replicate the same transmission properties as true urban song, suggesting changes in other song characteristics, such as temporal adjustments, are needed to further increase transmission of an avian signal in the city. We suggest that the structure of the acoustic environment, in addition to the background noise, plays an important role in signal adaptation.

The influences of Taiwan's National Health Insurance on women's choice of prenatal care facility: Investigation of differences between rural and non-rural areas

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Chen Chi-Liang

2008-03-01

Full Text Available Abstract Background Taiwan's National Health Insurance (NHI, implemented in 1995, substantially increased the number of health care facilities that can deliver free prenatal care. Because of the increase in such facilities, it is usually assumed that women would have more choices regarding prenatal care facilities and thus experience reduction in travel cost. Nevertheless, there has been no research exploring these issues in the literature. This study compares how Taiwan's NHI program may have influenced choice of prenatal care facility and perception regarding convenience in transportation for obtaining such care for women in rural and non-rural areas in Taiwan. Methods Based on data collected by a national survey conducted by Taiwan's National Health Research Institutes (NHRI in 2000, we tried to compare how women chose prenatal care facility before and after Taiwan's National Health Insurance program was implemented. Basing our analysis on how women answered questionnaire items regarding "the type of major health care facility used and convenience of transportation to and from prenatal care facility," we investigated whether there were disparities in how women in rural and non-rural areas chose prenatal care facilities and felt about the transportation, and whether the NHI had different influences for the two groups of women. Results After NHI, women in rural areas were more likely than before to choose large hospitals for prenatal care services. For women in rural areas, the relative probability of choosing large hospitals to choosing non-hospital settings in 1998–1999 was about 6.54 times of that in 1990–1992. In contrast, no such change was found in women in non-rural areas. For a woman in a non-rural area, she was significantly more likely to perceive the transportation to and from prenatal care facilities to be very convenient between 1998 and 1999 than in the period between 1990 and 1992. No such improvement was found for women in

Rural/Nonrural Differences in College Attendance Patterns.

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Byun, Soo-Yong; Irvin, Matthew J; Meece, Judith L

Using data from the National Education Longitudinal Study of 1988, this study documented college attendance patterns of rural youth in terms of the selectivity of first postsecondary institution of attendance, the timing of transition to postsecondary education, and the continuity of enrollment. The study also examined how these college attendance patterns among rural students differed from those among their non-rural counterparts and which factors explained these rural/nonrural differences. Results showed that rural youth were less likely than their nonrural counterparts to attend a selective institution. In addition, rural youth were more likely to delay entry to postsecondary education, compared to their urban counterparts. Finally, rural students were less likely than their urban counterparts to be continuously enrolled in college. Much of these rural/nonrural disparities in college attendance patterns were explained by rural/nonrural differences in socioeconomic status and high school preparation. Policy implications, limitations of the study, and future research directions are also discussed.

Educating Physicians for Rural America: Validating Successes and Identifying Remaining Challenges With the Rural Medical Scholars Program.

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Wheat, John R; Leeper, James D; Murphy, Shannon; Brandon, John E; Jackson, James R

2018-02-01

To evaluate the Rural Medical Scholars (RMS) Program's effectiveness to produce rural physicians for Alabama. A nonrandomized intervention study compared RMS (1997-2002) with control groups in usual medical education (1991-2002) at the University of Alabama School of Medicine's main and regional campuses. Participants were RMS and others admitted to regular medical education, and the intervention was the RMS Program. Measures assessed the percentage of graduates practicing in rural areas. Odds ratios compared effectiveness of producing rural Alabama physicians. The RMS Program (N = 54), regional campuses (N = 182), and main campus (N = 649) produced 48.1% (odds ratio 6.4, P rural physicians, respectively. The RMS Program, contrasted to other local programs of medical education, was effective in producing rural physicians. These results were comparable to benchmark programs in the Northeast and Midwest USA on which the RMS Program was modeled, justifying the assumption that model programs can be replicated in different regions. However, this positive effect was not shared by a disparate rural minority population, suggesting that models for rural medical education must be adjusted to meet the challenge of such communities for physicians. © 2017 National Rural Health Association.

Adverse selection in a voluntary Rural Mutual Health Care health insurance scheme in China.

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Wang, Hong; Zhang, Licheng; Yip, Winnie; Hsiao, William

2006-09-01

This study examines adverse selection in a subsidized voluntary health insurance scheme, the Rural Mutual Health Care (RMHC) scheme, in a poor rural area of China. The study was made possible by a unique longitudinal data set: the total sample includes 3492 rural residents from 1020 households. Logistic regression was employed for the data analysis. The results show that although this subsidized scheme achieved a considerable high enrollment rate of 71% of rural residents, adverse selection still exists. In general, individuals with worse health status are more likely to enroll in RMHC than individuals with better health status. Although the household is set as the enrollment unit for the RMHC for the purpose of reducing adverse selection, nearly 1/3 of enrolled households are actually only partially enrolled. Furthermore, we found that adverse selection mainly occurs in partially enrolled households. The non-enrolled individuals in partially enrolled households have the best health status, while the enrolled individuals in partially enrolled households have the worst health status. Pre-RMHC, medical expenditure for enrolled individuals in partially enrolled households was 206.6 yuan per capita per year, which is 1.7 times as much as the pre-RMHC medical expenditure for non-enrolled individuals in partially enrolled households. The study also reveals that the pre-enrolled medical expenditure per capita per year of enrolled individuals was 9.6% higher than the pre-enrolled medical expenditure of all residents, including both enrolled and non-enrolled individuals. In conclusion, although the subsidized RMHC scheme reached a very high enrollment rate and the household is set as the enrollment unit for the purpose of reducing adverse selection, adverse selection still exists, especially within partially enrolled households. Voluntary RMHC will not be financially sustainable if the adverse selection is not fully taken into account.

Social trust and grassroots governance in rural China.

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Huhe, Narisong; Chen, Jie; Tang, Min

2015-09-01

The relationship between social trust and governance has been one of the focal points of the academic and policy-making communities. Empirical studies on this relationship, however, have focused mostly on democracies. The scarcity of such studies in authoritarian countries has left many important questions unanswered: Is social trust associated with effective governance only in democratic settings? Can social trust improve the quality of governance in non-democracies as well? Drawing on data from 2005 China General Social Survey-a representative survey conducted nationwide at both the individual- and village-level in rural China, this paper attempts to answer these questions empirically by examining the relationship between social trust and the quality of governance in rural China. The findings reveal that different types of social trust-particularized trust and generalized trust-correspond with different effects in rural governance: whereas villagers' trust in people whom they knew personally was positively and significantly associated with the provision of various public goods and services, their trust in strangers had virtually no impact on rural governance. Copyright © 2015 Elsevier Inc. All rights reserved.

Disparities in the Utilization of Laparoscopic Surgery for Colon Cancer in Rural Nebraska: A Call for Placement and Training of Rural General Surgeons.

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Gruber, Kelli; Soliman, Amr S; Schmid, Kendra; Rettig, Bryan; Ryan, June; Watanabe-Galloway, Shinobu

2015-01-01

Advances in medical technology are changing surgical standards for colon cancer treatment. The laparoscopic colectomy is equivalent to the standard open colectomy while providing additional benefits. It is currently unknown what factors influence utilization of laparoscopic surgery in rural areas and if treatment disparities exist. The objectives of this study were to examine demographic and clinical characteristics associated with receiving laparoscopic colectomy and to examine the differences between rural and urban patients who received either procedure. This study utilized a linked data set of Nebraska Cancer Registry and hospital discharge data on colon cancer patients diagnosed and treated in the entire state of Nebraska from 2008 to 2011 (N = 1,062). Multiple logistic regression analysis was performed to identify predictors of receiving the laparoscopic treatment. Rural colon cancer patients were 40% less likely to receive laparoscopic colectomy compared to urban patients. Independent predictors of receiving laparoscopic colectomy were younger age (colon cancer and important disparities exist for rural cancer patients in accessing the specialized treatment. As cancer treatment becomes more specialized, the importance of training and placement of general surgeons in rural communities must be a priority for health care planning and professional training institutions. © 2015 National Rural Health Association.

The Consortium for Evidence Based Research in Rural Educational Settings (CEBRRES): Applying Collaborative Action Research as a Means of Enhancing the Development of Rural Middle School Science Teachers

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Wulff, A. H.

2006-05-01

Kentucky ranks third in the U.S. in need of rural education attention. Rural schools in Kentucky serve nearly 40% of the total student population, and graduation rates and NAEP scores are low. A two-year pilot study is being completed addressing psychological, social, and content knowledge based constructs, as they apply to science and mathematics achievement in rural environments. The goals are to identify the key aspects of rural teachers knowledge and skills, use a framework to describe how knowledge and skills develop in the rural classroom, apply a useful model of intervention to promote teacher development and increased student learning. If proven successful the knowledge can be incorporated into the practice of current teaching and preservice pedagogical methods. The problem that was identified and addressed by CEBRRES is the high level of student disengagement and the shortage of rigorous stimulating curriculum models. The action taken was the development and implementation of model eliciting activities. Teachers at the target school were expected to utilize action research methodology to execute model-eliciting activities in the classroom, and then communicate results in forms that are useful for other teachers. Benefits to teachers included stipends, increased science content depth and breadth, support to achieve "highly qualified teacher status", extensive professional development, and technology, equipment, and supplies for their school. Survey instruments were devised to address school perceptions (61% worry that they are not doing well enough in school), future plans (80% expect to attend college vs. the current 47.5%), various self concepts, academic self concepts (23% feel that learning is difficult for them), and family self concepts. Science was identified by the students as the subject that interests them the most, followed by math, yet Kentucky ranks near the bottom of the U.S. in math and science training in the workplace. Geology

Predicting prediabetes in a rural community: a survey among the Karen ethnic community, Thasongyang, Thailand

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Lorga T

2012-03-01

Full Text Available Thaworn Lorga1, Myo Nyein Aung1,2, Prissana Naunboonruang1, Payom Thinuan1, Nara Praipaksin3, Tida Deesakul3, Utumporn Inwan3, Tawatchai Yingtaweesak4, Pratumpan Manokulanan1, Srisomporn Suangkaew1, Apiradee Payaprom41Boromarajonani College of Nursing Nakhon Lampang (BCNLP, Lampang, Thailand; 2Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan; 3Baan Rekati Health Station, Thasongyang, Tak, Thailand; 4Thasongyang Hospital, Thasongyang, Tak, ThailandBackground: Diabetes is a growing epidemic in both urban and rural communities worldwide.Aim: We aimed to survey fasting plasma glucose (FPG status and awareness of diabetes in the rural Karen ethnic community. We investigated the predictors of impaired fasting plasma glucose (IFG status, which would be easily applicable for prevention of diabetes in a rural community.Materials and methods: This was a community-based cross-sectional study conducted at Thasongyang, the most north-western district in Thailand. A total of 299 Karen ethnic rural residents were included in the study. FPG, body mass index, and waist circumference were prospectively measured. We assessed the awareness of diabetes and lifestyle-related health behavior with closed questionnaires in a rural community setting.Results: On screening for FPG, 16.72% of the Karen ethnic residents had hyperglycemia: 3.68% in the diabetic range and 13.04% in the prediabetic range respectively. After adjustment for age, sex, and BMI, waist circumference (adjusted odds ratio [aOR] 3.5, 95% confidence interval [CI] 1.29–9.57, and having a diabetic blood relative (aOR 4.6, CI 1.81–11.71 are significant predictors of IFG status.Conclusion: It is necessary to promote awareness of diabetes among the Karen ethnic community. Application of simple evidence-based predictors of the prediabetic state may lead to timely and effective prevention of diabetes in rural settings.Keywords: diabetes, prediabetes, fasting plasma

Recruiting and retaining high-quality teachers in rural areas.

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Monk, David H

2007-01-01

In examining recruitment and retention of teachers in rural areas, David Monk begins by noting the numerous possible characteristics of rural communities--small size, sparse settlement, distance from population concentrations, and an economic reliance on agricultural industries that are increasingly using seasonal and immigrant workers to minimize labor costs. Many, though not all, rural areas, he says, are seriously impoverished. Classes in rural schools are relatively small, and teachers tend to report satisfaction with their work environments and relatively few problems with discipline. But teacher turnover is often high, and hiring can be difficult. Monk observes that rural schools have a below-average share of highly trained teachers. Compensation in rural schools tends to be low, perhaps because of a lower fiscal capacity in rural areas, thus complicating efforts to attract and retain teachers. Several student characteristics, including relatively large shares of students with special needs and with limited English skills and lower shares of students attending college, can also make it difficult to recruit and retain high-quality teachers. Other challenges include meeting the needs of highly mobile children of low-income migrant farm workers. With respect to public policy, Monk asserts a need to focus on a subcategory of what might be called hard-to-staff rural schools rather than to develop a blanket set of policies for all rural schools. In particular, he recommends a focus on such indicators as low teacher qualifications, teaching in fields far removed from the area of training, difficulty in hiring, high turnover, a lack of diversity among teachers in the school, and the presence of migrant farm workers' children. Successful efforts to stimulate economic growth in these areas would be highly beneficial. He also calls attention to the potential for modern telecommunication and computing technologies to offset some of the drawbacks associated with teaching

Distinct clinical characteristics and helminth co-infections in adult tuberculosis patients from urban compared to rural Tanzania.

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Sikalengo, George; Hella, Jerry; Mhimbira, Francis; Rutaihwa, Liliana K; Bani, Farida; Ndege, Robert; Sasamalo, Mohamed; Kamwela, Lujeko; Said, Khadija; Mhalu, Grace; Mlacha, Yeromin; Hatz, Christoph; Knopp, Stefanie; Gagneux, Sébastien; Reither, Klaus; Utzinger, Jürg; Tanner, Marcel; Letang, Emilio; Weisser, Maja; Fenner, Lukas

2018-03-24

Differences in rural and urban settings could account for distinct characteristics in the epidemiology of tuberculosis (TB). We comparatively studied epidemiological features of TB and helminth co-infections in adult patients from rural and urban settings of Tanzania. Adult patients (≥ 18 years) with microbiologically confirmed pulmonary TB were consecutively enrolled into two cohorts in Dar es Salaam, with ~ 4.4 million inhabitants (urban), and Ifakara in the sparsely populated Kilombero District with ~ 400 000 inhabitants (rural). Clinical data were obtained at recruitment. Stool and urine samples were subjected to diagnose helminthiases using Kato-Katz, Baermann, urine filtration, and circulating cathodic antigen tests. Differences between groups were assessed by χ 2 , Fisher's exact, and Wilcoxon rank sum tests. Logistic regression models were used to determine associations. Between August 2015 and February 2017, 668 patients were enrolled, 460 (68.9%) at the urban and 208 (31.1%) at the rural site. Median patient age was 35 years (interquartile range [IQR]: 27-41.5 years), and 454 (68%) were males. Patients from the rural setting were older (median age 37 years vs. 34 years, P = 0.003), had a lower median body mass index (17.5 kg/m 2 vs. 18.5 kg/m 2 , P urban Tanzania. There was no significant difference in frequencies of HIV infection, diabetes mellitus, and haemoglobin concentration levels between the two settings. The overall prevalence of helminth co-infections was 22.9% (95% confidence interval [CI]: 20.4-27.0%). The significantly higher prevalence of helminth infections at the urban site (25.7% vs. 17.3%, P = 0.018) was predominantly driven by Strongyloides stercoralis (17.0% vs. 4.8%, P rural setting (adjusted odds ratio [aOR]: 3.97, 95% CI: 1.16-13.67) and increasing age (aOR: 1.06, 95% CI: 1.02-1.10). Clinical characteristics and helminth co-infections pattern differ in TB patients in urban and rural Tanzania. The

Instrumental and socioemotional communications in doctor-patient interactions in urban and rural clinics.

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Desjarlais-deKlerk, Kristen; Wallace, Jean E

2013-07-08

Location of practice, such as working in a rural or urban clinic, may influence how physicians communicate with their patients. This exploratory pilot study examines the communication styles used during doctor-patient interactions in urban and rural family practice settings in Western Canada. We analyzed observation and interview data from four physicians practicing in these different locations. Using a grounded theory approach, communications were categorized as either instrumental or socioemotional. Instrumental communication refers to "cure-oriented interactions" and tends to be more task-oriented focusing on the patient's health concerns and reason for the appointment. In contrast, socioemotional communication refers to more "care-oriented interactions" that may make the patient feel comfortable, relieve patient anxiety and build a trusting relationship. The physicians in small, rural towns appear to know their patients and their families on a more personal level and outside of their office, and engage in more socioemotional communications compared to those practicing in suburban clinics in a large urban centre. Knowing patients outside the clinic seems to change the nature of the doctor-patient interaction, and, in turn, the doctor-patient relationship itself. Interactions between urban doctors and their patients had a mixture of instrumental and socioemotional communications, while interactions between rural doctors and their patients tended to be highly interpersonal, often involving considerable socioemotional communication and relationship-building. Despite the different ways that doctors and patients communicate with each other in the two settings, rural and urban doctors spend approximately the same amount of time with their patients. Thus, greater use of socioemotional communication by rural doctors, which may ease patient anxiety and increase patient trust, did not appear to add extra time to the patient visit. Research suggests that socioemotional

The Practice of Midwifery in Rural US Hospitals.

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Kozhimannil, Katy B; Henning-Smith, Carrie; Hung, Peiyin

2016-07-01

Workforce shortages limit access to care for pregnant women in rural and remote areas. The goal of this analysis was to describe the role of certified nurse-midwives (CNMs) in providing maternity care in rural US hospitals and to examine state-level variation in rural CNM practice. We identified 306 rural hospitals with at least 10 births in 2010 using discharge data from the Statewide Inpatient Databases for 9 US states. We conducted a telephone survey of hospital maternity unit managers (N = 244) from November 2013 to March 2014 to understand their maternity care workforce and practice models. We describe the presence of CNMs attending births by hospital and state characteristics. Using logistic multivariate regression, we examined whether CNMs attend births, adjusting for hospital characteristics, practice regulations, and state. We also analyzed the content of open-ended responses about staffing plans, challenges, and opportunities that unit managers identified, with a focus on midwifery practice. CNMs attend births at one-third of rural maternity hospitals in 9 US states. Significant variability across states appears to be partially related to autonomous practice regulations: states allowing autonomous midwifery practice have a greater proportion of rural hospitals with midwives attending births (34% vs 28% without autonomous midwifery practice). In rural maternity hospitals, CNMs practice alongside obstetricians in 86%, and with family physicians in 44%, of hospitals. Fourteen percent of all respondents planned recruitment to increase the number of midwives at their hospital, although many, especially in smaller hospitals, noted challenges in doing so. CNMs play a crucial role in the maternity care workforce in rural US hospitals. The participation of CNMs in birth attendance varies by hospital birth volume and across state settings. Interprofessional practice is common for CNMs attending births in rural hospitals, and administrators hope to increase the

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

African Journals Online (AJOL)

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

Work of female rural doctors.

Science.gov (United States)

Wainer, Jo

2004-04-01

To identify the impact of family life on the ways women practice rural medicine and the changes needed to attract women to rural practice. Census of women rural doctors in Victoria in 2000, using a self-completed postal survey. General and specialist practice. Two hundred and seventy-one female general practitioners and 31 female specialists practising in Rural, Remote and Metropolitan Area Classifications 3-7. General practitioners are those doctors with a primary medical degree and without additional specialist qualifications. Interaction of hours and type of work with family responsibilities. Generalist and specialist women rural doctors carry the main responsibility for family care. This is reflected in the number of hours they work in clinical and non-clinical professional practice, availability for on-call and hospital work, and preference for the responsibilities of practice partnership or the flexibility of salaried positions. Most of the doctors had established a satisfactory balance between work and family responsibilities, although a substantial number were overworked in order to provide an income for their families or meet the needs of their communities. Thirty-six percent of female rural general practitioners and 56% of female rural specialists preferred to work fewer hours. Female general practitioners with responsibility for children were more than twice as likely as female general practitioners without children to be in a salaried position and less likely to be a practice partner. The changes needed to attract and retain women in rural practice include a place for everyone in the doctor's family, flexible practice structures, mentoring by women doctors and financial and personal recognition. Women make up less than a quarter of the rural general practice workforce and an even smaller percentage of the specialist rural medical workforce. As a result their experiences are not well articulated in research on rural medical practice and their needs are

Rural health workers and their work environment: the role of inter-personal factors on job satisfaction of nurses in rural Papua New Guinea

Science.gov (United States)

2012-01-01

Background Job satisfaction is an important focal attitude towards work. Understanding factors that relate to job satisfaction allows interventions to be developed to enhance work performance. Most research on job satisfaction among nurses has been conducted in acute care settings in industrialized countries. Factors that relate to rural nurses are different. This study examined inter-personal, intra-personal and extra-personal factors that influence job satisfaction among rural primary care nurses in a Low and Middle Income country (LMIC), Papua New Guinea. Methods Data was collected using self administered questionnaire from rural nurses attending a training program from 15 of the 20 provinces. Results of a total of 344 nurses were available for analysis. A measure of overall job satisfaction and measures for facets of job satisfaction was developed in the study based on literature and a qualitative study. Multi-variate analysis was used to test prediction models. Results There was significant difference in the level of job satisfaction by age and years in the profession. Higher levels of overall job satisfaction and intrinsic satisfaction were seen in nurses employed by Church facilities compared to government facilities (P job satisfaction. The factors contributing most were work climate (17%) and supervisory support (10%). None of these factors were predictive of an intention to leave. Conclusions This study provides empirical evidence that inter-personal relationships: work climate and supportive supervision are the most important influences of job satisfaction for rural nurses in a LMIC. These findings highlight that the provision of a conducive environment requires attention to human relations aspects. For PNG this is very important as this critical cadre provide the frontline of primary health care for more than 70% of the population of the country. Many LMIC are focusing on rural health, with most of the attention given to aspects of workforce numbers and

Be known, be available, be mutual: a qualitative ethical analysis of social values in rural palliative care

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Bottorff Joan L

2011-09-01

Full Text Available Abstract Background Although attention to healthcare ethics in rural areas has increased, specific focus on rural palliative care is still largely under-studied and under-theorized. The purpose of this study was to gain a deeper understanding of the values informing good palliative care from rural individuals' perspectives. Methods We conducted a qualitative ethnographic study in four rural communities in Western Canada. Each community had a population of 10, 000 or less and was located at least a three hour travelling distance by car from a specialist palliative care treatment centre. Data were collected over a 2-year period and included 95 interviews, 51 days of field work and 74 hours of direct participant observation where the researchers accompanied rural healthcare providers. Data were analyzed inductively to identify the most prevalent thematic values, and then coded using NVivo. Results This study illuminated the core values of knowing and being known, being present and available, and community and mutuality that provide the foundation for ethically good rural palliative care. These values were congruent across the study communities and across the stakeholders involved in rural palliative care. Although these were highly prized values, each came with a corresponding ethical tension. Being known often resulted in a loss of privacy. Being available and present created a high degree of expectation and potential caregiver strain. The values of community and mutuality created entitlement issues, presenting daunting challenges for coordinated change. Conclusions The values identified in this study offer the opportunity to better understand common ethical tensions that arise in rural healthcare and key differences between rural and urban palliative care. In particular, these values shed light on problematic health system and health policy changes. When initiatives violate deeply held values and hard won rural capacity to address the needs of

Faces of Change. Five Rural Societies in Transition: Bolivia, Kenya, Afghanistan, Taiwan, China Coast.

Science.gov (United States)

Miller, Norman N., Ed.; Spitzer, Manon L., Ed.

The multidisciplinary film project focuses attention on what is happening to rural populations of the world, particularly among developing countries. The roles of women, education, social and economic systems, and the effects of modernization on values are themes explored in each of five rural settings--Bolivian highlands, northern Kenya, northern…

Factors Affecting Utilization of Family Planning Services in a Post-Conflict Setting, South Sudan: A Qualitative Study.

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Ahmed, Waled Amen Mohammed; Shokai, Sara Boutros; Abduelkhair, Insaf Hassan; Boshra, Amira Yahia

2015-01-01

This study aims to explore and examine the conjectures surrounding the utilization of family planning services among currently married couples of childbearing age in Renk County. This study has adopted a qualitative method to collect data on factors affecting the utilization of family planning services through focus group discussions and in-depth interviews, in rural and urban areas of Renk County. It targeted married women, men as well as unmarried men and women. The researchers conducted nine focus group discussions and nine interviews at both Jelhak (rural setting) and Renk (urban setting). The results suggested that the people of Renk County prefer to have large families and therefore choose not to use family planning methods. The data collected was analyzed by means of thematic analysis. This included the construction of a thematic framework, coding, editing and categorization of available data as well as the creation of sub-themes. The result also suggested that perception is a main factor that affects utilization of family planning services with a majority of the people in Renk and Jelhak preferring to have many children in order to increase the family size for some reasons. These are linked to religion, social stigma and taboo that are attached to childless people or users of family planning methods for birth control purposes. The responses revealed some variation in perception between rural (Jelhak) and urban (Renk) areas. Respondents from Renk area reported that some people use family planning services for economic reasons that involve alleviation of financial difficulties and provision of better education when the family size is small. On the other hand, rural people from Jelhak perceive family planning to be socially un-acceptable. Furthermore, men and women of Jelhak reported that after each birth of a child, married couples avoid sexual relationship for a period of two years as means of family planning. Women of both Urban and Rural settings reported

Census in a rural area of Ethiopia: methodology and results.

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Materia, E; Mehari, W; Mele, A; Rosmini, F; Stazi, M A; Damen, H M; Basile, G; Kifle, T; Miuccio, G; Ferrigno, L

1993-01-01

A census and an ecologic survey were performed in 39 villages of a rural district of Arsi Region, Ethiopia, in difficult field circumstances. Information on age, ethnic group, education and family relationship, as well as data on health facilities and availability of basic services were collected. Supervised students, working in teams, were used as interviewers. Communities were involved through plenary meetings and community health agents participated in the data collection process. A total of 64,714 people in 12,152 households were registered. The repeatability of age assessment was investigated by comparing the results from two villages with data obtained in a pilot study carried out 6 months earlier. The technical error was only 0.80 and 1.67 in the 0-5 and 6-15 age-groups, respectively. Three percent of the total population was under one year, less than previously estimated. This may, in part, be due to the family planning programme in the region. Eighteen percent of the households were headed by females. School attendance was less common among females and in the Oromo ethnic group. The availability of basic services, including safe water and basic sanitation supplies, was very poor in the area.

Risk Factors Associated with Crash Severity on Low-Volume Rural Roads in Denmark

DEFF Research Database (Denmark)

Prato, Carlo Giacomo; Rasmussen, Thomas Kjær; Kaplan, Sigal

2014-01-01

Safety on low-volume rural roads is drawing attention due to the high fatality and severe injury rates in comparison with high-volume roads and the increasing awareness of sustainable rural development among policy makers. This study analyzes the risk factors associated with crash severity on low......-volume rural roads, including crash characteristics, driver attributes and behavior, vehicle type, road features, environmental conditions, distance from the nearest hospital, and zone rurality degree. The data consist of a set of crashes occurred on low-volume rural roads in Denmark between 2007 and 2011...... advantage in accommodating the ordered-response nature of severity while relaxing the proportional odds assumption. Model estimates and pseudoelasticities show that aggravated crash injury severity is significantly associated with (1) alcohol and failure to wear seatbelts, (2) involvement of vulnerable road...

How Can a Computer be Useful to You? A Feasibility Study to Elicit Perceptions of Computers in Rural India

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Bhavnani, Suresh K.; Chavan, Apala L.; Jain, Isha; Maroo, Sudhanshoo

2011-01-01

The growing influx of information and communication technologies (ICTs) into rural India provides new opportunities for the prevention and treatment of diseases across millions of residents. However, little is known about how rural Indians with little or no exposure to computers perceive computers and their uses, and how best to elicit those perceptions. Such perceptions could lead to new insights for using ICTs to affect health behavior change in developing countries. We therefore developed a semi-structured interview approach to probe how residents of a north Indian village perceived computers and their uses. The results suggest that besides helping to overturn several assumptions of the researchers through unexpected insights, the approach could be easily implemented in rural settings, which could lead to deeper insights for developing future culturally and medically-relevant ICTs for rural residents. PMID:22195062

Narratives of social justice: learning in innovative clinical settings.

Science.gov (United States)

Reimer Kirkham, Sheryl; Van Hofwegen, Lynn; Hoe Harwood, Catherine

2005-01-01

The nursing profession has renewed its commitment to social and political mandates, resulting in increasing attention to issues pertaining to diversity, vulnerable populations, social determinants of health, advocacy and activism, and social justice in nursing curricula. Narratives from a qualitative study examining undergraduate nursing student learning in five innovative clinical settings (corrections, international, parish, rural, and aboriginal) resonate with these curricular emphases. Data were derived from focus groups and interviews with 65 undergraduate nursing students, clinical instructors, and RN mentors. Findings of this study reveal how students in innovative clinical placements bear witness to poverty, inequities, and marginalization (critical awareness), often resulting in dissonance and soul-searching (critical engagement), and a renewed commitment to social transformation (social change). These findings suggest the potential for transformative learning in these settings.

Rural electrification in Malaysia via small scale biomass gasifier

International Nuclear Information System (INIS)

Zainal Alimuddin Zainal Alauddin

2000-01-01

It is the government of Malaysia's vision to see that the rural community is not left behind in its endeavour to be an industrialised nation in the year 2020. The standard of living in the rural areas is very far different from that in the urban areas. To obtain equality the standard of living of the rural folks need to be ungraded. This is done largely by electrification. Electricity has been in the past the catalyst for development and raising the standard of living of the poor. Electricity supplied by the nation's electricity company might not reach all remote areas and therefore there must be a means to provide alternative electrical supply to these places. Present method employ the use of diesel generator sets to provide electricity. The availability of biomass source of supply in the rural areas could be effectively exploited to provide alternative source of energy via a gasification system to run a reciprocating engine coupled to a generator to generated electricity. A small-scale biomass gasification generator set in the range of 2-5 kW is suitable to provide electrical supply to a typical house in the rural area. The present use of biomass source of energy is in its utilisation to provide source of heat for cooking. Several tests have been conducted and the performance is very good. Alternatively another medium scale system generating about 50-20O kW would be suitable for a typical village having about 50 houses. A small-scale system has been developed in USM to provide 5 kW of electrical power. The system used a petrol engine and produces an overall efficiency of 7% with a specific consumption of about 3 kg/kWh. The biomass material used is wood. However for application in the rural areas the biomass material will depend on the type available. A further 50 kW system is being develop in USM. (Author)

Information sharing with rural family caregivers during care transitions of hip fracture patients

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Jacobi Elliott

2014-06-01

Full Text Available Introduction: Following hip fracture surgery, patients often experience multiple transitions through different care settings, with resultant challenges to the quality and continuity of patient care. Family caregivers can play a key role in these transitions, but are often poorly engaged in the process. We aimed to: (1 examine the characteristics of the family caregivers’ experience of communication and information sharing and (2 identify facilitators and barriers of effective information sharing among patients, family caregivers and health care providers.Methods: Using an ethnographic approach, we followed 11 post-surgical hip fracture patients through subsequent care transitions in rural Ontario; in-depth interviews were conducted with patients, family caregivers (n = 8 and health care providers (n = 24.Results: Priority areas for improved information sharing relate to trust and respect, involvement, and information needs and expectations; facilitators and barriers included prior health care experience, trusting relationships and the rural setting.Conclusion: As with knowledge translation, effective strategies to improve information sharing and care continuity for older patients with chronic illness may be those that involve active facilitation of an on-going partnership that respects the knowledge of all those involved.

Information sharing with rural family caregivers during care transitions of hip fracture patients

Directory of Open Access Journals (Sweden)

Jacobi Elliott

2014-06-01

Full Text Available Introduction: Following hip fracture surgery, patients often experience multiple transitions through different care settings, with resultant challenges to the quality and continuity of patient care. Family caregivers can play a key role in these transitions, but are often poorly engaged in the process. We aimed to: (1 examine the characteristics of the family caregivers’ experience of communication and information sharing and (2 identify facilitators and barriers of effective information sharing among patients, family caregivers and health care providers. Methods: Using an ethnographic approach, we followed 11 post-surgical hip fracture patients through subsequent care transitions in rural Ontario; in-depth interviews were conducted with patients, family caregivers (n = 8 and health care providers (n = 24. Results: Priority areas for improved information sharing relate to trust and respect, involvement, and information needs and expectations; facilitators and barriers included prior health care experience, trusting relationships and the rural setting. Conclusion: As with knowledge translation, effective strategies to improve information sharing and care continuity for older patients with chronic illness may be those that involve active facilitation of an on-going partnership that respects the knowledge of all those involved.

Traditional values of virginity and sexual behaviour in rural Ethiopian youth: results from a cross-sectional study

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Berhane Yemane

2008-01-01

Full Text Available Abstract Background Delaying sexual initiation has been promoted as one of the methods of decreasing risks of HIV among young people. In traditional countries, such as Ethiopia, retaining virginity until marriage is the norm. However, no one has examined the impact of this traditional norm on sexual behaviour and risk of HIV in marriage. This study examined the effect of virginity norm on having sex before marriage and sexual behaviour after marriage among rural Ethiopian youth. Methods We did a cross-sectional survey in 9 rural and 1 urban area using a probabilistic sample of 3,743 youth, 15–24 years of age. Univariate analysis was used to assess associations between virginity norm and gender stratified by area, and between sexual behaviour and marital status. We applied Kaplan-Meier and Cox regression analysis to estimate age at sexual debut and assessed the predictors of premarital sex among the never-married using SPSS. Results We found that maintaining virginity is still a way of securing marriage for girls, especially in rural areas; the odds of belief and intention to marry a virgin among boys was 3–4 times higher among rural young males. As age increased, the likelihood of remaining a virgin decreased. There was no significant difference between married and unmarried young people in terms of number of partners and visiting commercial sex workers. Married men were twice more likely to have multiple sexual partners than their female counterparts. A Cox regression show that those who did not believe in traditional values of preserving virginity (adjusted hazard ratio [AHR] = 2.91 [1.92–4.40], alcohol drinkers (AHR = 2.91 [1.97–4.29], Khat chewers (AHR = 2.36 [1.45–3.85], literates (AHR = 18.01 [4.34–74.42], and the older age group (AHR = 1.85 [1.19–2.91] were more likely to have premarital sex than their counterparts. Conclusion Although virginity norms help delay age at sexual debut among rural Ethiopian youth, and thus

Marketing strategy determinants in rural hospitals.

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Smith, H L; Haley, D; Piland, N F

1993-01-01

Rural hospitals confront an inauspicious environment due to changes in patient reimbursement and medical practice. Facing a situation of declining revenues, marketing presents an option for rural hospitals to adapt to the growing constraints. This paper analyzes the determinants of marketing strategy emphasis in rural hospitals. The conceptual model adopted in this study predicts that prior performance and contextual variables explain marketing strategy emphasis. The relationships are examined in a case study of rural New Mexico hospitals. Results suggest that prior performance and several contextual variables explain variations in marketing strategy emphasis. In particular, higher gross patient revenues are associated with more emphasis on television and radio advertising. Furthermore, rural New Mexico hospitals with high numbers of licensed beds and medical staff members, or that are affiliated with a chain organization, place greater emphasis on market research and market planning. The implications for marketing practice in rural hospitals are discussed.

Smoking and heavy drinking patterns in rural, urban and rural-to-urban migrants: the PERU MIGRANT Study.

Science.gov (United States)

Taype-Rondan, Alvaro; Bernabe-Ortiz, Antonio; Alvarado, Germán F; Gilman, Robert H; Smeeth, Liam; Miranda, J Jaime

2017-02-03

Previous studies have found mixed results about cigarette and alcohol consumption patterns among rural-to-urban migrants. Moreover, there are limited longitudinal data about consumption patterns in this population. As such, this study aimed to compare the smoking and heavy drinking prevalence among rural, urban, and rural-to-urban migrants in Peru, as well as the smoking and heavy drinking incidence in a 5-year follow-up. We analyzed the PERU MIGRANT Study data from rural, urban, and rural-to-urban migrant populations in Peru. The baseline study was carried out in 2006-2007 and follow-up was performed five years later. For the baseline data analysis, the prevalence of lifetime smoking, current smokers, and heavy drinking was compared by population group using prevalence ratios (PR) and 95% confidence intervals (95% CI). For the longitudinal analysis, the incidence of smoking and heavy drinking was compared by population group with risk ratios (RR) and 95% CI. Poisson regression with robust variance was used to calculate both PRs and RRs. We analyzed data from 988 participants: 200 rural dwellers, 589 migrants, and 199 urban dwellers. Compared with migrants, lifetime smoking prevalence was higher in the urban group (PR = 2.29, 95% CI = 1.64-3.20), but lower in the rural group (PR = 0.55, 95% CI = 0.31-0.99). Compared with migrants, the urban group had a higher current smoking prevalence (PR = 2.29, 95% CI = 1.26-4.16), and a higher smoking incidence (RR = 2.75, 95% CI = 1.03-7.34). Current smoking prevalence and smoking incidence showed no significant difference between rural and migrant groups. The prevalence and incidence of heavy drinking was similar across the three population groups. Our results show a trend in lifetime smoking prevalence (urban > migrant > rural), while smoking incidence was similar between migrant and rural groups, but higher in the urban group. In addition, our results suggest that different

Rural Communatcation: legitimizing digital inclusion in rural field

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Juliana Correa Bernardes

2016-03-01

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

An assessment of electricity and income distributional trends following rural electrification in poor northeast Brazil

International Nuclear Information System (INIS)

Obermaier, Martin; Szklo, Alexandre; La Rovere, Emilio Lèbre; Pinguelli Rosa, Luiz

2012-01-01

Rural electrification is considered to be a key strategy for poverty alleviation and sustainable development. It should therefore include (1) expanding electricity access and (2) enable new consumers to increase their electricity consumption. In this paper we ask how Brazil’s recent rural electrification efforts have managed to reach these objectives. A new method to measure energy and income equity is presented which uses estimations of non-parametric density curves for the analysis of energy and income distributional trends following electrification. By applying our method to a panel data set from two Brazilian states situated in the country’s poor northeast region we find that (1) rural consumers take up electricity consumption after electrification, and that (2) low consumption levels give way to higher electricity consumption levels after only a few years. This indicates immediate social benefits for households through consumption of electricity services. However, our analysis cannot verify a direct link between electricity use and rural income generation in the short term. The results emphasize the need for government and other actors to integrate rural electrification into broader rural development strategies in order to enable long-term welfare increases through electricity use. - Highlights: ► Comprehensive analysis of Brazil’s recent rural electrification efforts. ► New methodology to analyze energy and income equity trends ex post electrification. ► Analysis indicates immediate social benefits for electrified households. ► We cannot establish a direct link between electricity use and income in the short-run. ► Electrification thus should be integrated in long-term rural development strategies.

Higher Prices, Fewer Choices: Shopping for Food in Rural America.

Science.gov (United States)

Morris, Patricia McGrath

The Food Stamp Program is the U.S. government's primary program to prevent the rural poor from going hungry. Food stamp allotments are set each year based on the cost of the "Thrifty Food Plan" (TFP), a minimally adequate diet defined by the U.S. Department of Agriculture (USDA), which sets costs by examining average food prices in urban…

The rural areas electrification with a hybrid photovoltaic systems

International Nuclear Information System (INIS)

Kocev, Kiril I.; Dimitrov, Dimitar; Tudzharov, Gjorgji

2001-01-01

Depending on a daily load demand, distance from the utility grid and the available solar energy, the rural villages electrification with a hybrid photovoltaic (PV) system can be a cheaper solution than the classic electrification, by connecting them to the utility grid. Besides PV generator, the considered hybrid system is consisted of a battery and a diesel gen set. For the concrete case - rural village with estimated daily load demand of 15.5 kWh/day, with the computer program PVFORM, which is modified for such hybrid system, were simulated a few hundreds PV systems, with different sizes of the PV generator and of the battery capacity. Analyzing the obtained results, it can be foreseen the influence of the component size on the system functionality. From the mass of possible system combinations, it is chosen one that has 42 % lower initial investment, than the initial investment for connection of the village to the utility grid. (Original)

Consumers’ experiences of back pain in rural Western Australia: access to information and services, and self-management behaviours

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Briggs Andrew M

2012-10-01

Full Text Available Abstract Background Coordinated, interdisciplinary services, supported by self-management underpin effective management for chronic low back pain (CLBP. However, a combination of system, provider and consumer-based barriers exist which limit the implementation of such models into practice, particularly in rural areas where unique access issues exist. In order to improve health service delivery for consumers with CLBP, policymakers and service providers require a more in depth understanding of these issues. The objective of this qualitative study was to explore barriers experienced by consumers in rural settings in Western Australia (WA to accessing information and services and implementing effective self-management behaviours for CLBP. Methods Fourteen consumers with a history of CLBP from three rural sites in WA participated. Maximum variation sampling was employed to ensure a range of experiences were captured. An interviewer, blinded to quantitative pain history data, conducted semi-structured telephone interviews using a standardised schedule to explore individuals’ access to information and services for CLBP, and self-management behaviours. Interviews were digitally recorded and transcribed verbatim. Inductive analysis techniques were used to derive and refine key themes. Results Five key themes were identified that affected individuals’ experiences of managing CLBP in a rural setting, including: 1 poor access to information and services in rural settings; 2 inadequate knowledge and skills among local practitioners; 3 feelings of isolation and frustration; 4 psychological burden associated with CLBP; and 5 competing lifestyle demands hindering effective self-management for CLBP. Conclusions Consumers in rural WA experienced difficulties in knowing where to access relevant information for CLBP and expressed frustration with the lack of service delivery options to access interdisciplinary and specialist services for CLBP. Competing

A hospital-randomized controlled trial of a formal quality improvement educational program in rural and small community Texas hospitals: one year results.

Science.gov (United States)

Filardo, Giovanni; Nicewander, David; Herrin, Jeph; Edwards, Janine; Galimbertti, Percy; Tietze, Mari; McBride, Susan; Gunderson, Julie; Collinsworth, Ashley; Haydar, Ziad; Williams, Josie; Ballard, David J

2009-08-01

To investigate the effectiveness of a quality improvement educational program in rural hospitals. Hospital-randomized controlled trial. A total of 47 rural and small community hospitals in Texas that had previously received a web-based benchmarking and case-review tool. The 47 hospitals were randomized either to receive formal quality improvement educational program or to a control group. The educational program consisted of two 2-day didactic sessions on continuous quality improvement techniques, followed by the design, implementation and reporting of a local quality improvement project, with monthly coaching conference calls and annual follow-up conclaves. Performance on core measures for community-acquired pneumonia and congestive heart failure were compared between study groups to evaluate the impact of the educational program. No significant differences were observed between the study groups on any measures. Of the 23 hospitals in the intervention group, only 16 completed the didactic program and 6 the full training program. Similar results were obtained when these groups were compared with the control group. While the observed results suggest no incremental benefit of the quality improvement educational program following implementation of a web-based benchmarking and case-review tool in rural hospitals, given the small number of hospitals that completed the program, it is not conclusive that such programs are ineffective. Further research incorporating supporting infrastructure, such as physician champions, financial incentives and greater involvement of senior leadership, is needed to assess the value of quality improvement educational programs in rural hospitals.

Development Of A Surveillance System For Potability Of Water In Rural Areas

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Gandotra V.K

1998-01-01

Full Text Available Research question: Whether establishment of a water surveillance system in rural areas and concomitant action in event of detection of contamination will have an impact on diarrhoea related morbidity and mortality. Hypothesis: 1. It is possible to establish water testing laboratories in selected schools in rural areas. 2. If water samples are found contaminated, immediate corrective action will result in reduction of diarrhoea related morbidity and mortality. Objectives: 1. To study the feasibility of establishing water testing facility in the science laboratories of schools. 2. To study the impact of preventive measures in the community if immediate steps for household purification of water and treatment of diarrhoea cases are taken. Study design: Interventional study. Setting: A rural block. Participants: Science teachers of high schools and field workers. Interventions: 1. Training of schoolteachers for water testing and field workers for collection of water samples and diarrhoea control measures. 2. Establishing of water testing laboratories in schools. 3. In case of detection of water contamination, corrective action at different levels. 4. Propagation of ORS for management of diarrhoeas. Statistical analysis: Percentages, Paired ‘t’ test, Chi square test. Results: Reduction in diarrhoea related morbidity and mortality was observed. Conclusions: It is feasible to develop a water surveillance system in rural areas utilizing local resources. If combined with educational measures, it will significantly reduce diarrhoea related morbidity and mortality.

Impact of Rotavirus Vaccine Introduction and Postintroduction Etiology of Diarrhea Requiring Hospital Admission in Haydom, Tanzania, a Rural African Setting

Science.gov (United States)

Platts-Mills, James A.; Amour, Caroline; Gratz, Jean; Nshama, Rosemary; Walongo, Thomas; Mujaga, Buliga; Maro, Athanasia; McMurry, Timothy L; Liu, Jie; Mduma, Estomih; Houpt, Eric R

2017-01-01

Abstract Background No data are available on the etiology of diarrhea requiring hospitalization after rotavirus vaccine introduction in Africa. The monovalent rotavirus vaccine was introduced in Tanzania on 1 January 2013. We performed a vaccine impact and effectiveness study as well as a quantitative polymerase chain reaction (qPCR)–based etiology study at a rural Tanzanian hospital. Methods We obtained data on admissions among children <5 years to Haydom Lutheran Hospital between 1 January 2010 and 31 December 2015 and estimated the impact of vaccine introduction on all-cause diarrhea admissions. We then performed a vaccine effectiveness study using the test-negative design. Finally, we tested diarrheal specimens during 2015 by qPCR for a broad range of enteropathogens and calculated pathogen-specific attributable fractions (AFs). Results Vaccine introduction was associated with a 44.9% (95% confidence interval [CI], 17.6%–97.4%) reduction in diarrhea admissions in 2015, as well as delay of the rotavirus season. The effectiveness of 2 doses of vaccine was 74.8% (95% CI, –8.2% to 94.1%) using an enzyme immunoassay–based case definition and 85.1% (95% CI, 26.5%–97.0%) using a qPCR-based case definition. Among 146 children enrolled in 2015, rotavirus remained the leading etiology of diarrhea requiring hospitalization (AF, 25.8% [95% CI, 24.4%–26.7%]), followed by heat-stable enterotoxin-producing Escherichia coli (AF, 18.4% [95% CI, 12.9%–21.9%]), Shigella/enteroinvasive E. coli (AF, 14.5% [95% CI, 10.2%–22.8%]), and Cryptosporidium (AF, 7.9% [95% CI, 6.2%–9.3%]). Conclusions Despite the clear impact of vaccine introduction in this setting, rotavirus remained the leading etiology of diarrhea requiring hospitalization. Further efforts to maximize vaccine coverage and improve vaccine performance in these settings are warranted. PMID:28575304

Scaling up postabortion contraceptive service--results from a study conducted among women having unwanted pregnancies in urban and rural Tanzania

DEFF Research Database (Denmark)

Rasch, Vibeke; Yambesi, Fortunata; Kipingili, Rose

2005-01-01

Tanzania and 42% in rural Tanzania stated that their pregnancy was unwanted. Contraceptive acceptance among women with unwanted pregnancies was high; 93% in urban Tanzania and 71% in rural Tanzania left with a contraceptive method. CONCLUSION: The high proportion of women with unwanted pregnancies in urban...... and rural Tanzania underlines the need of scaling up postabortion contraceptive service....

Effects of a Metacognitive Social Skill Intervention in a Rural Setting with At-Risk Adolescents

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Whetstone, Patti J.; Gillmor, Susan C.; Schuster, Jonathan G.

2015-01-01

Ten at-risk students in a rural high school completed a social skills program based on metacognitive strategies and aligned with social and emotional learning principles. The intervention's primary goal was to stimulate the development of metacognitive strategies for internal locus of control in the students, rather than attempting to change their…

All Rural Places Are Not Created Equal: Revisiting the Rural Mortality Penalty in the United States

Science.gov (United States)

2014-01-01

Objectives. I investigated mortality disparities between urban and rural areas by measuring disparities in urban US areas compared with 6 rural classifications, ranging from suburban to remote locales. Methods. Data from the Compressed Mortality File, National Center for Health Statistics, from 1968 to 2007, was used to calculate age-adjusted mortality rates for all rural and urban regions by year. Criteria measuring disparity between regions included excess deaths, annual rate of change in mortality, and proportion of excess deaths by population size. I used multivariable analysis to test for differences in determinants across regions. Results. The rural mortality penalty existed in all rural classifications, but the degree of disparity varied considerably. Rural–urban continuum code 6 was highly disadvantaged, and rural–urban continuum code 9 displayed a favorable mortality profile. Population, socioeconomic, and health care determinants of mortality varied across regions. Conclusions. A 2-decade long trend in mortality disparities existed in all rural classifications, but the penalty was not distributed evenly. This constitutes an important public health problem. Research should target the slow rates of improvement in mortality in the rural United States as an area of concern. PMID:25211763

Blood-feeding preferences of Aedes albopictus (Diptera: Culicidae) in urban and rural settings within the province of Rome, Italy.

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Valerio, L; Marini, F; Bongiorno, G; Facchinelli, L; Pombi, M; Caputo, B; Maroli, M; della Torre, A

2008-06-01

We here report the results of field trials carried out in Rome with the aim to obtain data on the feeding behaviour of Aedes albopictus, in relation to different availability and abundance of putative hosts. Human Blood Index values were found higher than 75% in urban areas, where humans represented the most abundant hosts, and lower than 60% in rural areas, where host alternative to humans were frequent. The overall results confirm the generalist feeding-behaviour shown by this species in its original range of distribution and highlighting its high potential as vector of human pathogens in urban areas of Italy.

Assessment of pharmacists’ delivery of public health services in rural and urban areas in Iowa and North Dakota

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Scott, David M.; Strand, Mark; Undem, Teri; Anderson, Gabrielle; Clarens, Andrea; Liu, Xiyuan

2016-01-01

Background: The profession of pharmacy is expanding its involvement in public health, but few studies have examined pharmacists’ delivery of public health services. Objective: To assess Iowa and North Dakota pharmacists’ practices, frequency of public health service delivery, level of involvement in achieving the essential services of public health, and barriers to expansion of public health services in rural and urban areas. Methods: This study implemented an on-line survey sent to all pharmacists currently practicing pharmacy in Iowa and North Dakota. Results: Overall, 602 valid responses were analyzed, 297 in rural areas and 305 in urban areas. Three practice settings (chain stores [169, 28.2%], independent community pharmacies [162, 27.0%], and hospital pharmacies [156, 26.0%]) comprised 81.2% of the sample. Both chain and independent community pharmacists were more commonly located in rural areas than in urban areas (PDakota. These findings should be interpreted to be primarily due to differences in the role of the rural pharmacist and the quest for certain opportunities that rural pharmacists are seeking. PMID:28042356

The Road to Rural Primary Care: A Narrative Review of Factors That Help Develop, Recruit, and Retain Rural Primary Care Physicians.

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Parlier, Anna Beth; Galvin, Shelley L; Thach, Sarah; Kruidenier, David; Fagan, Ernest Blake

2018-01-01

To examine the literature documenting successes in recruiting and retaining rural primary care physicians. The authors conducted a narrative review of literature on individual, educational, and professional characteristics and experiences that lead to recruitment and retention of rural primary care physicians. In May 2016, they searched MEDLINE, PubMed, CINAHL, ERIC, Web of Science, Google Scholar, the Grey Literature Report, and reference lists of included studies for literature published in or after 1990 in the United States, Canada, or Australia. The authors identified 83 articles meeting inclusion criteria. They synthesized results and developed a theoretical model that proposes how the findings interact and influence rural recruitment and retention. The authors' proposed theoretical model suggests factors interact across multiple dimensions to facilitate the development of a rural physician identity. Rural upbringing, personal attributes, positive rural exposure, preparation for rural life and medicine, partner receptivity to rural living, financial incentives, integration into rural communities, and good work-life balance influence recruitment and retention. However, attending medical schools and/or residencies with a rural emphasis and participating in rural training may reflect, rather than produce, intention for rural practice. Many factors enhance rural physician identity development and influence whether physicians enter, remain in, and thrive in rural practice. To help trainees and young physicians develop the professional identity of a rural physician, multifactorial medical training approaches aimed at encouraging long-term rural practice should focus on rural-specific clinical and nonclinical competencies while providing trainees with positive rural experiences.

The Role of Language in Interactions with Others on Campus for Rural Appalachian College Students

Science.gov (United States)

Dunstan, Stephany Brett; Jaeger, Audrey J.

2016-01-01

Dialects of English spoken in rural, Southern Appalachia are heavily stigmatized in mainstream American culture, and speakers of Appalachian dialects are often subject to prejudice and stereotypes which can be detrimental in educational settings. We explored the experiences of rural, Southern Appalachian college students and the role speaking a…

Depression screening optimization in an academic rural setting.

Science.gov (United States)

Aleem, Sohaib; Torrey, William C; Duncan, Mathew S; Hort, Shoshana J; Mecchella, John N

2015-01-01

Primary care plays a critical role in screening and management of depression. The purpose of this paper is to focus on leveraging the electronic health record (EHR) as well as work flow redesign to improve the efficiency and reliability of the process of depression screening in two adult primary care clinics of a rural academic institution in USA. The authors utilized various process improvement tools from lean six sigma methodology including project charter, swim lane process maps, critical to quality tree, process control charts, fishbone diagrams, frequency impact matrix, mistake proofing and monitoring plan in Define-Measure-Analyze-Improve-Control format. Interventions included change in depression screening tool, optimization of data entry in EHR. EHR data entry optimization; follow up of positive screen, staff training and EHR redesign. Depression screening rate for office-based primary care visits improved from 17.0 percent at baseline to 75.9 percent in the post-intervention control phase (p<0.001). Follow up of positive depression screen with Patient History Questionnaire-9 data collection remained above 90 percent. Duplication of depression screening increased from 0.6 percent initially to 11.7 percent and then decreased to 4.7 percent after optimization of data entry by patients and flow staff. Impact of interventions on clinical outcomes could not be evaluated. Successful implementation, sustainability and revision of a process improvement initiative to facilitate screening, follow up and management of depression in primary care requires accounting for voice of the process (performance metrics), system limitations and voice of the customer (staff and patients) to overcome various system, customer and human resource constraints.

Rural health workers and their work environment: the role of inter-personal factors on job satisfaction of nurses in rural Papua New Guinea.

Science.gov (United States)

Jayasuriya, Rohan; Whittaker, Maxine; Halim, Grace; Matineau, Tim

2012-06-12

Job satisfaction is an important focal attitude towards work. Understanding factors that relate to job satisfaction allows interventions to be developed to enhance work performance. Most research on job satisfaction among nurses has been conducted in acute care settings in industrialized countries. Factors that relate to rural nurses are different. This study examined inter-personal, intra-personal and extra-personal factors that influence job satisfaction among rural primary care nurses in a Low and Middle Income country (LMIC), Papua New Guinea. Data was collected using self administered questionnaire from rural nurses attending a training program from 15 of the 20 provinces. Results of a total of 344 nurses were available for analysis. A measure of overall job satisfaction and measures for facets of job satisfaction was developed in the study based on literature and a qualitative study. Multi-variate analysis was used to test prediction models. There was significant difference in the level of job satisfaction by age and years in the profession. Higher levels of overall job satisfaction and intrinsic satisfaction were seen in nurses employed by Church facilities compared to government facilities (P job satisfaction. The factors contributing most were work climate (17%) and supervisory support (10%). None of these factors were predictive of an intention to leave. This study provides empirical evidence that inter-personal relationships: work climate and supportive supervision are the most important influences of job satisfaction for rural nurses in a LMIC. These findings highlight that the provision of a conducive environment requires attention to human relations aspects. For PNG this is very important as this critical cadre provide the frontline of primary health care for more than 70% of the population of the country. Many LMIC are focusing on rural health, with most of the attention given to aspects of workforce numbers and distribution. Much less attention is

Rural Nonfarm Activities and Poverty in the Brazilian Northeast

NARCIS (Netherlands)

Ferreira, FHG; Lanjouw, P.F.

2001-01-01

This paper combines two complementary data sets to present a disaggregated spatial profile of poverty in the Brazilian Northeast, and to investigate the importance of nonagricultural activities for its rural dwellers. We present both univariate and multivariate profiles of nonagricultural employment

Perspectives on healthcare, chronic non-communicable disease, and healthworlds in an urban and rural setting.

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Lopes Ibanez-Gonzalez, Daniel

2014-01-01

Amidst diverging discourses describing chronic non-communicable disease (NCD) and healthcare access, the hermeneutical tradition within sociology, particularly as exemplified in the work of Jurgen Habermas, provides a starting point for exploring and interpreting the experiences of chronic illness and healthcare access. In this study, we aimed to understand how women living with NCDs experience their illness and access healthcare in an urban and rural context. This study was a mixed-methods comparative case study of the healthcare access experiences of women with NCDs in an urban and rural area in South Africa. The core of the study methodology was a comparative qualitative case study, with quantitative methods serving to contextualise the findings. The cross-sectional survey describes a low resource population with a high prevalence of NCDs. Slightly over half the respondents in urban Soweto (50.7%) reported having at least one NCD. Only around a third (33.3%) of these participants reported accessing formal healthcare services in the past 6 months. Similar trends were found in the review of research carried out in rural Agincourt. The qualitative case study in Soweto is characterised by a preoccupation with how medicine from the clinic interacts with the body. The Agincourt qualitative case study highlights the importance of church membership, particularly of African Christian Churches, as the strongest factor motivating against the open use of traditional medicine. A consideration of the findings suggests five broad themes for further research: 1) processes of constructing body narratives; 2) encounters with purposive-rational systems; 3) encounters with traditional medicine; 4) encounters with contemporary informal medicine; and 5) religion and healthcare. These five themes constitute the beginning of a comprehensive schema of the lifeworld/healthworld.

Expanding HIV testing efforts in concentrated epidemic settings: a population-based survey from rural Vietnam.

Directory of Open Access Journals (Sweden)

Anastasia Pharris

Full Text Available BACKGROUND: To improve HIV prevention and care programs, it is important to understand the uptake of HIV testing and to identify population segments in need of increased HIV testing. This is particularly crucial in countries with concentrated HIV epidemics, where HIV prevalence continues to rise in the general population. This study analyzes determinants of HIV testing in a rural Vietnamese population in order to identify potential access barriers and areas for promoting HIV testing services. METHODS: A population-based cross-sectional survey of 1874 randomly sampled adults was linked to pregnancy, migration and economic cohort data from a demographic surveillance site (DSS. Multivariate logistic regression analysis was used to determine which factors were associated with having tested for HIV. RESULTS: The age-adjusted prevalence of ever-testing for HIV was 7.6%; however 79% of those who reported feeling at-risk of contracting HIV had never tested. In multivariate analysis, younger age (aOR 1.85, 95% CI 1.14-3.01, higher economic status (aOR 3.4, 95% CI 2.21-5.22, and semi-urban residence (aOR 2.37, 95% CI 1.53-3.66 were associated with having been tested for HIV. HIV testing rates did not differ between women of reproductive age who had recently been pregnant and those who had not. CONCLUSIONS: We found low testing uptake (6% among pregnant women despite an existing prevention of mother-to-child HIV testing policy, and lower-than-expected testing among persons who felt that they were at-risk of HIV. Poverty and residence in a more geographically remote location were associated with less HIV testing. In addition to current HIV testing strategies focusing on high-risk groups, we recommend targeting HIV testing in concentrated HIV epidemic settings to focus on a scaled-up provision of antenatal testing. Additional recommendations include removing financial and geographic access barriers to client-initiated testing, and encouraging provider

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

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

2016-01-01

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

Does Context Matter? An Analysis of Training in Multicultural Assessment, Consultation, and Intervention between School Psychologists in Urban and Rural Contexts

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Newell, Markeda; Looser, Joshua

2018-01-01

The purpose of this study was to analyze the extent of training in multicultural assessment, intervention, and consultation of school psychologists in urban and rural contexts. Although there is greater cultural and sociodemographic diversity in urban settings as compared to rural settings, it is unknown whether school psychologists in urban…

Stated preferences of doctors for choosing a job in rural areas of Peru: a discrete choice experiment.

Directory of Open Access Journals (Sweden)

J Jaime Miranda