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At least 595 records · Page 33Linked to original sources
PubMed2003

Adapting group interpersonal psychotherapy for a developing country: experience in rural Uganda.

The current prevalence of depressive symptoms in Southwest Uganda, an area greatly affected by the HIV epidemic, has been shown to be as high as 21%. Traditional healers have expressed inability to treat these symptoms. The lack of physicians and high cost of medication make the use of antidepressants unfeasible. Therefore, an evidence-based psychotherapy was considered a reasonable treatment option by a team of health researchers familiar with the local culture, who designed a randomized controlled clinical trial. Interpersonal psychotherapy in a group format (IPT-G) was selected because it was time limited, was described in a manual, and had evidence of efficacy from clinical trials. Moreover, its focus on interpersonal triggers of depression was considered compatible with the culture. This paper describes the process of adapting the psychotherapy manual and the training of the group leaders who undertook the first psychotherapy clinical trial in Africa.

Journal Article↗
PubMed1984

[Biological development of adolescents from rural areas, students of the School of Agriculture].

The paper contains the data on 15 somatic traits of 224 pupils of the Secondary School of Agriculture in Warsaw Voivodship, the time of menarche in girls was also noted. As compared with rural youth as a whole, their height and weight were found to be greater which is probably due to their superior living conditions. In comparison with their contemporaries living in Warsaw, their height and weight were found to be inferior while their body proportions were different. In girls, menarche appeared to have been delayed as compared with both Warsaw girls and rural girls generally throughout Poland.

Adolescent↗
PubMed1996

Ketamine safety profile in the developing world: survey of practitioners.

OBJECTIVE: To evaluate the safety profile of ketamine when used to facilitate surgical procedures in the less controlled setting of developing world, rural hospitals. METHODS: A survey addressing clinical experience with ketamine in the developing world was administered to a convenience sample of missionary physicians. Descriptive statistics are reported. RESULTS: Of the 172 surveyed physicians, 122 (71%) responded; 55 reported experience with ketamine. These physicians estimated a total of 12,844 administrations. The format of one procedural physician and a second trained anesthesiologist/anesthetist was unavailable in the practice of 59% of the responding physicians, and 34% routinely performed procedures while simultaneously supervising ketamine administration and monitoring its clinical effect. Pulse oximetry was used "often" or "always" by only 10% of the physicians. Cardiac monitoring and intermittent vital signs were used in only 19% and 45%, respectively. One unexplained pediatric death occurred during an unmonitored, unobserved ward recovery. An adult suffered cardiac arrest after a failed intubation attempt. Seventeen other complications possibly related to ketamine were apnea (n = 10), laryngospasm (n = 6), and aspiration (n = 1), all of which were transient and without sequelae. Physicians believed that recovery hallucinations and agitation were frequent in adults and unusual in children. CONCLUSIONS: Death and other serious complications were rare in this survey reporting > 12,000 estimated ketamine administrations in the developing world. Although the limitations of survey data are recognized, the margin of safety with ketamine appears to be high, even when administered by non-anesthesiologists in settings lacking basic mechanical monitoring. These findings have important implications for the use of ketamine outside the controlled operating room environment in developed countries.

Adult↗
PubMed1997

[Developing expertise in the rural milieu].

Although rural nursing gets little attention, the health of the farming family is increasingly threatened. Isolation, stress, psychological distress, violence, drug and alcohol abuse, suicide and the health risks of farming itself make daily life difficult. In terms of accident-prone occupations, farming is rated tenth and is considered one of the most stressful. These problems have resulted in a drop in the number of farming enterprises in Quebec, from 80,000 in the 1930s to less than 11,400 in the mid-1990s. The farming family is largely misunderstood and presents a sizeable challenge to researchers and health care providers. This population has no desire to disclose its problems or share confidences in others. A summary of American papers, plus information from a recent study by Santé-Québec, reveals the determining factors in the health of the faming family. In the rural environment, health is first defined by work and is influenced by rural values. Nurses must be able to offer health care that relies on these values and use their knowledge to be innovative and personalize interventions. It is important that nursing programs reflect current knowledge of rural nursing. Research is also needed to help nurses further define the problems and determine the factors that influence the health of the farming family.

Agriculture↗
PubMed2006

Neonatal exposure with LPS and/or allergen prevents experimental allergic airways disease: development of tolerance using environmental antigens.

BACKGROUND: Studies show that children in rural environments develop less asthma and allergic rhinitis than their urban counterparts. This may be a result, in part, of neonatal exposure to environmental antigens such as LPS and/or early exposure to allergens. OBJECTIVE: This study examined the effects of neonatal allergen and/or LPS exposure on subsequent immune responses to allergen. METHODS: Newborn mice were exposed to LPS and/or ovalbumin. At age 6 weeks, these animals were sensitized and challenged with ovalbumin, and airway inflammation, hyperresponsiveness, and cytokine expression were assessed. RESULTS: Animals exposed to LPS in the neonatal period developed T cells expressing CD25 and IL-10 on sensitization and challenge. They demonstrated abrogation of airway hyperresponsiveness and significant decreases in IL-13 from bronchoalveolar lavage fluid and in specific IgE. IL-4-expressing spleen cells were also significantly decreased. Mice exposed in the neonatal period to ovalbumin demonstrated airway hyporesponsiveness after subsequent ovalbumin sensitization and challenge and did not produce specific IgE. In contrast, these animals showed increases in IFN-gamma. Animals exposed to both LPS and ovalbumin developed a response characterized by IL-10 and IFN-gamma-expressing T cells. CONCLUSION: This suggests that mucosal antigen exposure in the neonatal period results in inhibition of allergic responses to environmental allergens. Early LPS exposure directs mucosal responses toward tolerance, whereas ovalbumin exposure follows the T(H)1-type response on subsequent sensitization. CLINICAL IMPLICATIONS: This study suggests that prevention of airways allergy may be best achieved by appropriate exposure of the airway mucosa early in life to environmental antigens.

Allergens↗
PubMed2005

Student-developed problem-based learning cases: preparing for rural healthcare practice.

INTRODUCTION: The need for health professionals is acute throughout rural communities worldwide. The Rural Health Interdisciplinary Program (RHIP) successfully trains health professional students for practice in rural USA. Student-developed problem-based learning (PBL) cases are a central feature of the RHIP and an important educational focus of learning. METHODS: This retrospective study was designed to describe 222 PBL cases developed by health professional students in the RHIP. The analysis focused on the extent to which student-developed cases reflect demographics and health conditions of rural New Mexico, as well as how successfully cases reflect rural interdisciplinary healthcare issues and practices. RESULTS: The PBL cases do reflect rural New Mexico in terms of population demographics, certain health problems and complexity of health issues. The cases appear to address interdisciplinary, rural clinical concerns. However, the cases are less effective at raising issues related to public health, financial, legal and ethical issues, and other non-medical health topics. CONCLUSIONS: In order to strengthen attention to non-medical issues, PBL groups should have broad interdisciplinary membership, special case development training, and faculty encouragement to address a wide variety of health-related topics. Student-developed PBL cases appear to be an interesting way for health professional students to learn about rural healthcare issues and could be used in a variety of different educational settings.

Female↗
PubMed2005

Student-developed problem-based learning cases: preparing for rural healthcare practice.

INTRODUCTION: The need for health professionals is acute throughout rural communities worldwide. The Rural Health Interdisciplinary Program (RHIP) successfully trains health professional students for practice in rural USA. Student-developed problem-based learning (PBL) cases are a central feature of the RHIP and an important educational focus of learning. METHODS: This retrospective study was designed to describe 222 PBL cases developed by health professional students in the RHIP. The analysis focused on the extent to which student-developed cases reflect demographics and health conditions of rural New Mexico, as well as how successfully cases reflect rural interdisciplinary healthcare issues and practices. RESULTS: The PBL cases do reflect rural New Mexico in terms of population demographics, certain health problems and complexity of health issues. The cases appear address interdisciplinary, rural clinical concerns. However, the cases are less effective at raising issues related to public health, financial, legal and ethical issues, and other non-medical health topics. CONCLUSIONS: In order to strengthen attention to non-medical issues, PBL groups should have broad interdisciplinary membership, special case development training, and faculty encouragement to address a wide variety of health-related topics. Student-developed PBL cases appear to be an interesting way for health professional students to learn about rural healthcare issues and could be used in a variety different educational settings.

Adolescent↗
PubMed2005

Early childhood development interventions and cognitive development of young children in rural Vietnam.

Little is known about the long-term benefits of interventions that aim to promote early childhood development programs. The goal of this research was to determine whether an early childhood development intervention added to a nutrition intervention during preschool ages had lasting effects on the cognitive development of school-age children in communes of Thanh Hoa province in rural Vietnam. The study focused on a total of 313 children aged 6.5-8.5 y (grades 1 and 2 in primary school) in 2 communes that were exposed to nutrition intervention or nutrition and early childhood development (ECD) intervention from 1999 to 2003. Measurements of height and cognitive test scores (Raven's Progressive Matrices Test) were collected from the children; household characteristics were determined by interviews with mothers. Longitudinal analysis was performed by integrating the data with that collected from the same children in past surveys. Significant effects of the ECD intervention compared with the nutrition intervention were detected. The beneficial effect of ECD intervention on the cognitive test scores was large for the most nutritionally challenged children whose height-for-age Z-scores declined or remained in the stunted range. The findings help provide useful insights into the development of an effective integrated model of ECD and nutrition intervention for children in rural Vietnam.

Body Height↗