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PubMedDate not supplied

[The physician and primary health cares (author's transl)].

For many years in developing countries, rural or sub-urban populations are trying to set up some structures, through community effort, capable to provide to them elementary but indispensable health cares. Because of its fundamental commitment, medical and Public Health staff must participate to the improvement of such structures which are out of the local government health facilities, but have to be integrated in the National Health Plan. Therefore, simple but effective and locally adapted technology has to be set up. The physician must go beyond his conventional technical responsibility, and must supervise and stimulate the village health teams composed essentially of first-aid and sanitation workers and rural matrons, all of them selected by the concerned communities themselves.

Community Health Services↗
PubMed2003

The Utah rural residency study: a blueprint for evaluating potential sites for development of a 4-4-4 family practice residency program in a rural community.

CONTEXT: Most graduates of rural residencies enter rural practice. Rural residencies therefore have emerged over the past 2 decades to increase the supply of rural physicians. However, researchers have published few descriptions of strategies to evaluate and select communities in which to locate rural residencies. PURPOSE: This report describes the development and application of such a strategy to assess 7 rural communities in Utah as potential sites for family practice residency training. METHODS: Criteria were developed on the basis of an examination of the literature, residency accreditation requirements, and characteristics of existing rural residency programs. Ten rural or frontier communities with hospitals were selected as study candidates, and 7 agreed to participate. Data were collected through hospital surveys, state hospital discharge records, and community site visits. FINDINGS: Specific evaluation criteria that were developed included the presence of a medical practice of the appropriate specialty and size, a sufficient number of medical subspecialty physicians, an adequate number and mix of hospitalized patients, an adequate number of ambulatory patients, adequate outpatient facility space to accommodate learners, and a commitment by the practicing physician and hospital to lead the program and teach residents. Two communities were found to be potentially capable of supporting a residency if physicians and hospital leaders in the communities were to become motivated to lead program development. CONCLUSIONS: These criteria may be useful in other states, but they have not been tested for validity or reliability and are subject to limitations such as exclusion of alternate rural residency models. Future research should address data needs and the relationship of the evaluation criteria to the quality of resident learning.

Accreditation↗
PubMed1982

A comparison of the levels of faecal indicator bacteria in water and human faeces in a rural area of a tropical developing country (Sierra Leone).

The levels of faecal coliforms (FC), indole-positive FC (presumptive Escherichia coli), faecal streptococci (FS), Streptococcus faecalis and Clostridium perfringens in the natural water sources used by 29 rural settlements in Sierra Leone were investigated. Levels of the same indicators in human faeces were also investigated. The incidence of Salmonella spp. in both habitats and the temperature, pH and conductivity of water sources were also recorded. All water sources were contaminated with the indicator bacteria, mean numbers of which occurred in the relationship FC greater than presumptive E. coli congruent to FS congruent to C. perfringens greater than S. faecalis. FC were also predominant in human faeces, the relationship of means being FC congruent to presumptive E. coli greater than FS greater S. faecalis greater than C. perfringens. The need for confirmation of FC counts obtained from water sources was indicated by the large number of positive tubes produced in the FC multiple-tube dilution test from some samples which could not be confirmed as presumptive E. coli. Salmonella spp. Were isolated from 13 water sources and 6% of faecal samples. Mean water temperature was high (26.2 degrees C), pH low (5.04) and conductivity low (34 microS cm-1). Presumptive E. coli was considered the most appropriate indicator of faecal pollution of the types of water investigated.

Bacteria↗
PubMed1998

One-two rural residency tracks in family practice: are they getting the job done?

BACKGROUND: In the 1990s, the Residency Review Committee for Family Practice (RRCFP) and the American Board of Family Practice used the development of rural training programs as a strategy to bridge training experiences across urban referral centers and rural community hospitals. These programs are relatively small and attract trainees who are predisposed to rural practice. Aggregating data from several programs yields insight about their challenges and their ability to produce graduates who enter rural practice. METHODS: This descriptive analysis is based on self-reported data from a 1996 survey mailed to the residency program directors of rural training programs, identified by the RRCFP office as one-two programs. RESULTS: More than half of the rural training programs surveyed were located in health professions shortage areas, most in communities with little urban influence. These programs are equally likely to be sponsored by university- or community-based residency programs. Most (75%) placed two or fewer residents per year in the rural site; minorities accounted for 4% of placements. Thirty percent of programs report unfilled positions. Seventy-five percent use televideo communications and find experiences in surgery and obstetrics relatively easy to arrange but dermatology and critical care difficult. Seventy-six percent of graduates enter rural practice after graduation. CONCLUSIONS: This survey suggests that family practice rural one-two residencies are meeting the goal of providing trainees with a rural immersion experience, in anticipation of selecting rural practice after graduation.

Community Health Services↗
PubMed2006

Cookin' Up Health: developing a nutrition intervention for a rural Appalachian population.

Cookin' Up Health is a culturally targeted and individualized tailored nutrition intervention using a computer-based interactive format. Using a cooking show theme, the program demonstrates step-by-step meal preparation emphasizing healthy selection and portion control. Focus groups were conducted with women in two rural counties in West Virginia to guide the development of the intervention. Women felt more susceptible to heart disease because the changing role of women creates more stress and less time; weight loss was a greater motivator for dietary change than was preventing heart disease; social support is a barrier and facilitator for dietary change; cultural heritage and the way women were raised were major barriers to making health changes as adults; convenience and the cost of eating healthier were major factors when trying to make changes in diet; and women did not feel confident in their ability to maintain dietary changes.

Appalachian Region↗
PubMed1992

Property structures, demography and the crisis of the agrarian economy of colonial Bombay Presidency.

Reasons for the relative failure of agricultural development in India during the colonial period are analyzed, and the effects of the scarcity of capital, the absence of suitable technology, and the growth of the population are assessed. "The article explores the manner in which peasant possession of land and other means of subsistence limited productive utilisation of capital and technology, triggered a certain demographic regime and, in turn, disrupted further developmental possibilities." The geographical focus is on the area coinciding with the modern states of Maharashtra and Gujarat.

Agriculture↗
PubMed1987

St. Lucia.

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Agriculture↗
PubMed1987

Belize.

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Agriculture↗