The Pacific Islands. Policy options for telecommunications investment.
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The author examines the relationships among migration, agricultural development, and economic development in the labor-exporting countries of Algeria, Morocco, Tunisia, and Turkey. She finds that "massive migration contributes much more to the growth of the service sector than to agricultural or industrial development in the countries of departure." (SUMMARY IN ENG AND FRE)
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The Rural Physician Associate Program (RPAP) has 34 years experience in training 1097 medical students as independent distance learners in a 36-week, community-based continuity primary care experience. This program has been successful in preparing competitive students who select primary care residencies and return to rural practice. The RPAP program has been based on traditional apprentice-style clinical teaching with the support of computer-based resources to enhance distance learning. However while the clinical exposure and development of medical skills was strong, there were weaknesses in evidence-based medicine and managing healthcare, and inconsistencies in community or population health learning. New directions in the educational program for RPAP are described that have been or are being developed to address the competencies as outlined by the Accreditation Council on Graduate Medical Education. They include online and other resources, preceptor education and support, interactive journaling and cases, electronic portfolios, community projects, observed structured clinical exams and examinations. Ongoing challenges to competency-based education include developing meaningful measures and tools to assess competence for areas such as professionalism or systems-based practice; providing faculty development toward being able to practice, teach and evaluate students with an understanding of the competencies; and to build in ways of practicing, learning and improving care that involve effective teams of health-care professionals.
The Senior Companion Program (SCP), a federally sponsored program, aims to enlist older volunteers to provide in-home services to the homebound elderly. A survey of 48 sample SCP projects providing family caregiver services reveals a distinctly different trajectory of urban and rural project development. In both environments, the longer a project has been in existence, the greater the number of volunteers in service. However, the number of clients served increases for urban projects, but not for rural projects. Relatedly, the unmet need for family caregiver services, the number of referrals unserved by the project, is considerably greater in rural areas. These results suggest that because of factors unique to rural areas, the expansion of clientele may be more restricted in rural settings compared to that in urban settings, thereby implying that rural-urban differences should be reflected in project planning and implementation.
The objectives of the Rural Healthy People 2010 project are to employ a survey of state and local rural health leaders to identify rural health priorities, to synthesize available research and other publications on these priorities, to identify and describe models for practice employed by rural communities to address these priorities, and to disseminate this information to rural communities. We describe these priorities; the content of Rural Healthy People 2010 products, methods, and target audiences; and the continuing evolution of the program. Rural Healthy People 2010 encourages rural support of Healthy People 2010 goals and invites state and local rural health leaders to share their successful models with others.
The Rural Physician Associate Program (RPAP) has 34 years experience in training 1097 medical students as independent distance learners in a 36 week, community-based continuity primary care experience. This program has been successful in preparing competitive students who select primary care residencies and return to rural practice. The RPAP program has been based on traditional apprentice-style clinical teaching with the support of computer-based resources to enhance distance learning. However while the clinical exposure and development of medical skills was strong, there were weaknesses in evidence-based medicine and managing healthcare, and inconsistencies in community or population health learning. New directions in the educational program for RPAP are described that have been or are being developed to address the competencies as outlined by the Accreditation Council on Graduate Medical Education. They include online and other resources, preceptor education and support, interactive journaling and cases, electronic portfolios, community projects, observed structured clinical exams and examinations. Ongoing challenges to competency-based education include developing meaningful measures and tools to assess competence for areas such as professionalism or systems-based practice; providing faculty development toward being able to practice, teach and evaluate students with an understanding of the competencies; and to build in ways of practicing, learning and improving care that involve effective teams of health-care professionals.
Delivering eHealth in developing countries faces different health and socio-economic challenges to the developed one. But, if a global health infrastructure is to evolve, then developing countries need to play their part. So, whilst the context may differ, the localization-globalization of content issues needs to be jointly addressed. In providing robust and affordable connectivity, particularly to rural areas, developing countries can fully exploit the potential of handheld computers and wireless connectivity. Over such an infrastructure new ways of building capacity, both locally and globally, can be supported. Finally, an eHealth infrastructure can support the delivery of healthcare in communities, thereby supporting individuals and community development.
"We find that a nation's urban population percentage increases with GDP per capita; industrialization; export orientation; and possibly, foreign assistance. It decreases with the importance of agriculture. Industrialization and agricultural importance have the same implications for the concentration of urban population in cities with 100,000+ population as for the urban percentage. Greater export orientation reduces such concentration. Finally, GDP per capita, population, and export orientation reduce primacy. Political factors, such as whether a country's largest city is also its capital, affect primacy. Our results do not seem to imply that developing-country urbanization today differs fundamentally from urbanization in the past."
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