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At least 1,279 records · Page 71Linked to original sources
PubMed2003

Long-term variation in surface ozone and its precursors in Athens, Greece: a forecasting tool.

INTENTION, GOAL, SCOPE, BACKGROUND: Photochemical pollution is a very complex process involving meteorological, topographic, emission and chemical parameters. The most important chemical mechanisms involved in the atmospheric process have already been identified and studied. However, many unknown parameters still exist because of the large number of participating chemical reactions. OBJECTIVE: The present study investigates the processes involved in the photochemical pollution effect of an urban station located in the greater area of the Athens basin and gives a plausible explanation for the different seasonal ozone development between that station and another rural one. Furthermore, the distribution of the mean monthly surface ozone observed at the urban station during 1987-2001 is examined in order to create a relevant forecasting tool. METHODS: Averaged hourly data of O3 and NOx observations monitored at the above mentioned stations, during 1987-2001, have been used in order to derive the daytime (7:00-15:00) values. Trajectories calculated by using a 2D-trajectory code and meteorological data, during the period 1988-1996, have also been used. RESULTS AND DISCUSSION: At the urban station, the percentage negative trend of NO and NOx data in winter and summer is higher than that in spring and autumn, while the percentage ozone trend is maximum in the summer. On the contrary, the negative surface ozone trend at the rural station exhibits a minimum in summer and a maximum in autumn and winter. The mean seasonal wind-rose for the selected months shows that the northward wind flow dominates during June, the month of the lowest negative ozone trend in the rural station. Finally, the development of the forecasting tool shows that the mean monthly surface ozone data during the period (1987-2001) demonstrates a semi-log distribution. CONCLUSIONS: Air transport effect on the air pollution of the rural station (not blocked by mountains) is deduced as a possible reason for the different seasonal ozone development observed between the rural and the urban station. Finally, the discrepancies between the theoretical probabilities deduced by the model and the empirical ones appear to be very small, and the corresponding correlation coefficient is 0.99. RECOMMENDATION AND OUTLOOK: However, to interpret the aforementioned statistical results about the negative trends in ozone and its precursors, additional parameters can be taken into account. Changes in NOx concentrations, for instance, can result not only from changes in emissions or meteorological conditions. There might also be a contribution through changes in the atmospheric composition. A study of the contribution of changes in atmospheric composition to trends of observed NOx concentrations requires that a series of steps be taken (removal of meteorological influence in the time series, calculation of trends in OH concentrations, etc.).

Air Movements↗
PubMed1994

A computer simulation of household sampling schemes for health surveys in developing countries.

BACKGROUND: Cluster sample surveys of health and nutrition in rural areas of developing countries frequently utilize the EPI (Expanded Programme on Immunization) method of selecting households where complete enumeration and systematic or simple random sampling (SRS) is considered impractical. The first household is selected by choosing a random direction from the centre of the community, counting the houses along that route, and picking one at random. Subsequent households are chosen by visiting that house which is nearest to the preceding one. METHODS: Using a computer, and data from a survey of all children in 30 villages in Uganda, we simulated the selection of samples of size 7, 15 and 30 children from each village using SRS, the EPI method, and four different modifications of the EPI method. RESULTS: The choice of sampling scheme for households had very little effect on the precision or bias of estimates of prevalence of malnutrition, or of recent morbidity, with EPI performing as well as SRS. However, the EPI scheme was inefficient and showed bias for variables relating to child care and for socioeconomic variables. Two of the modified EPI schemes (taking every fifth house and taking separate EPI samples in each quarter of the community) performed in general much better than EPI and almost as well as SRS. CONCLUSIONS: These results suggest that the unmodified EPI household sampling scheme may be adequate for rapid appraisal of morbidity prevalence or nutritional status of communities, but that it may not be appropriate for surveys which cover a wider range of topics such as health care, or seek to examine the association of health or nutrition with explanatory factors such as education and socioeconomic status. Other factors such as cost and the ability to monitor interviewers' performance should also be taken into account.

Bias↗
PubMed2002

The Professional Development Program of the Australian College of Rural and Remote Medicine.

BACKGROUND: The case for doctors' performance and maintenance of competence are issues of increasing importance for the profession, governments and communities. There is also increasing public expectation that the profession will be pro-active in protecting patients from under performing doctors. The Australian College of Rural and Remote Medicine (ACRRM) positions itself as the arbiter of standards for rural and remote medical practice and has assumed responsibility for providing a mandatory Professional Development Program (PDP) for its Fellows. OBJECTIVE: This paper outlines the steps taken by the ACRRM to design and develop a PDP. DISCUSSION: The PDP aims to enable doctors to participate in a range of continuing education activities that enhance their clinical, management and professional skills. Participation is mandatory but the program is designed to be flexible and responsive to the range of practice characteristics in rural Australia as well as to individual needs. The PDP includes categories on continuing medical education, quality assurance and clinical assessment (with minimum compulsory requirements), practice assessment, educator activities and educational development activities. The PDP will evolve over time to meet the needs of doctors and communities in rural and remote Australia.

Australia↗
PubMedDate not supplied

[The epidemiology of aging: a further stage in the demographic transition].

"Social and economic indicators depict Mexico as a country of intermediate development. It is also in intermediate stages of demographic and epidemiologic transitions. When these traits are translated into socio-demographic perspectives, all projections indicate that for the next fifty years we can expect: (i) percentage decreases in child and teen-age populations, (ii) large percentage and absolute increases in adult population, and (iii) important increases in the elderly population.... Among elders death due to infectious diseases is less common than within other sectors of [the] population. Mortality associated with chronic ailments has increased, with recent and remarkable changes during the last twenty years. This transformation is not evenly distributed. It is more accelerated in developed and urban areas as contrasted with the rural and less developed." (SUMMARY IN ENG)

Age Distribution↗
PubMedDate not supplied

[A comprehensive program in the fight against chronic non-infectious diseases in a basic population group--the Belec Study. IV. The interventional model].

As part of a comprehensive programme aimed at the struggle against chronic non-infectious diseases in basic population groups, an intervention model in the rural community Belec has been set up. The development, application and evaluation of this intervention model with an emphasis on positive experiences and difficulties connected with such a model have been described. The role of important parts of the programme has been emphasized--the work of the Health Committee and Guidance Clinic of Elevated Blood Pressure. The results show that there is necessary and possible to efficaciously involve the population of the community into the priority assessment, planning, application and follow-up of such a programme. However, the close cooperation with the local health service and other community sectors and their support is indispensible. It is also stressed that the economic and social development of the rural community is the prerequisite for the continuous intervention measures to be carried out and health care system promoted.

Community Health Services↗
PubMed1994

Aspects of insulin resistance in urbanisation-related hypertension in Zimbabwe: a preliminary report.

Insulin resistance has been associated with essential hypertension, obesity and old age. Likewise high blood pressure has been observed to develop in some rural people who migrate to urban areas in developing countries like Zimbabwe. The pathogenesis of this urbanisation-related hypertension is still unknown. We therefore investigated aspects of insulin resistance in urbanisation-related hypertension in Zimbabwean blacks using oral glucose tolerance tests. Thirty normotensive subjects and 30 newly diagnosed hypertensive patients participated in this study. All subjects had blood pressures measured by random zero sphygmomanometry. Fasting blood samples were taken before a 75 g oral glucose load was given. Four other blood samples were subsequently collected at 30 minute intervals and determination of blood glucose and insulin levels was made. Fasting glucose (mmol/l) and fasting insulin (in microU/ml) levels were, respectively, 4.8 +/- 0.2 and 19 +/- 2 in hypertensive patients which were significantly higher than 4.0 +/- 0.2 and 13 +/- 1.6 in normotensive patients (P < 0.05). In addition the area under the insulin curve was significantly higher in hypertensive than in normotensive patients (P < 0.05). These findings suggest that insulin resistance may play a role in urbanisation-related hypertension.

Adult↗
PubMed2000

A prevalence methodology for mental illness and developmental disorders in rural and frontier settings.

A prevalence study methodology developed for use in rural and frontier settings is described. The general method was developed over a 15 year period and has been successfully adapted and used in studies of 14 different childhood onset developmental disorders. Subjects were the 168,000 school aged children from North Dakota who were first surveyed for cases of autism--pervasive developmental disorders in 1985 and 1986. The results of the prevalence study were compared with the results of a 12-year ongoing surveillance of the cohort. The 12-year ongoing surveillance identified one case missed by the original prevalence study. Thus the original prevalence study methodology identified 98% of the cases of autism-pervasive developmental disorder in the population. This methodology may also be useful for studies of other developmental disorders in rural and frontier settings.

Adolescent↗
PubMed1995

Rural family medicine training in Canada.

OBJECTIVE: To examine the status of postgraduate family medicine training that occurs in rural family practice settings in Canada and to identify problems and how they are addressed. DESIGN: A retrospective questionnaire sent to all 18 Canadian family medicine training programs followed by a focus group discussion of results. SETTING: Canadian university family medicine training programs. PARTICIPANTS: Chairs or program directors of all 18 Canadian family medicine training programs and people attending a workshop at the Section of Teachers of Family Medicine annual meeting. MAIN OUTCOME MEASURES: Extent of training offered, educational models used, common problems for residents and teachers. RESULTS: Nine of 18 programs offer some family medicine training in a rural practice setting to some or all of their first-year family medicine residents, and 99 of 684 first-year family medicine residents did some training in a rural practice. All programs offer some training in a rural practice to some or all of the second-year residents, and 567 of 702 second-year residents did some training in a rural setting. In 12 of 18 programs, a rural family medicine block is compulsory. Education models for training for rural family practice vary widely. Isolation, accommodation, and supervision are common problems for rural family medicine residents. Isolation and faculty development are common problems for rural physician-teachers. Programs use various approaches to address these problems. CONCLUSIONS: The variety of postgraduate training models for rural family practice used in the 18 training programs reflects different regional health care needs and resources. There is no common rural family medicine curriculum. Networking through a rural physician-teachers group or a faculty of rural medicine could further the development of education for rural family practice.

Canada↗
PubMedDate not supplied

Validation of a predictive model for automated external defibrillator placement in rural America.

OBJECTIVE: The development of Automated External Defibrillators (AEDs) to treat out-of-hospital cardiac arrest (OOHCA) has greatly expanded the availability of life saving defibrillatory shocks in various settings. However, placement of AEDs in rural areas remains perplexing since OOHCAs are rare and unpredictable. We set out to develop a cost-effective rural AED placement model and to test the validity of the resulting model using OOHCAs attended by EMS. METHODS DESIGN: A population-based cross-sectional study. Analytic Plan: An exhaustive literature search was conducted to identify community attributes correlated with successful placement of AEDs in rural regions. Identified attributes were characterized using U.S. Census and CDC heart disease mortality data to estimate the potential risk for AED use and applied this estimate to rural census tracts in all 50 states. Based upon risk, AEDS were assigned to each tract using a first responder model and cost effectiveness was assessed. Using Utah State EMS data, the predicted placement of AEDs in each tract was validated using the actual number of OOHCAs attended by EMS. RESULTS: A total of 14,586 rural census tracts in 50 U.S. states were evaluated. On average, 2,600 AEDs were situated within each state. AED placement in rural areas proved as cost effective as health screening programs. In Utah, predicted AED placement correlated with the frequency of OOHCAs attended by EMS personnel (rho= 0.55, p < 0.001). CONCLUSIONS: The resulting model illustrates one potential way to determine the most beneficial location for rural AED placement.

Adult↗
PubMed1975

An outreach program for a rural medical school.

An outreach program for Dartmouth Medical School has been developed which utilizes rural communities in the education and training of medical students and residents in primary care. A correlated curricular track for primary care and a residency program have been established. The program is interdepartmental and administered by the dean, and services provided to patients are financed by fee-for-service. The cost incurred by the presence of residents and medical students is shared by the community and the medical school. The program is based on a close partnership between the medical school and the community in fulfilling their respective educational and service objectives.

Ambulatory Care↗