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PubMed2005

Stochastic model to forecast ground-level ozone concentration at urban and rural areas.

Stochastic models that estimate the ground-level ozone concentrations in air at an urban and rural sampling points in South-eastern Spain have been developed. Studies of temporal series of data, spectral analyses of temporal series and ARIMA models have been used. The ARIMA model (1,0,0) x (1,0,1)24 satisfactorily predicts hourly ozone concentrations in the urban area. The ARIMA (2,1,1) x (0,1,1)24 has been developed for the rural area. In both sampling points, predictions of hourly ozone concentrations agree reasonably well with measured values. However, the prediction of hourly ozone concentrations in the rural point appears to be better than that of the urban point. The performance of ARIMA models suggests that this kind of modelling can be suitable for ozone concentrations forecasting.

Cities↗
PubMed2002

Current status of coronary risk factors among rural Malays in Malaysia.

BACKGROUND: Coronary heart disease (CHD) is the leading cause of death in Malaysia, despite its status as a developing country. The rural population is thought to be at low risk. OBJECTIVE: To investigate the prevalence of risk factors and global risk profile among rural Malays in Malaysia. METHODS: We studied 609 rural Malay subjects (346 females, 263 males; age range 30-65 years). Blood pressure (BP), body mass index (BMI), waist-hip ratio (WHR), smoking habits and family history of premature CHD were documented. Fasting blood samples were analysed for serum lipids, lipoprotein (a), plasma glucose and fibrinogen. Oral glucose tolerance tests were performed using 75 g anhydrous glucose. RESULTS: The prevalence of hypercholesterolaemia for total cholesterol concentrations of > or = 5.2, > or =6.5 and > or =7.8 mmol/l were 67.3, 30.5 and 11.8% respectively. There was a high prevalence of low serum high-density lipoprotein cholesterol (13.1%), hypertension (30.3%), smokers (24.4%), diabetes (6.4%), impaired fasting glucose or glucose tolerance (13.9%), overweight or obesity (44.7%) and increased WHR (48.5%). Global risk assessment showed that 67.3% of the study population were at risk, with 15.9, 18.9 and 32.5% in the mild, moderate and high risk categories respectively. CONCLUSION: Prevalence of risk factors was high in the rural population. Global risk assessment showed a high-risk profile with two-thirds being at risk, and one-third being categorized into the high-risk group. Although rural communities were considered at low risk of developing CHD, this is changing fast, possibly due to the rapid socio-economic development, in addition to underlying genetic predisposition.

Adult↗
PubMed2004

A framework for landscape ecological design of new patches in the rural landscape.

This study developed a comprehensive framework to incorporate landscape ecological principles into the landscape planning and design process, with a focus on the design of new patches in the rural landscape. The framework includes two interrelated phases: patch analyst (PA) and patch designer (PD). The patch analyst augments the process of landscape inventory and analysis. It distinguishes nodes (associated with potential habitat patches) from links (associated with corridors and stepping stones between habitats). For natural vegetation patches, characteristics such as size, shape, and spatial arrangement have been used to develop analytical tools that distinguish between nodes and links. The patch designer uses quantitative information and analytical tools to recommend locations, shapes, sizes, and composition of introduced patches. The framework has been applied to the development of a new golf course in the rural Mediterranean landscape of Apulia, Southern Italy. Fifty new patches of Mediterranean maquis (24 patches) and garrigue (26 patches) have been designed and located in the golf course, raising the overall natural vegetation area to 70 ha (60% of total property). The framework has potential for use in a wide variety of landscape planning, design, and management projects.

Animals↗
PubMedDate not supplied

Nurse-midwifery service in a rural setting.

This article describes the structure and development of a successful, rural nurse-midwifery service consisting of nine certified nurse-midwives and four obstetricians. The model has shown that the addition of a nurse-midwifery service and the adoption of a collaborative care model can improve obstetric outcomes. The outcomes of this model include an increase in the number of women served each year, a decrease in the cesarean section rate, an increase in the number of twin gestations delivered vaginally, an increase in the number of breech presentations delivered vaginally, an increase in the success rate of vaginal birth after cesarean section, and decreased numbers of episiotomies, with a resulting decrease in the number of third- and fourth-degree lacerations.

Delivery, Obstetric↗
PubMed1989

Access to health care in urban areas of developing societies.

Emphasis on rural health problems has led to a relative neglect of urban health issues in developing societies. Yet the fact that a large proportion of the limited financial and human resources is allocated to urban health care makes it imperative for researchers and health planners to evaluate the effectiveness of the urban health care system. This paper examines data on health care utilization from a sample survey of 1500 households conducted in three areas of Accra, Ghana in 1982. The factors that influence the use of three types of health care services (clinics, drug vendors, and traditional healers) are examined. Suggestions are made for increasing the effectiveness of the health care system in Accra, with the aim of making medical care more accessible to all families.

Community Health Services↗
PubMed2004

Traffic safety assessment and development of predictive models for accidents on rural roads in Egypt.

This paper starts by presenting a conceptualization of indicators, criteria and accidents' causes that can be used to describe traffic safety. The paper provides an assessment of traffic safety conditions for rural roads in Egypt. This is done through a three-step procedure. First, deaths per million vehicle kilometers are obtained and compared for Egypt, three other Arab countries and six of the G-7 countries. Egypt stands as having a significantly high rate of deaths per 100 million vehicle kilometers. This is followed by compiling available traffic and accident data for five main rural roads in Egypt over a 10-year period (1990-1999). These are used to compute and compare 13 traffic safety indicators for these roads. The third step for assessing traffic safety for rural roads in Egypt is concerned with presenting a detailed analysis of accident causes. The paper moves on to develop a number of statistical models that can be used in the prediction of the expected number of accidents, injuries, fatalities and casualties on the rural roads in Egypt. Time series data of traffic and accidents, over a 10 years period for the considered roads, is utilized in the calibration of these predictive models. Several functional forms are explored and tested in the calibration process. Before proceeding to the development of these models three ANOVA statistical tests are conducted to establish whether there are any significant differences in the data used for models' calibration as a result of differences among the considered five roads.

Accident Prevention↗
PubMedDate not supplied

Rural system addresses social, economic needs. Cooperation, education, and advocacy revitalize a region's healthcare delivery.

In recent years leaders at Presentation Health System (PHS), Sioux Falls, SD, have expanded their mission to help strengthen local communities economically and socially. PHS now offers support to rural leaders in business, politics, and healthcare through its Center for Rural Health and Economic Development. In addition, educational outreach coordinators have created programs that address the needs of the entire rural community. To establish an effective network of services in the region, two of the system's tertiary care hospitals are collaborating to provide emergency helicopter service. These larger facilities also extend outreach services to rural hospitals and clinics. PHS assists rural hospitals in grant writing and in adapting to changing government reimbursement rules. In addition, the healthcare system coordinates a group purchasing program and a debt collection agency. An important voice for its region's healthcare needs, PHS has worked with the state of South Dakota to address problems and concerns about emergency medical services. The system also publishes Report, a quarterly newsletter that keeps rural residents abreast of healthcare issues affecting them. Two years ago, PHS's Center for Rural Health and Economic Development sponsored its first Invitational Rural Health Leadership Conference. These annual conferences bring together leaders to examine ways to improve rural healthcare delivery by strengthening the social and economic fabric of rural communities.

Catholicism↗
PubMed2004

Development of a semi-quantitative food frequency questionnaire to determine variation in nutrient intakes between urban and rural areas of Chongqing, China.

Nationwide surveys of food and nutrient intake in China have revealed geographical variation between urban and rural areas. This study developed a semi-quantitative food frequency questionnaire (SQFFQ) for cancer risk assessment suitable for both urban and rural populations by conducting a survey of food intake in Chongqing, China. We recruited 100 urban and 104 rural healthy residents aged from 35 to 55 years in Chongqing, and collected dietary data with 3-day weighed records to assist in the development of the SQFFQ. The intake of 35 nutrients was calculated according to Standard Food Composition Tables for China and Japan. For each nutrient estimated by percentage contribution analysis (CA) and multiple regression analysis (MRA), foods with up to a 90% contribution or a 0.90 cumulative R(2) were selected as items for SQFFQs. The food items of the combined SQFFQ were selected from all items listed in either urban or rural SQFFQs. Mean intake of energy, protein and carbohydrate did not differ between the urban and rural residents. The latter consumed more fat than their urban counterparts. We selected 119 food items for the combined SQFFQ, comprising 22 specific items for the urban SQFFQ, 6 for the rural, and 78 common and 13 additional items. The combined SQFFQ covered 33 nutrients with up to a 90% contribution in each area. We were able to develop a data-based SQFFQ that can estimate nutrient intake of both urban and rural populations, with suitable coverage rates. Further reliability and reproducibility tests are now needed to assess its applicability.

Adult↗
PubMed1997

Randomised controlled trial of anterior-chamber intraocular lenses.

BACKGROUND: There are an estimated 16 million people blind in both eyes with cataracts. Most live in rural areas of developing countries where surgical resources are scarce. There is no consensus on the most appropriate type of intraocular lens in situations where high-volume low-cost surgery is required. This study was undertaken to evaluate the safety of multiflex open-loop anterior-chamber lenses (ACIOLs). METHODS: 2000 people attending Lahan Eye Hospital, southern Nepal, with bilateral cataracts reducing vision to 6/36 or less were randomly allocated to receive standard surgery--intracapsular extraction (ICCE) with aphakic correction--or ICCE with an ACIOL in their first operated eye. The primary outcome was a visual acuity of less than 6/60 in the operated eye at 1 year follow-up. Visual acuity was measured for 91% of the cohort at 1 year. The sample size was estimated to detect a doubling in poor visual outcome from an estimated rate of 4% in the standard surgery (control) group. FINDINGS: The median (range) time taken to do the surgery was 6.0 (3.0-17.2) min for the ACIOL group and 4.1 (2.4-10.3) min for the control group. 1 year after surgery, 5.0% of the ACIOL group and 5.4% of controls had functional vision less than 6/60 (OR 0.93 [0.60-1.43], p = 0.71). The causes of poor vision in the ACIOL and control groups were: correctable refractive error (22 and 29), uveitis/secondary glaucoma (13 and two), endophthalmitis (four and seven), pre-existing eye disease (four and five), retinal detachment (none and four), cystoid macular oedema (two and none), corneal ulcer (one and one), and corneal decompensation (none and one). INTERPRETATION: This study provides evidence that, in rural areas of developing countries, multiflex open-loop ACIOLs can be implanted safely by experienced ophthalmologists after routine ICCE, avoiding the disadvantages of aphakic spectacle correction. Further follow-up is planned.

Anterior Chamber↗
PubMed2000

Randomized controlled trial of anterior-chamber intraocular lenses in Nepal: long-term follow-up.

Most of the estimated 20 million people who are blind with cataracts live in rural areas of developing countries, where expert surgical resources are scarce. We have studied the use of multiflex open-loop anterior-chamber intraocular lenses (ACIOL) in high-volume low-cost surgery. Between 1992 and 1995, a total of 2000 people attending Lahan Eye Hospital, Nepal, with bilateral cataracts reducing vision to < or = 6/36 were randomly allocated to receive intracapsular extraction (ICCE) with aphakic spectacles, or ICCE with an ACIOL. We re-examined the cohort (1305/2000, 65%) between November 1996 and April 1997 and report the findings in this article. There were 13 new cases of poor visual outcome (best corrected vision < 6/60) arising after one year: 9 in the ACIOL group and 4 in the control group; odds ratio 2.1 (95% confidence interval, 0.59-9.55). The causes of poor outcome were as follows: ACIOL group--retinal detachment (4 cases), cystoid macular oedema (2), epiretinal membrane (1), age-related macular degeneration (1), and late endophthalmitis (1); control group--retinal detachment (2 cases), late endophthalmitis (1), and primary open-angle glaucoma with age-related macular degeneration (1). In rural areas of developing countries, well-manufactured multiflex open-loop ACIOLs can be implanted safely by experienced ophthalmologists after routine ICCE, avoiding the disadvantages of aphakic spectacle correction.

Adult↗
PubMed1988

Regional development and seasonality of communicable diseases in rural Andhra Pradesh, India.

This paper explores the seasonality of morbidity due to communicable diseases in Guntur district in Andhra Pradesh, India. The district has been divided into development regions using cluster analysis. Seasonality of selected communicable diseases is then compared with the levels of development. It is shown that seasonality is most pronounced in the least developed region of the district. In the most developed region, seasonality of morbidity is low. The paper supports the general hypothesis that there is a decreased seasonality of illness as development takes place.

Communicable Diseases↗
PubMed1983

The International Eye Foundation/Kenya Rural Blindness Prevention Project.

This paper outlines briefly the background of the International Eye Foundation and the origins of the Kenya Rural Blindness Prevention Project (KRBPP). It examines in some detail the major objectives of the project and the activities which have contributed toward the achievement of those objectives. Objectives of the KRBPP include the strengthening of therapeutic services in rural areas, motivating a re-orientation toward preventive education and away from exclusively curative services and the development of appropriate educational and promotional materials on primary eye care and blindness prevention. The activities of the project have included the development of mobile rural blindness prevention units, the provision of training to health workers at all levels, curricula development for use in health training institutions and the development of a variety of educational and promotional materials for use by health workers, school teachers, students and the general public. It is suggested that the KRBPP can serve as a model for the development of similar national blindness prevention projects throughout the developing world.

Allied Health Personnel↗
PubMed1990

[Prospects of the development of emergency medical services for a rural population].

The results of a complex study of the requirements of rural population of the Moldavian SSR in emergency care are provided. The data on the requirements of rural population in emergency care at prehospital stage are given for the region as a whole, for urban and rural settlements with allowances made for age and sex, according to classes of diseases and with consideration for the season, month of the year, days of the week and hours. The study provides scientifically substantiated organizational forms and perspectives for the development of emergency care in heavily populated rural areas of the region.

Adolescent↗