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PubMed2007

Characteristics of urban natural areas influencing winter bird use in southern Ontario, Canada.

Characteristics of urban natural areas and surrounding landscapes were identified that best explain winter bird use for 28 urban natural areas in southern Ontario, Canada. The research confirms for winter birds the importance of area (size) and natural vegetation, rather than managed, horticultural parkland, within urban natural areas as well as percent urban land use and natural habitat in surrounding landscapes. Alien bird density and percent ground feeding species increased with percent surrounding urban land use. Higher percent forest cover was associated with higher percentages of forest, bark feeding, small (<20 g) and insectivorous species. Natural area size (ha) was related to higher species richness, lower evenness and higher percentages of insectivorous, forest interior, area-sensitive, upper canopy, bark feeding, and non-resident species. Higher number of habitat types within natural areas and percent natural habitat in surrounding landscapes were also associated with higher species richness. Common, resident bird species dominated small areas (<6.5 ha), while less common non-residents increased with area, indicative of a nested distribution. Areas at least 6.5 ha and more generally >20 ha start to support some area-sensitive species. Areas similar to rural forests had >25% insectivores, >25% forest interior species, >25% small species, and <5% alien species. Indicator species separated urban natural areas from rural habitats and ordination placed urban natural areas along a gradient between urban development and undisturbed, rural forests. More attention is needed on issues of winter bird conservation in urban landscapes.

Animals↗
PubMed1995

Public health crises of cities in developing countries.

During the decade and a half after Alma Ata hundreds of projects were started in developing countries to implement the principles of PHC and start community based health care programs in the rural areas of developing countries. Until the past five years urban health was not seen as a special health problem. Population pressure in the rural areas has created shortages of land, food and employment opportunities. These forces have generated major population movements to the urban centres. The population movements have encouraged unprecedented expansion of urban centres. This sudden concentration of large populations in small geographical areas has resulted in the urban health crises of the developing world. The poor who live in the slum areas have no access to adequate health services, they experience frequent epidemics of communicable diseases like cholera, they live within a heavily polluted environment, and their children have very poor health because they are not immunized and are malnourished. The paper agrees with approaches which have been championed by development agencies to address the urban health crises. These approaches propose the reorientation of urban health systems to include adoption of PHC for urban health programs, intersectoral collaboration and extra budgetary support. The paper argues for further strengthening of the reorientation approach by adjusting the development planning model. It is proposed that the urban plan be integrated into the national development plan so that emerging urban health crises can receive special attention in resource allocation.

Adult↗
PubMedDate not supplied

Assessment of water use and sanitation behavior of a rural area in Bangladesh.

A health development project was established in a rural area of Bangladesh that entailed training village health promoters to provide health education and to motivate families to install tubewells and sanitary latrines. Following a 2-y period of project implementation, the authors sought to assess knowledge and practice of mothers and family members about use of safe water and household tubewells. A household survey in the project area was compared with a similar one in a nearby control area. Three-hundred households in each area were selected, and mothers were interviewed with a standard questionnaire. Significantly more mothers in the health development project area (45.7%) used tubewell water for domestic purposes than in the control area (32.8%). However, hygienic practices of mothers were inadequate. Sanitary latrines were present in less than 20% of households in both areas. Approximately 97% of mothers and 78% of adult family members always used household latrines. However, the use of household latrines by children was low (26.7%). There was no statistically significant difference in the use of household latrines between the project and control areas. The results showed an improvement in use of household tubewells in the project area; however, there was no improvement in sanitation practices of families in the project area. Health education alone, without improvement of socioeconomic status, is not effective in changing behavior.

Adult↗
PubMed1988

Illness and reservoirs associated with Giardia lamblia infection in rural Egypt: the case against treatment in developing world environments of high endemicity.

A longitudinal investigation of the health effects and reservoirs of Giardia was undertaken during 1984-1985 in 40 households located in the rural Nile Delta region of Egypt. Stool specimens obtained once weekly for six months from 2-4-year-old children were cyst- or trophozoite-positive in 42% of the 724 examined. Only one child remained Giardia-negative during the study. The mean duration of excretion in Giardia-positive children was seven and one-half weeks with a range of one to 17 weeks. Mucus was present in 52% of all stools collected, and fecal leukocytes were observed with surprising frequency in the absence of identifiable pathogens. Clinical symptoms of illness were frequently observed within a month before or after Giardia excretion in stool of children, but a statistical inference of association was not demonstrated. Seventeen per cent of 697 specimens obtained from their mothers were Giardia-positive for a mean duration of four weeks and a range of one to 18 weeks. A total of 962 specimens were collected from 13 species of household livestock. Giardia was detected in 22 specimens from cows, goats, sheep, and one duck. Giardia cysts were detected in three of 899 samples of household drinking water. The ubiquity of the protozoan as well as the failure to show an association between infection and symptomatic illness argue against the administration of Giardia-specific drugs to children in settings where the risk of reinfection is high and for whom intestinal insults are both varied and constant.

Animals↗
PubMed2004

Tuberculosis control in rural India: lessons from public-private collaboration.

SETTING: A rural tuberculosis (TB) Unit (population 350 794) in Pune district, Maharashtra State, India. OBJECTIVE: To develop a 'model' partnership between rural private medical practitioners (PMPs) and the Revised National Tuberculosis Control Programme (RNTCP). DESIGN: A partnership was developed between 100 PMPs in the study area and the district health and tuberculosis staff through facilitation by a non-governmental organisation (NGO). Participatory research methods were used to plan and implement the partnership. The process of creation and implementation of the partnership was analysed using quantitative and qualitative research methods. RESULTS: The partnership contributed to 30% of the cases detected in the TB Unit over a 5-month period. Six months after withdrawal of the NGO, referrals from the private sector to the RNTCP were continuing to a lesser extent, but there was a breakdown of the communication and documentation systems. CONCLUSION: The project highlights the importance of organisational and individual commitment to these partnerships, the key roles of the District Health Officer and the District Tuberculosis Officer in guiding and supporting these initiatives from the public sector, the potential role of process and outcome 'indicators' in monitoring partnerships and the important role of NGOs as intermediaries and facilitators.

Communicable Disease Control↗
PubMed2000

Development of a health service at a rural community college in Appalachia.

The successful implementation by a large public university health service of a satellite clinic involves a number of processes and funding issues. The authors discuss the development of such a program at a small community college in Appalachia. The first 4 years' experience in operating the satellite clinic created a number of valuable management lessons that they believe could assist others with similar goals for extending their services.

Adult↗
PubMed2003

Integrated critical care: an approach to specialist cover for critical care in the rural setting.

Critical care encompasses elements of emergency medicine, anaesthesia, intensive care, acute internal medicine, postsurgical care, trauma management, and retrieval. In metropolitan teaching hospitals these elements are often distinct, with individual specialists providing discrete services. This may not be possible in rural centres, where specialist numbers are smaller and recruitment and retention more difficult. Multidisciplinary integrated critical care, using existing resources, has developed in some rural centres as a more relevant approach in this setting. The concept of developing a specialty of integrated critical-care medicine is worthy of further exploration.

Critical Care↗
PubMed1980

Rural water and sanitation. Community participation in appropriate water supply and sanitation technologies: the mythology for the Decade.

The International Drinking Water Supply and Sanitation Decade (1981-90) is almost upon us. During this period, massive international efforts will be made to accelerate the provision of domestic water supply and sanitation facilities for the rural population of developing countries. Certain concepts and approaches are being developed and promoted as guiding themes that will help to steer and coordinate the activities of the Decade. Among them are 'appropriate technology' 'community participation' and a 'village level' or 'user-choice' approach. The validity and importance of these concepts are discussed. It is concluded that these concepts are often applied in an over-simplified manner and that they divert attention away from the fundamental political and administrative realities that primarily determine the success or failure of rural water and sanitation programmes.

Community Participation↗
PubMed1996

Molecular approaches to vaccinating against hookworm disease.

Anthelminthic drug chemotherapy has failed as an acceptable approach to hookworm control in the less developed countries of the tropics. The development of a genetically engineered vaccine against hookworm infection would be a major advance in our efforts to control this parasitic disease. We have produced several lead recombinant hookworm vaccine antigens. Their development is based on scientific principles that were generated almost 70 years ago when investigators first began to attenuate living infective hookworm larvae. Those early studies on attenuated live vaccines highlighted the importance of secreted larval antigens for eliciting protective immunity in dogs challenged with Ancylostoma caninum. The two major secreted larval antigens have been recently identified as Ancylostoma secreted protein-1 (ASP-1) and ASP-2. The predicted amino acid sequences of the ASP cDNAs together with experimental immunogenicty data using the expressed recombinant protein suggest that the ASPs are promising vaccine antigens. Preliminary hookworm challenge data in mice immunized with recombinant ASP-1 helps to validate this assumption. Alternative vaccines based on either genetic immunization (DNA vaccines) or immunization with recombinant molecules expressed from adult hookworm cDNAs are also under evaluation. Optimization of vaccine route, delivery system, and adjuvant formulations will be required before future planned phase I testing in humans. Vaccine development for a target population living in rural areas of less developed countries will require innovative solutions to financing and manufacture.

Amino Acid Sequence↗
PubMed1994

The impact of rural-urban migration on child survival.

Large rural-urban child mortality differentials in many developing countries suggest that rural families can improve their children's survival chances by leaving the countryside and settling in towns and cities. This study uses data from Demographic and Health Surveys in 17 countries to assess the impact of maternal rural-urban migration on the survival chances of children under age two in the late 1970s and 1980s. Results show that, before migration, children of migrant women had similar or slightly higher mortality risks than children of women who remained in the village. In the two-year period surrounding their mother's migration, their chances of dying increased sharply as a result of accompanying their mothers or being left behind, to levels well above those of rural and urban non-migrant children. Children born after migrants had settled in the urban area, however, gradually experienced much better survival chances than children of rural non-migrants, as well as lower mortality risks than migrants' children born in rural areas before migration. The study concludes that many disadvantaged urban children would probably have been much worse off had their mothers remained in the village, and that millions of children's lives may have been saved in the 1980s as a result of mothers moving to urban areas.

Adolescent↗
PubMed1990

Sanitation in rural communities in Bangladesh.

Household sanitation in developing countries, especially in the rural areas, is poor. An evaluation of what was achieved in this regard during the 1980-90 decade of safe water supply for all was carried out in the present study. It was observed that even where a safe water supply and sanitary latrines were provided, people did not always use them. While 23% of the studied households had sanitary latrines, children in about 11.5% of these households did not use them and women in about 6% of households did not use them for micturition at night. Not a single house in the study area could fulfil all the criteria of sanitary housing in a strict sense; for example, although 34.5% of the households had tubewells, only 11.5% of them had a satisfactory level of water usage. Since socioeconomic conditions and education influence the level of sanitation, improvements in both are required.

Bangladesh↗
PubMedDate not supplied

The evolution of rural health networks: implications for health care managers.

This article examines the development and operation of rural health networks in the United States based on data collected from telephone surveys of rural health networks containing at least one rural hospital in the United States in 1996 and four years later in 2000. The implications of network development for health care managers participating in, or considering participation in, a rural health network are discussed.

Budgets↗
PubMed1999

Epidemiology of eye injuries in rural Tanzania.

In the developing world, ocular trauma is an important cause of monocular blindness. However, little is known about the epidemiology of eye injuries in rural Africa. This study presents five- year data on hospitalized ocular injuries in a rural region in Tanzania. Data were collected from Mvumi Hospital, a tertiary hospital serving rural Dodoma, and the only hospital during this time period able to care for serious trauma. All in-patient charts from January 1, 1985 to December 31, 1989 were reviewed for cases of ocular trauma who presented within 30 days of injury. Data on demographics, cause of injury, visual acuity, and current diagnosis were abstracted. A total of 157 cases were recorded, of whom 69% were male. A third of the injuries occurred in those less than age 20. Injury with a stick was the most common cause, accounting for 67% of the cases. A third of the cases presented to the hospital 8 or more days after the injury, and most had poor visual acuity in the affected eye. In those age 20 or younger, 82% of females and 67% of males presented with visual acuity <3/60. Ruptured globe and uveitis were the most common diagnosis made at presentation. Preventive ophthalmology efforts in this area should focus on decreasing stick-related ocular injuries and improving rapid access to appropriate care when injuries occur.

Adolescent↗
PubMed1993

International Foundation for Dermatology. A challenge to meet the dermatologic needs of developing countries.

The primary goal of the IFD, which serves under the aegis of the International Committee of Dermatology (the governing body of the International League of Dermatological Societies), is to improve dermatology and dermatologic care in rural areas and developing countries. The principal mission of the IFD is to create regional dermatology training centers in geographic areas of greatest need. The first such center, serving the 12 countries of the African Regional Health Community, is located in Moshi, Tanzania. After successfully completing a 2-year course, the emerging dermatology officers will return to their countries of origin to promulgate the information they have learned by teaching others. The second RDTC is located in Chimaltenango, Guatemala to serve 10 countries in the Caribbean basin by training auxiliary nurses to man health posts in rural areas in this region. All dermatologists in the developed world should view their responsibility to their profession and to those suffering from dermatologic diseases in developing countries as a challenge that can be met if we all labor together to ensure a better world for those who currently have minimal or no dermatologic care. Remember: Give a man a fish and you feed him for one day; teach a man to fish and you feed him for life!

Academic Medical Centers↗
PubMed1992

Female labour participation in agricultural production and the implications for nutrition and health in rural Africa.

The broad objectives of this paper are: firstly, to examine the initial impact of colonialism on food production by women, by considering their role and activity patterns within the household in terms of rights, obligations, exchanges, allocation of resources and responsibilities and the division of labour in the selected African Societies of the Luo, Kikuyu and Luhya (Kenya), Ewe and Kusasi (Ghana), Mandinka (The Gambia), Yoruba (Nigeria) and Azande (Sudan). These ethnic groups used as examples were mainly selected on the basis of their predominance and availability of data in these countries lying in the Sub-Saharan Africa having similar historical roots of the British colonial policies. Secondly, some of the possible social, economic and biological effects or implications on the changes in rural women's work in the chosen case studies in Africa are elucidated. It has been hypothesized that the development process in rural Africa has marginalized women (with varying degrees) in the subsistence sector, reducing their productivity and control over resources; and that women's total work burden has relatively increased, a phenomenon which can be understood as an integral process of capital penetration and accumulation. These changes may have significant implications for nutrition and health affecting the overall levels of food production. Although the selected illustrations do not represent the full range of possibilities in Sub-Saharan Africa, the data on the gender roles and workpatterns and the different changing ways do indicate that the women's role in food production has profound implications for socio-economic development in general and nutrition and health in particular with much wider applicability. In fact no such cross-sectional study has been conducted in rural Africa. It is generally concluded that any consideration of women's agricultural production should not neglect the structural bases of their inequality, and the policies can be inadequate if they overlook the relationship between the subsistence and commercial sectors and the women's role in each. In effect, the relative and absolute losses in women's food production and incomes bear immediately on the food crisis of many of the Sub-Saharan African countries, and that the current policies for the food crisis are likely to fail unless there is an improvement of the data base in women's and men's specific food production activities, processing and marketing for use in policy formulation and implementation. Indeed, the integration of women into the development process should be sensitive to and cognizant of their needs, contributions and potentials in Sub-Saharan Africa.

Africa↗