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PubMed1992

[Strategy for monitoring and implementing methods for correcting child growth and development in rural areas of Sonora. Mexico].

An appropriate health technology to facilitate child growth and development in a rural area is presented and documented. Because mother's adequate behavior related to child's care does not produce immediate behavioral or physical changes it is necessary to create a long term social system of consequences. This was achieved joining a longitudinal measurement system with a program to train mothers to identify and deal with health and development issues. During four years, data were collected on weight-length development and morbidity twice a year and simultaneously skills were taught to diagnose treatment and prevent growth and development problems. After the third session child development and anthropometry data became the base of a system to assess maternal behavior, providing consequences for links in the behavior chains associated with child care. This system made organization and participation of the community in primary health care programs more likely, which implied a better score in each child growth and development chart.

Adult↗
PubMed1979

Development of rural health services: problems illustrated by a nonprofit, privately-based approach.

The historic development of a nonprofit organization designed to improve rural health services in Colorado is described and some of the major problems of rural health are discussed. This corporation, originally derived from four different kinds of provider organizations, has developed a comprehensive approach to improving the utilization of existing rural health resources and to the recruitment and deployment of new resources. Emphasis has been placed on community involvement, decreasing the isolation of rural physicians by linking rural practices with urban resources, centralizing supportive services and development of quality control methods. The peculiarities of the target area and the evolution of the goals and methods of the organization are described in order to facilitate the adaptation of these concepts to other areas.

Colorado↗
PubMed2006

Early childhood growth and development in rural Guatemala.

BACKGROUND: Small size at birth and in early childhood has been associated with impaired neurodevelopment in studies from developing countries, but few have examined associations with growth. AIMS: The objective of this study was to assess the relationship between growth and neurodevelopment during early childhood (birth-36 months). DESIGN: Multivariate regression models were used to analyze the data collected in the course of a study of pregnancy outcomes and early childhood growth and development carried out in rural Guatemala in 1991-1999. Motor and mental development scores were based on the Psychomotor and Mental Development Indices, respectively, derived from the administration of an adapted version of the Bayley Scales of Infant Development (Second Edition, 1993) at 6, 24 and 36 months. Z-scores for height-for-age (HAZ), weight-for-age (WAZ), and head circumference-for-age (HCZ) were used as indicators of attained size; changes in these Z-scores over time represent growth. RESULTS: Birth size was significantly associated with child development at 6 and 24 months. Gains in length and weight during the first 24 months were positively associated with child development, whereas growth from 24 to 36 months age was not associated with child development at 36 months. Motor development was more strongly and consistently related to child growth than was mental development. Head circumference gain after 6 months was not a significant predictor of child development at 24 and 36 months. CONCLUSIONS: Small size at birth and poor physical growth during the first 24 months are related to neurodevelopmental delays. More evidence from developing countries will help explain the underlying mechanisms and identify appropriate interventions to prevent neurodevelopmental delay in early childhood.

Body Height↗
PubMed2005

Colorectal cancer detection in a rural community. Development of a colonoscopy screening program.

PROBLEM BEING ADDRESSED: Colorectal cancer (CRC) is a substantial cause of death and morbidity in Canada. Endoscopy screening by colonoscopy has been recommended, but widespread implementation is impossible because it is difficult to obtain, especially in rural areas. OBJECTIVE OF PROGRAM: To screen for CRC safely and effectively using colonoscopy performed by non-specialist endoscopists in rural areas. PROGRAM DESCRIPTION: Health providers and community organizations were informed about the screening program. Patients between the ages of 50 and 75 and those at high risk of CRC based on family history were screened. Measures of safety and effectiveness were monitored. In 2 years of screening, one of 152 patients was found to have CRC, and 23.7% had adenomatous polyps. There were no complications. Rates of CRC and adenoma detection and cecal intubation were similar to rates found in other screening studies. CONCLUSION: It was not difficult to design and implement a CRC screening program in our small rural community. Colonoscopies performed by family physicians have been effective, and there have been no serious complications.

Aged↗
PubMed2004

Rural policy development: an NRHA and PACE association collaborative model.

The Program of All-Inclusive Care for the Elderly (PACE) offers a unique model of comprehensive care for frail, elderly people. To date, all of the PACE programs have been located in urban areas. Rural advocates and policymakers, however, believe the program may hold great promise for use in rural areas, which have higher percentages of elderly residents than urban areas. In 2002, the National Rural Health Association and the National PACE Association convened a meeting that brought together PACE experts, policymakers, and rural health care providers to examine PACE and its applicability for rural communities. The meeting participants concluded that there were many rural communities where the PACE model might not only be appropriate but also highly successful in caring for rural, frail, elderly people. This article examines the notion of expanding the PACE model to rural communities, including some of the barriers and some of the possible solutions that might make PACE a viable part of the rural health care delivery system.

Aged↗
PubMedDate not supplied

Secondary sexual development in rural and urban South African black children.

The timing and duration of secondary sexual development in two samples of rural and urban South African black children were investigated using the Tanner staging techniques and compared to similar data from Switzerland and England. In general rural black children were consistently delayed in the age at which they entered the events of puberty, and took longer to pass through each of the stages. Urban black children, from good socioeconomic backgrounds, were advanced in relation to their rural peers and slightly ahead of the European samples. There were no significant differences in the sequence of events. Estimates of testicular volume on the well-off urban boys demonstrated that they exhibited similar volumes to European boys at similar ages. It is suggested that the British clinical longitudinal growth standards could be effectively used to sensitively monitor the growth and maturation of black urban children from good socioeconomic backgrounds.

Adolescent↗
PubMed1981

The relationship between physical growth and infant behavioral development in rural Guatemala.

The present study investigated the relationship between a number of anthropometric indices and behavioral development during the first 2 years of life in rural Guatemala. Length and weight were the indices most strongly correlated with behavioral development. If the effect of the infant's length and weight was statistically controlled for, none of the other anthropometric variables explained a significant proportion of the variance in behavioral development. Controlling the length (or weight) assessed at the same age as the behavioral assessment, length (or weight) for younger ages was not significantly correlated with behavioral development. Changes in length or weight over time correlated with changes in behavioral performance. We were unable to explain the association between physical growth and behavioral development by a number of variables including gestational age, nutrient intake, prevalence of disease, and familial characteristics.

Body Height↗
PubMed1997

Developing a rural primary care practice network.

Establishing and managing a primary care practice in rural communities is particularly challenging. Many rural practices are closing, and relatively few new practices are initiated independently. The integrated health system can provide at least part of the solution to the lack of physicians in the rural setting. The following article describes the objectives, methods, and results of an integrated health system's development of a rural primary care provider network.

Community Networks↗
PubMedDate not supplied

A dental school's role in developing a rural, community-based, dental care delivery system for individuals with developmental disabilities.

The long-standing problem of access to dental care for persons with developmental disabilities in rural Northern California has been addressed in several communities by a unique community-based program. The goal was to create a coalition to coordinate dental school resources with those of a consortium of agencies to address problems in the local communities. This program established a community-based model demonstrating the provision of quality preventive and therapeutic dental services to these individuals. Through this program, dental care delivery systems were formed in three rural communities involving local community dentists and agency personnel. The role of the dental school was: (1) to establish and then work with a consortium of hospitals, agencies, dentists, and other dental personnel; (2) to train local dental personnel; (3) to establish and equip hospital dental facilities; (4) to conduct dental screening and triage clinics; (5) to consult with local agencies and dentists; (6) to act as a referral center for patients with complex medical situations; and (7) to develop and disseminate preventive dentistry training materials.

California↗
PubMed2002

An interdisciplinary rural health course: opportunities and challenges.

What is the potential of courses designed for nursing students to meet the learning priorities of other disciplines? Who could benefit? Nursing students at Brandon University interested in the 'community as client' concept requested a course that focused on the health of rural residents and the communities in which they live. Questions about (1) measuring the health of rural populations; (2) comparing health status, health resources and health care utilization of rural and urban populations; and (3) determining the health of rural communities emerged. As a result the course, 'Health of Rural Populations and Communities', was created. The Director of the Rural Development Institute examined the syllabus for the new course and asked that Rural Development students be allowed to enroll. This paper focuses on the challenges and opportunities for nursing education to address learning needs of other disciplines by sharing health and nursing knowledge. In doing so the learning of nursing students is also advanced. The development and delivery of a rural health course is used as a case study to illustrate the potential of this approach for nursing and interdisciplinary education.

Community Health Nursing↗
PubMed1976

Developing a rural mental health service from a base in an academic clinical psychology program.

The development of a Community Mental Health Service for a multiethnic rural area by an academic psychology department clinical program was carried out for the purpose of providing relevant training for grauate students through realistic service functions. The population served was largely lower socioeconomic, and the available resources very limited. The Community Psychology course was used to assist the planning and negotiating for the clinic. Services provided during the first year are summarized. The graduate students' not-too-happy view of the program is presented. The problems and issues raised by this experience, for both training and service, are discussed.

Community Mental Health Services↗
PubMed1999

Agricultural policy and sustainable livestock development.

Future agricultural and rural development is, to a large extent, influenced by the projected food needs of 2.5 billion people expected to swell the world population by 2020. This increase will require more food in general and, in view of recent experience in East Asia, more animal products. To achieve this increase will require judicious use of resources, and trade, especially in those countries where natural resources are insufficient to support food production. Achieving food sufficiency in a sustainable manner is a major challenge for farmers, agro-industries, researchers and governments. The latter play an important role as many of the farmers' choices are, to a large extent, directed by government or supra-government, often through macro- and micro-economic policy. In many countries the economic, environmental, trade and agricultural policies have not been conducive to an agricultural development that is risk-free with respect to the environment, animal welfare or public health. The recent decline of government support in agriculture forced farmers in Western countries to think about more risk adverse agricultural practices and more efficient production systems. On the other hand, many countries in Eastern Europe and the former Soviet Union, as well as other developing countries, are still going through a painful process of adjustment to new market conditions. International banks and development agencies have a mandate to help developing countries, but are somewhat restricted both by needing to work directly with governments and by their perceived dogmatic approach to development. Changing policies do, now and in the future, also affect the development of animal disease control programmes, including the control of parasitic diseases. On the one hand there is an increasing interest in risk-free control practices, and on the other hand a demand for greater regulatory control over the production process. As parasitic diseases of animals are closely linked to the environment (i.e. grazing and waste management) and public health (i.e. parasitic zoonoses), the new interest in sustainable agriculture provides a challenge for those concerned with the control and prevention of animal parasitism.

Agriculture↗