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PubMed1997

A study of the attitudes of a rural Indian community toward people with physical disabilities.

OBJECTIVE: To examine the attitudes of a rural community in southern India toward its disabled members. DESIGN: Prospective cross-sectional study. METHOD: One hundred and twenty randomly selected villagers around the town of Vellore in southern India were invited to take part in the study. The attitudes towards individuals with physical disabilities were examined using a modified version of the Scale of Attitudes Toward Disabled Persons (SADP). The questionnaire was administered in its original English format with simultaneous translation into Tamil. RESULTS: Data were complete in 111 cases, 82% of whom showed a positive attitude toward people with disability. Gender and employment status did not appear to have an influence on whether the respondent regarded disabled people in a positive or negative way but most older individuals expressed prejudice and/or challenged the rights of disabled people to equal opportunities in education, employment and social integration. Further data analysis demonstrated that more subjects with than without a disabled family member supported the rights of disabled individuals to education, employment and social integration. By contrast, the items of SADP which described the personal attributes of disabled people did not discriminate between the two groups. CONCLUSION: The attitudes of the rural community studied toward people with disabilities were unrelated to the sex or educational status of the respondents but was influenced by their age. This suggests that older subjects in rural communities in developing countries should be the main target for educational programmes which promote positive images of disability.

Adolescent↗
PubMed2003

Recent advances in traditional plant drugs and orchids.

The main objective of this paper is to review recent advances in plant drug research and developments in orchid study, in an attempt to provide useful references for plant drug studies. Plants have been used as medicine for millennia. Out of estimated 250 000 to 350 000 plant species identified so far, about 35 000 are used worldwide for medicinal purposes. It has been confirmed by WHO that herbal medicines serve the health needs of about 80 percent of the world's population; especially for millions of people in the vast rural areas of developing countries. Meanwhile, consumers in developed countries are becoming disillusioned with modern healthcare and are seeking alternatives. The recent resurgence of plant remedies results from several factors: 1) the effectiveness of plant medicines; 2) the side effect of most modern drugs; and 3) the development of science and technology. It has been estimated that in the mid-1990s over 200 companies and research organizations worldwide are screening plant and animal compounds for medicinal properties. Actually, several important drugs used in modern medicine have come from medicinal plant studies, eg, taxol/paclitaxel, vinblastine, vincristine, topotecan, irinotecan, etoposide, teniposide, etc. As for drugs derived from orchids, some novel discoveries, both in phytochemical and pharmacological properties, were reported by some universities. However, studies on plants are very limited. Only about a third of the million or so species of higher plants have been identified and named by scientists. Of those named, only a tiny fraction has been studied. Nowadays the linking of the indigenous knowledge of medicinal plants to modern research activities provides a new approach, which makes the rate of discovery of drugs much more effective than with random collection.

History, Ancient↗
PubMed2001

[The norms of SF-36 scale scores in urban and rural residents of Sichuan province].

OBJECTIVE: To develop the norms of SF-36 in Sichuan, China. METHODS: A total of 1603 rural residents and 646 urban residents were surveyed. Both the US scaling criteria and China scaling criteria were used to score the 8 domains of the SF-36 and compared with the norms of Hong Kong and US populations. RESULTS: The scores of the 8 domains of the SF-36 using China scaling criteria were highly correlated with those using the US scaling criteria, with correlation coefficients greater than 0.98, however, the mean scores using the two scaling criteria were different significantly. The norms of the Sichuan population were more similar to the Hong Kong norms than the US norms. The scores of the SF-36 were different between different age and sex groups and between urban and rural populations. CONCLUSION: We have developed the norms of SF-36 by age/sex groups in urban and rural population of Sichuan, China.

Activities of Daily Living↗
PubMed2004

Experiences of Organization for Economic Cooperation and Development countries with recruiting and retaining physicians in rural areas.

OBJECTIVE: This present study discusses the potential pitfalls in measuring physician shortages in rural areas and presents existing evidence of the effectiveness of policy interventions designed to influence the geographical distribution of physicians. DESIGN: Information on the geographical distribution of physicians was derived from a survey of Organization for Economic Cooperation and Development (OECD) countries and a desk review of the academic literature and policy documents of OECD governments. MAIN OUTCOME MEASURE: Whether policies have been effective in recruiting and retaining physicians in rural areas. RESULTS: Existing measures of physician shortages in rural areas may be misleading as they do not account for a number of supply side factors (e.g. physician productivity, mobility of physicians across areas) and demand-side factors (e.g. patient needs for physician services). Increases in the national number of physicians have narrowed, but not eliminated, shortages in rural areas. Some success in increasing physician supply to rural areas has been reported with educational, regulatory and financial policies; whereas countries' experiences with education-related funding policies are mixed. There is some evidence suggesting that the effectiveness of these policies can be enhanced by supporting occupational opportunities for the spouse/partner, education of children and accommodation. CONCLUSIONS: Although there has been little evaluation of policy interventions, physician shortages in rural areas may be reduced by supply side policies that focus on the physician in combination with measures to sustain the economic and social viability of rural communities.

Delivery of Health Care↗
PubMed2005

Suicide in the elderly in Kaniyambadi block, Tamil Nadu, South India.

BACKGROUND: Inefficient civil registration systems, non-report of deaths, variable standards in certifying death and the legal and social consequences of suicide are major obstacles in investigating suicide in the developing world. Very high rates of suicide have been recorded in the region in the general population and among younger people. OBJECTIVE: This paper describes the suicide rate among the elderly in Kaniyambadi block, Tamil Nadu, South India for the years 1994-2002 using verbal autopsies. METHOD: The setting for the study was a comprehensive community health program in a development block in rural South India. The main outcome measure was death by suicide diagnosed by a detailed verbal autopsy and census, birth and death data to identify the population base. RESULTS: The average annual suicide rate was 189 per 100,000 for people over 55 years of age. The ratio of male to female suicides was 1: 0.66. The age-specific suicide rate for men and women increased with age. Hanging (52%) and poisoning with organo-phosphorus compounds (39%) were the commonest methods employed for committing suicide. Significantly more women chose drowning or burning than men who preferred poisoning or hanging (chi2 19.75; df 1; p < 0.001). CONCLUSIONS: The suicide rate documented in this study among the elderly is very high. The reasons for the high suicide rate observed in older people are not known. There is a need to develop innovative strategies to reduce deaths by suicide.

Age Distribution↗
PubMed2006

Australian issues in the provision of after-hours primary medical care services in rural communities.

OBJECTIVE: In 2003 the Rural Doctors Workforce Agency in South Australia (SA) facilitated the 'SA Rural Hospital After Hours Triage Education and Training Program'. It was designed to improve communication between rural general practitioners (GPs) and nurses undertaking after-hours triage, provide training in triage for rural nurses and develop local collaborative after-hours primary medical care models that can be applied in other settings. DESIGN: The program consisted of a series of three workshops. The first workshop provided an opportunity for GPs and nurses to discuss local issues relating to after-hours primary medical care service delivery. This was followed by a one-day workshop on triage for nurses. A follow-up refresher workshop was conducted approximately six months later. SETTING: Twenty-three rural communities in SA. PARTICIPANTS: Rural GPs and nurses working in rural communities. RESULTS: This paper reports on the issues highlighted by clinicians in providing after-hours primary medical care in rural and remote communities. These included community expectations, systems of care, scope of practice, private practice/public hospital interface, and medico legal issues. CONCLUSION: The issues facing after-hours health services in rural communities are not new. There are many opportunities for improvement of systems. A formal program including workshops and training has provided a useful forum to commence service improvements.

After-Hours Care↗
PubMed2003

Trauma care systems in India.

Trauma-care systems in India are at a nascent stage of development. Industrialised cities, rural towns and villages coexist, with almost complete lack of organised trauma care. There is gross disparity between trauma services available in various parts of the country. Rural India has inefficient services for trauma care, due to the varied topography, financial constraints and lack of appropriate health infrastructure. There is no national lead agency to co-ordinate various components of a trauma system. No mechanism for accreditation of trauma centres and professionals exists. Education in trauma life-support (TLS) skills has only recently become available. A nation-wide survey encompassing various facilities has demonstrated significant deficiencies in current trauma systems.Although injury is a major public-health problem, the Government of India has failed to recognise it as a priority. Significant efforts to develop trauma-care systems across the country are seen mainly in the private sector. New initiatives under National Health Policy 2002 are expected to result in improvement in the systems, but the allocation of funds remains grossly inadequate for any significant impact on the outcome.

Accidents, Traffic↗
PubMed1988

Health promotion for the rural elderly.

There has been increased interest in developing health promotion programs for the rural elderly as a means to foster successful aging. The present study describes one such program and identifies rural and urban differences in health promotion activities. Data come from the California Preventive Health Care for the Aging Program (PHCAP) which is one of the oldest and largest such programs in the United States. A sample of over 5,000 PHCAP clients was drawn from rural, semi-rural and urban projects. Though the rural and urban clients differed significantly with respect to demographic characteristics, differences in health promotion practices were relatively minor. However, the health promotion practices of semi-rural residents differed considerably from that in rural projects. Though less disabled, semi-rural clients received a greater scope of health promotion activities than rural clients. The authors discuss possible site, practitioner and client factors which may have accounted for rural health promotion activities being more restricted. Regardless of project site, the California PHCAP detected many health problems and a majority of clients were referred to other health professionals for treatment.

Aged↗
PubMed2003

Rising consumption of meat and milk in developing countries has created a new food revolution.

People in developing countries currently consume on average one-third the meat and one-quarter of the milk products per capita compared to the richer North, but this is changing rapidly. The amount of meat consumed in developing countries over the past has grown three times as much as it did in the developed countries. The Livestock Revolution is primarily driven by demand. Poor people everywhere are eating more animal products as their incomes rise above poverty level and as they become urbanized. By 2020, the share of developing countries in total world meat consumption will expand from 52% currently to 63%. By 2020, developing countries will consume 107 million metric tons (mmt) more meat and 177 mmt more milk than they did in 1996/1998, dwarfing developed-country increases of 19 mmt for meat and 32 mmt for milk. The projected increase in livestock production will require annual feed consumption of cereals to rise by nearly 300 mmt by 2020. Nonetheless, the inflation-adjusted prices of livestock and feed commodities are expected to fall marginally by 2020, compared to precipitous declines in the past 20 y. Structural change in the diets of billions of people is a primal force not easily reversed by governments. The incomes and nutrition of millions of rural poor in developing countries are improving. Yet in many cases these dietary changes also create serious environmental and health problems that require active policy involvement to prevent irreversible consequences.

Animals↗
PubMed2000

Preventive attitudes towards the threat of AIDS: process and determinants in rural Senegal.

This report is intended to identify the determinants of preventive attitudes and thereby enable the further elaboration of effective prevention programs in a country where the HIV epidemic has remained controlled. Across-sectional survey using a standardized questionnaire was conducted among a sample of 866 adults of the general population of the rural area of Niakhar, Senegal. The analysis identified psychosocial determinants related to preventive attitudes and the influence of sociodemographic characteristics and of sources of AIDS information on these determinants. Psychosocial determinants of preventive attitudes differed according to gender: Among men, personal risk perception was associated with preventive attitudes. Among women, level of AIDS-related knowledge, communication about AIDS, and optimism about the future were associated with preventive attitudes. Sociodemographic factors and sources of information were similar for men and women: Preventive attitudes were adopted primarily by young, educated subjects who had been exposed to urban life. Religion appeared to be a major obstacle to preventive attitudes. Preventive messages broadcast on radio or television may be determinative. Our results call for a strengthened collaboration with religious leaders and a focus on risk perception to rationalize preventive actions. We also encourage the targeting of vulnerable populations, such as women in rural areas, by developing preventive messages to be delivered through national media (radio, television) and by staff from health centers, which most women visit, at least for prenatal care.

Adolescent↗
PubMed1980

The recruitment, training, and distribution of physicians in Yugoslavia.

Yugoslavia has developed a form of communism very different from that found in other communist nations, yet it has faced problems of health manpower distribution not unlike those existing in other countries, both communist and non-communist. Recruitment and training patterns are in some respects similar to those found in the United States: medical students tend to come from high-status, urban families and specialization has increased very dramatically over the past thirty years, in marked contrast to the pattern in the United States. Moreover, though there are continuing discrepancies in physician distribution among urban and rural communes and developed and underdeveloped republics and provinces, these differences are not widening as they have in the United States when similar regional units are observed. It is suggested that physician distribution has been controlled more effectively in Yugoslavia than in the United States, in large part because of the control over available positions exercised by health workers and representatives of social insurance and other institutions.

Communism↗
PubMed2006

Metabolic syndrome in young adults from two socioeconomic Latin American settings.

BACKGROUND AND AIM: Since little information on the metabolic syndrome (MS) is available in Latin America, the aim of this study was to explore whether and to what extent differing socioeconomic conditions influence the prevalence of MS and its associated factors among young adults from two towns in Latin America: semi-rural Limache (L), Chile, and urban Ribeirão Preto (RP), Brazil. METHODS AND RESULTS: A cross-sectional study based on two independent investigations of 22- to 28 year-old subjects using a common methodology. The prevalence of MS (according to the US National Cholesterol Education Program) and its risk factors (smoking habit, alcohol and caloric intake, obesity, physical activity and socioeconomic conditions) were assessed. The prevalence of MS was 10% in L and in RP men, but was lower (4.8%) in RP women. Hyperglycemia was very low (0.8% in L and 1.1% in RP), while the prevalence of low HDL cholesterol levels was high (66.7% and 42.2%, respectively). Intermediate prevalences of hypertriglyceridemia (17.9% and 12.9%), elevated blood pressure (15.5% and 23.1%) and abdominal obesity (19.3% versus 12.7%) were detected. RP subjects had a higher educational level and more qualified jobs, came from smaller families, and a higher proportion were car owners. In L, the smoking habit was more frequent, subjects had higher excess weight and caloric intake, and lower levels of physical activity. CONCLUSIONS: Metabolic changes possibly leading to cardiovascular diseases in later life were present in both populations at an early age, but were higher in the rural and less developed county. Our findings point to the existence of a cultural, educational and socioeconomic phenomenon that possibly influences the prevalence of the diagnostic components of MS through differences in lifestyles.

Adult↗
PubMed1986

BioPrep. A premedical program for rural high school students.

To address physician maldistribution in Alabama and the Southeast region. The University of Alabama established the Biomedical Sciences Preparation Program (BioPrep) in five rural high schools. Its purpose is to help rural, disadvantaged high school students develop academically and socially so that they will be motivated and able to enroll in and progress successfully through college, specifically in pre-health professional curricula. It aims to develop their desire to return eventually to rural areas of Alabama as professionals. Project students are compared with two control groups. Performance on the American College Testing Program college entrance examination revealed significantly higher achievement by the project students. The project students also chose professional careers earlier and more frequently than matched high school students not receiving this special program, but similar to medical students and premedical students. The implications of the project for increasing the size of the rural, disadvantaged student applicant pool are discussed.

Alabama↗
PubMed1996

Translation and reassessment of the Adolescent Self-Perception Profile for a rural, Mexican-American population.

Research has identified problems with self-concept in abused adolescents, and past studies have been conducted primarily with urban populations. Rural and minority adolescents also constitute subgroups at risk for abuse. This study was conducted to reassess reliability and validity of the Adolescent Self-Perception Profile (ASPP), for investigation of relationships between self concept and abuse in rural communities and to develop and perform initial psychometric evaluation of a Spanish language version of the ASPP as a tool to enable investigation of rural Mexican-American adolescents. ASPP development is projected for data base formation of theoretically based interventions and outcome measurement for self-concept. This study provides preliminary validation of the ASPP for these purposes.

Adolescent↗
PubMed1996

Integrated pathways for managing rural health services.

Rural providers must redefine their role in the changing health care system to include a more integrated approach to health care delivery. The rural provider must develop integrated pathways to coordinate all medical, behavior, and social services to ensure that appropriate services are available, locally or through linkages with other providers, for the population. The integrated pathway must manage care across the continuum of services and coordinate decisions occurring at the point of service.

Community-Institutional Relations↗
PubMedDate not supplied

High-performance, low-cost solar collectors for disinfection of contaminated water.

Although the germicidal action of sunlight has long been recognized, its potential for practical applications has to be researched more thoroughly. This paper summarizes the progress made toward a commercially practical collector for solar disinfection applications. Nontracking compound parabolic collectors (CPCs), developed originally for capturing solar photons for thermal energy applications, were examined as potential solar photoreactors. A field demonstration of solar disinfection treatment using commercially manufactured solar reactors was conducted. Field tests showed successful destruction of Escherichia coli and Enterococcus faecalis and have provided data for full-scale design of water treatment systems. From above observations, a throughput value of 50 L/m2 h for the low-cost CPC reactor tested was estimated. For a 190 m3/d (0.05 MGD) facility, the estimated total costs for disinfection using UV-A is U.S. $0.19/m3 ($0.70/1000 gal). The use of near-UV sunlight to disinfect water supplies seems promising in rural communities of developing countries where treated water is unavailable.

Bacillus subtilis↗