Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Rural Development”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,603 records · Page 89Linked to original sources
PubMed1995

Pharmacological aspects of obesity treatment: towards the 21st century.

Obesity: a bio-behavioural-environmental phenomenon: Obesity is on the increase all over the world in technologically advanced countries, developing countries and rural communities. What is causing this upward drift in body weight? Can drugs do anything to ameliorate the situation? It is generally agreed that obesity results from genetic vulnerability combined with a provocative environmental situation. This provides the basis for a psychobiological interaction in which behaviour plays a key role. This is the case since it is behaviour which translates biological propensities into action on the environment, and it is behaviour which mediates (in part) the effect of the environment upon biology. Two particularly important behavioural aspects of the genes-environment interaction are low levels of physical activity (high sedentariness) and dietary habits which favour overconsumption (high intake of energy, particularly as fat). One continuing theme of research is the development of drugs to allow people to gain control over appetite by modifying eating patterns (dietary habits) through a number of possible mechanisms. The use of drugs to make people more willing or more able to engage in physical activity is not widely discussed although the use of drugs to increase total energy expenditure (via a variety of mechanisms) is actively researched. More than a decade ago Sullivan defined the framework for the development of anti-obesity drugs by specifying that drugs could act on energy intake, energy output or on those mechanisms involved in the assimilation and storage of lipids in the body.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Weight↗
PubMed2001

Demographic and health issues in rural aging: a global perspective.

The world is witnessing unprecedented changes in population structure, so that both the absolute number and proportion of older people are increasing worldwide. For many developing countries, rapid population aging and the phenomenon of a "double burden" of both infectious disease and emerging chronic diseases represent a major challenge. Many of those who will contribute to these extraordinary transitions will live in rural areas. Many countries, especially the poorest, still have a huge burden of infectious diseases, including increasing rates of HIV/AIDS along with a growing problem of chronic diseases. A number of critical policy considerations come to the fore in examining issues associated with rural aging, including: the need for rural development policies that take account of population aging and the needs of older people; improved coordination and integration of public health and care services in rural areas; support for nongovernmental organizations and community group efforts; and greater use of new technologies for communication. The year 1999 was pivotal for aging in terms of perceptions, attitudes, public action, better research and knowledge, and improved policy decisions that will benefit all of society into this new century. The Second United Nations World Assembly to be held in Madrid in April 2002 will provide further opportunity to build upon this progress and in the formulation of a new International Plan of Action on Aging to point the way for decisive action on positive policy and program initiatives for the future.

Aged↗
PubMed1999

Beliefs about children's illness.

Beliefs about child illness were investigated using semi-structured interviews with mothers and providers in four rural Guatemalan communities. The two most common forms of child illness in Guatemala--diarrhoea and respiratory disease--were focused upon. These illnesses are particularly difficult to prevent and treat, especially with the rudimentary health services available in rural areas of developing countries. Comparisons with other ethnographic studies in Guatemala suggest that some traditional models of illness causation identified in these earlier investigations are relatively unimportant in the communities studied here. This finding, in conjunction with frequent responses related to hygiene and water, suggests that traditional explanations may be co-existing with biomedical views of illness causation to a greater degree today than in the past.

Child↗
PubMed2006

A deployable framework for mobile telemedicine applications.

In recent years, the shortage of medical specialists and access to medical information has necessitated a growing interest for cost effective and efficient telemedicine tools for healthcare delivery. Mobile telemedicine applications are aimed at meeting the mobility requirements of patients and doctors by integrating wireless communications for different health care services and education.Although, telemedicine holds great promises in enhancing health care delivery in rural area and developing countries, only a few applications exist because of poor frameworks for their deployments. This paper, aims at providing a deployable framework for Mobile Telemedicine Applications for Tropical Diseases (MTATD).MTATD presented here, provides access to a telemedicine unit via hand held devices over a PSTN/GSM and the Internet for a collaborative health care delivery and education between patients and care providers.

Computer Communication Networks↗
PubMed1995

Reproductive tract infections and abortion among adolescent girls in rural Nigeria.

Few studies from developing countries have investigated reproductive tract infections or other indicators of sexual health among unmarried adolescent girls in rural areas. We have obtained baseline demographic, clinical, and microbiological data on reproductive tract infections and induced abortion in girls in a rural area of southeast Nigeria, in order to assess the need for health care for adolescents. 868 females attended for interview and examination: 458 aged 20 and above and 410 aged 12-19, the latter representing 93.4%of the adolescent population. 43.6% of those < 17 and 80.1% aged 17-19 years were sexually active and at least 24.1% had undergone an induced abortion; only 5.3% had ever used a modern contraceptive. Vaginal discharge was reported by 82.4%, though few sought treatment. 94.1% of sexually active adolescents and 97.6% of sexually active women 20 years old or over were gynaecologically examined and screened for reproductive tract infections. Of those aged less than 17, 19.8% had symptomatic candida and 11.1% trichomonas infections. Among those aged 17-19 years, chlamydia was detected in 10.5%, and symptomatic candidosis in 25.6%; this was the group most likely to have any infection (43.8%). 42.1% of sexually active adolescents had experienced either an abortion or a sexually transmitted disease. Syphilis was the only infection for which the incidence clearly increased with age. Health-care services for adolescents in this community are needed and should include sex education, contraceptive provision (especially barrier methods), and access to treatment for reproductive tract infections. Investments in health for this age group will have an effect on subsequent reproductive health.

Abortion, Induced↗
PubMed1977

Massive cataract relief in eye camps.

The concept of "eye camp" represents a revolutionary approach to the massive problem of cataract-related blindness and visual disability. The "eye camp" involves comprehensive cooperative relief efforts on a large scale to combat the widespread incidence of cataract as it affects residents of rural areas, especially in developing nations. We worked in an eye camp in Johilpatti, India, in the rural province of Tamil Nadu. On this site, 216 cataract operations were performed in one morning by 8 doctors and 16 nurses. In this province alone, an estimated 700,000 persons have cataract requiring operation. However, presently existing facilities are equipped to handle a maximum of only 20,000 cases annually. But from June 1972 to June 1973, approximately 50,000 cataract operations were performed in the eye camps. Evidently, the eye camp idea has great potential to significantly reduce the incidence of untreated cataract in rural areas where there are chronic shortages of treatment facilities and medical personnel.

Adult↗
PubMed2000

Comparative risk assessment: an international comparison of methodologies and results.

Comparative risk assessment (CRA) is a systematic procedure for evaluating the environmental problems affecting a geographic area. This paper looks beyond the U.S. border and examines the experience with CRAs conducted in various developing countries and economies in transition, including Bangkok, Thailand, Cairo, Egypt and Quito, Ecuador, as well as other locations in Eastern Europe, Asia and Central and South America. A recent pilot CRA conducted in Taiwan is also considered. Comparisons are made of both the methodologies and the results across the relatively diverse international literature. The most robust finding is that conventional air pollutants (e.g., particulate matter and lead) consistently rank as high health risks across all of the CRAs examined. Given the varied nature of the settings studied in the CRAs, including level of economic development, urban-rural differences, and climate, this finding is particularly significant. Problems involving drinking water are also ranked as a high or medium health risk in almost all the countries studied. This is consistent with the results of analyses conducted by the World Bank suggesting contamination, limited coverage and erratic service by water supply systems. Beyond the major air pollutants and drinking water, the CRA results diverge significantly across countries. A number of problems involving toxic chemicals, e. g., hazardous air pollutants, rank as high health risks in the US but do not appear as consistent areas of concerns in the other countries studied. This likely reflects the so-called "risk transition" - the shift from sanitation and infection disease problems to those involving industry, vehicles and toxic substances - that often occurs with economic development. It may also reflect the greater information about sources of toxic pollutants in the U.S. For other problems, there are important differences across the developing countries and economies in transition. For example, hazardous and (industrial) non-hazardous waste issues ranked as medium or low health risks in all the countries studied, except for Taiwan where unmanaged toxic waste sites were considered to pose high risks. While the generally low ranking is consistent with the notion that few people are directly exposed to hazardous and (industrial) non-hazardous waste, it is not entirely surprising that views might be different in Taiwan, where space is so limited and population density is so high. We suggest that the wide range of findings likely reflect genuine differences among the countries studied. However, we cannot entirely rule out the possibility that some of the observed similarities (and differences) arise from the (relatively) common methodologies employed.

Animals↗
PubMed1988

Rural hospital, board changes demand new executive leadership.

Changes in rural hospitals, their boards, and the potential administrative work force have resulted in an increase in experienced, educated healthcare administrators relocating to rural institutions. Rural quality of life, a competitive healthcare environment that demands competent executives, multi-institutional systems replacing rural freestanding facilities, and a saturated urban market have contributed to this shift. Major conflicts of interest between rural boards and executive candidates kept many administrators from choosing rural positions 15 to 20 years ago. Most candidates had an urban background, were dissatisfied with rural salaries, and saw little chance for a sustained challenge, career development, or peer contact. Rural boards saw no great need for executive leadership or formally educated administrators, and they generally distrusted outsiders. Today rural boards have assumed more progressive recruitment methods, comparable with those of urban boards. They cite the importance of a health and business educational background, although candidates' academic records, affiliations, and memberships are less important. Rural chairpersons use well-established criteria in determining prospective administrators' strengths and weaknesses.

Economic Competition↗
PubMed2003

Lessons learned in phase I of the Southern Rural Access Program.

The Robert Wood Johnson Foundation's Southern Rural Access Program has been an important investment of philanthropic funds to augment resources and improve health care access in underserved rural communities. The program's first phase has taught important lessons about building capacity in rural health care. This article uses a variety of data to document the program's major accomplishments and most significant challenges to date. The program's revolving loan fund efforts are promising. The program has also played a catalytic role in stimulating rural health network development in the South and has helped stimulate partnerships with Southern philanthropies and multiple local, state, and federal agencies. Challenges have included the broad geographic and programmatic focus of the initiative as well as changing and often difficult state policy environments. Additional challenges include maintaining interagency coordination over time and managing staff and lead agency turnover. Overall, the experience suggests that a concentrated regional approach has merit.

Community Health Planning↗
PubMed1995

Effective teaching behaviours of rural family medicine preceptors.

OBJECTIVE: To describe effective teaching behaviours of rural family medicine preceptors. DESIGN: Descriptive qualitative study using the critical incident technique. SETTING: Rural Manitoba community practices affiliated with the University of Manitoba's 8-week family medicine/community medicine rotation (clinical clerkship). PARTICIPANTS: All family medicine preceptors and fourth-year medical students involved in two family medicine rotations from Mar. 11 to June 14, 1991. During the first rotation all 12 students and 21 preceptors participated. During the second rotation 12 of the 13 students and 20 of the 21 preceptors participated. The overall response rate was 97%. OUTCOME MEASURES: Effective and less effective preceptor teaching behaviours. RESULTS: During 120 telephone interviews (48 with the students and 72 with the preceptors) 275 critical teaching incidents were elicited. Over 800 teaching behaviours were identified, and seven main categories describing effective teaching behaviours of preceptors were formed: (a) actively involves the student, providing adequate supervision and appropriate independence, (b) develops and fosters a supportive interpersonal relationship with the student to facilitate learning, (c) emphasizes problem solving and the understanding of general principles, (d) balances clinical and teaching responsibilities, (e) demonstrates clinical and professional competence, (f) uses an organized approach, including goal setting and summation, and (g) provides the student with ongoing feedback, assessments and evaluations. CONCLUSION: The teaching behaviours described in this study augment and corroborate findings from previous studies on clinical teaching and provide a better understanding of effective teaching behaviours. The findings suggest a curriculum for a faculty-development program for rural family medicine preceptors.

Canada↗
PubMed1999

The sustainability of telemedicine projects.

Although there are instances where the provision of health care is successfully driven by the profit motive, in most countries it is considered a public service. The provision of telemedicine services assuredly meets an important social need to extend health care to remote and rural areas in developing countries. While there are potential advantages and benefits from telemedicine, the evidence of its cost-effectiveness and sustainability is meagre. Telemedicine undoubtedly yields cost savings in certain circumstances, but few service providers have found a way to recover their costs (and make a profit) from those to whom they provide their service. With their low expenditures per person, developing countries face a daunting challenge in making such public services sustainable. Pilot projects should be a first step in demonstrating the cost-effectiveness and benefits of telemedicine, but such projects should also be sustainable. Sponsors of such pilot projects must have a clear plan from the start about how the project can continue after the sponsorship comes to an end. This paper examines ways in which telemedicine services can be made sustainable.

Capital Financing↗
PubMed2006

Epidemiology of methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus in a rural state.

BACKGROUND: Most data on methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) isolates come from large tertiary care centers. Infection control personnel need to understand the epidemiology of MRSA and VRE across the continuum of care, including small rural hospitals, to develop effective control strategies. OBJECTIVE: To describe the epidemiology of MRSA and VRE in Iowa. SETTING: Fifteen hospitals in Iowa. Methods Between July 1998 and June 2001, a total of 1,968 S. aureus isolates and 1,845 Enterococcus isolates from patients infected with these pathogens were examined. Multivariate models were developed to evaluate patient and institutional risk factors for MRSA infection and VRE infection. RESULTS: The proportion of S. aureus isolates resistant to methicillin was 31%, and the proportion of Enterococcus isolates resistant to vancomycin was 6%. Independent risk factors for MRSA infection included residence in a long-term care facility, age of more than 60 years, hospitalization in a hospital with less than 200 short-term care beds, and acquiring the infection in the hospital. Independent risk factors for VRE infection included use of a central venous catheter, residence in a long-term care facility, acquisition of infection in the hospital, and hospitalization in a hospital with more than 200 short-term care beds. CONCLUSIONS: In Iowa, the epidemiology of MRSA differ from those of VRE. MRSA has become established in small rural hospitals. Effective MRSA control strategies may require inclusion of all hospitals in a state or region.

Aged↗
PubMedDate not supplied

From research to policy: rural women in India.

The following article describes the new awareness of rural women's role in development in India that has resulted from studying rural women directly. It indicates the possibility of moving from research on rural women to the formation of policy and the design of programs that take into account the reality of rural women's lives.

Employment↗
PubMed1995

Adult Self-Perception Profile (ASPP) Spanish translation and reassessment for a rural, minority population.

Research has identified problems with self-concept in abused women, and past studies have been conducted, primarily within urban populations. Rural and minority women also constitute subgroups of women at risk for abuse. This study was conducted to reassess reliability and validity of the Adult Self-Perception Profile (ASPP), for investigation of relationships between self-concept and woman 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 self-concept and abuse for rural Mexican American women. ASPP development is projected for database formation of theoretically based interventions and outcome measurement for woman abuse.

Adolescent↗
PubMed1997

Telemedicine for dermatology care in rural patients.

BACKGROUND: Rural patients who develop dermatologic disorders often do not seek specialty care because of multiple logistical and economic factors. OBJECTIVE: To assess the effect of teledermatology consultations on the cost of care for a given episode of illness. METHODS: Telemedicine records were reviewed for 119 visits by 87 patients referred for teledermatology consultation over a 17-month period. RESULTS: Seven patients (8%) required follow-up in the dermatologist office for extended care, while 20 patients (23%) (52 visits) underwent follow-up teledermatology evaluation. The average duration of the dermatologic condition for each patient prior to the telemedical consultation was 17 months. The average of care for the diagnosed dermatologic condition, for all patients during an average period of 8 months prior to teledermatology was $294, compared with $141 for the 6 months after diagnosis by teledermatology. CONCLUSIONS: Telemedicine can be effective for dermatology consultation in new patients referred from rural communities. Our data indicate teledermatology can decrease the cost of care for the diagnosed condition.

Cost-Benefit Analysis↗
PubMed2000

Long-term care restructuring in rural Ontario: retrieving community service user and provider narratives.

This paper examines the extensive restructuring of community-based long-term care that was initiated in Ontario, Canada in 1996, and does so with particular reference to longstanding problems of provision in rural communities. Specifically, it draws on a case study focussed on two small rural towns to develop a 'situated understanding' of service-user and service-provider perspectives on service coordination issues and on service cuts, particularly as they affect the ability of elderly people reliant on publicly-funded community services to stay in their homes, to continue to 'age in place'. The general and specific antecedents of long-term care reform are considered prior to the presentation of the case study. General antecedents include the rapid aging of Canada's population and aggressive strategies to reduce government deficits, while specific antecedents flow from a decade of failed attempts to address longstanding issues of service coordination and from the ideologically-driven, free market stance of the provincial government elected in 1995. The analysis of interviews conducted with 14 community-service users and 17 providers suggests that the managed competition system introduced as the centerpiece of long-term care reform has resulted in increasing diversity and uncertainty on both sides of the service provision equation. Despite continued attempts by rural elderly people and their families to 'cut and paste' support packages, it seems that the restructuring of publicly-funded community services, combined with a substantial re-investment in long-term care facilities, will make some elderly people more vulnerable to institutionalization.

Aged↗
PubMed2006

An energy-saving development initiative increases birth rate and childhood malnutrition in rural Ethiopia.

BACKGROUND: Evolutionary life history theory predicts that, in the absence of contraception, any enhancement of maternal condition can increase human fertility. Energetic trade-offs are likely to be resolved in favour of maximizing reproductive success rather than health or longevity. Here we find support for the hypothesis that development initiatives designed to improve maternal and child welfare may also incur costs associated with increased family sizes if they do not include a family planning component. METHODS AND FINDINGS: Demographic and anthropometric data were collected in a rural Ethiopian community benefiting from a recent labour-saving development technology that reduces women's energetic expenditure (n = 1,976 households). Using logistic hazards models and general linear modelling techniques, we found that whilst infant mortality has declined, the birth rate has increased, causing greater scarcity of resources within households. CONCLUSIONS: This study is, to our knowledge, the first to demonstrate a link between a technological development intervention and an increase in both birth rate and childhood malnutrition. Women's nutritional status was not improved by the energy-saving technology, because energy was diverted into higher birth rates. We argue that the contribution of biological processes to increased birth rates in areas of the developing world without access to modern contraception has been overlooked. This highlights the continued need for development programmes to be multisectoral, including access to and promotion of contraception.

Adolescent↗