Rural Community Area Research Articles

A study to assess the effectiveness of structural teaching programme on knowledge regarding the oral rehydration therapy in management of diarrhea among mothers of under five children in selected community

Diarrhea is one of the top five causes of death among infants and under-five children in India (1) , despite the availability of easily implementable interventions and existence of National Guidelines for management at the community level. Oral rehydration therapy (ORT) with oral rehydration salt (ORS) solution remains the cornerstone of appropriate case management of diarrheal dehydration and is considered the single most effective strategy toprevent diarrheal deaths in children. Diarrheal illnesses are the leading causes of childhood deaths beyond infancy; it is responsible for 24% of the deaths in children aged 1-4 years, and 17% of all deaths in children 5-14 years. (1). Diarrhea is a common disease and is one of the major determinants of death in pediatric population of the developing Countries.Diarrhea is mainly develop by the lack of healthy practices such as improper breast feeding, unhygienic weaning practices unsafe drinking water, poor practice of hand washing and malnutrition. The mother of rural community areas are unaware about causes sign and symptoms of diarrhea and use of oral rehydration therapy for management of diarrhea. (2) In this context, it was attempted to assess the effectiveness of a structured teaching programme on knowledge regarding the oral rehydration therapy in management of diarrhea among mothers of under five children. A quasi experimental approach with purposive sampling technique was used in the study. The findings of the study shows that the difference between pre-testmean knowledge score of control and experimental group was statistically non-significant at p< 0.05 level whereas the difference between post-test mean knowledge score of both groups was statistically highly significant at p< 0.001 level. It was thus concluded that the structured teaching programme was effective in raising the knowledge level of mothers of under five children regarding the oral rehydration therapy in management of diarrheaand there was statistically significant effect of age, educational status and occupation on knowledge level of mothers of under five children regarding the oral rehydration therapy in management of diarrhea.

"I live in a bubble": Speech-language therapy and audiology students' expectations and experiences of a rural community work practicum

Locally and internationally, there have been renewed calls for equitable access to healthcare services. Simultaneously, caseloads have become more challenging and contexts more complex, which may be overwhelming to new graduates. The South African context offers a particularly interesting example of these challenges. Educators need to use innovative ways to ensure that curricula adequately prepare students for rural community work, while developing a sense of leadership that links clinical practice to theory, policy, ethics and social responsibility. Rural practica offer opportunities for sensitizing and equipping students for working in underserviced communities and a number of international studies have documented their potential usefulness. There is limited research, however, that examines how exposure to rural community work may shape students' responses to the realities of working in such contexts. This study aimed to explore the processes underlying a group of South African speech-language therapy and audiology students' appreciation and understanding of the realities of work in a rural community after a rural practicum. A four-day practicum took place in a rural community in South Africa. The practicum incorporated basic audiological tasks and structured observations. Twenty-five third-year students completed anonymous pre- and post-practicum open-ended questionnaires. The questionnaires explored their expectations and perceptions of the practicum, perceived challenges and benefits of working in rural community areas, and considerations that might need to be taken into account. The questionnaires were analysed and compared using thematic analysis principles. Results revealed a distinction between students' emotional and personal expectations of, and responses to, the practicum compared to their clinical expectations and responses. Before the practicum, students indicated a number of anxieties such as not feeling emotionally prepared or feeling anxious about infection control. The rural practicum appeared to provide a powerful teaching tool that led to growth in students' empathy and awareness of community needs and contextual issues through a shift from an intrapersonal to an interpersonal focus in their responses. A lack of growth was noted in some areas after the practicum, however, such as students' ideas about implementing appropriate therapy and making modifications to materials. This study holds significant implications for preparing students to work in challenging contexts and rural communities both in South Africa and abroad. The results suggest that a one-off practicum is not sufficient to sensitize students to the challenges of rural work and enable them to overcome anxieties. Rather, a sustained commitment to rural community work should be introduced early on in the curriculum and educators should be encouraged to reflect on their own attitudes, experiences, biases and anxieties towards community work.

A Study to assess the Satisfaction and Expectation of People Towards Services Provided by the Nursing Students among Rural and Urban Community in Selected Areas

Home visiting is the nurse's key activity in meeting the needs of patient, family and community in general for nursing services and health counseling. Home visits refer to meeting the health need of the people at their door steps. the goals of these early home health care visits were to care for the sick, to teach the family how to care the ill person, and above all to protect the spread of diseases. Keeping in view to assess the satisfaction and expectation of people towards services provide by the nursing students among rural and urban community areas, an exploratory study was undertaken to assess the satisfaction and expectation of people towards services provide by the nursing students among rural and urban community areas. The study adopted Health belief model as the theoretical base for the framework of the study. A Qualitative research approach was adopted to conduct this study and the exploratory survey method was used. A Non-probability convenient sampling was used for the selection of the representative samples for the study. Data was collected from total 300 people, 150 people were selected from rural area and 150 people from urban areas of Pune district. A final Study was conducted in selected rural and urban areas of Pune district. Descriptive and inferential Statistics was used to analyze the data.

Suicide and alcohol: do outlets play a role?

The purpose of this study was to determine whether the number of alcohol outlets in local and adjacent areas, in particular bars, was related over time to completed suicide and suicide attempts. There is evidence both from studies of individuals and time series aggregate studies, mostly at the national level, of substantial alcohol involvement in suicide, but no small-area, longitudinal studies have been carried out. The present study is the first that is both longitudinal and based on a large number of small spatial units, California zip codes, a level of resolution permitting analysis of the relationship between local alcohol access and suicide rates over time. Longitudinal data were obtained from 581 consistently defined zip code areas over 6 years (1995-2000) using data from the California Index Locations Database, a geographic information system that contains both population and place information with spatial attributes for the entire state. Measures obtained from each zip code included population characteristics (e.g., median age) and place characteristics (e.g., numbers of retail and alcohol outlets) which were related in separate analyses to (i) suicide mortality and (ii) the number of hospitalizations for injuries caused by suicide attempts. The effect of place characteristics in zip code areas adjacent to each of the 581 local zip codes (spatial lags) was also assessed. Analysis methods were random effects models corrected for spatial autocorrelation. Completed suicide rates were higher in zip code areas with greater local and lagged bar densities; and higher in areas with greater local but not lagged off-premise outlet densities. Whereas completed suicide rates were lower among blacks and Hispanics, completed suicide rates were higher among low income, older whites living in less densely populated areas, that is, rural areas. Rates of suicide attempts were higher in zip code areas with greater local but not lagged bar densities, and higher among low income younger whites living in smaller households and in rural areas. Rates of attempted suicide were also higher among blacks. Completed suicide and suicide attempt rates were lower in zip code areas with greater local restaurant densities; there were no lagged effects for restaurants. Bar densities in particular appear related to suicide, meaning, because this is an aggregate-level spatial analysis, that suicides, both attempted and completed, occur at greater rates in rural community areas with greater bar densities. Because the suicide rate is highest in rural areas, this study suggests that although the number of completed and attempted suicides is no doubt greater in absolute numbers in urban areas, the suicide rate, both completed and attempted, is greater in rural areas, which draws attention, perhaps much needed, to the problems of rural America.

Knowledge, Perception and Health Behavior about Metabolic Syndrome for an at Risk Group in a Rural Community Area

This study was to identify knowledge, perception and health behavior about metabolic syndrome for an at risk group in a rural community area. A descriptive cross-sectional survey design was used. A total of 575 adults with hypertension, diabetes mellitus, dyslipidemia, and/or abdominal obesity were recruited from 11 rural community health care centers. A questionnaire was developed for this study. Anthropometric measures were measured and blood data was reviewed from the health record. Knowledge about the metabolic syndrome was low as evidenced by only a 47% correct answer rate. Only 9% of the subjects ever heard about the disease, and 87% answered they do not know the disease at all. 87% of the subjects were not performing regular exercise, 31% drank alcohol more than once a month, 12.5% were current smokers, and 33.6% are did not have a regular health check-up. Development of systematic public health care programs are needed to prevent future increases in cardiovascular complications and to decrease health care costs. These might include educational programs for the primary health care provider and an at risk group, a therapeutic lifestyle modification program, and a health screening program to identify potential groups.

Triangulation Analysis of Tele-Palliative Care Implementation in a Rural Community Area in Japan

We conducted a comprehensive evaluation of tele-palliative care by triangulation method. This consisted of qualitative analyses of 2 patients and then performing quantitative analysis of a simulated model for tele-palliative care based on that experience. Semistructured interviews with 2 patients were conducted for qualitative analysis. The recorded conversations were analyzed using traditional categorization and coding techniques, looking for patterns and themes both within and across the interviews. A state-transition process was modeled using a Markov model to compare the costs for three different options for patients requiring palliative care: admission to the palliative care unit, home care only (8 physician visits), and tele-palliative care. The cost data were mainly derived from the reimbursement scale of the Japanese Health Insurance System. Sensitivity analysis was used to assess the influence of particular conditions or costs. The qualitative assessment identified some positive concepts, such as "expectation," "convenience," "reliance," and "communication." In the cost analysis, the reference case yielded the annual costs as follows: (1) costs for admission to the palliative care unit were 1,137,000 dollars; (2) costs for home care were 521,000 dollars; and (3) costs for telepalliative care were 478,000 dollars. One-way sensitivity analyses showed that home care was the most cost-saving strategy if the care was continued for more than 4 months or the number of physician visits during tele-palliative care could be reduced to less than 6 physician visits per month. The important issues in reducing the cost of tele-palliative care were (1) having adequate patient numbers, (2) reducing the number of physicians' visits, and (3) offsetting the costs of telemedicine against cost savings to the system to sustain the program. In addition, the qualitative analysis demonstrated patients positive views of tele-palliative care.

Identification and characterization of a novel cassava (Manihot esculenta Crantz) clone with high free sugar content and novel starch

This study reports the identification of a new class of cassava (Manihot esculenta Crantz) with a storage root showing unusual free sugar accumulation and novel starch. Twenty-seven clones high in free sugar were identified under cultivation in primitive rural community areas in the Amazon. Iodine test and glucose oxidase-peroxidase reagent strips were used, in the field, for identification of starch and glucose, respectively. Five out of these 27 clones of cassava were cultivated at EMBRAPA Genetic Resources and Biotechnology and used for biochemical characterization, starch synthesis enzyme activities and gene expression analysis. Carbohydrates were fractioned into free sugar, polymerized water-soluble and -insoluble alpha-polyglucan. Clones of series CAS36 accumulate over 100 times more free sugar (mainly glucose) than commercial varieties. Monosaccharide composition analysis revealed one clone with distinct water-soluble sugars not present in the commercial cultivar. Structure analysis of the water-soluble and -insoluble alpha-polyglucan revealed the presence of a glycogen-like starch in clone CAS36.1. This clone indicated disruption in the starch synthesis pathway for enzyme activities and protein blot analyses in ADPG-pyrophosphorylase and branching enzyme, and their corresponding protein. Gene expression analysis indicated the lack of transcript for the gene coding for branching enzyme, but not for the gene coding for the ADPG-pyrophosphorylase small subunit. In addition, the pattern of distribution of sugar and starch content showed to be related to tissue age in the storage root.

Epidemiological survey of histoplasmine and paracoccidioidine skin reactivity in an agricultural area in Bolívar state, Venezuela.

Paracoccidiodomycosis and histoplasmosis are endemic diseases in the south of Venezuela, representing a public health problem. Prevalence of Paracoccidiodes brasiliensis and Histoplasma capsulatum infections were estimated in Monte Ralo, a rural community area of Bolivar state using paracoccidiodine and histoplasmine skin tests. Paracoccidiodine was intradermically injected to 173 persons and readings were made at 24 and 48 h afterwards to 167 persons (97.85%). Reaction was positive in 8.5% (n = 14) at 24 h post-injection and 13.2% (n = 20) at 48 h. Farmers showed the higher percentage of positivity at 24 and 48 h. One hundred-seventy five persons were intradermically injected with histoplasmine but 167 and 157 of them attended for reading of the dermal reaction at 24 and 48 h post-injection respectively. Tests were positive in 25.7% (n = 43) at 24 h and 42.7% (n = 67) at 48 h. Further studies are needed in surrounding places to delimit the endemic area of these mycosis in the Bolivar state. However, epidemiological vigilance of PCM and H should be considered by local health authorities.

Lay Perceptions of Mental Disorder in Agricultural Greece: A Qualitative Approach

This exploratory survey aimed to investigate and to explore, using the vignette methodology, community perceptions of mental disorder in a rural area in Greece. The influence of the nature of the problematic behaviour depicted in the vignettes, the gender of the vignette actor and the demographic characteristics of respondents were also examined.A series of vignettes in combination with an open‐ended response format were used. Fifty face‐to‐face interviews were carried out with residents in a rural community area in Crete. A thematic analysis was employed.It was found that the type of symptomatology influenced respondents' reactions. Social environmental factors, childhood experiences and personality characteristics were more likely to be offered as ætiological factors for depression, anxiety and schizophrenia with negative symptoms. In contrast, the positive symptoms of schizophrenia and paranoia were more likely to be attributed to biological factors. The respondents expressed a remarkably reserved attitude towards psychiatrists and use of psychotropic drugs. Psychological assistance and social support were more likely to be recommended as treatment methods. The gender of the vignette actor influenced respondents' reactions in relation to schizophrenia with positive symptoms and schizophrenia with negative symptoms. Respondents' gender and age were found to have no influence.Vignette methodology was proved to be a valuable tool to demonstrate the complexity of lay perceptions concerning mental disorder. Respondents clearly expressed a need for mental health education indicating future implications for interventions in this area.

Tree Care Advisor: A Voluntary Stewardship Program

Fifty-two urban forestry volunteers completed a specialized training program that included thirty classroon hours of training and a pledge of a minimum of fifty hours of service to urban forestry educational programs and projects in two Minnesota urban-centered areas. As part of a two year pilot program developed by the Minnesota Extension Service and the Minnesota Department of Natural Resources Division of Forestry, the volunteers contributed more than 2000 hours of service and program assistance to their communities over a period of fourteen months. The training program has developed into a continuing Minnesota Extension Service specialization training program for Master Gardeners and non- Master Gardeners, and will be expanded to more rural and small community areas of the state.

Epidemiologic assessment of female urinary incontinence - Comparison of the females with urinary incontinence between a rural community (Kijimadaira village) and urban area (Hokushin General Hospital)

On the basis of 803 answers of Yes/No questionaires about urinary incontinence from the females in Kijimadaira village and at the Hokushin General Hospital, the actual incidence was discussed especially for the purpose of the comparison between the female farmers and nurses including nurse students with urinary incontinence.