Current Status and Family Factors Influencing Caries in the Deciduous Teeth of Children 3-6 Years of Age in Families Residing in Rural Heishanzui Township

PURPOSE

To determine the caries status in children's deciduous teeth and examine the influence of family oral health behaviours on the caries status.

MATERIALS AND METHODS

This cross-sectional study included 329 children aged 3-6 years in rural Heishanzui Township, Hebei Province, China, and used a completely random sampling method. These children underwent physical and oral health examinations. The questionnaires were given to the parents and caregivers of the examined children.

RESULTS

The prevalence of caries in the deciduous dentition among children aged 3-6 years was 80.55%, with a dmft index of 4.93. Children in the caries group ate sweets, chocolates, and carbonated drinks more frequently than did children in the caries-free group (p < 0.05). Children in the caries-free group brushed their teeth more frequently, with parents helping their children brush, more often than did those in the caries-affected group (p < 0.05). The level of parental education and annual household income also had statistically significant effects on the prevalence of caries in the two groups (p < 0.05). Logistic regression analysis revealed that the frequency of eating sweets was a risk factor for caries in deciduous teeth (odds ratio = 2.20; p < 0.05).

CONCLUSION

The prevalence of caries in deciduous teeth among children aged 3-6 years in rural Heishanzui Township was high. Compared to children in the caries-affected group, the families and children in the caries-free group had better oral hygiene behaviours. Moreover, the frequency of eating sweets was shown to be a risk factor for caries in deciduous teeth in children aged 3-6 years.

Violence, Abuse and Neglect in Older Women in Rural and Remote Areas: A Scoping Review and Prevalence Meta-Analysis

This systematic review addressed the issue of the abuse and neglect of older women (age 60 and over) in rural and remote areas, examining these phenomena's prevalence, risk and protective factors, consequences, and associated perceptions. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Arksey and O'Malley methodological framework, peer-reviewed articles published until September 2023 were identified in six electronic databases. Out of the manuscripts initially identified (n = 219), 28 articles met the selection criteria. The study's quality was assessed using the Mixed Methods Appraisal Tool. The included studies provided a comprehensive overview of this phenomenon, encompassing data from 6,579 older rural women. Prevalence rates of abuse and neglect exhibited wide variability, with an average of 27.3%. Among the risk factors, financial dependence and incapacity stood out, while higher income and education levels were protective factors, among others. Emotional/psychological abuse emerged as the most common form, with significant impacts on older women's physical and mental health. Cultural norms and gender expectations also influenced perceptions of abuse and victims' coping mechanisms. In a context in which access to specialized resources and services is hampered by significant limitations, community awareness and education prove vital to address this issue, which positions social work as key to addressing these challenges. The prevalence of abuse against older rural women is significant. Emotional abuse stands out as a major issue, underscoring the need for comprehensive interventions accounting for cultural and gender factors.

First-contact patients with a community mental health service in rural Greece: A 3-year prospective study of treatment attendance and its co-relations

BACKGROUND

Treatment continuation is essential for the optimal management of patients with mental disorders in the community, but treatment and outcome are often undermined by the high rates of service disengagement and treatment non-adherence across all psychiatric diagnoses. The phenomenon may be even more relevant in rural settings.

AIMS

The aim of the present study was to explore attendance to treatment in first-contact patients in a community-based treatment setting in rural Greece and to explore the associations of treatment attendance with demographic and clinical factors.

METHOD

Data were collected prospectively over a 3-year period, with 1-year follow-up interval. All first-contact cases with the Mobile Mental Health Unit of the prefectures of Ioannina and Thesprotia (MMHU I-T), Northwest Greece were considered, but only clinical cases were processed.

RESULTS

The sample size consisted of 446 patients, with a mean age 65.4 ± 18.8 years. The rate of 12-month attendance to mental health treatment was 13.5% (60 out of 446 patients). Treatment attendance was found to be correlated with younger age, the diagnosis of schizophrenia-spectrum disorder, and patients' referral by other psychiatric services. First examination over the year 2019 had been significantly inversely associated with treatment engagement.

CONCLUSION

Rates of subsequent attendance after initial assessment in a rural community mental healthcare setting were rather low in the present study. Several variables that have been previously associated with service engagement were found to be related in this study too, whereas other were not. Research on treatment engagement in rural treatment settings should be ongoing to reveal all associated factors.

Telemedicine interventions for older adults: A systematic review

INTRODUCTION

Telemedicine may help improve older adults' access, health outcomes, and quality of life indicators. This review aims to provide current evidence on the effectiveness of telemedicine in the aged population.

METHOD

A systematic literature search was conducted in PubMed, Google Scholar, and Web of Science electronic databases between January 2015 and September 2021 using the keywords "telemedicine" or "telehealth" and "older people" or "geriatrics" or "elderly." The articles were classified under three headings according to the purposes: feasibility, diagnosis and management of chronic diseases, and patient satisfaction.

RESULTS

A total of 22 articles were included. Across most disciplines, evidence has shown that telemedicine is as effective as usual care, if not more so, in the feasibility, chronic disease management, and patient satisfaction of the elderly. However, a few studies reported challenges such as difficulty with technology, hearing problems, and the inability to perform hands-on examinations for physicians.

CONCLUSION

Findings from this review support the view that health care providers can use telemedicine to manage elderly individuals in conjunction with usual health care. However, future research is needed to eliminate barriers to increasing telemedicine use among older adults.

The Quality of Life of Older Adults in Rural Eastern India and Its Influencing Factors: A Cross-Sectional Study

Aims This study aimed to assess the quality of life (QoL) of older adults in rural Odisha, India, exploring its multidimensional nature across physical, psychological, social, and environmental domains. The impact of depression and various sociodemographic factors on QoL was also investigated. Methods The research was conducted in the Tangi block of Khordha district, Odisha, encompassing 468 older adults. The World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire, Geriatric Depression Scale (GDS-15), and sociodemographic questionnaire were used in data collection. Sampling employed a multistage approach, with statistical analysis utilizing Statistical Package for the Social Sciences (SPSS) version 20 (IBM SPSS Statistics, Armonk, NY), including t-tests for normally distributed data and the Mann-Whitney U test for non-normally distributed data. Results The QoL of older adults in rural Odisha showed variability, with physical and social domains exhibiting relatively positive scores compared to psychological and environmental domains. Depression significantly impacted all QoL dimensions, with the most profound effect observed in global QoL and global health. Sociodemographic factors such as employment, substance use, elder abuse, adverse life events, and poverty were identified as significant determinants of global QoL. Additionally, recreational activity, elder abuse, education, and employment significantly affected all QoL domains. Conclusions This study reveals the complex landscape of QoL of older adults in rural Odisha. The findings emphasize the need for comprehensive interventions targeting mental health, social support, and environmental conditions to enhance the overall well-being of this population. Policymakers and healthcare professionals should consider these multidimensional factors to develop effective strategies for improving the QoL of older adults in similar contexts.

Referral of patients from rural primary care clinics to telemedicine vendors for opioid use disorder treatment: A mixed-methods study

INTRODUCTION

Rural primary care clinics can expand their medication treatment for opioid use disorder (MOUD) capacity by coordinating care with external telemedicine (TM) vendors specializing in addiction medicine. This study used mixed methods to identify factors that influence patient referrals from rural primary care clinics to TM vendors for MOUD.

METHODS

Between July/August 2020 and January/February 2021, 582 patients with OUD were identified across six primary care sites; that included 68 referred to an external TM vendor to receive MOUD. Mixed effects logistic regression identified individual and site-level factors associated with being referred to the TM vendor. Clinic providers and staff participated in in-depth interviews and focus groups to discuss their considerations for referring patients to the TM vendor.

RESULTS

Patient referrals were positively associated with local household broadband coverage (OR = 2.55, p < 0.001) and negatively associated with local population density (OR = 0.01, p  =  0.003) and the number of buprenorphine prescribers in the county (OR = 0.85, p < 0.001). Clinic personnel expressed appreciation for psychiatric expertise and the flexibility to access MOUD brought by the TM vendor. Perceived concerns about TM referral included a lack of trust with external providers, uncertainty about TM service quality, workflow delays, and patients' technological and insurance challenges.

CONCLUSION

This study revealed several clinic-level factors that may potentially influence patient referral to TM vendor services for MOUD. To facilitate the referral process and utilization of TM vendors, efforts should be made to foster open communication and trust between clinic providers and TM vendors, streamline workflows, and improve Internet access for patients.

Why Acute Undernutrition? A Qualitative Exploration of Food Preferences, Perceptions and Factors Underlying Diet in Adolescent Girls in Rural Communities in Nigeria

BACKGROUND

Adolescent girls are nutritionally vulnerable due to their rapid growth and increased nutrient requirements. Nigeria has the sixth-largest population in the world. This study qualitatively explored the food preferences, perceptions of nutritive value and factors underlying food consumption of adolescent girls in rural communities in Nigeria.

METHODS

The data were collected via the free listing of foods and focus group sessions conducted in the Hausa language with 48 unmarried adolescent girls. The discussions were audio-recorded, transcribed, translated into English, and analyzed using a deductive thematic framework.

RESULTS

The mean age of the respondents was 13.0 ± 2.7, and almost half (48%) had a primary school education. A total of 19 and 23 foods were identified as preferred, and perceived as nourishing, respectively. The top 10 foods present on both free lists overlapped considerably in terms of cognitive salience. The focus group themes included nutrition knowledge, food preferences, autonomy, household food allocation, courtship practices, and agricultural landscapes and economic access. The participants had minimal knowledge of nutrients and food groups, and their preferred foods were limited in diversity. The key factors in food preferences were desirable health effects, sensory attributes, and the contribution of foods to a desirable body image for marriage. Household food choices depended on parents. Thus, a desire for independence was an incentive for early marriage, mostly at 13 to 17 years. Gender inequities in household food distribution (quantity) and animal protein intake were reported. The participants believed that boys need more food for strength to impregnate girls. As part of a courtship practice, the girls received gifts of animal source foods from potential suitors. The food options were limited by financial challenges and low agricultural diversity.

CONCLUSION

To interrupt the cycle of inadequate food consumption and undernutrition in these adolescent girls, policy makers need to promote nutrition education and address the underlying determinants of inequitable access to nutritious foods.

Associations between cohort derived dementia and COVID-19 serological diagnosis among older Black adults in rural South Africa

Objectives

This study investigates the association between cohort derived dementia and serologically confirmed SARS-CoV-2 infection, an underexplored phenomena in low-and middle-income countries. Examining this relationship in a rural South African community setting offers insights applicable to broader healthcare contexts.

Methods

Data were collected from Black South Africans in the Mpumalanga province who participated in the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa. Cohort derived dementia was developed using a predictive model for consensus-based dementia diagnosis. Multinomial logistic regression models estimated the association between predicted dementia probability in 2018 and SARS-CoV-2 infection risk in 2021, controlling for demographics, socioeconomic status, and comorbidities.

Results

Fifty-two percent of the tested participants had serologically confirmed SARS-CoV-2 infections. In the fully adjusted model, cohort derived dementia was significantly associated with over twice the risk of serological diagnosis of COVID-19 (RRR = 2.12, p = 0.045).

Conclusion

Complying with COVID-19 prevention recommendations may be difficult for individuals with impaired cognitive functioning due to their symptoms. Results can inform community-based public health initiatives to reduce COVID-19 transmission among South Africa's rapidly aging population.

Feasibility of Endoscopic Lumbar Discectomy in a Remote Government Hospital in Thailand: A Cost-Utility Analysis

BACKGROUND

Treatments for lumbar discectomy have developed over time. Recently, endoscopy has played an important role. However, a major obstacle to endoscopy in rural areas is the cost of surgery, particularly for endoscopes and disposable equipment. We assessed the cost effectiveness of endoscopic lumbar discectomy compared to the traditional open microdiscectomy technique in a government hospital in a developing country.

METHODS

This study focused on 50 patients who underwent endoscopic lumbar discectomy between April 2019 and March 2020 at Yala Regional Hospital and were reviewed by our team. The duration of hospital stays, operative time, follow-up, and clinical outcomes at one, three, and six months postoperatively were observed and compared with 30 patients who underwent microscopic lumbar discectomy. Hospital expenses were calculated and compared using t-tests.

RESULTS

Endoscopic discectomy was 4.00 days length of stay while microscopic discectomy has 9.77 days in averages. The pain score was 8.82 for endoscopic surgery and 9.1 for microscopic surgery. The operative price for the endoscopic discectomy was 144.69 USD higher than that for the open lumbar discectomy because of the disposable equipment. However, each patient in the microdiscectomy group had a longer hospital stay and required more perioperative care, which decreased the difference of the total hospital expenses (1,420.612 vs 1,399.16 USD).

CONCLUSION

Full endoscopic lumbar discectomy is an effective procedure that is beneficial for patients. The total hospital costs are not significantly different between the two procedures. To ensure that more patients receive this benefit and to develop surgical competency in government hospitals, the surgical reimbursement fee for endoscopic discectomy should be more affordable than that for conventional discectomy.

Spring is not yet here: raising a child with ASD in rural southwest China

PURPOSE

This study aims to reveal the parenting experiences of parents of children with autism spectrum disorder (ASD) in rural southwest China under the framework of ecological systems theory.

MATERIALS AND METHODS

Semi-structured interviews were conducted with 21 parents of children with ASD from rural southwest China and the interview data were analyzed using the three coding steps of the grounded theory method, namely open, axial, and selective coding.

RESULTS

The results showed four themes: challenges from within the family; relationships between parents, the school, and the community; scarcity and low accessibility of available resources and services; the culture of discriminating against people with disabilities and the loss of eligibility for welfare. The mismatch between the needs of families of children with ASD and the resources available in social-environmental systems is the major issue faced by parents.

CONCLUSIONS

Raising a child with ASD in rural southwest China is affected by the interactions between the families and the internal structures in different environmental systems. The culture of discriminating against people with disabilities formed in the macrosystem could be the essential factor that affects the smoothness of the parenting process of children with ASD.

Health Disparities in Appalachian and Other Rural Communities

Rural areas are home to a larger proportion of older adults and populations who age within these locales and suffer disproportionately from health, mental health, and economic disparities compared to their urban counterparts. This article will explore the disparities faced by persons that reside in rural communities across the lifespan. It will briefly discuss what is meant by rural. As a rural region at specific risk, the issues confronting those aging in Appalachia will be examined. Finally, best practices and future directions to combat health disparities among rural residents and elders will be discussed. This includes the Appalachian Gerontology Experiences: Advancing Diversity in Aging Research training program which recruits and trains minority and first-generation undergraduate students in aging and health disparity research.

Current Scenario and Future Prospects of Adverse Drug Reactions (ADRs) Monitoring and Reporting Mechanisms in the Rural Areas of India

BACKGROUND

Pharmacovigilance (PV) deals with the detection, collection, assessment, understanding, and prevention of adverse effects associated with drugs. The objective of PV is to ensure the safety of the medicines and patients by monitoring and reporting all adverse drug reactions (ADRs) associated with prescribed medicine usage. Findings have indicated that about 0.2- 24% of hospitalization cases are due to ADRs, of which 3.7% of patients have lethal ADRs. The reasons include the number of prescribed drugs, an increased number of new medicines in the market, an inadequate PV system for ADR monitoring, and a need for more awareness and knowledge about ADR reporting. Severe ADRs lead to enhanced hospital stays, increased treatment costs, risk of death, and many medical and economic consequences. Therefore, ADR reporting at its first instance is essential to avoid further harmful effects of the prescribed drugs. In India, the rate of ADR reporting is less than 1%, whereas worldwide, it is 5% due to a need for more awareness about PV and ADR monitoring among healthcare providers and patients. The main objective of this review is to highlight the current scenario and possible futuristic ways of ADR reporting methods in rural areas of India. We have searched the literature using PubMed, Google scholar, Indian citation index to retrieve the resources related to ADR monitoring and reporting in India's urban and rural areas. Spontaneous reporting is the most commonly used PV method to report ADRs in India's urban and rural areas. Evidence revealed that no effective ADR reporting mechanisms developed in rural areas causing underreporting of ADR, thus increasing the threat to the rural population. Hence, PV and ADR reporting awareness among healthcare professionals and patients, telecommunication, telemedicine, use of social media and electronic medical records, and artificial intelligence are the potential approaches for prevention, monitoring, and reporting of ADRs in rural areas.

Knowledge Regarding Reproductive Tract Infection Among Ever Married Females of Reproductive Age Group in Rural Tamil Nadu

Background Reproductive tract infection (RTI) is an overgrowth of the normal flora of the reproductive tract. It is an iatrogenic infection caused by unhygienic practices like unsafe abortion. Lack of knowledge plays a major role among the factors associated. The District Level Health Survey (DLHS)-4 reported that the knowledge about RTI among the rural population of Tamil Nadu is 8 percent. It is thus necessary to know about their knowledge regarding RTI. Aim To assess the knowledge regarding reproductive tract infection among the ever-married rural women in the reproductive age group in Kancheepuram district, Tamil Nadu. Settings and design A cross-sectional study was conducted in the rural Kancheepuram district of Tamil Nadu. Materials and methods The sample size calculated was 330. Using multi-stage random sampling, a population proportion to the calculated sample size was used. A standardized questionnaire was used for data collection. Ethical approval was obtained. Statistical analysis used SPSS -21.0 was used for statistical purposes. A chi-square test was applied for significance. P-value <0.05 is considered significant. Results Among 330 females, 166 (50.3%) presented with any symptom of RTIs in the past three months, and 300 (90.9%) have heard about RTIs, with the main source of information being health education by the health care workers (155, 46.9%); 9.1% (31) females had no or poor knowledge regarding the RTIs. Conclusions Because of a lack of knowledge, RTI was prevalent among women in the rural community who were of reproductive age. Regular health education should be given to women who are fertile in order to increase their understanding.

A cross-sectional study

Despite WHO recommendations to reduce the global prevalence of anemia among women of reproductive age by 2025, anemia remains a truly global public health problem, especially among pregnant women. The objective of our study was to examine the relationship between anemia and the place of residence in pregnant women. This cross-sectional study was conducted in six health facilities between December 2018 and March 2019. Anemia was diagnosed using HemoCue HB 301 and a hemoglobin concentration <11 g/dl was classified as anemic. Adjusted logistic regression analysis was performed to examine relation between anemia and the place of residence in pregnant women. A total of 1027 pregnant women were included in the study. The average age of females was 25.79±6.02 years. The prevalence of anemia was 57.2% (585/1023). In logistic regression analysis adjusted for age, wealth, education and parity, women living in rural areas were more likely to be anemic compared to women living in urban areas (ORa=1.33; 95% CI [1.01-1,74]. Rural women are more likely to be anemic. Strategies to prevent anemia among pregnant women need to be strengthened in rural areas.

Assessing the Occurrence of Host-Specific Faecal Indicator Markers in Water Systems as a Function of Water, Sanitation and Hygiene Practices: A Case Study in Rural Communities of Vhembe District Municipality, South Africa

In settings where humans and animals closely coexist, the introduction of faecal material into unprotected water sources significantly increases the risk of contracting diarrhoeal and zoonotic waterborne diseases. The data were gathered from a survey conducted through interviews at randomly sampled villages; additionally, water samples were collected in randomly selected households and their associated feeder catchments. Molecular techniques were used, specifically qPCR, to run host-specific Bacteroides microbial source tracking (MST) assays for human, cattle, pig, chicken and dog faecal contamination. Unexpectedly, the qPCR assays revealed dogs to be the most prevalent (40.65%) depositor of faecal matter in unprotected surface water, followed by humans (40.63%); this finding was contradictory to survey findings indicating cattle as the leading source. At the household level, dogs (16.67%) and chickens (15.28%) played prominent roles, as was expected. Reflecting on some of the basic daily practices in households, nearly 89.00% of the population was found to store water due to erratic supply, in contrast to 93.23% using an improved water source. Additionally, a significant association was found between water, sanitation and hygiene (WASH) variables and the occurrence of MST markers after performing a bivariate linear regression. However, the inconsistency between the MST results and household surveys suggests pervasive sanitation issues, even in households without domesticated animals.

Epidemiological profile, temporal analysis, and future projections of suicide cases in rural cities in the extreme south of Brazil

The present study aimed to verify the time series (2000-2017) of death rates by suicide and its associated factors in 4 municipalities in the extreme south of Brazil. Data were obtained through the analysis of medical reports and police report bulletins at the Instituto Médico Legal, in the city of Rio Grande. The suicide rate in the Rio Grande region varied from 4 to 11 suicides per 100,000 inhabitants and it is estimated that by 2030 this rate could reach 16.5 suicides per 100,000 inhabitants. The rural cities of Santa Vitória do Palmar and Chuí present even higher suicide averages when compared to Rio Grande, the most populous city of the four. The death rate from suicide increased gradually in the period analyzed, with the prevalence rising among the youngest and the elderly population. A more comprehensive understanding of the influences of environmental issues on suicidal decisions constitutes an important action that needs to be taken, both because of regional vulnerabilities and the target population identified. Evidence indicates that knowledge of factors affecting individuals residing in this Brazilian region where increased suicide rates are recorded needs to be recognized as a priority.

Prevalence and Risk Factors of Leptospira spp. Infection in Backyard Pigs in the State of Paraná, Brazil

Leptospirosis is a zoonotic disease that poses a significant threat to human and animal health worldwide. Among different animal species, pigs are known to play a crucial role in the transmission of the pathogenic Leptospira spp. This study aimed to investigate the prevalence of Leptospira spp. infection and associated risk factors in backyard pigs in the state of Paraná, Brazil. A set of 1393 blood samples were collected from pigs on 188 subsistence properties from 136 different municipalities of the Paraná state and tested using the microscopic agglutination test (MAT) to detect antibodies against 24 different Leptospira spp. serovars. The results revealed an overall seroprevalence of 15.87% (221/1393; 95% CI: 13.95-17.78%) for Leptospira spp. antibodies, with Icterohaemorrhagiae, Butembo, and Pomona being the most commonly detected in serovar levels. The lack of rodent control (OR 1.12, 95% CI: 0.63-1.98, p = 0.02) was the only variable associated with disease incidence and was identified as a significant risk factor for Leptospira spp. infection in this context. These findings highlight the urgent need to implement effective control measures, such as improved housing conditions, rodent control, and veterinary assistance, to prevent the spread of this zoonotic disease in backyard pigs in Paraná, Brazil.

Building rural community disaster resilience in developing countries: insights from a Chinese NGO's Safe Rural Community programme

As rural areas in developing countries are generally more vulnerable to disasters triggered by natural hazards than urban areas, it has become critical to strengthen rural community disaster resilience (CDR) to reduce the risks. Using follow-up interviews, surveys, and secondary data, this study reviewed the Safe Rural Community (SRC) programme implemented by the One Foundation, a Chinese civilian non-governmental organisation (NGO), after the 2013 Lushan earthquake in China. The study focused on five key resilience aspects: networks; infrastructure; institutions; capacity; and culture. It found that the SRC programme successfully developed five standardised, systematic, interrelated, and practical elements: localised volunteer rescue teams; adequate emergency supplies; practical disaster reduction training; community emergency plans; and regular emergency rescue drills. Third-party evaluations and a 2022 Lushan earthquake test revealed that this NGO-led, community-based, and team-oriented initiative had been effective. Consequently, the study provides some guidance for the development of effective CDR programmes in rural communities in developing countries.

Interactive effects of sleep and physical activity on depression among rural university students in China

Background

Decreased sleep quality and physical activity among university students have become important concerns, while depressive symptoms are on the rise, especially in rural areas. Previous studies have confirmed the association between sleep quality and physical activity and depressive symptoms, but the effect of their interaction on depressive symptoms has been less studied. For this reason, the present study analyzed the interaction between sleep quality and physical activity on depressive symptoms to provide reference and assistance for mental health promotion and intervention for university students in rural areas of China.

Methods

In this study, we investigated sleep quality, physical activity, and depressive symptoms in 11,423 university students in rural areas of China. The association of sleep quality and physical activity with depressive symptoms was analyzed by using univariate analysis and logistic regression analysis. And further analyzed the association between the interaction effect of sleep quality and physical activity and depressive symptoms.

Results

The proportion of university students with depressive symptoms in rural China was 33.3%, with a higher proportion of girls students (36.7%) having depressive symptoms than boys students (28.8%). Logistic regression analysis of the interaction between sleep quality and physical activity and depressive symptoms in university students showed that university students with poor sleep quality and MVPA>60 min/d (OR = 4.40,95% CI: 3.75-5.05) had the highest risk of depressive symptoms (p < 0.001). University students with moderate sleep quality and MVPA of 30-60 min/d (OR = 1.18, 95% CI: 0.75-1.61) had the lowest risk of depressive symptoms (p < 0.001). Moreover, there was no gender difference in this result.

Conclusion

The prevalence of depressive symptoms was higher among university students in rural areas of China. There was an interaction between sleep quality and MVPA on depressive symptoms, maintaining a good quality of sleep and an appropriate length of MVPA has a contributory effect on mental health, and the same trend was found for both boys and girls students. It is recommended that university students in rural areas of China should first maintain proper sleep quality while maintaining 30-60 min of MVPA per day, which may reduce the risk of depressive symptoms.

Rural and urban differences in lifetime occupation and its influence on mortality among Mexican adults

OBJECTIVE

To determine how primary lifetime occupation type is associated with mortality, and how the relationship varies by rural and urban dwelling.

MATERIALS AND METHODS

Data come from 2001-2018 Mexican Health and Aging Study (adults aged 50+, n=11 094). We created five occupation categories. Cox proportional hazard models predicted mortality using baseline covariates.

RESULTS

In both rural and urban settings, participants with manual jobs, such as agriculture and production/industrial jobs, had an increased risk of mortality compared to those with administrative/professional jobs. In urban settings, participants in the domestic/service and no main job categories had higher risk of mortality than those in the administrative/professional category. For men these differences remained, but not for women.

CONCLUSION

In a context of rural and urban demographic shifts, it is crucial to consider the implications that occupation as a socioeconomic factor can have on health and to identify the most vulnerable groups.

Influence of social factors on adoption of sanitation practices in rural areas: a mixed methods study in Nzaui, Kenya

Introduction

provision of adequate sanitation is among the common strategies of preventing sanitation-related diseases. However, provision of sanitation facilities may only be a sustainable solution if the population´s behavior changes and positive perception is embraced. This paper highlights the influence of social factors on adoption of sanitation practices.

Methods

convergent mixed methods design was employed. Quantitative data was gathered using structured questionnaires from 100 household heads selected using cluster and simple random techniques. Logistic regression analysis was performed to explore factors that influenced adoption of sanitation practices. Qualitative data was gathered from a purposively selected focus group and analyzed thematically.

Results

many (57%) of the participants were males. The average age for participants was 39 years, standard deviation (SD)=0.20. From the multivariable regression analysis with adjusted odds, household heads being aged 18-33 years (OR 1.76, 95% CI: 0.62-3.02, p=0.015) and safety of latrines (OR 1.72, 95% CI: 0.70-5.15, p<0.001) was associated with increased open defecation chances; whereas being a female (OR 0.16 95% CI: 0.06-1.81, P=0.01), availability of open spaces near households (OR 0.12, 95% CI: 0.05-1.13, p=0.30), and mason skills (OR 0.29, 95% CI: 0.13-1.65) were associated with reduced likelihood of open defecation practices. Further, being a female (OR 1.06, 95% CI: 0.18-3.16, p=0.043), having knowledge on safe sanitation (OR 1.01, 95% CI: 0.74-3.08, p=0.02), engaging skilled masons for toilet construction (OR 1.299, 95% CI: 1.01-8.95, p=0.005) and financial stability (OR 1.95, 95% CI: 0.98-23.40, P=0.032<0.001) were positively associated with adoption of improved toilets.

Conclusion

the sanitation status in the study area was mainly poor due to the influence of multiple factors like gender, absence of toilets, knowledge on safe sanitation, poverty, mason skills and toilet location in relation to safety. The findings showed the need for innovative planning approaches based on the social aspects of communities for progress in sanitation standards in rural areas. Such approaches should adhere to the sanitation hardware versus software components of communities to promote active utilization of the available toilets, construction of improved toilets and reduction of open defecation.

The Fascinating Cross-Paths of Pathogenic Bacteria, Human and Animal Faecal Sources in Water-Stressed Communities of Vhembe District, South Africa

Access to clean and safe drinking water still remains a major challenge in the developing world, causing public health risks in terms of waterborne infections, especially in rural areas of sub-Saharan Africa. This study aimed to track and detect enteric pathogens (Salmonella enterica subsp. enterica serovar Typhimurium str. LT2, Shigella flexneri, and Campylobacter jejuni subsp. jejuni) in rural water sources. It also sought to establish a correlation between these pathogens and the sources of faecal pollution. Multiplex qPCR and specific primers and probes were used for detection and tracking. The study successfully correlated the occurrence of target pathogens with sources of human and animal faecal contamination using host-specific genetic markers (BacHum and HF183 for humans, BacCow for cows, Pig-2-Bac for pigs, Cytb for chickens, and BacCan for dogs). The study revealed that enteric pathogens were found in 47.69% and 32.80% of samples during the wet and dry seasons, respectively. These pathogens were associated with human or animal faecal contamination. Correlations between pathogens and contamination sources were significant (p ≤ 0.05), with varying strengths during the wet and dry seasons. The findings emphasize the importance of identifying faecal contamination sources to protect rural communities from waterborne infections.

Molecular Identification of Enteric Viruses in Domestic Animals in Northeastern Gabon, Central Africa

Astroviruses (AstVs), enteroviruses (EVs), and caliciviruses (CaVs) infect several vertebrate taxa. Transmitted through the fecal-oral route, these enteric viruses are highly resistant and can survive in the environment, thereby increasing their zoonotic potential. Here, we screened for AstVs, EVs, and CaVs to investigate the role of domestic animals in the emergence of zoonoses, because they are situated at the human/wildlife interface, particularly in rural forested areas in Central Africa. Rectal swabs were obtained from 123 goats, 41 sheep, and 76 dogs in 10 villages located in northeastern Gabon. Extracted RNA reverse-transcribed into cDNA was used to detect AstVs, EVs, and CaVs by amplification of the RNA-dependent RNA polymerase (RdRp), or capsid protein (VP1) gene using PCR. A total of 23 samples tested positive, including 17 goats for AstVs, 2 goats, 2 sheep, 1 dog for EVs, and 1 dog for CaVs. Phylogenetic analyses revealed that AstV RdRp sequences clustered with sheep-, goat-, or bovine-related AstVs. In addition, one goat and two sheep VP1 sequences clustered with caprine/ovine-related Evs within the Enterovirus G species, and the CaV was a canine vesivirus. However, human-pathogenic Evs, EV-B80 and EV-C99, were detected in goats and dogs, raising questions on the maintenance of viruses able to infect humans.

Reversed urban-rural gradient in COVID-19 seroprevalence and related factors in a nationally representative survey, Poland, 29 March to 14 May 2021

BackgroundWe anticipated that people in rural areas and small towns with lower population density, lower connectivity and jobs less dependent on social interaction will be less exposed to COVID-19. Still, other variables correlated with socioeconomic inequalities may have a greater impact on transmission.AimWe investigated how COVID-19 affected rural and urban communities in Poland, focussing on the most exposed groups and disparities in SARS-CoV-2 transmission.MethodsA random digit dial sample of Polish adults stratified by region and age was drawn from 29 March to 14 May 2021. Serum samples were tested for anti-S1 and anti-N IgG antibodies, and positive results in both assays were considered indicative of past infection. Seroprevalence estimates were weighted to account for non-response. Adjusted odds ratios (AORs) were calculated using multivariable logistic regression.ResultsThere was serological evidence of infection in 32.2% (95% CI: 30.2-34.4) of adults in rural areas/small towns (< 50,000 population) and 26.6% (95% CI: 24.9-28.3) in larger cities. Regional SARS-CoV-2 seroprevalence ranged from 23.4% (95% CI: 18.3-29.5) to 41.0% (95% CI: 33.5-49.0) and was moderately positively correlated (R = 0.588; p = 0.017; n = 16) with the proportion of respondents living in rural areas or small cities. Upon multivariable adjustment, both men (AOR = 1.60; 95% CI: 1.09-2.35) and women (AOR = 2.26; 95% CI: 1.58-3.21) from these areas were more likely to be seropositive than residents of larger cities.ConclusionsWe found an inverse urban-rural gradient of SARS-CoV-2 infections during early stages of the COVID-19 pandemic in Poland and suggest that vulnerabilities of populations living in rural areas need to be addressed.

HIV/AIDS Knowledge, Depression, and HIV-Related Stigma Among Elderly Men in Rural China: A Hierarchical Regression Analysis

This study explored the current status and influencing factors of HIV-related stigma among elderly men (≥50 years old) in rural Chengdu, China. A structured face-to-face interview survey was conducted among 286 elderly males from three towns in Chengdu using convenience sampling, 240 men (83.9%) who had heard of HIV/AIDS were included in the analysis. Hierarchical regression was used to examine the associated factors of HIV-related stigma, including demographic variables, HIV/AIDS knowledge level, receiving HIV/AIDS-related health education in the past year, depression, and anxiety, and to examine the moderating effect of educational level on HIV/AIDS knowledge and HIV-related stigma. Hierarchical regression analysis showed that men with lower HIV/AIDS knowledge scores, primary school or below educated, and depression had higher HIV-related stigma total score and social stigma dimensional scores than their counterparts. In addition, living alone was associated with higher HIV-related stigma, and elderly men with lower monthly income and those without HIV/AIDS-related health education in the past year had higher levels of social stigma. Higher HIV/AIDS knowledge score was significantly associated with lower HIV-related stigma level among those with middle school or above education level, but no such effect in those with primary school or below. In conclusion, the HIV-related stigma level among elderly men in rural Chengdu was high and positively associated with depression. HIV/AIDS education should target elderly men with low education, living alone, and low income, and interventions to promote mental health may work together to reduce HIV-related stigma in the rural elderly population.

The mental health of rural older adults: the role of the built environment in Jintang County

The mental health of older adults has become one of the major health challenges facing society today, which has attracted wide concerns from scholars in urban areas, but research in rural areas has been neglected. Therefore, this paper took rural older adult residents of 11 sample villages in Jintang County, Chengdu City, Sichuan Province, as the research object. After controlling the demographic characteristics of older adults in rural areas, this paper attempted to explore the effects of the rural built Environment on the mental health of older adults. Through field investigation in the sample villages, 515 valid questionnaires were obtained. The results from the Binary Logistic Regression Model show that good marital status, physical health, education level, well-constructed roads, and safe neighborhoods had significant positive effects on the mental health of rural older adults. Rural older adults who prefer to walk, cycle, and use public transport have better mental health, and accessibility to the periodic market, health station, bus station, village committee, supermarket, and the main road is positively correlated with the mental health of rural older adults, while the distance from home to the town center and coach terminal has a significant negative impact on the mental health of rural older adults. The research results provide a theoretical reference for further construction of rural aging environments.

Effects of dynamic zero COVID-19 policy on anxiety status and lifestyle changes of pregnant women in rural South China: a survey-based analysis by propensity score matching method

Introduction

The coronavirus disease 2019 (COVID-19) pandemic triggered a global public health crisis and has brought an unprecedented impact on pregnant women. The problems faced by pregnant women in the rural areas of China during the epidemic are different from those in urban areas. Although the epidemic situation in China has gradually improved, studying the impact of the previous dynamic zero COVID-19 policy on the anxiety status and lifestyle of pregnant women in rural areas of China, is still necessary.

Methods

A cross-sectional survey of pregnant women in rural South China was conducted from September 2021 to June 2022.Using questionnaires, sociodemographic characteristics, anxiety status, physical activity, sleep quality, and dietary status of the population were collected. Using the propensity score matching method, the effect of the dynamic zero COVID-19 strategy on the anxiety status and lifestyle of pregnant women was analyzed.

Results

Among the pregnant women in the policy group (n = 136) and the control group (n = 680), 25.7 and 22.4% had anxiety disorders, 83.1 and 84.7% had low or medium levels of physical activity, and 28.7 and 29.1% had sleep disorders, respectively. However, no significant difference (p > 0.05) was observed between the two groups. Compared with control group, the intake of fruit in the policy group increased significantly (p = 0.019), whereas that of aquatic products and eggs decreased significantly (p = 0.027). Both groups exhibited an unreasonable dietary structure and poor compliance with the Chinese dietary guidelines for pregnant women (p > 0.05). The proportion of pregnant women in the policy group, whose intake of stable food (p = 0.002), soybean, and nuts (p = 0.004) was less than the recommended amount, was significantly higher than that in the control group.

Discussion

The dynamic zero COVID-19 strategy had little impact on the anxiety status, physical activity, and sleep disorders of pregnant women in the rural areas of South China. However, it affected their intake of certain food groups. Improving corresponding food supply and organized nutritional support should be addressed as a strategic approach to improve the health of pregnant women in rural South China during the pandemic.

Factors promoting willingness to practice medicine in rural regions and awareness of rural regions in the university's catchment area - cross-sectional survey among medical students in central Germany

Aim

Many universities offer rural medical internships for medical students. The present survey was designed to show how rural medical work is perceived by students, whether these perceptions are associated with origin and previous experience, and how well medical students know rural regions in the vicinity of their university. In addition, students were asked how to support and inspire medical students to later work in a rural region.

Methods

This cross-sectional study was based on an anonymous online survey of medical students at the Universities of Halle-Wittenberg and Leipzig. The evaluations included descriptive statistics, statistical group comparisons, and qualitative content analysis of free text answers.

Results

A total of 882 students took part in the survey. Students who had grown up in a rural region or had lived there for a longer time (71.7% of the respondents) rated the work-life balance better (p<0.01) and the patient variety in the countryside slightly higher (p<0.05) than their fellow students from the big city. Students who had worked in a rural practice or hospital before (62.2%) rated patient diversity (p<0.001) and work variety (p<0.001), as well as workload (p<0.01), slightly higher in rural areas than students with no prior experience. On average, the specified rural model regions were still unknown to more than 60% of the students. The suggestions for attracting medical students to later work as rural physicians included financial incentives and, above all, better information about life as a rural physician and the rural regions.

Conclusion

Thus, the medical faculties of the universities as well as the counties threatened by medical undersupply should further expand the transfer of knowledge and experience regarding rural physician life for the students.

Prevalence and Awareness of Hypertension among a Rural Jazan Population

BACKGROUND

Hypertension (HTN) is a major global public health problem. Knowledge of the risk factors and repercussions of HTN is crucial to preventing the disease. Rural populations have lower levels of knowledge of the disease than urban populations. However, no studies have assessed the levels of awareness of HTN and their determinants in rural regions of Saudi Arabia.

OBJECTIVES

This study aimed to assess the awareness of HTN and its determinants among a rural population of Jazan region, Saudi Arabia.

METHODOLOGY

We conducted a cross-sectional analytical study among six primary healthcare centers selected randomly from the rural areas of Jazan region. We targeted all Saudi adults visiting these centers. Information was gathered using interview questionnaires completed by 607 people. SPSS was utilized to analyze the collected data.

RESULTS

In all population groups, the prevalence of diagnosed HTN increased with age, particularly gradually increasing in those aged younger than 40 years and then rapidly and sharply increasing in those aged 40 years and over. The women (43.3%) had a higher prevalence of HTN than the men (34.6%), which is comparable with findings in other areas in Saudi Arabia and the Middle East. Approximately 65.6% of the participants without HTN and 34.4% of the participants with HTN did not know their normal blood pressure. Approximately 61.7% of the participants without HTN and 59.0% of the participants with HTN felt that pharmaceuticals are insufficient in curing HTN, while 60.7% and 64.7% believed that HTN can be cured.

CONCLUSIONS

The global prevalence of HTN is increasing annually owing to rapid changes in lifestyle and dietary habits. Furthermore, because adherence to antihypertensives is poor in rural Jazan, the Ministry of Health and researchers advocate implementing a program to increase awareness and assess patient adherence to prescribed medication for the control of HTN.

Prevention and Mitigation of Rural Higher Education Dropout in Colombia: A Dynamic Performance Management Approach

Background: Dropout in higher education is a socio-educational phenomenon that has the scope to limit the benefits of education as well as to widen social disparities. For this reason, governments have implemented various public policies for its prevention and mitigation. However, in rural populations, such policies have proven to be ineffective. The aim of this paper is to simulate public policy scenarios for the treatment of school dropout in rural higher education in Colombia from a Dynamic Performance Management approach. Methodology: To achieve the aim, a parameterised simulation model was designed with data from Colombian state entities in rural higher education. Five simulations were carried out. The analysis of the results was carried out using descriptive statistics and comparison of means using the Wilcoxon Sign Rank statistic. Results: The adoption of such an approach based on simulations suggests that policies to expand the coverage of educational credits and financial support, as well as the addition of a family income subsidy, allow for a reduction in the number of dropouts. Conclusions: A dynamic, data-driven approach can be effective in preventing and mitigating dropout in these areas. It also highlights the importance of identifying the key factors contributing to dropout. The results also suggest that government policies can have a significant impact on school retention in rural areas.

Predictors of COVID-19 Related Health Literacy among Older People Living in Rural Areas of Indonesia

Objective

. This study aims to identify predictive factors of COVID-19-related health literacy (HL) among older adults living in rural areas.

Methods

This study used a cross-sectional design. A total of 106 respondents participated in this study. HL was measured by using a questionnaire modified from the HLS-COVID-Q22, in addition, the scales 'Health Information Seeking','Family's Social Support Scale', 'Health Service Utilization'; and information on some socio-demographic variables was also obtained. A multiple linear regression model was used to identify the predictors of HL.

Results

About two-thirds of the respondents had a moderate level of HL (63.2%). Multiple linear regression analysis showed that education level, family support, information source, and gender were significant predictors for HL (p<0.01).

Conclusion

HL literacy was better among males, highly educated older people, media users, and those with adequate family support. This study provided insight for nurses and healthcare professionals to pay greater attention to vulnerable groups of older people (ie. female gender and those with less formal education) as well as involve family members in education or health promotion activities and use easily accessed media, such as television and radio.

Identification of status quo and association rules for chronic comorbidity among Chinese middle-aged and older adults rural residents

Background

Chronic comorbidity has become a major challenge in chronic disease prevention and control. This issue is particularly pronounced in rural areas of developing countries, where the prevalence of chronic disease comorbidity is high, especially among middle-aged and older adults populations. However, the health status of middle-aged and older adults individuals in rural areas of China has received inadequate attention. Therefore, it is crucial to investigate the correlation among chronic diseases to establish a reference basis for adjusting health policies aimed at promoting the prevention and management of chronic diseases among middle-aged and older adults individuals.

Methods

This study selected 2,262 middle-aged and older adults residents aged 50 years or older in Shangang Village, Jiangsu Province, China, as the study population. To analyze the chronic comorbidity of middle-aged and older adults residents with different characteristics, we used the χ² test with SPSS statistical software. Data analysis was conducted using the Apriori algorithm of Python software, set to mine the strong association rules of positive correlation between chronic disease comorbidities of middle-aged and older adults residents.

Results

The prevalence of chronic comorbidity was 56.6%. The chronic disease comorbidity group with the highest prevalence rate was the lumbar osteopenia + hypertension group. There were significant differences in the prevalence of chronic disease comorbidity among middle-aged and older adults residents in terms of gender, BMI, and chronic disease management. The Apriori algorithm was used to screen 15 association rules for the whole population, 11 for genders, and 15 for age groups. According to the order of support, the most common association rules of comorbidity of three chronic diseases were: {lumbar osteopenia} → {hypertension} (support: 29.22%, confidence: 58.44%), {dyslipidemia} → {hypertension} (support: 19.14%, confidence: 65.91%) and {fatty liver} → {hypertension} (support: 17.82%, confidence: 64.17%).

Conclusion

The prevalence of chronic comorbidity among middle-aged and older adults rural residents in China is relatively high. We identified many association rules among chronic diseases, dyslipidemia is mostly the antecedent, and hypertension is primarily the result. In particular, the majority of comorbidity aggregation patterns consisted of hypertension and dyslipidemia. By implementing scientifically-proven prevention and control strategies, the development of healthy aging can be promoted.

Why Do People Gain Belly Fat in Rural Areas? A Study of Urinary Metal(loid)s and Abdominal Obesity in China

Obesity is prevalent in rural areas of China, and there are inconsistent findings regarding the association between metal(loid) exposure and the risk of obesity. Abdominal obesity (AOB), which reflects visceral fat abnormity, is a crucial factor in studying obesity-related diseases. We conducted a study measuring 20 urinary metal(loid)s, 13 health indicators, and the waist circumference (WC) in 1849 participants from 10 rural areas of China to investigate their relationships. In the single exposure models, we found that urinary chromium (Cr) was significantly associated with the odds of having AOB [adjusted odds ratio (OR) = 1.81 (95% confidence interval (CI): 1.24, 2.60)]. In the mixture exposure models, urinary Cr consistently emerged as the top contributor to AOB, while the overall effect of mixed metal(loid)s was positive toward the odds of having AOB [adjusted OR: 1.33 (95% CI: 1.00, 1.77)], as revealed from the quantile g-computation model. After adjusting for the effects of other metal(loid)s, we found that the elevation of apolipoprotein B and systolic blood pressure significantly mediated the association between urinary Cr and the odds of having AOB by 9.7 and 19.4%, respectively. Our results suggest that exposure to metal(loid)s is a key factor contributing to the prevalence of AOB and WC gain in rural areas of China.

Determination of Quality of Life and Related Factors in Overweight Women Living in Rural Areas

Background

Obesity is more common among women living in rural areas of Türkiye and being overweight affects the quality of life of women.

Aim

Through this study, we aimed to determine the quality of life and related factors of overweight women living in rural areas.

Materials and Methods

This is a descriptive correlational study. The data were collected using the Personal Information Form and the Scale of Quality-of-Life Overweight Women (SMQLOW) between April and June 2020. The study sample comprised women with a body mass index (BMI) of 25 and above.

Results

The study included 201 women, 41.8% of the participants were in the 36-51 age group and 50.2% had a BMI between 30 and 49.2 (obese). It was determined that the quality of life of women was at a moderate level. The difference between the total SMQLOW score with respect to age, educational status, economic status, occupation of the spouse, general health status, and BMI were found to be statistically significant (P < 0.05). We examined the correlation of some variables with the total scale score of overweight women. A significant positive and weak correlation was found between weight and the SMQLOW total score (r = 0.390, P = 0.001). There was a positively weak and highly significant, correlation between waist circumference and SMQLOW total score (r = 0.277, P < 0.001).

Conclusion

Preventing obesity may improve the quality of life among rural women in the study Population.

Perception of dental students regarding possible career challenges and associated factors towards working in rural areas: A questionnaire based survey

OBJECTIVE

The shortage of health care professionals in rural areas contributes toward discriminatory health care delivery. The present study was planned with a similar intent and aimed to evaluate the perception of dental students regarding their future in rural areas.

MATERIALS AND METHODS

The present study was designed as a cross-sectional study comprising of a 30-item questionnaire survey instrument distributed among a total of 550 dental students while the results obtained were subjected to statistical analysis. Statistical analysis was done using SPSS version 12.0 (SPSS Inc., Chicago, IL, USA). Independent student's t-test and one-way analysis of variance (ANOVA) were used for comparison among the variables while the Chi-square test was used to determine the association between the variables. P < 0.05 was considered statistically significant.

RESULTS

No significant difference was observed in the attitude based on gender (P = 0.43), although, a statistically significant difference was observed in the attitude of students based on the year of their education with a positive attitude toward rural dental practice generally noted in the first year Bachelor of Dental Surgery (BDS) students which significantly declined with the increasing level of education (P = 0.01).

CONCLUSIONS

Dental students were more influenced by the negative aspects of rural dental practice though they had, in their mind, a positive approach for the same at the beginning of their education, but this significantly declined with the increasing level of their education.

Effect of integrated intervention to prevent child drowning in rural areas of Guangdong, China: a cluster randomized controlled trial

BACKGROUND

Drowning is the leading cause of death for children under the age of 15 years in Guangdong Province, China. This serious public health issue also exists in low- and middle-income countries (LMICs), which have few value-integrated intervention programs. The current study presents an integrated intervention project that aims to explore an effective pattern of prevention for child drowning in rural areas and feasibility to perform in other LMICs.

METHODS

We conducted a cluster randomized controlled trial by comparing the incidence of non-fatal drowning among children in two groups in rural areas of southern China. We recruited the participants in two phases and reached a total of 10 687 students from 23 schools at two towns in Guangdong Province, China. At the first and second phases, 8966 and 1721 students were recruited, respectively.

RESULTS

The final evaluation questionnaires were collected after 18 months of integrated intervention, where we obtained 9791 data from Grades 3-9. The incidence of non-fatal drowning between the intervention and control groups after intervention did not differ significantly from the baseline according to the total number of students, male students, female students and Grades 6-9 [0.81; 95% confidence interval (CI): [0.66, 1.00]; p = 0.05, 1.17; 95% CI: [0.90, 1.51]; p = 0.25, 1.40; 95% CI: [0.97, 2.02]; p = 0.07 and 0.97; 95% CI: [0.70, 1.34]; p = 0.86], except for Grades 3-5 (1.36; 95% CI: [1.02, 1.82]; p = 0.037). The study observed a significantly positive benefit of awareness and risk behaviours of non-fatal drowning between the intervention and control groups (0.27, 95% CI: [0.21, 0.33]; p = 0.00, -0.16; 95% CI: [-0.24, -0.08]; p = 0.00).

CONCLUSIONS

The integrated intervention exerted a significant impact on the prevention and management of child non-fatal drowning, especially in rural areas.

Angebote zur Prävention von sozialer Isolation und Einsamkeit bei älteren Menschen im ländlichen Raum

Hintergrund

In ländlichen Regionen sind ältere Menschen besonders mit sozialer Isolation und Einsamkeit sowie deren gesundheitlichen Auswirkungen (z. B. erhöhte Gesamtmortalität, kardiovaskuläre Erkrankungen) konfrontiert. Um diesem zunehmenden Public-Health-Problem entgegenzuwirken, bedarf es Angebote zur Förderung von Sozialkontakten und gesellschaftlicher Teilhabe.

Fragestellung

Liegt ein Bedarf an Präventionsangeboten in Bezug auf soziale Isolation bzw. Einsamkeit vor und wie kann diesem begegnet werden?

Methoden

Eine quantitative, deskriptive Analyse mittels Paper-pencil-Fragebogen wurde von Dezember 2019 bis Januar 2020 durchgeführt, um das (1) Vorliegen von sozialer Isolation und Einsamkeit sowie deren Risikofaktoren, (2) Bedürfnisse und Bedarfe sowie (3) die Eignungsbewertung von und das Interesse an Angeboten zur Prävention von sozialer Isolation und Einsamkeit bei Einwohner/-innen ≥ 65 Jahre einer ländlichen Kommune zu erfassen.

Ergebnisse

Die Rücklaufquote betrug 48,9 % von N = 331. In der Studienpopulation lagen verschiedene Risikofaktoren für soziale Isolation und Einsamkeit vor (z. B. Kinderlosigkeit, eingeschränkte Mobilität). Zudem hat fast ein Fünftel der Personen innerhalb von 14 Tagen keinen persönlichen Kontakt zu Menschen aus dem öffentlichen Bereich. Über ein Fünftel gab an, sich „manchmal“ oder „oft“ einsam zu fühlen. Die Angebotsvorschläge „Gottesdienste, Nutzen von kirchlichen Angeboten“, „Ausflüge“, „Informationsveranstaltungen zu verschiedenen Themen“, „Gemeinsame Bewegung/Sport“ und eine „Unterstützungsgruppe, in der man anderen Personen seine Hilfe anbieten und/oder Hilfe bekommen kann“ wurden am häufigsten als geeignet sowie interessant beurteilt.

Schlussfolgerungen

Die Ergebnisse zeigen einen hohen Bedarf, Bedürfnisse und Interesse an Angeboten zur Prävention von sozialer Isolation und Einsamkeit auf. Angebote sollten die spezifischen Bedarfe und Bedürfnisse (z. B. geringe finanzielle Mittel, eingeschränkte Mobilität) älterer Menschen berücksichtigen.

Zusatzmaterial online

Zusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s11553-023-01025-8) enthalten.

Understanding the Relationship between Financial Literacy and Chinese Rural Households' Entrepreneurship from the Perspective of Credit Constraints and Risk Preference

Farmers' entrepreneurship is an important factor in promoting rural economic growth, yet few studies have systematically discussed the impact of financial literacy. Using the 2021 China Land Economic Survey data, this study analyzes the relationship between financial literacy and Chinese rural households' entrepreneurship from the perspective of credit constraints and risk preferences by the IV-probit, stepwise regression, and moderating effects methods. This study finds that: (1) the financial literacy of Chinese farmers is low, with only 11.2% of the sample households starting businesses; and (2) Financial literacy can promote rural households' entrepreneurship. After introducing an instrument variable to control endogenous problems, the positive correlation is still significant; (3) financial literacy effectively alleviates the traditional credit constraints of farmers, thereby promoting entrepreneurship; (4) risk preference weakens the positive impact of financial literacy on rural households' entrepreneurship. This study provides a reference for optimizing entrepreneurship policies.

A randomised controlled trial to improve the resilience of oesophageal cancer survivors in rural China: A study protocol

AIM

To design a protocol based on the experiences of long-term survivors to facilitate resilience for oesophageal cancer patients in rural China.

BACKGROUND

According to the latest Global Cancer Statistics Report, 604,000 new cases of oesophageal cancer were reported, of which over 60% of the disease burden is distributed in China. The incidence of oesophageal cancer in rural China (15.95/100,000) is twice as high as those in urban areas (7.59/100,000). To be sure, resilience can help patients better adapt to post-cancer life. But universal interventions involving improving the resilience of oesophageal cancer patients have much less been explored, especially for rural patients.

METHODS

The two-arm, parallel design, non-blinded, randomised controlled trial will be implemented in 86 adults diagnosed with oesophageal cancer and will be randomly assigned to the control group or the intervention group via the blocked randomisation. The intervention group will undergo an intervention with one-on-one guidance from a nurse while viewing a CD of the experiences of long-term survivors with oesophageal cancer in rural areas. Every 2 weeks, a theme session will be introduced, and the entire intervention will continue for 12 weeks. Psychosocial variables (resilience, self-efficacy, coping mode and family support) will be surveyed at baseline, post-intervention and 3 months after the intervention. The paper complies with the Standard Protocol Items: Recommendations for Intervention Trials 2013 and Consolidated Standards of Reporting Trials guidelines for study protocols adapted for designing and reporting parallel group randomised trials.

CONCLUSION

The intervention programme transitions from hospitalisation to discharge, which includes one-on-one interventions by medical personnel and a portable CD describing the experiences of long-term survivors with rural oesophageal cancer. Once the intervention's effectiveness is proven, this protocol will provide psychological support for massive oesophageal cancer patients.

RELEVANCE TO CLINICAL PRACTICE

The intervention programme may be used as an auxiliary therapy to promote patients' postoperative psychological rehabilitation. This programme has the advantages of being cost-effective, flexible, accessible, and convenient and can be implemented without the limitation of time, place and clinical medical staff.

TRIAL REGISTRATION

The Chinese Clinical Trial Registration number is ChiCTR2100050047. Registered on 16 August 2021.

How Social Responses to Child Sexual Abuse and Intimate Partner Violence Affect Homelessness Among Women in Two Rural Regions With Resource-Based Economies in Eastern Quebec

This study presents findings from a qualitative study conducted in two relatively remote, primarily rural regions of the Canadian province of Quebec whose resource-based economic structures exacerbate inequalities between men and women. The purpose of this study was to understand how violence and homelessness intertwine in women's life courses in such regions. On the basis of past research showing that gender socialization around traditional roles and conservative values is particularly tenacious in non-urban areas, we conducted life-course interviews with 22 women in 13 different towns and villages of these two regions. Our content analysis of these interviews showed that specific social responses have forced women to maintain relationships with their aggressors or with people who have protected them, thus relegating these women's lives to the private sphere while reducing their opportunities for social participation in the public sphere. These social responses, together with women's economic and social disadvantages in these regions, were also the main factors that explain homelessness experienced by the participants in this study. Our analysis of these responses illustrates the patriarchal social structure of power in these regions, which is perpetuated in the interpersonal, institutional, and representational dimensions and keeps women in precarious, subordinate social positions, while ostracizing or punishing women who try to resist.

Title: Caring for Children with Cerebral Palsy: A Challenge to Caregivers in Rural Areas of South Africa

BACKGROUND

In South Africa, children with cerebral palsy are nested within a family setting by immediate relatives, particularly in the rural areas. These immediate relatives are regarded as caregivers and are not trained with regard to providing care to children with special needs. Therefore, they have to find ways to adapt to their new roles of caregiving using the available resources. The aim of this paper is to present the challenges encountered by caregivers of children with cerebral palsy in rural areas of South Africa.

METHODS

This qualitative, explorative, descriptive, and contextual study included 10 caregivers for children with cerebral palsy who were purposively recruited from the three respective hospitals in Vhembe District within Limpopo Province. Data were collected through individual in-depth interviews and analysed using a thematic approach. Ethical considerations and measures to ensure trustworthiness were upheld throughout the study.

RESULTS

Four themes emerged from the study, namely economic problems facing caregivers; health problems encountered by caregivers; maltreatment of caregivers by community members, as well as access to transport for caregivers and children.

CONCLUSION

Participants narrated that caring for a child with cerebral palsy is not an easy task for the caregiver, particularly in the rural areas of South Africa. They encounter various challenges as they strive to provide quality care to the children that they are caring for. An investigation is recommended concerning the kind of model which should be developed to support caregivers in caring for children with cerebral palsy in the rural areas.

Lifestyle Entrepreneurship as a Vehicle for Leisure and Sustainable Tourism

The subject of this research is related to sustainable tourism and its connection with lifestyle entrepreneurship. The Portuguese business fabric is formed by micro, small, and medium sized enterprises which have emerged in big numbers over the last years, mainly related directly and indirectly to the tourism industry. The discussed issue of this study is whether these companies are a vehicle for sustainable tourism in rural areas. Via a qualitative method, through a comparative case study of 11 businesses, the goal is to evaluate if the lifestyle entrepreneurship initiatives promote sustainable tourism in rural areas, identifying the specific business created and evaluating their growth toward the planned strategies and actions related to internal resources and capacity, as well as marketing. Lastly, the results present the plans made for growth according to the necessary balance among economic progress, environment, public health, and a social context. This study promotes decision tools for entrepreneurs and destination managers as to the practices to be adopted with the goal of sustainable development. Thus, in terms of ecological responsibility, the use of renewable energy through biomass is a very efficient practice because it both produces energy and reduces waste, since the energy production comes from plants and animal waste.

Vaccination rates against COVID-19 in patients with severe mental illness attending community mental health services in rural Greece

BACKGROUND

Patients with severe mental illness (SMI) may be at increased risk for COVID-19-related severe morbidity and mortality. There is limited research on the vaccination rates against COVID-19 in patients with SMI.

AIMS

The objective of the present study is to explore vaccination rates and co-relations in patients with SMI, attending community mental health services, namely the Mobile Mental Health Units (MMHUs) in rural Greece.

METHOD

All treatment engaged patients with SMI (schizophrenia-spectrum or bipolar disorder) with two MMHUs (MMHU of Kefalonia, Zakynthos and Ithaca, [MMHU KZI] and MMHU of the prefectures of Ioannina and Thesprotia [MMHU I-T]) in rural Greece were enrolled prospectively over a six-month period. The MMHU I-T had adopted a more proactive approach to patients' vaccination, by informing patients and caregivers for its benefits.

RESULTS

Data were analyzed for 197 patients with SMI. The overall vaccination rate was 68.5% and did not differ from the respective rates in the general population. There were no differences in vaccination rates among patients attending the two MMHUs, nor among patients with different diagnoses (schizophrenia spectrum disorders or bipolar disorder). Vaccination was not associated with gender, educational level, history of alcohol and substance abuse, illness duration, or number of previous hospitalizations, whereas the effect size of age was moderate. In more than half non-vaccinated patients the refusal to get vaccinated was associated with fears and concerns as well as false beliefs that are encountered in the general population.

CONCLUSION

In the present sample of treatment-engaged rural patients vaccination rates against COVID-19 appear to be satisfactory. There were no differences in vaccination rates with regard to the interventions that were applied to enhance vaccination. It seems that other forms of intervention should be applied to reluctant patients to modify their attitudes toward vaccination.

Telepharmacy: A Systematic Review of Field Application, Benefits, Limitations, and Applicability During the COVID-19 Pandemic

Introduction: Telepharmacy is widely known as the delivery of pharmacy care offered by registered pharmacists and pharmacies using telecommunication technologies to patients at a distance. We conducted a systematic review of the reported usages, benefits, and limitations of telepharmacy models worldwide to further clarify the pros and cons of a telepharmacy model. Methods: A total of 39 relevant articles was included after searching for articles with a fixed term on four databases, including PubMed, Virtual Health Library (VHL), Global Health Library (GHL), and Google Scholar, as of April 2021. Results: Our review suggested that telepharmacy has played an essential role in addressing pharmacist shortages and helping patients both safely and effectively administer medications in underserved areas. During the COVID-19 pandemic, remote dispensing and counseling are effective measures to avoid infection. Conclusion: Telepharmacy could potentially replace or complement pharmaceutical-related activities, facilitating future innovation in the health care industry.

How Does Problematic Internet Use Influence Chinese Rural Adolescent Externalizing Problem Behaviors? The Mediating Role of Mental Health and the Moderating Role of Parental Knowledge

This study aims to provide a new perspective on the relationship between problematic Internet use and externalizing problem behavior among adolescents. Many studies have focused on the relationship between problematic Internet use and adolescent externalizing problem behavior; however, research on the underlying mechanism remain understudied. Altogether, 1161 Chinese rural adolescents aged 13-17 years completed a self-report questionnaire. The results indicate that: (1) Problematic Internet use has a negative effect on rural adolescent externalizing problem behaviors; (2) mental health has an effect on the relationship between problematic Internet use and externalizing problem behaviors; and (3) parental knowledge may moderate the indirect effect by attenuating the relationship between problematic Internet use and externalizing problem behaviors. Regarding these findings, this study has discussed the potential reasons and provided some practical suggestions to improve problematic Internet use among rural adolescents.

Intercity Mobility Assessment Facing the Demographic Challenge: A Survey-Based Research

The key factor in moving towards a more sustainable travel model is based on improving mobility, especially in rural areas that share territorial dynamics with urban areas and are connected by a daily flow of inhabitants. The purpose of this article is to carry out a diagnosis of the daily mobility patterns of the inhabitants of a number of rural municipalities, with the aim of promoting sustainability and mitigating the phenomenon of territorial depopulation in future local planning policies. The research methodology is based on the use of revealed preference surveys together with accessibility analysis using GIS tools, allowing for an in-depth knowledge of the mobility patterns of the municipalities in the area under analysis. In this respect, the reference parameters in terms of territorial accessibility are determined by applying the network analysis procedure to basic public services. The results reflect the existence of an unbalanced modal split with a preponderance of private vehicle use (regardless of the destination or the reason for the journey). In addition, a very weak inter-municipal connection dynamic is observed. There is a knowledge gap in the verification of the long-term suitability of sustainable measures in rural areas implemented after the development of mobility plans (in order to assess their effectiveness).

The compliance of free folic acid supplements among pregnant women in rural areas of Northwestern China: The role of related knowledge

Background

High prevalence of neural tube defects remains one of the major threats to newborns in rural China. Folic acid supplementation before and during early pregnancy can effectively reduce the risk of neural tube defects. Despite the efforts of the free folic acid mass distribution, the actual usage of folic acid supplements was still suboptimal among rural pregnant women in China. The objective of this study is to investigate if and how knowledge can influence the picking up and intake of the free folic acid supplements distributed by the government.

Methods

We collected survey data from 821 pregnant women in rural areas of Shaanxi, China, in March and December of 2021. Face-to-face interviews and questionnaire surveys were conducted with every participant. Univariate and multivariate logistic regression analyses were performed to test the relationship between knowledge and dependent variables.

Results

Our study found that there were 76.4% of pregnant women would pick up folic acid supplements distributed by the government and only 44.5% of women would use folic acid before current pregnancy. Awareness of folic acid policy both affects the picking up (OR: 6.708, 95% CI: 4.672-9.632) and periconceptional intake (OR: 1.912, 95% CI:1.326-2.758) of folic acid supplements. Knowledge of health and nutrition in pregnancy showed no significant relationship with the picking up and periconceptional intake of folic acid supplements but was positively associated with the intake duration (Coefficient: 9.278, 95% CI: 2.966-15.591).

Conclusion

Despite the relatively high level of picking up, the actual folic acid usage was not ideal among pregnant women in rural areas of China. Folic acid policy awareness was positively associated with the picking up and intake of folic acid before and during conception. Knowledge of health and nutrition about pregnancy was related to a longer duration of folic acid intake but had no impact on the picking up rate and periconceptional intake of folic acid supplements.

The association between muscle strength and executive function in children and adolescents: Based on survey evidence in rural areas of China

Background

In recent years, muscle strength in children and adolescents has continued to decline, especially in rural areas. Executive function as a higher function of the brain, is closely related to the future achievement of children and adolescents. For this reason, this study analyzed the correlation between muscle strength and executive function in children and adolescents in rural areas of China to better promote the development of muscle strength and executive function.

Methods

Demographic factors, muscle strength, and executive function were tested in 1,335 children and adolescents in rural China using a three-stage stratified whole-group sampling method. One-way ANOVA and chi-square test were used to compare the differences in executive function among children and adolescents with different muscle strengths. Multiple linear regression analysis and logistic regression analysis were used to analyze the association that exists between muscle strength and executive function.

Results

When comparing the inconsistently, congruent, 1back, 2back, conversion, size parity, and cognitive flexibility response times of children and adolescents with different muscle strength indexes in rural China, the differences were statistically significant (F = 46.592, 45.610, 10.809, 32.068, 24.095, 19.260, 11.501, p < 0.001). Logistic regression analysis was performed using children and adolescents with muscle strength index >P80 as the control group. The results showed that the risk of 1back dysfunction was higher (OR = 1.764, 95% CI:1.094, 2.843) in children and adolescents with muscle strength index <P20 (p < 0.05). The risk of 2back dysfunction was higher in children and adolescents with a muscle strength index <P20 (OR = 2.129, 95% CI:1.329, 3.410) (p < 0.01). Compared with children and adolescents with muscle strength index >P80. The muscle strength index <P20 group had a higher risk of cognitive flexibility dysfunction (OR = 1.820, 95% CI:1.111, 2.982) (p < 0.05).

Conclusion

There is a association between muscle strength and executive function in children and adolescents in rural areas of China. Those with higher muscle strength have shorter executive function reaction times and are at lower risk of developing executive dysfunction. Future measures should be taken to improve muscle strength and executive function levels in children and adolescents in rural areas to promote healthy physical and mental development.

Factors influencing cataract awareness and treatment attitudes among the middle-aged and older in western China's rural areas

Purpose

This study was conducted to determine the level of knowledge about cataracts and the associated factors among adults aged 50 and above in rural areas of Qingcheng county in Gansu Province of Western China, 2020.

Methods

A large community-based cross-sectional study was conducted among the randomly selected 1,503 adults aged 50 and above from October to December 2020. Data were collected by conducting eye examinations and face-to-face interviews. Multivariate binary logistic regression and multivariate linear regression were used to identify associated factors of knowledge about cataracts. Odds Ratio (OR), Coefficient (C), and 95% Confidence Interval (CI) were reported to declare the statistical associations between knowledge about cataracts and the independent variables.

Results

Of the 1,503 study participants, 1,078 (71.7%) had good knowledge about cataracts. The primary school completed [OR = 1.43 (95% CI 1.08-1.90), P = 0.012], Secondary school & above [OR = 2.69 (95% CI 1.86-3.89), P <0.001], Examine for cataract [OR = 1.82 (95%CI 1.27-2.62), P = 0.001] were positively significantly associated with knowledge about cataracts. Whereas eye examinations [OR = 0.73(95% CI 0.55-0.96), P = 0.022] were negatively associated with knowledge about cataracts. Multivariate linear regression analyses showed a significant negative correlation between age and knowledge of cataract treatment options. Living with at least one child was positively correlated with knowledge of the therapeutic effects of cataracts. And monthly household income was significantly positively correlated with knowledge of the therapeutic effects of cataracts, treatment options, and the surgical reimbursement ratio for cataracts.

Conclusions

More than one-third of the participants still had poor knowledge about cataracts. The respondents with at least primary education and above, with previous examinations, and with examination for cataracts had significant associations with good knowledge about cataracts. So, it is recommended that stakeholders in different hierarchies organize health education by considering the education level of the community, focusing on cataract treatment knowledge and the surgical reimbursement ratio to improve cataract surgery rates.

A systematic review of the epidemiology of epilepsy in Mexico during 1970 to 2020

BACKGROUND

Epilepsy is the most common major neurological disorder that affects people of all ages. The prevalence varies from one country to another and even between different areas, due to a lack of access to medical care for reasons related to limited resources.

OBJECTIVE

Epilepsy is a worldwide public health problem that affects more deeply populations living in developing countries such as Mexico, where more aggressive health policies based on epidemiological data are needed; however, this information is scarce and the evolution of this data over time remains unclear. The aim of the present study is to provide an overview of the epidemiology of epilepsy in Mexico from 1970 to 2020.

METHODS

We searched descriptive epidemiological studies on epilepsy in rural and urban regions of Mexico from 1970 to 2020. Available data on the sociodemographic characteristics, prevalence, and incidence data were extracted. Finally, the abstract, full-text review, and data abstraction were conducted in duplicate and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Descriptive statistics was also used.

RESULTS

Overall, 11 underrepresented and heterogeneous epidemiological studies were included. In total, the prevalence of epilepsy in Mexico is 3.9 to 41:1,000 inhabitants; 3.9 to 41 per 1,000 persons in rural regions, and 3.49 to 44.3 per 1,000 persons in urban regions. None of these studies addressed the incidence of epilepsy. The prevalence of epilepsy in Mexico has remained unchanged during the last 5 decades.

CONCLUSIONS

Our results confirm a high prevalence of epilepsy in both urban and rural settings in Mexico that remain unchanged during the last 5 decades. All studies included in the present review showed multiple methodological limitations. New and robust epidemiological studies are needed to delineate the epidemiological profile of epilepsy in Mexico.