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BACKGROUND: Coxiella burnetii is a bacterium with extreme tenacity and contagiousness that is mainly transmitted by inhalation of contaminated aerosols. Nevertheless, a transmission by ticks is under discussion. We report a case of Q fever in an urban environment and far away from sheep breeding that caused a rare right-sided endocarditis. CASE PRESENTATION: A 55-year-old man who was in good health before the event developed a C. burnetii -endocarditis of the tricuspid valve. He had no contact with sheep and no recent travel in a rural or even endemic area. The infection originated in a strictly urban environment, and the patient's occupation as a cemetery gardener in Berlin, coupled with the close temporal and local exposure to wild boar, made a transmission by these animals a plausible hypothesis. The infection was confirmed by the German Reference Laboratory, and the patient recovered completely after treatment with doxycycline and hydrochlorquine. CONCLUSIONS: The specialities of this case report are the right-sided endocarditis and the transmission of C. burnetii in a metropolitan area without sheep contact. We think that this case should serve to increase awareness of the potential for Q fever infection even in non-rural areas.
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Coxiella burnetii , Endocardite Bacteriana , Febre Q , Valva Tricúspide , Febre Q/transmissão , Febre Q/microbiologia , Febre Q/diagnóstico , Febre Q/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Humanos , Valva Tricúspide/microbiologia , Endocardite Bacteriana/microbiologia , Endocardite Bacteriana/transmissão , Endocardite Bacteriana/tratamento farmacológico , Coxiella burnetii/isolamento & purificação , Animais , Antibacterianos/uso terapêutico , Doxiciclina/uso terapêutico , OvinosRESUMO
A cross-sectional study was conducted with three aims: (1) to determine the degree of compliance with physical activity recommendations among adolescents according to sex and place of residence, (2) to determine the perceived support of family and friends for physical activity among adolescents according to sex and place of residence, and (3) to analyse the influence of family and friends support on compliance with physical activity recommendations among adolescents according to sex and place of residence. A total of 694 adolescents from an inland area of Spain (14.06 ± 1.27 years) participated. Four one-day physical activity questionnaires were administered to assess physical activity and the Parental Support Scale and Peer Support to measure perceived support from family and friends regarding physical activity. Chi-square, Crammer's V and Student's tests were calculated to identify differences between variables according to sex and municipality of residence. Moreover, the initial binary logistic regression model was constructed to predict the physical activity compliance. Differences in adherence to physical activity recommendations were found according to the sex of the students (rural area: x2 = 4.192, p < 0.05; V = 0.106, p < 0.05; urban area: x2 = 8.999, p < 0.05; V = 0.167, p < 0.01). There were also sex differences in rural areas on items related to families providing transport (t = 3.878, p ≤ 0.001; d = 0.40) and doing physical activity together (t = 4.974, p ≤ 0.001; d = 0.50). It is concluded that most adolescents do not comply with physical activity recommendations. In addition, 30.4% of urban girls' compliance was predicted by the perception that their family members saw them doing physical activity and doing it with friends.
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BACKGROUND/PURPOSE: The integrated home-based medical care (iHBMC) program has been implemented by the Taiwanese government since 2016. The pandemic of coronavirus disease 2019 (COVID-19) accelerated the shift from hospital-based to community-based healthcare, with a special focus on advanced home care for frail older adults. This study focuses on home-based advanced care, such as hospital at home (HaH), aiming to explore the feasibility and resilience of HaH within a home-based medical care model in a rural community in Taiwan. METHODS: We conducted a retrospective review of medical records from February 2020 to August 2022. Two clinical professionals reviewed and abstracted data from the electronic medical records of 189 patients receiving home healthcare during the COVID-19 pandemic. The HaH event was calculated if patients had any acute infection and received treatment at home. RESULTS: A total of 62 HaH events occurred during 2020-2022 and the average HaH events per person was 1.4. In these events, the top reason for patients receiving HaH was pneumonia, followed by urinary tract infection, soft tissue infection, and sepsis. 77.4% of patients completed the HaH treatment and did not experience any recurrent acute infections in the 30-day follow-up. CONCLUSION: Different forms of home healthcare enhance the resilience of medical care provision in rural areas. As Taiwan approaches a hyper-aged society by 2025, it is crucial that National Health Insurance policies support various home-based care models that address transportation issues and maintain high care standards in underserved rural areas.
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Background: Multimorbidity is a condition that refers to the coexistence of two or more chronic diseases or long-term medical conditions in an individual. It has become one of the key issues in the public health sector, particularly among older adults. So, this study aimed to estimate the prevalence of multimorbidity and its associated factors among older adults. Methodology: The present study was a community-based cross-sectional study carried out on the elderly population (≥60 years) in a rural area of the study district, Gujarat. The estimated sample size was 384, and the final sample size was taken as 420, considering the multistage sampling procedure for fair distribution. The eligibility criteria included elderly people ≥60 years old, who were permanent residents (living for ≥6 months) of the study district and willing to participate in the study. Elderly people who were not willing to participate in the study for their reasons were excluded. A multistage sampling procedure was used to choose the study participants. The data collection tools included a pretested, predesigned, semi-structured questionnaire. The questionnaire consisted of two parts: sociodemographic details and morbidity details. Categorical variables were described by frequency and percentage, and numerical variables were described by mean ± SD. Logistic regression analyses were applied to test the relationship of categorized independent and dependent variables, and all tests were two-tailed with statistical significance set at the probability value (P < 0.05). Results: Out of the 420 study participants, 52.1% were male and 47.9% were female, with a mean age of 70.70 years (SD ± 8.18 years). The prevalence of multimorbidity was 50%, with males having a mean number of morbidities of 1.38 ± 1.06 and females having a mean number of morbidities of 1.44 ± 0.99. As the age increased, the strength of association of multimorbidity also increased. Literacy level, marital status, occupation (business, farmer, housewife), and family history were statistically associated with multimorbidity in the study participants in both bivariate and multivariate analyses (P < 0.05). Conclusion: The study provides valuable insights into the health status of the elderly population in the rural area and can be used to inform healthcare policies and interventions aimed at improving the health outcomes of this population.
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Context: Adolescent phase is a very crucial period in one's life, much emotional and psychological support is needed for an adolescent to bloom into a responsible adult. But unfortunately adolescents do not get the support or they fail to seek support due to lack of awareness. Government of India, to address this issue has established dedicated adolescent friendly health services (AFHS). This study estimates the utilisation of adolescent friendly health clinics in a rural area of Maharashtra. Aims: Aim is to the study the utilisation of adolescent friendly health services and its various determinants in a rural area of Maharashtra. Objectives: Objectives of this study were to assess the sociodemographic profile of study participants, to study the utilisation of adolescent friendly health services among them and to determine the factors associated with utilisation of adolescent friendly health services. Settings and Design: A community based cross-sectional study was conducted among 290 late adolescents from a rural area of Maharashtra from October 2022 to December 2022. Methods and Material: With the help of data from Gram panchayat about residing adolescents in the rural field practice area of tertiary care hospital, all late adolescents were included in this study after obtaining informed consent. Data was collected with and Statistical analysis was done using 'Open Epi Info' software. Results: Out of 290 adolescents, 35% (102) were aware of adolescent friendly health clinics (AFHS), 20% (58) utilised AFHS, the significant sociodemographic components for utilisation were found to be females (AOR: 2.161,95% CI: 1.088-4.295), Bauddha religion (AOR: 2.465,95% CI: 0.585-10.383), socioeconomic class I and II- B.G Prasad classification (AOR: 1.544,95% CI: 0.786-3.030), higher secondary education (AOR: 8.025,95% CI: 1.434-44.916) and Government schooling (AOR:0.389,95% CI: 0.080-1.889). Conclusions: Though initiatives are taken from the Government to lend a helping hand to the adolescents, awareness and utilisation seems to be minimal.
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Telemedicine is the delivery of healthcare services using information and communication technologies to diagnose, treat, and prevent diseases. The COVID-19 pandemic has accelerated the adoption of telemedicine, transforming how healthcare is delivered, especially in remote and underserved areas. Despite its potential, no systematic reviews have been conducted in the last five years to assess the effectiveness of telemedicine for managing diabetes in rural populations. This review addresses this gap by evaluating studies on telemedicine's impact on glycemic control among diabetic patients in these settings. We searched five databases: PubMed, Google Scholar, ClinicalTrials.gov, ScienceDirect, and Science.gov, covering studies published in the last five years. Of the 331 articles identified, 10 met our inclusion criteria: English-language studies from the past five years involving adults in rural areas or comparing rural and urban settings, focusing on telemedicine's impact on glycemic control in diabetic patients. In many studies, the findings revealed that telemedicine interventions integrated into structured programs significantly improved HbA1c levels. Successful implementation requires local infrastructure and consistent patient-provider interactions, although increased healthcare provider workloads may affect sustainability. Telemedicine alone was less effective for patients with complex comorbidities, suggesting that a combined approach with in-person visits may be more effective. This review highlights telemedicine's potential to replace routine in-person visits for diabetes management in rural areas, demonstrating significant improvements in HbA1c levels, medication adherence, and timely care management support. Future research should focus on randomized controlled trials in rural settings, hybrid care models that optimize in-person visit frequency and remote monitoring, and addressing technological challenges such as broadband access and platform usability to ensure sustainable telehealth interventions.
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BACKGROUND: Breast cancer awareness is a concept suggesting that awareness of signs and symptoms and early seeking of medical advice may decrease mortality, especially in limited resource settings. METHODS: A modified questionnaire based on the breast cancer awareness measure (BCAM) by Cancer Research UK was translated into Greek and used for the first time. Participants were women residing in a rural border area in Greece. For statistical analysis the χ2 goodness-of-fit and Cramer's V test for categorical comparisons were used and Cronbach's alpha for reliability analysis. RESULTS: In total, 110 women filled out and returned the questionnaire. Respondents appeared to be inappropriately informed regarding the less common warning signs of breast cancer, the most common age of breast cancer occurrence, the national screening program, and the less important risk factors of breast cancer. On the other hand, most women appeared to be confident in recognizing breast changes and seeking medical advice if needed. CONCLUSIONS: The translated modified BCAM tool can be used to evaluate breast cancer awareness in Greek women. Future campaigns developed by policymakers should focus on improving breast cancer awareness, especially in socioeconomically deprived areas.
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Background: A scale is used to establish performance ranges in different sciences, it being necessary to design specialized biological and pedagogical indicators in physical activity, sport and health. Objective: To design a scale for the pedagogical control of the vertical jumping ability in untrained adolescents (13-16 years), stratifying the sample by age range, ethnicity, urban and rural area, socioeconomic level, and gender. Methods: A representative sample of the Ecuadorian population (n = 3,705) is studied, classifying it into the aforementioned strata, controlling the vertical jump by ISAK I and II level experts, applying the Sargent Test to measure vertical jumps on a multi-force wall, establishing scales with seven percentile levels, and making comparisons related to chronological age, gender, socioeconomic, and genetic indicators. Results: Significant differences in the vertical jumping performance were determined according to the category or age range (13-14 ≠ 15-16 years) and by gender (w = 0.000). Various levels of performance were determined, classifying the maximum level as talented in the female gender (≥40 cm; and ≥42 cm) and male gender (≥47 cm; and ≥57 cm) in the 13â14 and 15â16 years categories, respectively. Sampling comparisons by geographical area only determined significant differences in the male gender, with the jumping ability being higher in urban areas (13â14 years: w = 0.046; 15â16 years: w = 0.013). The comparison by ethnic groups showed significant differences (k = 0.030), favoring the Afro-Ecuadorian ethnic group in both genders, while there are significant differences by socioeconomic level, especially between the middle and lower classes. Conclusions: The present research solves the lack of a tool for making correct didactic decisions related to the vertical jumping ability, taking into account various important stratified indicators. The complementary conclusions show significant differences according to the category stratum or age range, the gender stratum, and the ethnic stratum in females and males, where the best average rank favored the Afro-Ecuadorian ethnic group in both genders. There are significant differences in the geographical area stratum in the male gender, and differences in the socioeconomic stratum in favor of the upper and middle classes.
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Desempenho Atlético , Humanos , Adolescente , Masculino , Feminino , Equador , Desempenho Atlético/fisiologia , Fatores Sexuais , Exercício Físico/fisiologia , População RuralRESUMO
Midwifery centers are places where midwives not only provide antenatal checkups and delivery care but also offer a wide range of health guidance to pregnant women, postpartum mothers, newborns, and older women. In recent years, midwives have also provided onsite and online health guidance. However, diagnosis and prescribing medication are impossible in midwifery centers because no doctor is present. If the midwife determines that the patient should consult doctors, the patient may have to go to a hospital and see doctors in person, which can be burdensome. Online telemedicine facilitates midwife-doctor collaboration and may solve this problem. We report a case of headache management by telemedicine that minimized the patient's travel burden by collaborating with a midwifery center that provides onsite, visiting, and online health guidance for patients who have difficulty visiting a hospital due to postpartum period, childcare, and breastfeeding. A 29-year-old woman and her husband were raising an infant in Sado City (a remote island across the sea), Niigata Prefecture. She developed acute back pain and was bedridden for several days due to immobility. She consulted a midwife because of stress and anxiety caused by childcare and acute back pain, as well as newly occurring headaches. The midwife visited her and provided on-site health guidance. The midwife decided that a doctor's diagnosis and treatment with painkillers were desirable for the headache and back pain, so she contacted a doctor based on the patient's request. The doctor provided online telemedicine across the sea, diagnosed her headache as a tension-type headache, and prescribed acetaminophen 500 mg as an abortive prescription. The prescription was faxed to a pharmacy on the island, and the original was sent by post. The midwife picked up the medication and delivered it to the patient. After taking the medication, the patient's back pain and headache went into remission. Collaboration between midwifery centers that provide onsite, visiting, and online health guidance and medical institutions that offer online telemedicine can potentially improve accessibility to medical care. It differs from conventional online telemedicine in the midwife's coordination practice by monitoring the patient's condition and requesting the physician based on the patient's request.
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The misdiagnosis of headache disorders is a serious issue, and AI-based headache model diagnoses with external validation are scarce. We previously developed an artificial intelligence (AI)-based headache diagnosis model using a database of 4000 patients' questionnaires in a headache-specializing clinic and herein performed external validation prospectively. The validation cohort of 59 headache patients was prospectively collected from August 2023 to February 2024 at our or collaborating multicenter institutions. The ground truth was specialists' diagnoses based on the initial questionnaire and at least a one-month headache diary after the initial consultation. The diagnostic performance of the AI model was evaluated. The mean age was 42.55 ± 12.74 years, and 51/59 (86.67%) of the patients were female. No missing values were reported. Of the 59 patients, 56 (89.83%) had migraines or medication-overuse headaches, and 3 (5.08%) had tension-type headaches. No one had trigeminal autonomic cephalalgias or other headaches. The models' overall accuracy and kappa for the ground truth were 94.92% and 0.65 (95%CI 0.21-1.00), respectively. The sensitivity, specificity, precision, and F values for migraines were 98.21%, 66.67%, 98.21%, and 98.21%, respectively. There was disagreement between the AI diagnosis and the ground truth by headache specialists in two patients. This is the first external validation of the AI headache diagnosis model. Further data collection and external validation are required to strengthen and improve its performance in real-world settings.
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The applicability of the specific human IgG antibody response to Anopheles gambiae salivary Gland Protein-6 peptide 1 (gSG6-P1 salivary peptide) as a biomarker able to distinguish the level of exposure to mosquito bites according to seasonal variations has not yet been evaluated in Central African regions. The study aimed to provide the first reliable data on the IgG anti-gSG6-P1 response in rural area in Cameroon according to the dry- and rainy-season. Between May and December 2020, dry blood samples were collected from people living in the Bankeng village in the forest area of the Centre region of Cameroon. Malaria infection was determined by thick-blood smear microscopy and multiplex PCR. The level of IgG anti-gSG6-P1 response, was assessed by enzyme-linked immunosorbent assay. Anopheles density and aggressiveness were assessed using human landing catches. The prevalence of malaria infection remains significantly higher in the rainy season than in the dry season (77.57% vs 61.44%; p = 0.0001). The specific anti-gSG6-P1 IgG response could be detected in individuals exposed to few mosquito bites and showed inter-individual heterogeneity even when living in the same exposure area. In both seasons, the level of anti-gSG6-P1 IgG response was not significantly different between Plasmodium infected and non-infected individuals. Mosquito bites were more aggressive in the rainy season compared to the dry season (human biting rate-HBR of 15.05 b/p/n vs 1.5 b/p/n) where mosquito density was very low. Infected mosquitoes were found only during the rainy season (sporozoite rate = 10.63% and entomological inoculation rate-EIR = 1.42 ib/p/n). The level of IgG anti-gSG6-P1 response was significantly higher in the rainy season and correlated with HBR (p Ë 0.0001). This study highlights the high heterogeneity of individual's exposure to the Anopheles gambiae s.l vector bites depending on the transmission season in the same area. These findings reinforce the usefulness of the anti-gSG6-P1 IgG response as an accurate immunological biomarker for detecting individual exposure to Anopheles gambiae s.l. bites during the low risk period of malaria transmission in rural areas and for the differentiating the level of exposure to mosquitoes.
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Anopheles , Imunoglobulina G , Mordeduras e Picadas de Insetos , Proteínas e Peptídeos Salivares , Adolescente , Adulto , Animais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Anopheles/parasitologia , Anopheles/imunologia , Camarões/epidemiologia , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Mordeduras e Picadas de Insetos/imunologia , Mordeduras e Picadas de Insetos/epidemiologia , Mordeduras e Picadas de Insetos/sangue , Proteínas de Insetos/imunologia , Malária/epidemiologia , Malária/imunologia , Malária/sangue , Malária/transmissão , Mosquitos Vetores/parasitologia , Mosquitos Vetores/imunologia , População Rural , Proteínas e Peptídeos Salivares/imunologia , Estações do AnoRESUMO
INTRODUCTION: Examining the equity of health care and financial burden in households of deceased individuals in urban and rural areas is crucial for understanding the risks to both national and individual household finances. However, there is a lack of research on catastrophic health expenditure (CHE) in these households, specifically in urban and rural contexts. This study aims to identify the ability to pay and equity of CHE for both households of deceased individuals in urban and in rural areas. METHODS: This study analysed data from the Korea Health Panel for 10 years (2009-2018) and targeted 869 deceased individuals and their households in the Republic of Korea (South Korea). Annual household income and living costs were adjusted based on equivalent household size, and the difference between these values represented the household's ability to pay. Out-of-pocket (OOP) expenditure included copayments and uninsured healthcare expenses for emergency room visits, inpatient care, outpatient treatments and prescription medications. CHE was defined as OOP expenditure reaching or exceeding 40% of the household's ability to pay. ANCOVA was performed to control for confounding variables, and the equity of CHE prevalence between urban and rural area was assessed using χ2 analysis. RESULTS: Compared to urban households, the rural households of deceased individuals had, respectively, fewer members (2.7 v 2.4, p=0.03), a higher rate of presence of a spouse (63.8% v 70.7%, p=0.04) and a higher economic activity rate (12.7% v 20.5%, p=0.002). The mean number of comordities before death was 3.7 in both urban and rural areas, and there was no difference in the experience of using over-the-counter medicines for more than 3 months, emergency room, hospitalisation, and outpatient treatment. In addition, annual household OOP expenditures in urban and rural areas were US$3020.20 and US$2812.20, respectively, showing no statistical difference (p=0.341). This can be evaluated as a positive effect of various policies and practices aimed at alleviating urban-rural health equity. However, the financial characteristics of the household of the deceased in the year of death differed decisively between urban and rural areas. Compared to urban households, the annual income of rural households (US$15,673.80 v US$12,794.80, respectively, p≤0.002) and the annual ability to pay of rural households (US$14,734.10 v US$12,069.30, respectively, p=0.03) were lower. As a result, the prevalence of CHE was higher in rural areas than in urban areas (68.3% v 77.6%, p=0.003). CONCLUSION: The findings of this study highlight the higher risk of CHE in rural areas due to the lower income level and ability to pay of the household of the deceased. It is evident that addressing the issue of CHE requires broader social development and policy efforts rather than individual-level interventions focused solely on improving health access and controlling healthcare costs. The findings of this study contribute to the growing evidence that income plays a crucial role in rural health outcomes.
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Financiamento Pessoal , Gastos em Saúde , População Rural , População Urbana , Humanos , Gastos em Saúde/estatística & dados numéricos , População Urbana/estatística & dados numéricos , População Rural/estatística & dados numéricos , Feminino , Masculino , Financiamento Pessoal/estatística & dados numéricos , República da Coreia , Pessoa de Meia-Idade , Adulto , Características da Família , Doença Catastrófica/economia , IdosoRESUMO
BACKGROUND: Unequal access to primary healthcare (PHC) has become a critical issue in global health inequalities, requiring governments to implement policies tailored to communities' needs and abilities. However, the place-based facility dimension of PHCs is oversimplified in current healthcare literature, and formulating the equity-oriented PHC spatial planning remains challenging without understanding the multiple impacts of community socio-spatial dynamics, particularly in remote areas. This study aims to push the boundary of PHC studies one step further by presenting a nuanced and dynamic understanding of the impact of community environments on the uneven primary healthcare supply. METHODS: Focusing on Shuicheng, a remote rural area in southwestern China, multiple data are included in this village-based study, i.e., the facility-level healthcare statistics data (2016-2019), the statistical yearbooks, WorldPop, and Chinese GDP's spatial distribution data. We evaluate villages' PHC service capacity using the number of doctors and essential equipment per capita, which are the major components of China's PHC delivery. The indicators describing community environments are selected based on extant literature and China's planning paradigms, including town- and village-level factors. Gini coefficients and local spatial autocorrelation analysis are used to present the divergences of PHC capacity, and multilevel regression model and (heterogeneous) difference in difference model are used to examine the driving role of community environments and the dynamics under the policy intervention. RESULTS: Despite the general improvement, PHC inequalities remain significant in remote rural areas. The village's location, aging, topography, ethnic autonomy, and economic conditions significantly influence village-level PHC capacity, while demographic characteristics and healthcare delivery at the town level are also important. Although it may improve the hardware setting in village clinics (coef. = 0.350), the recent equity-oriented policy attempts may accelerate the loss of rural doctors (coef. = - 0.517). Notably, the associations between PHC and community environments are affected inconsistently by this round of policy intervention. The town healthcare centers with higher inpatient service capacity (coef. = - 0.514) and more licensed doctors (coef. = - 0.587) and nurses (coef. = - 0.344) may indicate more detrimental policy effects that reduced the number of rural doctors, while the centers with more professional equipment (coef. = 0.504) and nurses (coef. = 0.184) are beneficial for the improvement of hardware setting in clinics. CONCLUSIONS: The findings suggest that the PHC inequalities are increasingly a result of joint social, economic, and institutional forces in recent years, underlining the increased complexity of the PHC resource allocation mechanism. Therefore, we claim the necessity to incorporate a broader understanding of community orientation in PHC delivery, particularly the interdisciplinary knowledge of the spatial lens of community, to support its sustainable development. Our findings also provide timely policy insights for ongoing primary healthcare reform in China.
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Acessibilidade aos Serviços de Saúde , Atenção Primária à Saúde , Serviços de Saúde Rural , População Rural , China , Humanos , Atenção Primária à Saúde/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , População Rural/estatística & dados numéricos , Serviços de Saúde Rural/estatística & dados numéricos , Política de Saúde , Médicos/provisão & distribuição , Médicos/estatística & dados numéricos , Disparidades em Assistência à Saúde , Equipamentos e Provisões/provisão & distribuiçãoRESUMO
Introduction: Retaining doctors and dentists in remote areas of Indonesia remains a national priority of the Indonesian government. The purpose of this study was to analyze the interventions for retention of doctors and dentists in remote areas using the discrete choice experiment (DCE) approach. Materials and Methods: A DCE was conducted to investigate preferences of doctors and dentists for retention in remote areas. This research was conducted in 78 primary healthcare settings across 15 provinces in Indonesia. The conditional logit model was used to explore stated preferences for each attribute. Results: The total number of respondents was 158, including 113 doctors and 45 dentists. In general, doctors placed the highest preference on getting priority for government scholarships to facilitate retention in remote areas (OR=5.65, p<0.001). Specifically, dentists preferred security guarantees from local government (OR = 4.87, p<0.001). Both groups valued having an official residence (OR=3.6, p<0.001) as a factor for retention in remote areas. Conclusion: Scholarship, security guarantees, housing facilities, and medical facilities were the most considered factors for retaining doctors and dentists in a remote area. This study confirms the importance of a combination of interventions in maintaining doctors and dentists in remote areas. Policy options in the form of non-financial and financial intervention packages can be combined to improve their retention.
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BACKGROUND: Breastfeeding technique is a combination of positioning, attachment, and breast milk suckling. Breastfeeding problems are caused by incorrect breastfeeding practices, which lead to premature discontinuation of breastfeeding. Therefore, this study aimed to determine the proportion of breastfeeding techniques and associated factors among lactating primiparous mothers during the postpartum period in the Debre Markos town health facility in 2021. METHODS: An institutional-based cross-sectional study was conducted from November 1st to December 30, 2021. A systematic sampling technique was utilized to select study participants. An observational checklist developed by WHO and an interviewer-administered questionnaire were used to collect data from 409 mothers. The collected data were entered into Epi-Data version 4.6.0.4 statistical software and then exported to SPSS version 24.0 for cleaning and analysis. Binary and multivariable logistic regression was carried out to identify the factors associated with the practice of effective breastfeeding techniques. A variable that has a p-value of ≤0.2 was transferred to a multivariable for further analysis. The strength of association was identified using an adjusted odds ratio with a 95% confidence interval, and a p-value <0.05 was taken as statistically significant. RESULTS: The proportion of practicing effective breastfeeding techniques among lactating primipara mothers was 29.1% (CI: 24.7, 33.3). Baby aged ≥29 days, mothers who were living in urban, mothers who attended college or higher education, mothers who have heard about BFT practices, mothers who received counseling on BFT after delivery, and mothers whose breast nipples had everted were variables that were significantly associated with the practice of effective breastfeeding techniques. CONCLUSION: The findings of this study revealed that the practice of effective breastfeeding techniques among lactating primipara mothers was lower in the study area. Therefore, healthcare providers should have to counsel mothers on how to position and attach their infants during breastfeeding. PRACTICE IMPLICATION: The provision of breast-feeding method counseling to nursing mothers is one way to enhance the practices of breast feeding.
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Aleitamento Materno , Lactação , Humanos , Feminino , Aleitamento Materno/estatística & dados numéricos , Etiópia , Estudos Transversais , Adulto , Lactação/fisiologia , Período Pós-Parto , Mães/psicologia , Mães/estatística & dados numéricos , Recém-Nascido , Adulto Jovem , Inquéritos e Questionários , Paridade , GravidezRESUMO
Aim: Few health checkup studies have reported lifestyle habits and examination results before and during the COVID-19 pandemic. We compared lifestyle habits and examination results surveyed before and during the COVID-19 pandemic. Methods: Five hundred and ten and 396 participants attended the health checkup in 2019 and 2022, respectively. The median age of females was 65 in 2019 and 2022, and that of males was 68 in 2019 and 69 in 2022. We investigated dietary and exercise habits, alcohol consumption, sleeping situation, and examination results, including body mass index (BMI), smell function, and blood examination results before and during the COVID-19 pandemic in a rural area in Japan. Results: An ordinal logistic regression analysis revealed that the intake frequency of vegetables and marine products was significantly less in 2022 than in 2019 after adjusting age and sex; green leafy vegetables (p = .016), fish (p = .002), and other marine products, including squid, shrimp, crabs, and octopus (p = .008). Alcohol consumption amount increased significantly in 2022 than in 2019 in men who drank beer (p = .007) and chuhai (p = .040). Albumin, hematocrit, cholesterols, and uric acid decreased, but serum calcium increased significantly in 2022 than in 2019 after adjusting age and sex. BMI and hemoglobin A1c were not significantly different between 2019 and 2022. A decrease in subjective smell feeling and smell test results was associated with decreased intake frequency of vegetables. Conclusion: Both dietary habits and blood examination results changed significantly during the COVID-19 pandemic in a rural area in Japan.
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INTRODUCTION: Almost a quarter of the people on earth are anemic, and most of them reside in regions of sub-Saharan Africa and South Asia. Anemia in children is linked with impaired cognitive and motor development and affects the future earning capacity. The most common cause of anemia is iron deficiency. The Indian Government has initiated multiple programs for the eradication of anemia. The prevalence of anemia has not decreased despite the improvements in the country's economy. It increased from 58.7% in 2015-16 to 67.1% in 2019-21 in children and from 50.4% in 2015-16 to 52.2% in 2019-21 in pregnant women. Maternal education, socioeconomic status, and number of children in the family are some factors that influence the prevalence of anemia. As these factors cannot be improved in a short time, we aimed to increase awareness about this issue by targeting school students from rural/semi-urban backgrounds. METHODS: This pilot study aimed at promoting school students as public health advocates in their community. Anemia Awareness Program was conducted in a local middle school in the suburban area, which was attended by 153 class eight students (72 female). Pre- and post-test questionnaires comprising 20 multiple-choice/true-false type questions were used. Pre- and post-test scores were obtained. The second part of the study was the identification of students with anemia. Blood hemoglobin levels of 127 students (58 female) were measured from venous blood samples. The students were also asked to inform their friends/relatives about anemia and to send people with symptoms of anemia to the free two-day Anemia Awareness Camp organized by the Medical College Hospital for check-ups. RESULTS: The mean post-test score (15.68/20) was much higher than the pretest score (2.99/20). Thirty-eight (25 female) out of 127 students had mild/moderate microcytic hypochromic anemia, suggesting iron deficiency. Thirty-two persons visited the free health camp to receive information from the students, of whom four had normal hemoglobin levels. CONCLUSION: This pilot study showed that physician-conducted anemia awareness programs are relatively low-cost methods to spread information among the general population in India.
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<b>Background and Objective:</b> Molepo Dam is a small dam with several aquatic animal species. An assessment of the water quality index of Molepo Dam is necessary because it is situated close to a largely rural community. In this study, the physicochemical variables of Molepo Dam were observed to better understand the water quality situation of this dam. <b>Materials and Methods:</b> The study was carried out from October 2022 to March 2023; 126 samples of water were taken from the Molepo Dam. The physicochemical parameters of the water were determined through standard methods. <b>Results:</b> The site within the dam exhibited a clear separation. Site 1, 2 and 4 were found to be more similar to each other, while Site 3 was separated from them. Site 5, 6 and 7 were more similar together as well. The results showed that the pollution level in Site 3 was the lowest. The pollution level in Site 1, 2 and 4 was more similar and the level of pollution in Site 5, 6 and 7 was the highest. <b>Conclusion:</b> According to the study, pollution levels were found to be different in various parts of the Molepo Dam. This was because the wastewater generated by rural communities was predominantly discharged towards the northern part of the dam.
Assuntos
Qualidade da Água , África do Sul , Análise Multivariada , Animais , Monitoramento Ambiental/métodos , Poluentes Químicos da Água/análiseRESUMO
In Japanese agricultural lands, nitrate-nitrogen contamination of soil and groundwater often occurs due to the application of livestock excrements and compost. Therefore, rural soils in Japan were sampled and analyzed for nitrate-nitrogen leaching, heavy metal content, and sterols associated with livestock excrement and compost to calculate contamination risk indicators. The results were analyzed using self-organizing maps and cluster analysis. Nitrate-nitrogen content using water extraction was detected in most of the sampled soils. In addition, many samples from areas that were already severely contaminated with nitrate-nitrogen showed particularly high concentrations. Coprostanol, an indicator of fecal contamination, was detected in more than half of the samples. The main source of nitrate-nitrogen contamination in these areas is livestock excrement and compost. Self-organization maps showed that areas with high nitrate-nitrogen contamination also corresponded to areas with high copper and zinc soil contents. The self-organization maps and cluster analysis resulted in five clusters: a nitrate-contaminated group mainly originating from livestock excrement and compost, a heavy metal-contaminated group, a general group, a nitrate-contaminated group mainly originating from chemical fertilizers, and a contaminated group with potentially hazardous substances requiring attention. Authorities and decision-makers can use the results to prioritize areas requiring remediation.
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Agricultura , Monitoramento Ambiental , Água Subterrânea , Metais Pesados , Nitratos , Poluentes do Solo , Solo , Esteróis , Poluentes do Solo/análise , Nitratos/análise , Metais Pesados/análise , Água Subterrânea/química , Solo/química , Japão , Esteróis/análise , Gado , Poluentes Químicos da Água/análise , Animais , Fertilizantes/análise , População do Leste AsiáticoRESUMO
This study aimed to examine the impact of COVID-19 on loneliness among rural older women in senior cohousing in Korea. Using a natural experimental study design, we investigated how the pandemic-induced closure of cohousing affected the former residents' loneliness. The sample comprised 84 cohousing residents and 51 individuals in conventional homes. The dependent variable is loneliness, and the independent variables include housing transition, social contact, and support from neighbors and friends. Our findings from fixed effect regression models showed former cohousing residents were less likely to experience loneliness when they had more contact with their friends and neighbors, while negative relationships exacerbated feelings of loneliness. Sharing meals and participating in activities with friends and neighbors in cohousing helped the residents develop effective coping strategies. Senior cohousing in rural areas has the potential to strengthen social ties and protect the most vulnerable subgroup of older adults from social isolation and loneliness.