Need of rural communities to be engaged and empowered for global health and wellness

For health and wellness rural communities do many things with whatever they have, use various modalities of actions for prevention, therapy of disorders, maintenance, promotion of health. Also, for everyday life they do various activities which affect their health. Present article is based on observations, information in context of activities by rural people for their health and wellness. Personal observations, experiences were added to information about actions by rural communities for health and wellness. Rural communities use their own wisdom, do many things with whatever they have for living a healthy life. They use various modalities during pregnancy, birth for mother, new born, persons of all ages. Therapies are used for pregnancy care, birth, post birth, other illnesses, injuries and so on. In modern day practice it has become essential to priorities modes of actions for best therapy, best outcome without harmful effects. In addition to various actions for prevention, therapy, maintenance and promotion of health and wellness, communities do other activities which impact their health. This needs sharing for best of global health. Communities use many modalities for therapy, prevention of disorders, rehabilitation and health promotion. Need is of learning from them, adding science to such modes if needed, robust evaluation of community actions with long term outcomes, cost-effectiveness, in various settings globally. World needs to know and use for healthy life and make communities aware of modern medicine, technology wherever essential for global health.

Uso y conocimiento tradicional de plantas medicinales en comunidades de Villa Corzo, Chiapas, México / Use and traditional knowledge of medicinal plants in communities of Villa Corzo, Chiapas, Mexico

The use and knowledge of native and naturalized medicinal plants were evaluated in four communities of Villa Corzo, Chiapas, Mexico. The information was obtained through semi - structured surveys conducted with 1 18 people of different age and gender categories. To determine the most important plant species, indexes of value and frequency of use were generated. Seventy - nine species of 49 families were recorded, as well as their use in the treatment of various disea ses according to local knowledge. The species with the highest value of use were Aloe vera (L.) Burm. f., Verbena officinalis L. (verbena), Ocimum basilicum L. (basil) and Psidium guajava L. (guava). (guava). The most important families by number of specie s used were, in order of importance: Asteraceae and Rutaceae with five species Lamiaceae, Fabaceae and Rosaceae with four species each.

Se evaluaron el uso y conocimiento de las plantas medicinales nativas y naturalizadas en cuatro comunidades de Villa Corzo, Chiapas, México. La información se obtuvo a través de encuestas semiestructuradas realizadas a 118 personas de distintas categorías de edad y género. Para determinar las especies de plantas más importantes se generaron índices de valor y frecuencia de uso. Se registraron 79 especies de 49 familias, así como su uso en el tratamiento de diversas enfermedades de acuerdo al conocimiento local. Las especies con mayor valor de uso fueron Aloe vera (L.) Burm. f. (sábila), Verbena officinalis L. (verbena), Ocimum basilicum L. (albahaca) y Psidium guajava L. (guayaba). Las familias más importantes por el número de especies utilizadas fueron, en orden de importancia: Asteraceae y Rutaceae con cinco especies, Lamiaceae, Fabaceae y Rosaceae con cuatro especies cada una.

Usos medicinales y alimenticios de flora introducida en el Chaco Seco argentino: contrastes entre el conocimiento local y el científico / Medicinal and nutritional uses of flora introduced in the Argentine Dry Chaco: contrasts between local and scientific knowledge

Introduced species generate worldwide concern due to in many cases manifest their potential as invasive as invasives. However, little is known about its sociocultural importance and biocultural interaction. Through open and semi-structured interviews, guided walks and participant observation, the main uses and cultural valuations of biogeographically introduced plants in localities of the Dry Chaco (Catamarca and Córdoba) were investigated. A total of 53 species were documented, 18 with medicinal use and 40 for food. The most recurrent treatments correspond to digestive disorders and respiratory conditions; in food, those for direct consumption stand out. Most taxa with local therapeutic applications coincide with theoretical studies on active principles and their curative effects. Finally, it is concluded that the biogeographic origin of the species is independent of the cultural valuations as long as they are potentially usable, in addition to recognizing that ethnobotanical knowledge based on experience supports the uses found from the academy.

Las especies introducidas generan preocupación mundial debido a que en muchos casos manifiestan su potencialidad como invasoras. Sin embargo, poco se conoce su importancia sociocultural e interacción biocultural. Por medio de entrevistas abiertas y semiestructuradas, caminatas guiadas y observación participante se indagó sobre los principales usos y las valoraciones culturales de las plantas biogeográficamente introducidas en localidades del Chaco Seco (Catamarca y Córdoba). Se documentaron un total de 53 especies, 18 con uso medicinal y 40 alimenticias. Los tratamientos más recurrentes corresponden a trastornos digestivos y afecciones respiratorias; en las alimenticias se destacan aquellas de consumo directo. La mayoría de taxones con aplicaciones terapéuticas locales, coinciden con estudios teóricos sobre principios activos y sus efectos curativos. Finalmente, se concluye que, el origen biogeográfico de las especies es independiente de las valoraciones culturales mientras sean potencialmente aprovechables, además de reconocer que los conocimientos etnobotánicos basados en la experiencia fundamentan los usos encontrados desde la academia.

TRIBAL CONSUMER BEHAVIOUR TOWARDS ONLINE SHOPPING: AN EMPIRICAL STUDY OF RURAL RANCHI DISTRICT

This paper discusses the Tribal people of Ranchi District behavior towards online shopping, it also discusses why they prefer online shopping and why not. In recent years, rural markets have acquired significance, as the overall growth of the economy has resulted into substantial increase in the purchasing power of the rural communities. Rural Markets are defined as those segments of overall market of any economy, which are distinct from the other types of markets like stock market, commodity markets or Labor economics. Online shopping or e-shopping is a form of electronic commerce which allows consumers to directly buy goods or services from a seller over the Internet using a web browser. Alternative names are: e-web-store, e-shop, e-store, Internet shop, web-shop, web-store, online store, online storefront and virtual store. The purpose of this study is to analyze the impact of consumer perceptions in regards to online shopping. A sample of 100 (55 males and 45 females) respondents were taken into consideration from tribal people of rural Ranchi District.

Assessment of Knowledge Regarding Osteoporosis among Pre-Menopausal Women residing in Selected Rural Communities

Background: As a woman approaches menopause there are gradual changes in the physiology of her body. One of the prominent changes is an increase in the fragility of bone due to calcium variation causing Osteoporosis. A low level of estrogen, which occurs around the time of menopause leads to increased bone loss. A woman can undergo either primary or secondary osteoporosis. In most cases, the first 'symptom' of osteoporosis is broken bone. As osteoporosis is an emerging health problem, that creates an economic burden, it needs a special focus to promote healthy ageing. Knowledge is the best contributor to reducing the risk of premenopausal women getting osteoporosis. Methods: Total 70 pre-menopausal women living in chosen rural communities in Bagalkot were chosen with a convenient sampling technique. A structured questionnaire developed by the researcher was used to gather information concerning knowledge about osteoporosis. Chi-square analysis was used to uncover the relationship between knowledge about osteoporosis with socio-demographic factors. Results: Total 24.28% of women were having good knowledge, 54.28% were having average knowledge, and 21.42% of women were having poor knowledge about osteoporosis. A significant relationship was attained between knowledge regarding osteoporosis and occupation (?2=14.20, p<0.007) and formal education (?2=16.22, p<0.039) at the position of the significance of 0.05. Conclusion: After evaluation of knowledge on the subject of osteoporosis among pre-menopausal women, it was found that most women had average knowledge regarding osteoporosis.

Gender-Stratified Factors Associated with Stigma Toward HIV/ AIDS among Rural Communities in Sarawak, Malaysia

@#Introduction: Many factors hinder the effective responses to the HIV/AIDS epidemic. Stigma is one of the major barriers to effective responses to the HIV/AIDS epidemic. It is often considered the main reason for the low response to access proper services for prevention, treatment, and care for HIV/AIDS. In this context, we assessed the perceived level of stigmatisation towards people with HIV/AIDS among rural communities in Sarawak and determined its associated factors. Methods: This cross-sectional community-based study was conducted among the adult population aged 18 years and above among rural communities in Sarawak, Malaysia. A gender-stratified multistage cluster sampling technique was adopted to select the respondents. A total of 900 respondents were successfully interviewed using interviewer-guided questionnaires. Stepwise multiple linear regression with forward and backward selection method was used to determine the HIV/AIDS-related stigma. A p-value of ≤.05 was considered statistically significant. Results: Analysis revealed that females are more stigmatised than males (p<.05). Multivariate analysis showed that those who did not know someone had HIV and Chinese ethnicity were potential predictors in both male and female groups. Having no gainful job, and discussion of HIV/AIDS, household income less than MYR 500, history of HIV testing, knowledge on HIV transmission and exposure to HIV/AIDS information were factors that influenced HIV/ AIDS-related stigma among female respondents. On the other hand, age group 30 to 39, Bidayuh, Chinese ethnicity, and not knowing someone had HIV and media exposure on HIV were factors that influenced HIV/AIDS-related stigma among male respondents. Conclusion: HIV/AIDS-related stigma towards HIV/AIDS existed in rural communities. Enhanced health promotion related to HIV/AIDS activities in rural communities are needed to curb stigmatisation toward people with HIV/AIDS.

Prevalence of violence towards men living with HIVAIDS in rural communities of Southwestern Uganda

Background: Violence towards HIV positive men is one of the silent barriers to utilization of HIV care services. HIV positive men are potential victims of violence from other people including women, and violence may interfere with treatment outcomes. This study determined the prevalence of violence towards HIV positive men in rural communities of southwestern Uganda. Methods: A cross-sectional study was conducted among 307 HIV positive men at selected health centers using an interviewer administered questionnaire. Data were analyzed in SPSS version 23 using chi-square and multivariate regression at 95% level of significance and a precision of 0.05. Results: Of the 307 participants, 45.3% had experienced violence. Of these, 23.8% (n=73) had experienced kicking or slapping while 12.7% (39) reported sexual violence. Factors associated with violence were; using alcohol and drugs (aOR 0.26, 95% CI 0.09-0.76, p=0.014), knowledge of support structures (OR 2.25, 95% CI 1.33-3.78, p=0.002) and owning land for farming (aOR 0.26, 95% CI 0.10-0.70, p=0.011). Conclusion: The prevalence of violence at 45.3% is quite high especially since violence against men is rarely talked about. This should not be ignored there should be strategies to support this vulnerable group

Barreiras de acessibilidade à atenção básica em assentamento em Pernambuco, Brasil, sob a ótica de camponesas, profissionais de saúde e gestão / Accessibility barriers to primary care in a Pernambuco, Brazil, settlement via the perspective of peasants, health professionals, and management / Barreras de accesibilidad a la atención primaria en un asentamiento de Pernambuco, Brasil, desde la perspectiva de campesinas, profesionales de la salud y la gestión

São inegáveis as iniquidades envolvidas diretamente nos modos de nascer, viver, adoecer e morrer da população do campo. Para analisar a acessibilidade ao cuidado em saúde desse povo, consideramos quatro barreiras pertinentes à acessibilidade aos serviços de atenção básica: as geográficas, organizacionais, financeiras e de informação. O estudo objetivou evidenciar as barreiras de acessibilidade à atenção básica pela população de um assentamento em Pernambuco, Brasil, sob a perspectiva de assentadas, profissionais e gestão. Trata-se de uma pesquisa descritiva, transversal, qualitativa, do tipo caso único realizada em um assentamento de reforma agrária pernambucano e na unidade de saúde da família responsável pela assistência desse território. Um representante da gestão municipal em atenção básica foi entrevistado e dois grupos focais foram realizados, um com as assentadas e outro com os profissionais de saúde da equipe de saúde da família. Para a análise dos dados utilizou-se o método do Discurso do Sujeito Coletivo. As barreiras de acessibilidade geográfica evidenciaram distância entre unidade e assentamento sem a garantia de um transporte; as barreiras organizacionais expuseram alta demanda de usuários e estrutura física precária; as barreiras financeiras demonstraram ameaças do novo financiamento e condições socioeconômicas precárias da população; e as barreiras de informação revelaram a escassez da educação permanente e o preconceito associado às lacunas de comunicação entre profissionais e assentados. Ante às inúmeras barreiras de acessibilidade e suas consequências para a população do estudo, cabe avançar na adequação da atenção básica, com vistas a ampliar o acesso às necessidades de saúde evidenciadas.

We are unable to deny the iniquities which are directly involved in the ways of being born, living, falling ill, and dying of the rural population. To analyze these people's accessibility to health care, we considered four barriers pertinent to accessibility to primary care: geography, organization, finance, and information. This study stresses the accessibility barriers to primary care which the population of a Pernambuco, Brazil, settlement faces from the perspective of settlers, professionals, and management. This is a descriptive, cross-sectional, qualitative, single-case research conducted in a Pernambuco agrarian reform settlement and in the family health unit responsible for caring for this territory. We interviewed a primary care municipal management representative and conducted two focus groups, one with settlers and another with the healthcare providers of the family health team. To analyze data, the Discourse of the Collective Subject method was used. Geographical accessibility barriers showed a distance between unity and settlement without guaranteeing transportation; organizational ones showed high user demand and precarious physical structure; financial ones, threats of new financing and precarious socioeconomic conditions of this population; and information ones revealed the scarcity of continuing education and the prejudice associated with communication gaps between professionals and settlers. In view of the numerous accessibility barriers and their consequences for the studied population, we must improve primary care adequacy to expand access to the evinced health needs.

Son innegables las iniquidades involucradas directamente en las formas de nacer, vivir, enfermarse y morir de la población del campo. Para analizar la accesibilidad al cuidado en salud de estas personas, consideramos cuatro barreras relacionadas a la accesibilidad a los servicios de atención primaria: geográficas, organizativas, financieras y de información. Este estudio tuvo como objetivo identificar las barreras de accesibilidad a la atención primaria para la población de un asentamiento de Pernambuco, Brasil, desde la perspectiva de asentadas, profesionales y la gestión. Se trata de una investigación descriptiva, transversal, cualitativa, de caso único, realizada en un asentamiento de reforma agraria de Pernambuco y en la unidad de salud de la familia responsable de la asistencia de este territorio. Se entrevistó a un representante de la gestión municipal en atención primaria y se realizaron dos grupos focales, uno con las asentadas y el otro con los profesionales de la salud del equipo de salud de la familia. Para el análisis de datos se utilizó el método del Discurso del Sujeto Colectivo. Las barreras de accesibilidad geográfica revelaron la distancia entre la unidad y el asentamiento sin la garantía de transporte; las barreras organizativas expusieron la alta demanda de los usuarios y la precariedad de la estructura física; las barreras financieras demostraron las amenazas de la nueva financiación y las precarias condiciones socioeconómicas de la población; y las barreras de información revelaron la escasez de educación permanente y el prejuicio asociado con las lagunas de comunicación entre los profesionales y los asentados. Ante las numerosas barreras de accesibilidad y sus consecuencias para la población del estudio, cabe avanzar en la adecuación de la atención primaria para ampliar el acceso a las necesidades de salud evidenciadas.

Tendencias metodológicas para la inclusión social de tecnologías apropiadas en zonas rurales / Methodological Trends for the Social Inclusion of Appropriate Technologies in Rural Areas

Resumen Este artículo tiene por objetivo estudiar las tendencias metodológicas a nivel mundial de tecnologías apropiadas (TA) desarrolladas en zonas rurales con inclusión social. Se realiza una revisión sistemática en bases de datos científicas. Se identifican las principales metodologías (cualitativas, cuantitativas y mixtas), herramientas y enfoques en procesos rurales con TA. Se detectan también los principales factores (social, técnico, económico, ambiental, institucional y cultural) y variables de estudio en procesos de TA rurales. Los continentes con un mayor número de experiencias en TA rurales son África y Asia. El sector de energía asocia el 56,0% de las experiencias detectadas.

Abstract This article aims to study the global methodological trends of appropriate technologies (TAs) developed in rural areas with social inclusion. A systematic review is carried out in scientific databases. The main methodologies (qualitative, quantitative, and mixed), tools and approaches in rural processes with TA are identified. The main factors (social, technical, economic, environmental, institutional, and cultural) and study variables in rural TA processes are also detected. The continents with the highest number of rural TA experiences are Africa and Asia. The energy sector associates 56.0% of the experiences detected.

A Fuzzy Approach to Assess the Perception of a Rural Community Concerning the Impact of Distributed Power Generation on Local Sustainability

Abstract This paper aims to evaluate the perception of residents of a rural quilombola community, about the impacts of distributed energy generation (DG) on the social, economic and environmental dimensions. The main challenge of the proposed model was to quantify the main perceptions of the target population of the research, as well as maintain the coherence of the specifications of the sustainability parameters. Diffuse modeling allows the transformation of linguistic variables into numerical values, the disadvantage is the dependence of the specialist to construct the rules. The methodology used was the application of a semi-structured questionnaire, and the results were used as a reference to build the discourse domain of the input variables of the Fuzzy inference system, which generated an index of 54.1% classified in the category partially sustainable. Specifically, the economic and social dimensions obtained an index of 46.7% and the environmental dimension of 69%. From the perspective of the perception of the respondents, the variables with the greatest impact were: landscape change (LCH) 92%, environmental awareness (EA) and reduction of global warming (GW) with values of both 69%. The variable of the most prominent economic dimension was: cost of the system with a value of 69%. In the social dimension, the variables with the greatest impact were: Community Acceptability (AC), Expansion of the support network (ESN) with values of 69%. The proposed model allowed us to interpret the respondents' perception, and can be used to generate effective actions that solve the identified demands.

Relationship of health promotion lifestyle with social support and self-efficacy of the elderly in urban-rural communities / 上海交通大学学报（医学版）

Objective:To investigate the health promoting lifestyle of the elderly in one urban-rural community in Shanghai, and explore its relationship with social support and self-efficacy. Methods:Using cluster sampling method, 984 senior citizens in a community of Pujiang Town, Minhang District, Shanghai were investigated with general situation, Social Support Rating Scale (SSRS), General Self-Efficacy Scale (GSES) and Health Promotion Lifestyle Profile Ⅱ (HPLPⅡ ). Results:The total score of social support was 40.51±5.92. The total score of general self-efficacy was 2.35±0.58. The total score of health-promoting lifestyle was 120.44±22.75. The total score of SSRS, subjective support and utilization of support, and the total score of GSES were positively correlated with the scores of all dimensions and total scores of HPLPⅡ(P<0.01).The factors that have a strong ability to predict the total score of HPLPⅡ for the elderly are in sequence the total score of GSES, the total score of SSRS, the number of children, and the utilization score of support. Conclusion:The level of health promoting lifestyle of the elderly in the urban-rural community needs to be improved. Among them, the score of nutrition dimension is the highest, and the score of exercise dimension is the lowest. The health promotion behavior and health level of the elderly in the community can be improved by improving social support and self-efficacy.

Factors associated with leisure activities of elderly residents in rural areas / Factores relacionados a las actividades recreativas de ancianos residentes en la zona rural / Fatores associados às atividades de lazer de idosos residentes na zona rural

ABSTRACT Objective: To identify factors associated with leisure activities of elderly residents in rural areas. Method: Quantitative cross-sectional study carried out with 258 elderly living in the rural area of Paraná. The collection instrument addressed sociodemographic, economic, and self-reported leisure activities. The association between variables and leisure activities was verified by means of bivariate and multivariate analysis. Results: Among the elderly interviewed, 63.9% were female, and 36.1% were male, with an average of 68.3 years old (± 5.8 years). Participation in leisure activities was high (79.8%), and the factors associated with their practice were: marital status, gender, and education. Conclusion: Considering that the practice of leisure activities promotes better living and health conditions, we reinforce the need to implement actions and instruments that provide individual and collective leisure in rural areas.

RESUMEN Objetivo: Identificar los factores relacionados a las actividades recreativas de ancianos residentes en la zona rural. Método: Estudio transversal cuantitativo realizado con 258 ancianos residentes en el área rural de Paraná. El instrumento para la recogida abordó cuestiones sociodemográficas, económicas y actividades recreativas autoreferidas. La relación entre las variables y las actividades recreativas ha sido verificada por medio de análisis bivariado y multivariado. Resultados: Entre los ancianos entrevistados, 63,9% fueron del sexo femenino y 36,1% del sexo masculino, con media de edad de 68,3 años (± 5,8 años). La participación en actividades recreativas ha sido alta (79,8%), y los factores que se asociaron a su práctica han sido: situación conyugal, sexo y escolaridad. Conclusión: Considerando que la práctica de actividades recreativas promueve mejores condiciones de vida y salud, se refuerza la necesidad de implementación de acciones e instrumentos que proporcionen ocio individual y colectivo en el espacio rural.

RESUMO Objetivo: Identificar os fatores associados às atividades de lazer de idosos residentes na zona rural. Método: Estudo transversal quantitativo realizado com 258 idosos residentes na área rural do Paraná. O instrumento para a coleta abordou questões sociodemográficas, econômicas e atividades de lazer autorreferidas. A associação entre as variáveis e as atividades de lazer foi verificada por meio de análise bivariada e multivariada. Resultados: Entre os idosos entrevistados, 63,9% eram do sexo feminino e 36,1% do sexo masculino, com média de idade de 68,3 anos (± 5,8 anos). A participação em atividades de lazer foi alta (79,8%), e os fatores que se associaram à sua prática foram: situação conjugal, sexo e escolaridade. Conclusão: Considerando que a prática de atividades de lazer promove melhores condições de vida e saúde, reforça-se a necessidade de implementação de ações e instrumentos que proporcionem lazer individual e coletivo no espaço rural.

Ophthalmic Problems of Adults in Rural Communities of Rivers State, Nigeria

Aim: To determine the ophthalmic problems and their possible causes among adults in rural communities in Rivers State.Methods: A multistage population based random sampling study of adults in five clans of Etche Local Government Area of Rivers State. Medical history was taken and comprehensive ocular examination done on each subject.Ocular examination included visual acuity, visual field, tonometry and ophthalmoscopy. Data taken were recorded and analysed using statistical software called Minitab 11. Ethical approval was obtained from relevant authorities.Results: Out of the 600 subjects seen in this study 276 (46.0%) were males and 324 (54.0%) females. They were all above 21 years old. Twenty six (2.4%) subjects had good vision while 8 (0.8%) were blind. The ophthalmic problems identified werePresbyopia 298 (28.0%), Refractive error 247 (23.2%), Cataract 126 (11.8%), Allergic conjunctivitis 106 (9.9%), Glaucoma 94 (8.8%), Pterygium 86 (8.1%), Bacterial conjunctivitis 35 (3.3%), Corneal opacity 32 (3.0%), Chalazion 4 (0.4%), Diabetic retinopathy 3 (0.3%) and Ptosis 1 (0.1%). Conclusion: The most common ophthalmic problems in this study which were dependent on gender and occupation include Presbyopia, Refractive Error, Cataract and Allergic Conjunctivitis. More females and farmers were seen in this study. The problems identified can be easily managed if well-equipped health facilities are provided by the government.

Gestión ambiental del recurso hídrico en jagüeyes comunitarios de Sincelejo, Sucre, Colombia / Environmental management of water resource in community jagüeyes from Sincelejo, Sucre, Colombia

La presente investigación determina si en algunas comunidades rurales de Sincelejo, Caribe colombiano se realiza una adecuada gestión ambiental del recurso hídrico en jagüeyes comunitarios. Se efectuó la caracterización de 10 unidades seleccionadas, enfatizando en áreas y volúmenes de almacenamiento. Se estableció la relación comunidades-jagüeyes respecto a demandas de agua, balances hídricos y problemas socio-productivos relevantes presentados por limitaciones de acceso al agua. Y se definió la calidad del agua almacenada. Las medidas de área de los jagüeyes oscilaron entre 0,09 ha y 0,27 ha, con capacidades entre 1.632,28 m3 y 5.269,98 m3. Se evidenciaron balances hídricos negativos resultando en la definición de déficits. Los inconvenientes socio-productivos identificados se relacionaron con la evidente negligencia de los usuarios para administración, operación, mantenimiento e inversión económica sobre los jagüeyes. Por otro lado, aunque la ingesta es un aprovechamiento de menor consideración entre los usuarios, la calidad del agua se precisó como sanitariamente inviable para consumo humano. Se concluye que no existe una adecuada gestión ambiental del recurso hídrico de los jagüeyes estudiados, siendo necesaria la ampliación del estudio de estos por su relevancia para las comunidades rurales.

The present research determines if in some rural communities of Sincelejo, Colombian Caribbean, an adequate environmental management of the water resource is carried out in community jagüeyes. The characterization of 10 selected units was carried out, emphasizing areas and storage volumes. The community-jagüeyes relationship was established regarding water demands, water balances and relevant socio-productive problems presented by limitations on access to water. And the quality of the stored water was defined. The area measurements of the jagüeyes ranged from 0.09 ha to 0.27 ha, with capacities between 1,632.28 m3 and 5,269.98 m3. Negative water balances were evidenced resulting in the definition of deficits. The socio-productive disadvantages identified were related to the obvious negligence of the users for administration, operation, maintenance and economic investment on the jagüeyes. On the other hand, although the intake is an use of less consideration among users, water quality was specified as sanitary unfeasible for human consumption. It is concluded that there is no adequate environmental management of the water resource of the jagüeyes studied, being necessary the extension of the study of these due to their relevance for rural communities.

Integrative literature review: access to primary healthcare services / Acceso a los servicios de la Atención Primaria de Salud: revisión integradora de la literature / Acesso aos serviços da Atenção Primária em Saúde: revisão integrativa da literatura

ABSTRACT Objective: Analyze the scientific production that describes the type of access to primary healthcare services and identify specific populations that have differentiated access to health services. Method: An integrative review. For study selection, the following databases were used: PubMed, Scopus, Bireme, and Cinahl. The sample included 22 national and international articles. Results: The results describe the access of specific populations to health services, the access to primary care through health plans and proposed improvements to the access to primary care. Conclusion: The access to services is a challenge in many countries and some strategies and policies are implemented to solve and improve primary health care.

RESUMEN Objetivo: analizar la producción científica que describe la forma de acceso a los servicios de la Atención Primaria de Salud e identificar las poblaciones específicas que tienen acceso diferenciado a los servicios de salud. Método: revisión integradora. Para seleccionar los estudios, se utilizaron las bases de datos: PubMed, Scopus, Bireme y Cinahl. La muestra incluyó 22 artículos nacionales e internacionales. Resultados: describir sobre el acceso de poblaciones específicas a los servicios de salud, acceso a cuidados primarios por medio de seguros médicos y algunas propuestas para mejorar el acceso. Conclusión: el acceso a los servicios es un reto en muchos países y algunas estrategias y políticas son aplicadas para la resolución y perfeccionamiento del cuidado en la atención primaria.

RESUMO Objetivo: analisar a produção científica que descreve a forma de acesso aos serviços da Atenção Primária em Saúde e identificar as populações específicas que têm acesso diferenciado aos serviços de saúde. Método: revisão integrativa. Para a seleção dos estudos, utilizou-se as bases de dados: PubMed, Scopus, Bireme e Cinahl. A amostra incluiu 22 artigos nacionais e internacionais. Resultados: descrever sobre o acesso de populações específicas aos serviços em saúde, acesso a cuidados primários por meio de planos de saúde e algumas proposições para melhorar o acesso. Conclusão: o acesso aos serviços é um desafio em muitos países e algumas estratégias e políticas são implementadas para a resolução e melhoria do cuidado na atenção primária.

Imagen corporal y representaciones alimentarias en mujeres de trece comunidades rurales mexicanas / Body image and food representations in women of thirteen Mexican rural communities

Resumen Introducción: Estudios de nutrición en México apuntan en tres direcciones: la obesidad, como un problema de salud pública, particularmente en la población femenina; el aumento de otros padecimientos como anorexia y bulimia; y el incremento de la preocupación por el cuerpo, que lleva a transformar algunas prácticas y representaciones alimentarias no solo en población urbana, sino en mujeres de las zonas rurales. Objetivos: tener un primer acercamiento a la percepción corporal de las mujeres de las zonas rurales, conocer cómo son, cómo se perciben y cómo les gustaría ser, e identificar algunas de sus representaciones alimentarias. Material y Métodos: Se estudiaron 564 mujeres de 13 comunidades rurales, se les pesó y midió, y se les aplicó un cuestionario. Resultados: Según el IMC, 33% de las mujeres fueron clasificadas con normopeso; 9.6% con delgadez; 29.4% con sobrepeso; y 28% con obesidad. Las mujeres se percibieron más delgadas, a diferencia de otras investigaciones, y les gustaría ser más delgadas. Discusión: Se resalta la elevada prevalencia de sobrepeso y obesidad de las mujeres de estas zonas. El "desagrado hacia su cuerpo", relacionado con el aspecto estético, muestra un aumento en la preocupación por el cuerpo en mujeres de las comunidades rurales. Conclusiones: Se considera que la inclusión de temas como la percepción y el ideal corporal en los programas de alimentación y nutrición es relevante para prevenir trastornos de la alimentación. De igual manera, los significados que tienen para las mujeres el acto de comer o no comer determinados alimentos o productos "buenos para transformar el cuerpo" son centrales para la programación de las acciones o estrategias en este campo.

Abstract Introduction. Nutrition studies in Mexico point in three directions: obesity as a public health problem, particularly among women; the increasing prevalence of other illnesses as anorexia and bulimia; and the concerns about the body perception, leading to transform some practices and food performances, in women who lives in rural areas. Objectives: to have a first approach to the body perception of women in rural areas, know how they are, how they perceived themselves, and how they like to be, and identifying some of their food representations. Material and Methods: We studied 564 women from 13 rural communities; they were weighed and measured, and they answered a questionnaire. Results: According to BMI, 33% of women were classified as normal weight; 9.6%, with thinness; 29.4%, overweight; and 28%, obese. Women were perceived thinner, unlike other research, and would like to be thinner. Discussion: The prevalence of overweight and obesity among women in these areas is highlighted. The "dislike to her body", related to the aesthetic aspect, shows an increase in the concern for the body in the women of the rural communities. Conclusions: It is considered that including issues, such as body perception and body ideal, in feeding and nutritional programs is relevant to prevent eating disorders. The meanings that the women have about the act of eating or not eating certain foods, meals or products "good to transform the body" are central topic for planning actions and strategies in this field.

Family strategies to climate change in a rural community of Calixto Garcia, Holguin, Cuba / Estrategias familiares ante el cambio climático en una comunidad rural de calixto garcía (holguín, cuba)

RESUMEN El artículo tiene como objetivo reflexionar sobre la necesidad de generar estrategias familiares ante el cambio climático en comunidades rurales. La investigación combina las perspectivas cuantitativas y cualitativas para develar el estado de los recursos naturales y las presiones que ejerce el medio socioeconómico sobre estos. Se realizó una encuesta de percepción a los pobladores sobre cambio climático. A través de entrevistas en profundidad se analizó el rol de las mujeres en las estrategias de adaptación ante el cambio climático en el ámbito familiar. El resultado es la propuesta de estrategias familiares en una comunidad rural de Calixto García (Holguín, Cuba) con enfoque de género, bajo el principio de sostenibilidad.

ABSTRACT The aims of this article is to reflect on the need to create family strategies of adaptation to climate change in rural communities, the study combines quantitative and qualitative techniques that reveal state of natural resources and the pressures exerted by the socioeconomic environment. Applied perception survey on climate change; through indepth interviews the role of women is valued in adaptation strategies to climate change in the family. The research results include a proposal in Calixto García, Holguín- Cuba of family strategies for adaptation to climate change, under the principle of sustainability and making visible women.

Construcción de identidad de la niñez en contextos de ruralidad en la comuna de Concepción, Chile / Construction of children's identity in rural contexts in the district of Concepción, Chile / Construção da identidade da infancia no contexto das zonas rurais, na cidade de Concepcion, Chile

Los estudios sobre la nueva ruralidad dan cuenta de las grandes transformaciones a las que se enfrentan el mundo rural y los sujetos que habitan dichos territorios. En este ámbito de estudio, resulta interesante acercarse a las construcciones de significados que se atribuyen a la niñez en comunidades rurales de la comuna de Concepción en la zona sur de Chile, entregando así un espacio de reflexión teórica tanto a los cambios de lo rural como a la vivencia infantil; dimensiones que han sido frecuentemente "invisibilizadas" por los estudios sociales. Mediante una metodología cualitativa -específicamente con un estudio de caso instrumental-, este estudio se planteó como objetivo, recoger las distinciones del mundo rural y los rasgos de su construcción identitaria y cultural, indagando en las percepciones y experiencias de niños y niñas y describir patrones culturales, necesidades, problemas sociales, habilidades y fortalezas que los caracterizan. Se destaca entre los principales resultados la coexistencia de patrones culturales rurales-tradicionales junto a elementos modernizadores-urbanos que tensionan la cotidianeidad, y los procesos de construcción identitaria lo que interpela la definición de marcos teóricos utilizados para la comprensión de la ruralidad. La evidencia muestra que los niños y niñas de zonas rurales viven en condición desmejorada respecto de aquellos que habitan zonas urbanas, sin embargo, se destaca que en los contextos rurales existe para los niños y niñas aspectos protectores y potenciadores de conductas resilientes.

Studies on new ruralities give us an account of the significant transformations in the rural world and the challenges that living in rural areas have to face. The authors of this study decided to enquire about the construction of meaning that is attributed to childhood in rural communities in the District of Concepcion in southern Chile, delivering a space for the theoretical contemplation of changes in both rural and childhood experiences. These dimensions are not often examined in social research. Through a qualitative methodology -specifically focused on an instrumental case study- the research has the main objective of collecting rural differences and characteristics related to the construction of children's identity and cultural features. The study analyses children's experiences and perceptions, describing the cultural patterns, needs, social problems, abilities and strengths that characterize them. One of the main results of the study is the coexistence of traditional rural cultural patterns with urban modernizing elements, tightening everyday reality and the processes of identity construction, calling into question the definition of the theoretical framework used to comprehend rurality. Results shows that boys and girls from rural areas live in worse conditions that those who belong to urban areas. However the research also draws attention to the fact that in a rural context there are aspects that are protective of and strengthen the resilient behavior of children.

Os estudos sobre a nova ruralidade mostram as grandes transformações que o mundo rural e as pessoas que habitam esses territorios vem enfrentando. Neste âmbito de estudo, torna-se interesante se aproximar às construções dos significados que são atribuídos a infancia nas conunidades rurais da cidade de Concepcion, na zona sul do Chile, entregando um espaço de reflexão teórica, não somente para mudanças rurais, mas também a vivência infantil, dimensões frequentemente não visualizadas pelos estudos sociais. Mediante uma metodologia qualitativa -especificamente com um estudo de caso instrumental- este estudo propôs como objetivo, recolher as distinçōes do mundo rural e traços da sua construção identitária e cultural, aprofundando nas percepções e experiencias de meninos e meninas e descrever padrões culturais, necesidades, problemas sociais, habilidades e fortalezas. Pode-se destacar os principais resultados, a coexistencia de padrões culturais rurais-tradicionais junto com elementos modernizadores-urbanos que tensionam a cotidianidade e os procesos de construção identitária o que interpela a definição do marco teórico utilizado para a compreensão da ruralidade. As evidências mostram que os meninos e meninas das zonas rurais moram em piores condições com relação à aqueles que moram em zonas urbanas, porém destaca-se que no contexto rural existe para meninos e meninas aspectos protetores e potenciadores do comportamento resiliente

Percepciones sobre la atención de salud en personas con problemas autoidentificados de salud mental en zonas rurales del Perú / Perceptions on healthcare in people with self-identified mental health problems in the rural areas of Peru

Una salud centrada en la persona y en las perspectivas de la comunidad acerca de sus necesidades y recursos, es mandatorio en las políticas de atención de salud en contextos de alta diversidad cultural. Desde esta perspectiva, se requiere que la epidemiología se centre no solo en la enfermedad, sino en el diagnóstico de la salud y su contexto, incluyendo las perspectivas de las personas y la comunidad acerca de sus problemas y necesidades. En este artículo se describe y analiza cualitativamente las percepciones de los adultos con problemas de salud mental (PSM) autoidentificados en regiones rurales de la costa sierra y selva del Perú, como factores causales, recursos personales y expectativas de atención de los establecimientos de salud, utilizando el enfoque narrativo de la formulación ideográfica propuesta por la Asociación Mundial de Psiquiatría. Se utilizó la base de datos de los estudios epidemiológicos de salud mental del Instituto Nacional de Salud Mental. El análisis cualitativo de las respuestas de 235 personas revela una notoria adjudicación de los PSM a dinámicas familiares conflictivas y a la pérdida de personas significativas. Se destaca la presencia de escasos recursos comunitarios que ayuden a superar estos problemas. Entre las expectativas de atención de los establecimientos de salud destaca la consejería; sin embargo, un grupo importante de personas desconocen qué esperar del mismo. Consideramos que el enfoque narrativo es una herramienta importante en la perspectiva de una medicina centrada en la persona y la comunidad, y en la planificación de estrategias de intervención.

Person-centered health and community health perspectives on its needs and resources are mandatory in healthcare policies in highly cultural diverse contexts. From this point of view, epidemiology needs to be centered not only on the disease, but also on the health diagnosis and its context, including the points of view of people and the community about their problems and needs. This article describes and qualitatively analyzes the views of adults with self-identified mental health disorders (MHD) in rural regions on the coast, highlands, and jungle of Peru, as causal factors, personal resources, and healthcare expectations from health facilities, using the narrative approach of ideographic formulation proposed by the World Psychiatric Association. The database of mental health epidemiological studies from the National Mental Health Institute was used. The qualitative analysis on answers from 235 people reveals that a large part of MHD is linked to the dynamics of troubled families and to the loss of loved ones. The presence of scarce community resources that help overcome these problems is noted. Counseling is stressed among the expectations of healthcare at facilities; nevertheless, many people do not know what to expect from such healthcare. We believe that the narrative approach is an important tool as regards to community- and person-centered medicine and intervention strategy planning.

Propagación vegetativa por estacas de dasyphyllum diacanthoidesmediante recursos endogenos. una aproximación agroecológica / Cutting vegetative propagation of dasyphyllum diacanthoides, with endogenous resources: an agroecological approach

La evidencia empírica obtenida por los agricultores del sector de Huechelepún (comuna de Melipeuco, Región de La Araucanía, Chile) indica que la especie Dasyphyllum diacanthoides, además de presentar propiedades medicinales, es una alternativa forrajera invernal. Esta propiedad junto con su condición de especie endémica de los bosques de Chile obliga a compatibilizar el uso y la conservación de esta especie. El objetivo de este estudio fue propagar D. diacanthoides mediante esquejes semilignificados y determinar el efecto de la presencia de espinas en los esquejes y la exposición Norte o Sur de las plantas madres en el enraizamiento. El estudio se realizó utilizando recursos endógenos, por lo que las variables evaluadas se determinaron sobre la base del conocimiento de los agricultores. El diseño experimental incluyó cuatro tratamientos: T1: estacas de plantas con exposición sur y espinas, T2: estacas de plantas con exposición sur sin espinas, T3: estacas de plantas con exposición norte sin espinas y T4: estacas de plantas con exposición norte con espinas. Cada tratamiento constó de 25 réplicas y se utilizó un diseño completo aleatorio para la ubicación de las estacas en el invernadero. Las estacas de plantas en laderas Norte tuvieron porcentajes mayores de sobrevivencia, enraizamiento y formación de callos que las de plantas en laderas S. La prueba U de Mann- Whitney evidenció diferencias significativas entre estacas con y sin espinas con exposición norte sólo para la longitud de raíces (p ≤ 0,05). La propagación vegetativa de D. diacanthoides mediante esquejes semilignificados es factible. Los mejores resultados se obtienen con estacas sin espinas de plantas madres con exposición Norte.

The empirical evidence obtained by farmers of Huechelepún area (commune of Melipeuco, La Araucania, Chile) indicates that the specie Dasyphyllum diacanthoides, besides presenting medicinal properties, is a winter forage alternative. This property along with its status as endemic forests of Chile requires reconciling the use and conservation of this species. The aim of this study was to propagate D. diacanthoides by semi lignified cuttings and determine the effect of the presence of thorns in the cuttings and North or South exposure mother plants in rooting. The study was performed using endogenous resources, so the evaluated variables were determined on the basis of knowledge of farmers. The experimental design included four treatments: T1: cuttings of plants with southern exposure and thorns, T2: Stakes southern exposure plants without thorns, T3: cuttings of plants with northern exposure spineless and T4: cuttings of plants with northern exposure with thorns. Each treatment consisted of 25 replicates and a complete randomized design for location of the cuttings in the greenhouse was used. Cuttings from plants in North slopes had higher percentages of survival, rooting and callus formation the plant on hillsides South. Mann-Whitney U test showed significant differences between stakes with and without spines north only exposure length roots (p ≤ 0.05). The vegetative propagation of cuttings D. diacanthoides by semi lignified is feasible. The best results are obtained with stakes thornless plants mothers with Northern exposure.