Village Settlements in Mountainous Tropical Areas, Hotspots of Fecal Contamination as Evidenced by Escherichia coli and Stanol Concentrations in Stormwater Pulses.

Fecal bacteria in surface water may indicate threats to human health. Our hypothesis is that village settlements in tropical rural areas are major hotspots of fecal contamination because of the number of domestic animals usually roaming in the alleys and the lack of fecal matter treatment before entering the river network. By jointly monitoring the dynamics of Escherichia coli and of seven stanol compounds during four flood events (July-August 2016) at the outlet of a ditch draining sewage and surface runoff out of a village of Northern Lao PDR, our objectives were (1) to assess the range of E. coli concentration in the surface runoff washing off from a village settlement and (2) to identify the major contributory sources of fecal contamination using stanol compounds during flood events. E. coli pulses ranged from 4.7 × 104 to 3.2 × 106 most probable number (MPN) 100 mL-1, with particle-attached E. coli ranging from 83 to 100%. Major contributory feces sources were chickens and humans (about 66 and 29%, respectively), with the highest percentage switching from the human pole to the chicken pole during flood events. Concentrations indicate a severe fecal contamination of surface water during flood events and suggest that villages may be considered as major hotspots of fecal contamination pulses into the river network and thus as point sources in hydrological models.

Food insecurity is related to eating disorder psychopathology beyond psychological distress in rural Chinese adolescents.

OBJECTIVE: This study aimed to examine the relationship between food insecurity (FI) and eating disorder psychopathology in a large sample of rural Chinese adolescents. METHODS: Analyses included 1654 adolescents (55.4% girls; Mage = 16.54 years, SD = 1.45) from a rural high school in southwestern China. FI, eating disorder psychopathology, and psychological distress (i.e., symptoms of depression, anxiety, and stress) were assessed. Data were analyzed by sex. Pearson correlation analysis was performed to investigate the zero-order association between FI and eating disorder psychopathology. Hierarchical linear regressions were used to explore whether FI could explain meaningful variance in eating disorder psychopathology beyond psychological distress and demographic covariates (e.g., socioeconomic status). RESULTS: FI was significantly associated with higher eating disorder psychopathology for boys (r = 0.44, p < 0.001) and girls (r = 0.43, p < 0.001), with medium-to-large effect sizes. FI accounted for significant unique variance in eating disorder psychopathology beyond psychological distress and demographic covariates for boys (ΔR2 = 0.14, p < 0.001) and girls (ΔR2 = 0.10, p < 0.001). DISCUSSION: Using a large sample of rural Chinese adolescents, this study extends the connection between FI and eating disorder pathology in adolescents beyond the Western context. Future investigations on the mechanisms underlying FI and eating disorder psychopathology are warranted for developing prevention strategies for eating disorders among rural Chinese adolescents. PUBLIC SIGNIFICANCE: This is the first investigation that examined the link between FI and eating disorder psychopathology among rural Chinese adolescents. Our findings highlight the importance of incorporating FI as a potential risk factor to screen for the prevention and intervention of eating disorders among rural Chinese adolescents.

Flying endoscopists in the Arctic: initiatives for quality assurance of endoscopies in Greenland.

BACKGROUND: Surgical coastal expeditions (SCEs) have been organized in Greenland for many years. They aim to provide small coastal hospitals with specialist services, such as endoscopies (SCEEs), by deploying specialist personnel, surgeons, and the necessary equipment to the hospital temporarily. The purpose of this program is to increase accessibility for patients, while simultaneously reducing the costs associated with patient transport to the central hospital. METHODS: This retrospective pilot review of medical records identified quality indicators, such as bowel cleansing (BP), cecal intubation rate (CIR), and adenoma and advanced adenoma detection rates (ADR, AADR), to investigate the status and establish a system for quality monitoring of SCEsE in Greenland. RESULTS: During two SCEs (8 working days), 89 SCEE were performed at Qaqortoq and Sisimiut Hospitals. The 60 patients who underwent colonoscopy included 32 men and 28 women with a mean age of 61 years (range 24-80 years). The unadjusted CIR was 91.7%. In eight (13.3%) examinations, bowel preparation was rated as unsatisfactory, resulting in two incomplete procedures. The ADR and AADR were 35% and 11.7%, respectively, and one cancer was detected (1.7%). CONCLUSION: The results showed satisfactory ADR, AADR, and CIR levels. However, the review also highlighted the need for increased attention to BP by developing a new procedure that considers differences due to specific eating habits in Greenland and provides much better information for patients. The review provided a snapshot of the quality of colonoscopies in Greenland, highlighting the necessity to continue this process to ensure that the quality is up to standard. Furthermore, SCE helps reduce the environmental footprint of gastrointestinal endoscopy by avoiding the need for patient air transport; instead of 77 round trips (61,830 km), only 8 (6440 km) were required.

Assessing public health service capability of primary healthcare personnel: a large-scale survey in Henan Province, China.

BACKGROUND: The public health service capability of primary healthcare personnel directly affects the utilization and delivery of health services, and is influenced by various factors. This study aimed to examine the status, factors, and urban-rural differences of public health service capability among primary healthcare personnel, and provided suggestions for improvement. METHODS: We used cluster sampling to survey 11,925 primary healthcare personnel in 18 regions of Henan Province from 20th to March 31, 2023. Data encompassing demographics and public health service capabilities, including health lifestyle guidance, chronic disease management, health management of special populations, and vaccination services. Multivariable regression analysis was employed to investigate influencing factors. Propensity Score Matching (PSM) quantified urban-rural differences. RESULTS: The total score of public health service capability was 80.17 points. Chronic disease management capability scored the lowest, only 19.60. Gender, education level, average monthly salary, professional title, health status, employment form, work unit type, category of practicing (assistant) physician significantly influenced the public health service capability (all P < 0.05). PSM analysis revealed rural primary healthcare personnel had higher public health service capability scores than urban ones. CONCLUSIONS: The public health service capability of primary healthcare personnel in Henan Province was relatively high, but chronic disease management required improvement. Additionally, implementing effective training methods for different subgroups, and improving the service capability of primary medical and health institutions were positive measures.

A lightweight intelligent laryngeal cancer detection system for rural areas.

OBJECTIVE: Early diagnosis of laryngeal cancer (LC) is crucial, particularly in rural areas. Despite existing studies on deep learning models for LC identification, challenges remain in selecting suitable models for rural areas with shortages of laryngologists and limited computer resources. We present the intelligent laryngeal cancer detection system (ILCDS), a deep learning-based solution tailored for effective LC screening in resource-constrained rural areas. METHODS: We compiled a dataset comprised of 2023 laryngoscopic images and applied data augmentation techniques for dataset expansion. Subsequently, we utilized eight deep learning models-AlexNet, VGG, ResNet, DenseNet, MobileNet, ShuffleNet, Vision Transformer, and Swin Transformer-for LC identification. A comprehensive evaluation of their performances and efficiencies was conducted, and the most suitable model was selected to assemble the ILCDS. RESULTS: Regarding performance, all models attained an average accuracy exceeding 90 % on the test set. Particularly noteworthy are VGG, DenseNet, and MobileNet, which exceeded an accuracy of 95 %, with scores of 95.32 %, 95.75 %, and 95.99 %, respectively. Regarding efficiency, MobileNet excels owing to its compact size and fast inference speed, making it an ideal model for integration into ILCDS. CONCLUSION: The ILCDS demonstrated promising accuracy in LC detection while maintaining modest computational resource requirements, indicating its potential to enhance LC screening accuracy and alleviate the workload on otolaryngologists in rural areas.

Nurses' health promotion practices in rural primary health care in Nigeria. A qualitative study.

Nurses play a vital role in providing high-quality primary healthcare and health promotion services. The state of research highlights their often complex operational realities and shows the need for an evidence-based understanding of nurses' perspectives on health promotion practices, especially in low-resource settings. This study focuses on how community health nurses in rural primary healthcare centers in Nigeria perceive their health promotion role and the opportunities and challenges of, and potential entry points for strengthening, their practice. A sample of 10 nurses from eight rural primary healthcare centers in eight local government areas of Anambra state, Nigeria, was purposively selected. Data were collected via semistructured telephone and written interviews and analyzed by qualitative content analysis using a deductive-inductive approach. Nurses emphasized their commitment to supporting patients and communities to develop skills and take control of their own lives. Nurses described their role as facilitators of behavioral and environmental change, individual and community empowerment facilitators as well as social activists. Factors that enhance the health promotion practice of nurses include adequate skills, sufficient human and material resources and community support and participation. Inhibiting factors included insufficient funding, poor working conditions, staff shortages, high workload, lack of training opportunities and low participation of community members. Overcoming challenges and facilitating health promotion activities in rural communities require bolstering nurses by providing further training opportunities for enhancing their health promotion competencies and creating supportive environments. Future research should focus on how to strengthen nurses' health promotion efforts through interprofessional and intersectoral collaboration.

No place for young women? The impact of internal migration on adult sex ratios in rural East Germany.

Shortages of women in rural areas occur in many highly urbanized countries. Rural East Germany is an ideal case for studying this phenomenon because of its low adult sex ratio (ASR)-men greatly outnumber women-coupled with high outmigration among young adults. This study identifies how internal migration between rural and urban areas contributes to the shortage of young adult women. We use data on inter-county migration flows (for years 2002-21) to decompose the impacts of migration flows on ASRs. We find that the low ASRs in rural East Germany have been driven by sex-selective migration. In the early 2000s the main destination of sex-selective outflows was West Germany, while in the 2010s urban areas in East Germany were the key destinations. We find that moves among 18-24-year-olds increased the shortage of women in the rural population, whereas moves among 25-29-year-olds contributed to more balanced ASRs.

A Method for Extracting High-Resolution Building Height Information in Rural Areas Using GF-7 Data.

Building height is important information in disaster management and damage assessment. It is also a key parameter in studies such as population modeling and urbanization. Relatively few studies have been conducted on extracting building height in rural areas using imagery from China's Gaofen-7 satellite (GF-7). In this study, we developed a method combining photogrammetry and deep learning to extract building height using GF-7 data in the rural area of Pingquan in northern China. The deep learning model DELaMa was proposed for digital surface model (DSM) editing based on the Large Mask Inpainting (LaMa) architecture. It not only preserves topographic details but also reasonably predicts the topography inside the building mask. The percentile value of the normalized digital surface model (nDSM) in the building footprint was taken as the building height. The extracted building heights in the study area are highly consistent with the reference building heights measured from the ICESat-2 LiDAR point cloud, with an R2 of 0.83, an MAE of 1.81 m and an RMSE of 2.13 m for all validation buildings. Overall, the proposed method in this paper helps to promote the use of satellite data in large-scale building height surveys, especially in rural areas.

The degree of population aging and living carbon emissions: Evidence from China.

Population aging and global warming have become everyday concerns of all countries. Based on the panel data of 30 provinces in China from 2003 to 2019, this paper uses the panel fixed effect model and two-stage least square method to analyze the effect of population aging on domestic energy carbon emissions of urban and rural residents. On this basis, the threshold regression model is introduced to explore the heterogeneity of the effect under different aging levels. The results show that (1) the progress of population aging at the overall level will significantly increase the level of carbon emissions from household energy consumption. At the regional level, the effect of population aging on carbon emissions from household energy consumption in rural areas is higher than in urban areas. (2) Population aging has a nonlinear effect on the carbon emissions of residential energy consumption. For urban areas, when the level of population aging crosses the threshold, its marginal impact on living carbon emissions in urban areas is further enhanced. In contrast, the opposite is true in rural areas. (3) Heterogeneity analysis results show that the impact of population aging on residential energy carbon emissions differs in different regions at the national and rural levels but does not show regional heterogeneity at the urban level.

Relationship between perceived value, attitudes, and academic motivation in distance learning among nursing students in rural areas.

BACKGROUND: Nursing students manifest a distinct level of intellect and comprehension, impacting their attitudes and perceived significance of distance learning in education. This study examined the attitudes, perceived value, and academic motivation surrounding distance learning among Jordanian nursing students, offering insights crucial to optimizing their educational journey. METHODS: A descriptive cross-sectional design was used. A convenience sample of 298 undergraduate Jordanian nursing students was recruited from two public universities in rural cities in south Jordan. Data were collected via self-reported instruments (June 2022 to August 2022). A Pearson correlation and independent t-test were used to examine the relationship between variables. RESULTS: The mean age of students was 20.9 years (SD = 1.16), and most students have a low perceived value of distance learning (n = 181, 60.7%). Most students (n = 179, 60.1%) have negative attitudes toward distance learning, and only 39.9% reflected positive attitudes. More than half of the participants (n = 166, 55.7%) reflected less academic motivation toward distance learning. Positive significant relationships were found between students' perceived value of distance learning and their attitudes and academic motivation toward distance learning; low perceived value of distance learning was related significantly with low attitudes (r = 0.844, p < 0.01) and less academic motivation toward it (r = 0.721, p < 0.01). CONCLUSION: Nursing students' perceived value, attitudes, and academic motivation toward DL in rural regions is inadequate. Educators must provide valuable visions to expand the quality of health education in rural universities and improve health care.