A protocol for eliciting nonmaterial values through a cultural ecosystem services frame

PubMed Central

Gould, Rachelle K; Klain, Sarah C; Ardoin, Nicole M; Satterfield, Terre; Woodside, Ulalia; Hannahs, Neil; Daily, Gretchen C; Chan, Kai M

2015-01-01

Stakeholders’ nonmaterial desires, needs, and values often critically influence the success of conservation projects. These considerations are challenging to articulate and characterize, resulting in their limited uptake in management and policy. We devised an interview protocol designed to enhance understanding of cultural ecosystem services (CES). The protocol begins with discussion of ecosystem-related activities (e.g., recreation, hunting) and management and then addresses CES, prompting for values encompassing concepts identified in the Millennium Ecosystem Assessment (2005) and explored in other CES research. We piloted the protocol in Hawaii and British Columbia. In each location, we interviewed 30 individuals from diverse backgrounds. We analyzed results from the 2 locations to determine the effectiveness of the interview protocol in elucidating nonmaterial values. The qualitative and spatial components of the protocol helped characterize cultural, social, and ethical values associated with ecosystems in multiple ways. Maps and situational, or vignette-like, questions helped respondents articulate difficult-to-discuss values. Open-ended prompts allowed respondents to express a diversity of ecosystem-related values and proved sufficiently flexible for interviewees to communicate values for which the protocol did not explicitly probe. Finally, the results suggest that certain values, those mentioned frequently throughout the interview, are particularly salient for particular populations. The protocol can provide efficient, contextual, and place-based data on the importance of particular ecosystem attributes for human well-being. Qualitative data are complementary to quantitative and spatial assessments in the comprehensive representation of people's values pertaining to ecosystems, and this protocol may assist in incorporating values frequently overlooked in decision making processes. Un Protocolo para Obtener Valores No Materiales por medio de un Marco de Servicios Ambientales Culturales Resumen Los deseos, necesidades y valores no materiales de los accionistas influyen frecuentemente sobre el éxito de los proyectos de conservación. Estas consideraciones son difíciles de articular y caracterizar, lo que resulta en entendimiento limitado en el manejo y la política. Concebimos un protocolo de entrevista diseñado para mejorar el entendimiento de los servicios ambientales culturales (SAC). El protocolo inicia con la discusión de actividades relacionadas con ecosistemas (p. ej.: recreación, cacería) y manejo; después señala a los SAC, dando pie a los valores que encierran conceptos identificados en la Evaluación Ambiental del Milenio (2005) y explorado en otras investigaciones sobre SAC. Hicimos pruebas piloto del protocolo en Hawái y Columbia Británica. En cada localidad entrevistamos a 30 individuos de diversos entornos. Analizamos los resultados de las dos localidades para determinar la efectividad del protocolo de entrevista en la obtención de valores no materiales. Los componentes cualitativos y espaciales del protocolo nos ayudaron a caracterizar los valores culturales, sociales y éticos asociados con el ecosistema de múltiples maneras. Los mapas y las preguntas de situación, o de tipo viñeta, ayudaron a los encuestados a articular valores difíciles de discutir. Las preguntas abiertas permitieron a los encuestados expresar una diversidad de valores ambientales y demostraron ser suficientemente flexibles para que los encuestados comunicaran valores que el protocolo no buscaba explícitamente. Finalmente, los resultados sugieren que ciertos valores, aquellos mencionados frecuentemente en la entrevista, son particularmente prominentes para poblaciones particulares. El protocolo puede proporcionar datos eficientes, contextuales y basados en lugar sobre la importancia de atributos ambientales particulares para el bienestar humano. Los datos cualitativos son complementarios para las evaluaciones cuantitativas y espaciales en la representación comprensiva de los valores de los valores que pertenecen a los ecosistemas. Este protocolo puede ayudar a incorporar valores frecuentemente ignorados en el proceso de toma de decisiones. PMID:25354730

"Una mujer trabaja doble aqui": Vignette-based focus groups on stress and work for Latina blue-collar women in eastern North Carolina.

PubMed

Easter, Michele M; Linnan, Laura A; Bentley, Margaret E; DeVellis, Brenda M; Meier, Andrea; Frasier, Pamela Y; Kelsey, Kristine S; Campbell, Marci K

2007-01-01

Latina women are a growing percentage of the working population, and very little is known about their health needs and interests. The purpose of this article is to share qualitative research results gathered from Latina women with a particular focus on exploring stress and health. This project was a substudy of Health Works in the Community, a 5-year CDC-funded multiple risk-factor reduction trial using participatory action research approaches to address smoking, healthy eating, stress, and physical activity among blue-collar women from 12 manufacturing work sites in rural, eastern North Carolina. Five focus groups were conducted with trained, bilingual facilitators using a vignette-based moderator guide that appeared particularly effective with this population. Results from the focus groups are used to make recommendations for future research with Latinas and for developing effective work-site-based interventions to address issues of stress and health within this population.

Capacitación-acción participativa: una experiencia de 24 años en las comunidades rurales de Oaxaca, México.

PubMed

Ysunza, Alberto M; Diez-Urdanivia, Silvia; Pérez-Gil, Sara E

2017-12-01

Resumen: En este artículo presentamos el proyecto de capacitación llevado a cabo en comunidades de la sierra y costa de Oaxaca, México, desde 1991, por el Centro de Capacitación Integral para Promotores Comunitarios (CECIPROC). La decisión de hacer este trabajo en Oaxaca responde a que ese estado ocupa uno de los primeros lugares de marginación y de desnutrición en menores de 5 años. El objetivo es describir un modelo de capacitación y compartir parte de las experiencias derivadas, tanto del modelo como del trabajo realizado en las distintas áreas (nutrición y alimentación, salud comunitaria, ecología y etnobotánica, y educación y organización), por promotores mujeres y hombres en sus comunidades. La experiencia obtenida en 24 años muestra la factibilidad técnica y social del proyecto en el ámbito de la salud, el reconocimiento social del proyecto del CECIPROC como un organismo civil que ha aportado alternativas como solución a la problemática de salud, el hacer suyo el proyecto por algunos promotores y los diferentes obstáculos a los que se ha enfrentado. Enfatizamos el hecho de que la situación socioeconómica y política prevaleciente en el estado de Oaxaca es una limitante para el buen desarrollo de los programas colectivos de salud, e insistimos en la necesidad de compartir nuestras experiencias para que puedan ser utilizadas en la planificación y ejecución de otros proyectos.

Isolation and characterization of active LINE and SINEs from the eel.

PubMed

Kajikawa, Masaki; Ichiyanagi, Kenji; Tanaka, Nozomu; Okada, Norihiro

2005-03-01

Long interspersed elements (LINEs) and short interspersed elements (SINEs) are retrotransposons. These elements can mobilize by the "copy-and-paste" mechanism, in which their own RNA is reverse-transcribed into complementary DNA (cDNA). LINEs and SINEs not only are components of eukaryotic genomes but also drivers of genomic evolution. Thus, studies of the amplification mechanism of LINEs and SINEs are important for understanding eukaryotic genome evolution. Here we report the characterization of one LINE family (UnaL2) and two SINE families (UnaSINE1 and UnaSINE2) from the eel (Anguilla japonica) genome. UnaL2 is approximately 3.6 kilobases (kb) and encodes only one open reading frame (ORF). UnaL2 belongs to the stringent type--thought to be a major group of LINEs--and can mobilize in HeLa cells. We also show that UnaL2 and the two UnaSINEs have similar 3' tails, and that both UnaSINE1 and UnaSINE2 can be mobilized by UnaL2 in HeLa cells. These elements are thus useful for delineating the amplification mechanism of stringent type LINEs as well as that of SINEs.

The Use and Interpretation of Sodium Concentrations in Casual (Spot) Urine Collections for Population Surveillance and Partitioning of Dietary Iodine Intake Sources

PubMed Central

Conkle, Joel; van der Haar, Frits

2016-01-01

In 2013, the World Health Organization (WHO) called for joint surveillance of population salt and iodine intakes using urinary analysis. 24-h urine collection is considered the gold standard for salt intake assessment, but there is an emerging consensus that casual urine sampling can provide comparable information for population-level surveillance. Our review covers the use of the urinary sodium concentration (UNaC) and the urinary iodine concentration (UIC) from casual urine samples to estimate salt intakes and to partition the sources of iodine intakes. We reviewed literature on 24-h urinary sodium excretion (UNaE) and UNaC and documented the use of UNaC for national salt intake monitoring. We combined information from our review of urinary sodium with evidence on urinary iodine to assess the appropriateness of partitioning methods currently being adapted for cross-sectional survey analyses. At least nine countries are using casual urine collection for surveillance of population salt intakes; all these countries used single samples. Time trend analyses indicate that single UNaC can be used for monitoring changes in mean salt intakes. However; single UNaC suffers the same limitation as single UNaE; i.e., an estimate of the proportion excess salt intake can be biased due to high individual variability. There is evidence, albeit limited, that repeat UNaC sampling has good agreement at the population level with repeat UNaE collections; thus permitting an unbiased estimate of the proportion of excess salt intake. High variability of UIC and UNaC in single urine samples may also bias the estimates of dietary iodine intake sources. Our review concludes that repeated collection, in a sub-sample of individuals, of casual UNaC data would provide an immediate practical approach for routine monitoring of salt intake, because it overcomes the bias in estimates of excess salt intake. Thus we recommend more survey research to expand the evidence-base on predicted-UNaE from repeat casual UNaC sampling. We also conclude that the methodology for partitioning the sources of iodine intake based on the combination of UIC and UNaC measurements in casual urine samples can be improved by repeat collections of casual data; which helps to reduce regression dilution bias. We recommend more survey research to determine the effect of regression dilution bias and circadian rhythms on the partitioning of dietary iodine intake sources. PMID:28025546

Entropía de la información: una herramienta útil

NASA Astrophysics Data System (ADS)

Cincotta, P.

En este trabajo se presenta una muy breve introducción al concepto de Entropía de la Información y se muestran distintas aplicaciones de una misma técnica para estudiar problemas tan variados como la determinación de periodicidad en una serie de tiempo arbitraria o de estimar el grado de caoticidad de una trayectoria en un sistema dinámico de N grados de libertad.

Understanding differences in access and use of healthcare between international immigrants to Chile and the Chilean-born: a repeated cross-sectional population-based study in Chile

PubMed Central

2012-01-01

Introduction International evidence indicates consistently lower rates of access and use of healthcare by international immigrants. Factors associated with this phenomenon vary significantly depending on the context. Some research into the health of immigrants has been conducted in Latin America, mostly from a qualitative perspective. This population-based study is the first quantitative study to explore healthcare provision entitlement and use of healthcare services by immigrants in Chile and compare them to the Chilean-born. Methods Data come from the nationally representative CASEN (Socioeconomic characterization of the population in Chile) surveys, conducted in 2006 and 2009. Self-reported immigrants were compared to the Chilean-born, by demographic characteristics (age, sex, urban/rural, household composition, ethnicity), socioeconomic status (SES: education, household income, contractual status), healthcare provision entitlement (public, private, other, none), and use of primary services. Weighted descriptive, stratified and adjusted regression models were used to analyse factors associated with access to and use of healthcare. Results There was an increase in self-reported immigrant status and in household income inequality among immigrants between 2006 and 2009. Over time there was a decrease in the rate of immigrants reporting no healthcare provision and an increase in reporting of private healthcare provision entitlement. Compared to the Chilean-born, immigrants reported higher rates of use of antenatal and gynaecological care, lower use of well-baby care, and no difference in the use of Pap smears or the number of attentions received in the last three months. Immigrants in the bottom income quintile were four times more likely to report no healthcare provision than their equivalent Chilean-born group (with different health needs, i.e. vertical inequity). Disabled immigrants were more likely to have no healthcare provision compared to the disabled Chilean-born (with similar health needs, i.e. horizontal inequity). Factors associated with immigrants’ access to, and use of, healthcare were sex, urban/rural status, education and country of origin. Conclusion There were significant associations between SES, and access to and use of healthcare among immigrants in Chile and a higher prevalence of no health care provision entitlement among poor and disabled immigrants compared to the Chilean-born. Changing associations between access and use of healthcare and SES among immigrants in Chile over time may reflect changes in their socio-demographic composition or in the survey methodology between 2006 and 2009. Resumen Introducción La evidencia internacional indica menor acceso y uso de servicios de salud por parte de inmigrantes, pero sus factores desencadenantes varían significativamente dependiendo del contexto. Algunas investigaciones se han desarrollado en este tema en América Latina, desde una perspectiva cualitativa. Este estudio cuantitativo exploró el auto-reporte de acceso y uso de servicios de salud de inmigrantes en Chile y los comparó con la población chilena. Métodos Análisis secundario de datos de encuesta nacional CASEN 2006 y 2009. Inmigrantes fueron comparados con chilenos en características demográficas (edad, sexo, urbano/rural, composición del hogar, etnia), estatus socioeconómico (educación, ingreso, situación contractual), tipo de previsión (pública, privada, otra, ninguna), y uso de varios servicios de atención primaria. Análisis descriptivo, estratificado, y modelos de regresión ponderados para entender factores asociados al acceso y uso de servicios de salud en STATA 11.0. Resultados Se observó un aumento de reporte de inmigrantes y de la desigualdad en el ingreso de inmigrantes entre 2006 y 2009. Hubo una disminución en la tasa de inmigrantes sin previsión y un aumento en el acceso al sistema privado. Los inmigrantes usaron más frecuentemente la atención prenatal y ginecológica, y menos la atención del niño sano. No hubo diferencia en el uso de citología vaginal o el número total de atenciones recibidas en comparación con los chilenos. Los inmigrantes en el quintil inferior de ingresos reportaron 4 veces más la ausencia de prestación de salud que los chilenos (inequidad vertical). Similares resultados se observaron al comparar inmigrantes con discapacidad con chilenos con discapacidad (inequidad horizontal). Los factores asociados con el acceso y uso del servicio de salud por parte de los inmigrantes fueron el sexo, urbano/rural, educación y país de origen. Conclusión Se observó una asociación significativa entre estatus socioeconomico, migración y acceso y uso de asistencia sanitaria. Los resultados de este estudio pueden deberse a verdaderos cambios en la composición de los inmigrantes y sus patrones de uso del sistema de salud chileno, pero también pueden deberse a cambios en la metodología y recolección de datos entre encuestas 2006 y 2009. Este aspecto requiere mayor análisis y debate en la región. PMID:23158113

Thermodynamics of RNA duplexes modified with unlocked nucleic acid nucleotides

PubMed Central

Pasternak, Anna; Wengel, Jesper

2010-01-01

Thermodynamics provides insights into the influence of modified nucleotide residues on stability of nucleic acids and is crucial for designing duplexes with given properties. In this article, we introduce detailed thermodynamic analysis of RNA duplexes modified with unlocked nucleic acid (UNA) nucleotide residues. We investigate UNA single substitutions as well as model mismatch and dangling end effects. UNA residues placed in a central position makes RNA duplex structure less favourable by 4.0–6.6 kcal/mol. Slight destabilization, by ∼0.5–1.5 kcal/mol, is observed for 5′- or 3′-terminal UNA residues. Furthermore, thermodynamic effects caused by UNA residues are extremely additive with ΔG°37 conformity up to 98%. Direct mismatches involving UNA residues decrease the thermodynamic stability less than unmodified mismatches in RNA duplexes. Additionally, the presence of UNA residues adjacent to unpaired RNA residues reduces mismatch discrimination. Thermodynamic analysis of UNA 5′- and 3′-dangling ends revealed that stacking interactions of UNA residues are always less favourable than that of RNA residues. Finally, circular dichroism spectra imply no changes in overall A-form structure of UNA–RNA/RNA duplexes relative to the unmodified RNA duplexes. PMID:20562222

Use of mean spot urine sodium concentrations to estimate daily sodium intake in patients with chronic kidney disease.

PubMed

Kang, Shin Sook; Kang, Eun Hee; Kim, Seon Ok; Lee, Moo Song; Hong, Changgi D; Kim, Soon Bae

2012-03-01

Sodium intake is an important issue for patients with chronic kidney disease (CKD). The two most widely used methods to measure sodium are 24-h urinary sodium excretion (24HUNa), which can be difficult to perform routinely, and sodium intake by dietary recall, which can be inaccurate. This study evaluated use of the mean value of three spot urinary sodium (UNa) concentrations to estimate daily sodium intake in patients with CKD. This cross-sectional study enrolled 305 patients with CKD, none of whom were on dialysis, who visited the nephrology clinic at the Asan Medical Center (Seoul, Korea). We performed three spot UNa tests, three calculations of the UNa/creatinine (UCr) ratio, one measurement of 24HUNa, and one measurement of sodium intake by dietary recall. The 24HUNa and mean spot UNa values were significantly lower in patients with more advanced CKD (P = 0.006 and P < 0.001, respectively). One-time spot UNa was significantly higher in the evening than in the morning for patients with stage III, IV, or V CKD. Total sodium intake, but not sodium nutrient density (milligrams of sodium per 1000 kcal), was significantly different for patients with different stages of CKD (P = 0.001). The correlation coefficient between 24HUNa and mean spot UNa was 0.477 (95% confidence interval [CI] 0.384-0.562, P < 0.001), slightly higher than that between 24HUNa excretion and mean spot UNa/UCr (r = 0.313, 95% CI 0.207-0.465, P < 0.001). There was a linear relation between spot UNa and 24HUNa: mean spot UNa = 0.27 × 24HUNa + 60. Therefore, a 24HUNa excretion of 87 mEq (sodium intake 2 g/d) corresponded to a mean spot UNa level of 83 mEq/L. The correlation coefficient between sodium intake and mean spot UNa was 0.435 (95% CI 0.336-0.524, P < 0.001), significantly higher than that between sodium intake and mean spot UNa/UCr (r = 0.197, 95% CI 0.091-0.301, P = 0.001). Mean spot UNa tended to be better correlated with 24HUNa than with sodium intake. Mean spot UNa is a simple and effective method that can be used to monitor sodium intake in patients with CKD. A daily intake of 2 g of sodium corresponds to a mean spot UNa level of approximately 83 mEq/L in patients with CKD. Copyright © 2012 Elsevier Inc. All rights reserved.

Scienza dei servizi

NASA Astrophysics Data System (ADS)

Cavenago, Dario; Mezzanzanica, Mario

I servizi sono oramai centrali nella vita sociale di ogni Paese. L'aspettativa di ogni attore sociale, sia esso cittadino/utente e/o istituzione, è quella di ricevere da uno scambio che ha alla base un servizio un contributo che si caratterizza per una qualità intrinseca. Il mantenimento di tale promessa richiede all'azienda erogatrice un forte coinvolgimento, nel disegno del servizio, degli utenti ed una capacità di gestione della conoscenza; ciò è particolarmente significativo per quei servizi che si caratterizzano per una forte personalizzazione o complessità progettuale. Disegnare un servizio, metterlo in produzione e gestirne l'erogazione ha una complessità variabile in base al grado di coinvolgimento dei destinati ed alle dimensioni critiche che esprimono le condizioni di fattibilità di un servizio di qualità appropriato alle attese degli utilizzatori. Ugualmente la globalizzazione dell'economia e la scarsità delle risorse ha portato l'attenzione, ai fini della sostenibilità delle condizioni sopra richiamate, di una ricerca di modelli e strumenti che permettano una valutazione e una standardizzazione dei processi di produzione ed erogazione secondo condizioni di economicità. Tali primi e sintetici elementi hanno condotto diversi attori istituzionali, grandi imprese ed università attraverso i loro centri di ricerca, ad una azione di riflessione sul grado di "ingegnerizzazione" dei processi sottesi alla erogazione dei servizi ed in particolare ai servizi che attuano le politiche dei grandi settori di base dell'economia di una Nazione: educazione, sanità, sociale, sviluppo infrastrutture ecc.

Accidentes laborales asociados al desánimo de médicos SERUMS para laborar en el primer nivel de atención de Lima, Perú

PubMed Central

Mejia, Christian R.; Valladares-Garrido, Mario J.; Romero, Brian M.; Valladares-Garrido, Danai; Linares-Reyes, Edgardo

2018-01-01

Introducción la retención laboral es un tema de suma importancia, porque se requiere de profesionales en el primer nivel de atención (PNA). El objetivo fue determinar si los accidentes laborales se asociaron al desánimo de los médicos para trabajar en el PNA de Lima, Perú. Métodos estudio transversal analítico de datos secundarios de una base de datos generada de una encuesta a médicos que realizaron su Servicio Rural y Urbano-Marginal en Salud (SERUMS). Se incluyó solo a los médicos que manifestaron al inicio del SERUMS que podían trabajar en el PNA de Lima. Se definió como cambio de intención de trabajo en el PNA a los que finalizando el SERUMS refirieron que ya no deseaban laborar en Lima. Esto se asoció según si tuvieron un accidente laboral y se ajustó por otras variables. Resultados de los 124 médicos el 63% fueron hombres (78). La mediana de edad fue de 26 años (rango intercuartílico: 25-27 años). Después de su SERUMS, el 12% (15) manifestó que cambió su interés y que deseaba trabajar en la capital. En el análisis multivariado, haber tenido un accidente laboral disminuyó la frecuencia del cambio de intención de trabajo en el PNA (RPa: 0.28, IC 95%: 0.14-0.54, p < 0,001), ajustado por ocho variables. Conclusiones en un estudio previo los accidentes laborales disminuyeron la frecuencia de trabajar en provincias, pero nuestro estudio dice lo contrario, posiblemente por la percepción de que un trabajo en la capital del país permite estar más cerca de los servicios para ser atendido en caso de cualquier emergencia. PMID:29190859

Flying Off a Frictionless Curved Ramp

DTIC Science & Technology

2015-06-01

mechanical energy . The object is assumed to start from rest at a point on the curve of zero slope. The launch speed and angle are calculated for the...Conservation of mechanical energy . Resumen Una ecuación general se deriva para un punto a lo largo de una trayectoria curvada descendente, de una partícula...porque no puede alcanzar la velocidad de un objeto en caída libre que coincide superficialmente con una trayectoria de este tipo. Palabras clave

Urinary Sodium Concentration Is an Independent Predictor of All-Cause and Cardiovascular Mortality in a Type 2 Diabetes Cohort Population

PubMed Central

Gand, Elise; Ragot, Stéphanie; Bankir, Lise; Piguel, Xavier; Fumeron, Frédéric; Halimi, Jean-Michel; Marechaud, Richard; Roussel, Ronan; Hadjadj, Samy; Study group, SURDIAGENE

2017-01-01

Objective. Sodium intake is associated with cardiovascular outcomes. However, no study has specifically reported an association between cardiovascular mortality and urinary sodium concentration (UNa). We examined the association of UNa with mortality in a cohort of type 2 diabetes (T2D) patients. Methods. Patients were followed for all-cause death and cardiovascular death. Baseline UNa was measured from second morning spot urinary sample. We used Cox proportional hazard models to identify independent predictors of mortality. Improvement in prediction of mortality by the addition of UNa to a model including known risk factors was assessed by the relative integrated discrimination improvement (rIDI) index. Results. Participants (n = 1,439) were followed for a median of 5.7 years, during which 254 cardiovascular deaths and 429 all-cause deaths were recorded. UNa independently predicted all-cause and cardiovascular mortality. An increase of one standard deviation of UNa was associated with a decrease of 21% of all-cause mortality and 22% of cardiovascular mortality. UNa improved all-cause and cardiovascular mortality prediction beyond identified risk factors (rIDI = 2.8%, P = 0.04 and rIDI = 4.6%, P = 0.02, resp.). Conclusions. In T2D, UNa was an independent predictor of mortality (low concentration is associated with increased risk) and improved modestly its prediction in addition to traditional risk factors. PMID:28255559

What does it take? The influence of rural upbringing and sense of rural background on medical students' intention to work in a rural environment.

PubMed

Somers, George T; Strasser, Roger; Jolly, Brian

2007-01-01

There is abundant evidence that rural origin is an influence on rural career choice. Rural origin is widely used to select students to be supported into programs designed to address the rural medical workforce shortage. What is not as clear is how many years of rural upbringing are required to have a maximal effect on rural career choice. Neither is the place of having a sense of rural background well understood. A cross-sectional self-completed paper-based survey of all students in years one through four of the Monash University medical course was undertaken in 2003. The survey included a scale to measure stated rural career intention as well as questions about the number of years of rural upbringing and whether students had a sense of rural background. The Rural Intention score was divided into three categories: strong urban intent, strong rural intent, and an intermediate, less certain intent. There was an 88% (n = 399) response rate from students holding Commonwealth Supported Places. Approximately 30% of these claimed a sense of rural background, and 28% had more than 8 years of rural upbringing. Twenty-five percent stated a strong intention to choose a rural career and 34.5% had strong urban intent. The remaining 40.5% were in the intermediate group. Almost all students (97.5%) with over 5 years of rural upbringing had developed a sense of rural background, and almost all (97.5%) with less than 5 years' rural upbringing denied a sense of rural background. Rural intent was high for those with a sense of rural background and those with more than 8 years of rural upbringing, but the students who had had from 4 to 8 years of rural upbringing mainly fell into the 'uncertain' category. In this cohort of almost 400 Australian medical students, a sense of rural background developed at a clear point, around 5 years of rural upbringing. Students with a sense of rural background were likely to develop a strong rural intent several years before similar students who had failed to make this connection with a rural community. This latter group displayed uncertainty toward a rural career choice, possibly due to unfamiliarity. Unlike those with strong urban intent, these students have not excluded a rural career and should be supported. The inclusion of a measure of the intention of students to work in a rural environment is likely to increase the reliability and validity of selection procedures.

Novel isoguanine derivative of unlocked nucleic acid-Investigations of thermodynamics and biological potential of modified thrombin binding aptamer.

PubMed

Kotkowiak, Weronika; Czapik, Tomasz; Pasternak, Anna

2018-01-01

Thrombin binding aptamer (TBA), is a short DNA 15-mer that forms G-quadruplex structure and possesses anticoagulant properties. Some chemical modifications, including unlocked nucleic acids (UNA), 2'-deoxy-isoguanosine and 2'-deoxy-4-thiouridine were previously found to enhance the biological activity of TBA. In this paper, we present thermodynamic and biological characteristics of TBA variants that have been modified with novel isoguanine derivative of UNA as well as isoguanosine. Additionally, UNA-4-thiouracil and 4-thiouridine were also introduced simultaneously with isoguanine derivatives. Thermodynamic analysis indicates that the presence of isoguanosine in UNA or RNA series significantly decreases the stability of G-quadruplex structure. The highest destabilization is observed for substitution at one of the G-tetrad position. Addition of 4-thiouridine in UNA or RNA series usually decreases the unfavorable energetic cost of the presence of UNA or RNA isoguanine. Circular dichroism and thermal denaturation spectra in connection with thrombin time assay indicate that the introduction of UNA-isoguanine or isoguanosine into TBA negatively affects G-quadruplex folding and TBA anticoagulant properties. These findings demonstrate that the highly-ordered structure of TBA is essential for inhibition of thrombin activity.

Combined Spectroscopic and Interferometric (NPOI) Observations of the Be Star o Cassiopeiae

DTIC Science & Technology

2010-01-01

velocidades radiales de la estrella o Cas de los espectros tomados entre 1992 y 2008 en Ondřejov y Dominion Astrophysical Observatory nos permitieron...orbitales de este sistema SB1 implican una función de masa muy alta de alrededor de una masa solar. Esto implica una masa muy alta de la estrella ...secundaria, posiblemente mayor que la de la estrella primaria. Para comprobar si hay la existencia de una secundaria tan masiva, o Cas fue observada con

DNA Vaccination of the American Crow (Corvus brachyrhynchos) Provides Partial Protection Against Lethal Challenge with West Nile Virus

DTIC Science & Technology

2007-01-01

mortality but did not provide sterile immunity. RESUMEN. La vacunación del cuervo Americano (Corvus brachyrhynchos) con vacuna de ADN proporciona...casi 100% fatal en el cuervo Americano (Corvus brachyrhynchos). Evaluamos cuatro formulaciones de vacunas en cuervos Americanos, incluyendo una vacuna de...ADN, una vacuna de ADN con adyuvante, ambas aplicadas por la vı́a intramuscular, una vacuna de ADN microencapsulada aplicada por la vı́a oral, y una

The 'rural pipeline' and retention of rural health professionals in Europe's northern peripheries.

PubMed

Carson, Dean B; Schoo, Adrian; Berggren, Peter

2015-12-01

The major advance in informing rural workforce policy internationally over the past 25 years has been the recognition of the importance of the 'rural pipeline'. The rural pipeline suggests that people with 'rural origin' (who spent some childhood years in rural areas) and/or 'rural exposure' (who do part of their professional training in rural areas) are more likely to select rural work locations. What is not known is whether the rural pipeline also increases the length of time professionals spend in rural practice throughout their careers. This paper analyses data from a survey of rural health professionals in six countries in the northern periphery of Europe in 2013 to examine the relationship between rural origin and rural exposure and the intention to remain in the current rural job or to preference rural jobs in future. Results are compared between countries, between different types of rural areas (based on accessibility to urban centres), different occupations and workers at different stages of their careers. The research concludes that overall the pipeline does impact on retention, and that both rural origin and rural exposure make a contribution. However, the relationship is not strong in all contexts, and health workforce policy should recognise that retention may in some cases be improved by recruiting beyond the pipeline. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Changes in Veterinary Students' Attitudes Toward the Rural Environment and Rural Veterinary Practice: A Longitudinal Cohort Study.

PubMed

Hashizume, Cary T; Woloschuk, Wayne; Hecker, Kent G

2015-01-01

There is a paucity of research regarding veterinary students' attitudes toward the rural environment and rural veterinary practice and how these attitudes might change over the course of a veterinary medicine program that includes rural clinical experience. Using a 23-item questionnaire, attitudes toward rural lifestyle, rural work-life balance, opportunities for career and skill development in rural veterinary practice, and inter-professional teamwork in the rural environment were assessed at the beginning and completion of a four-year veterinary medicine program. Eighty-six students (74.4% female) were included in this Canadian study over a six-year period. Thirty-one participants (36.1%) were rural students. Overall, students' attitudes toward the rural lifestyle, rural work-life balance, and inter-professional teamwork in rural veterinary practice all significantly decreased (p<.001) over the course of the program. As compared to urban students, rural students had significantly higher rural lifestyle scores at both the beginning (p<.001) and end (p<.01) of the veterinary medicine program. A less positive attitude toward living and working in a rural environment could influence students to exclude rural veterinary practice as a career choice. Rural clinical experiences designed to sustain or increase veterinary student interest in rural practice may not be sufficient to support positive rural attitudes. Given the demand for rural veterinary services in developed countries, the implications of this study may extend beyond Canada.

Self-efficacy reduces the impact of social isolation on medical student's rural career intent.

PubMed

Isaac, Vivian; Pit, Sabrina Winona; McLachlan, Craig S

2018-03-20

Social isolation in medical students is a subjective experience that may influence medical career decision making. Rural self-efficacy has been shown to influence rural career intentions following a rural clinical placement, however its impact on social isolation during a rural clinical placement has not been previously modeled. The objective of this study is to explore whether self-perception of social isolation is associated with rural career intent in rural medical students. Secondly, to determine whether self-efficacy influences the association between social isolation and rural career intent. 2015 data, from a cross-sectional survey of the National Federation of Rural Australian Medical Educators (FRAME) study. Among 619 medical students attending rural clinical schools (RCS), rural career intent was assessed. This included intended rural location for either postgraduate medical specialist or generalist training or completion of that training. Self-efficacy beliefs in rural medical practice were based on a validated scale consisting of six questions. Social isolation was measured asking students whether they felt socially isolated during their RCS placement. 31.3% of surveyed students self-reported feeling socially isolated during their rural placement. Social isolation was associated with reduced rural career intent after controlling for gender, rural background, RCS preference, RCS support and wellbeing. In step-wise logistic regression the association between social isolation and rural intent disappeared with the inclusion of rural self-efficacy. Social isolation during a rural clinical placement is commonly reported and is shown to reduce rural career intent. High levels of rural clinical self-efficacy reduce the effects of social isolation on future rural workforce intentions.

Rural origin plus a rural clinical school placement is a significant predictor of medical students' intentions to practice rurally: a multi-university study.

PubMed

Walker, Judith H; Dewitt, Dawn E; Pallant, Julie F; Cunningham, Christine E

2012-01-01

Health workforce shortages are a major problem in rural areas. Australian medical schools have implemented a number of rural education and training interventions aimed at increasing medical graduates' willingness to work in rural areas. These initiatives include recruiting students from rural backgrounds, delivering training in rural areas, and providing all students with some rural exposure during their medical training. However there is little evidence regarding the impact of rural exposure versus rural origin on workforce outcomes. The aim of this study is to identify and assess factors affecting preference for future rural practice among medical students participating in the Australian Rural Clinical Schools (RCS) Program. Questionnaires were distributed to 166 medical students who had completed their RCS term in 2006; 125 (75%) responded. Medical students were asked about their preferred location and specialty for future practice, their beliefs about rural work and life, and the impact of the RCS experience on their future rural training and practice preferences. Almost half the students (47%; n=58) self-reported a 'rural background'. Significantly, students from rural backgrounds were 10 times more likely to prefer to work in rural areas when compared with other students (p<0.001). For those preferring general practice, 80% (n=24) wished to do so rurally. Eighty-five per cent (n=105) of students agreed that their RCS experience increased their interest in rural training and practice with 62% (n=75) of students indicating a preference for rural internship/basic training after their RCS experience. A substantial percentage (86%; n=108) agreed they would consider rural practice after their RCS experience. This baseline study provides significant evidence to support rural medical recruitment and retention through education and training, with important insights into the factors affecting preference for future rural practice. By far the most significant predictor of rural practice intention is recruitment of students with a rural background who also undertake an RCS placement. This research also demonstrates significant demand for post-graduate rural training places, including specialty places, as RCS graduates become junior doctors and vocational trainees.

Acceptability of an Embodied Conversational Agent-based Computer Application for Hispanic Women

PubMed Central

Wells, Kristen J.; Vázquez-Otero, Coralia; Bredice, Marissa; Meade, Cathy D.; Chaet, Alexis; Rivera, Maria I.; Arroyo, Gloria; Proctor, Sara K.; Barnes, Laura E.

2015-01-01

There are few Spanish language interactive, technology-driven health education programs. Objectives of this feasibility study were to: 1) learn more about computer and technology usage among Hispanic women living in a rural community; and 2) evaluate acceptability of the concept of using an embodied conversational agent (ECA) computer application among this population. A survey about computer usage history and interest in computers was administered to a convenience sample of 26 women. A sample video prototype of a hospital discharge ECA was administered followed by questions to gauge opinion about the ECA. Data indicate women exhibited both a high level of computer experience and enthusiasm for the ECA. Feedback from community is essential to ensure equity in state of the art dissemination of health information. Hay algunos programas interactivos en español que usan la tecnología para educar sobre la salud. Los objetivos de este estudio fueron: 1) aprender más sobre el uso de computadoras y tecnología entre mujeres Hispanas que viven en comunidades rurales y 2) evaluar la aceptabilidad del concepto de usar un programa de computadora utilizando un agente de conversación encarnado (ECA) en esta población. Se administro una encuesta sobre el historial de uso y del interés de aprender sobre computadoras fue a 26 mujeres por muestreo de conveniencia. Un ejemplo del prototipo ECA en forma de video de un alta hospitalaria fue administrado y fue seguido por preguntas sobre la opinión que tenían del ECA. Los datos indican que las mujeres mostraron un alto nivel de experiencia con las computadoras y un alto nivel de entusiasmo sobre el ECA. La retroalimentación de la comunidad es esencial para asegurar equidad en la diseminación de información sobre la salud con tecnología de punta. PMID:26671558

Rural nursing education: a photovoice perspective.

PubMed

Leipert, Beverly; Anderson, Emma

2012-01-01

For many rural Canadians nursing care is the primary and often the sole access point to health care. As such, rural nurses are an invaluable resource to the health and wellbeing of rural populations. However, due to a nursing workforce that is aging and retiring, limited resources and support, healthcare reform issues, and other factors, these rural professionals are in short supply. Because of limited opportunities to learn about rural practice settings, nursing students may be reluctant to select rural practice locations. Relevant and effective educational initiatives are needed to attract nursing students to underserved rural and remote communities so that rural people receive the health care they require. The purpose of this study was to explore the use of the innovative research approach called photovoice as an educational strategy to foster learning about and interest in rural locations and rural nursing as future practice settings. Fostering of interest in rural may help to address nursing workforce shortages in rural settings. Thirty-eight third and fourth year nursing and health sciences students enrolled in an elective 'Rural Nursing' course used the qualitative research method photovoice to take photographs that represented challenges and facilitators of rural nursing practice. They then engaged in written reflection about their photos. Photos were to be taken in rural settings of their choice, thus fostering both urban and rural student exposure to diverse rural communities. One hundred forty-four photos and reflections were submitted, representing students' appreciation of diverse facilitators and challenges to rural nursing practice. Facilitators included technology, a generalist role, strong sense of community, and slower pace of life. Challenges included inadequate rural education in undergraduate nursing programs, professional isolation, safety issues, few opportunities for professional development, lack of anonymity, and insider/outsider status. Exemplar photos and reflections are provided. The photovoice research approach used in this rural education endeavour proved to be very useful in fostering students' exposure to, interest in, and understanding of rural settings and their influence on rural nursing practice. Photovoice is also recommended for use in rural courses other than nursing. Suggested strategies include group photovoice experience and the expansion of reflection to enhance rural health research.

The Road to Rural Primary Care: A Narrative Review of Factors That Help Develop, Recruit, and Retain Rural Primary Care Physicians.

PubMed

Parlier, Anna Beth; Galvin, Shelley L; Thach, Sarah; Kruidenier, David; Fagan, Ernest Blake

2018-01-01

To examine the literature documenting successes in recruiting and retaining rural primary care physicians. The authors conducted a narrative review of literature on individual, educational, and professional characteristics and experiences that lead to recruitment and retention of rural primary care physicians. In May 2016, they searched MEDLINE, PubMed, CINAHL, ERIC, Web of Science, Google Scholar, the Grey Literature Report, and reference lists of included studies for literature published in or after 1990 in the United States, Canada, or Australia. The authors identified 83 articles meeting inclusion criteria. They synthesized results and developed a theoretical model that proposes how the findings interact and influence rural recruitment and retention. The authors' proposed theoretical model suggests factors interact across multiple dimensions to facilitate the development of a rural physician identity. Rural upbringing, personal attributes, positive rural exposure, preparation for rural life and medicine, partner receptivity to rural living, financial incentives, integration into rural communities, and good work-life balance influence recruitment and retention. However, attending medical schools and/or residencies with a rural emphasis and participating in rural training may reflect, rather than produce, intention for rural practice. Many factors enhance rural physician identity development and influence whether physicians enter, remain in, and thrive in rural practice. To help trainees and young physicians develop the professional identity of a rural physician, multifactorial medical training approaches aimed at encouraging long-term rural practice should focus on rural-specific clinical and nonclinical competencies while providing trainees with positive rural experiences.

Rural Policies for the 1990s. Rural Studies Series.

ERIC Educational Resources Information Center

Flora, Cornelia B., Ed.; Christenson, James A., Ed.

Written by some of the foremost experts on rural America, this book focuses on policy-relevant research on the problems of rural areas. In each chapter, rural policy needs are identified by examining the flow of events and rural sociology of the 1980s. Chapters are: (1) "Critical Times for Rural America: The Challenge for Rural Policy in the…

Financial Performance of Rural Medicare ACOs.

PubMed

Nattinger, Matthew C; Mueller, Keith; Ullrich, Fred; Zhu, Xi

2018-12-01

The Centers for Medicare & Medicaid Services (CMS) has facilitated the development of Medicare accountable care organizations (ACOs), mostly through the Medicare Shared Savings Program (MSSP). To inform the operation of the Center for Medicare & Medicaid Innovation's (CMMI) ACO programs, we assess the financial performance of rural ACOs based on different levels of rural presence. We used the 2014 performance data for Medicare ACOs to examine the financial performance of rural ACOs with different levels of rural presence: exclusively rural, mostly rural, and mixed rural/metropolitan. Of the ACOs reporting performance data, we identified 97 ACOs with a measurable rural presence. We found that successful rural ACO financial performance is associated with the ACO's organizational type (eg, physician-based) and that 8 of the 11 rural ACOs participating in the Advanced Payment Program (APP) garnered savings for Medicare. Unlike previous work, we did not find an association between ACO size or experience and rural ACO financial performance. Our findings suggest that rural ACO financial success is likely associated with factors unique to rural environments. Given the emphasis CMS has placed on rural ACO development, further research to identify these factors is warranted. © 2016 National Rural Health Association.

Initial evaluation of rural programs at the Australian National University: understanding the effects of rural programs on intentions for rural and remote medical practice.

PubMed

Lee, Yin Huey; Barnard, Amanda; Owen, Cathy

2011-01-01

Rural health workforce issues are a priority area for the Australian Government and substantial funding has been provided for rural education programs to address health workforce disparities across Australia's rural and remote communities. The Australian Government established a Rural Health Strategy in 2001 and as a result there are now 14 rural clinical schools in Australia. The 2008 Urbis Report highlighted the lack of research on rural programs and workforce outcomes, essential to ensuring that educational efforts, resources and funding are being concentrated appropriately. This study examined the Australian National University (ANU) Medical School's 4 year rural program to identify the impact of elective and compulsory program components on student intentions to practice in a rural and remote location post-graduation. The study also explores factors that affect student decisions to apply for year-long rural placements. METHODS; ANU Medical School's graduating cohort of 2008 fourth year medical students completed an anonymous and voluntary online survey questionnaire. Survey sections included student demographics, compulsory and elective components of the ANU rural program, and an overall evaluation of the ANU rural curriculum. The survey contained a mixture of forced-answer questions and open-ended commentary. Quantitative data were analyzed for descriptive and frequency statistics using EpiInfo V3.5.1 (http://wwwn.cdc.gov/epiinfo/). Qualitative data were reviewed and consistent themes among responses extracted. In total, 40 students from a cohort of 88 (45%) responded, with 26 respondents (65%) indicating that at medical school commencement they considered working in a rural or remote area. At the end of their medical education, 33 respondents (82%) indicated their intention to spend some time in their careers working in a rural or remote area. Students from non-rural backgrounds had greater positive change in their intentions to practice rurally as a direct effect of ANU rural programs when compared with students from rural backgrounds. More than 70% of students believed the amount of rural focus in the curriculum was correct, 75% believed that they will be better medical practitioners because of the program, and 85% found the curriculum was delivered effectively. Students who undertook elective rural programs such as a year-long rural placement were more likely to have future rural career intentions when compared with students undertaking compulsory rural components. Compulsory components, however, had a strong influence on students applying for elective programs. Regarding application for the year-long rural placement, students reported clinical exposure was the most encouraging factor, and time away from family and friends, and lack of spousal and family support were the most discouraging factors. Rural programs at the ANU, and medical school exposure to rural health experiences is important in influencing students' perceptions of a career in rural and remote health. This study provides evidence that both compulsory and elective components contribute to a successful holistic rural program which nurtures the rural interest of all students. Overall, students at the ANU medical school were satisfied with the rural curriculum. The results confirm that there is difficulty in recruiting students with family commitments into year-long rural placement programs, despite incentives. Those students who select long-term rural study for reasons other than an interest in a career in rural health end the program with positive rural intentions.

7 CFR 1951.218 - Use of Rural Development loans and grants for other purposes.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE... Servicing of Community and Direct Business Programs Loans and Grants § 1951.218 Use of Rural Development... the Administrator of the Rural Housing Service or Rural Business-Cooperative Service that has the...

Different perspectives on the key challenges facing rural health: The challenges of power and knowledge.

PubMed

Malatzky, Christina; Bourke, Lisa

2018-05-25

To examine the effects of dominant knowledge in rural health, including how they shape issues central to rural health. In particular, this article examines the roles of: (i) deficit knowledge of rural health workforce; (ii) dominant portrayals of generalism; and (iii) perceptions of inferiority about rural communities in maintaining health disparities between rural- and metropolitan-based Australians. A Foucauldian framework is applied to literature, evidence, case studies and key messages in rural health. Three scenarios are used to provide practical examples of specific knowledge that is prioritised or marginalised. The analysis of three areas in rural health identifies how deficit knowledge is privileged despite it undermining the purpose of rural health. First, deficit knowledge highlights the workforce shortage rather than the type of work in rural practice or the oversupply of workforce in metropolitan areas. Second, the construction of generalist practice as less skilled and more monotonous undermines other knowledge that it is diverse and challenging. Third, dominant negative stereotypes of rural communities discourage rural careers and highlight undesirable aspects of rural practice. The privileging of deficit knowledge pertaining to rural health workforce, broader dominant discourses of generalism and the nature of rural Australian communities reproduces many of the key challenges in rural health today, including persisting health disparities between rural- and metropolitan-based Australians. To disrupt the operations of power that highlight deficit knowledge and undermine other knowledge, we need to change the way in which rural health is currently constructed and understood. © 2018 National Rural Health Alliance Ltd.

Joining Rural Development Theory and Rural Education Practice.

ERIC Educational Resources Information Center

Hammer, Patricia Cahape

Karl N. Stauber proposes three goals for rural development policy: helping the rural middle class survive, reducing concentrated rural poverty, and sustaining and improving the quality of the natural environment. In contrast to other visions, he advises policy that focuses on rural places rather than rural economic sectors such as agriculture,…

Defining and Describing Rural: Implications for Rural Special Education Research and Policy

ERIC Educational Resources Information Center

Hawley, Leslie R.; Koziol, Natalie A.; Bovaird, James A.; McCormick, Carina M.; Welch, Greg W.; Arthur, Ann M.; Bash, Kirstie

2016-01-01

A critical aspect of rural research is carefully defining and describing the rural context. This is particularly important in rural special education research because different definitions of rural may influence resource allocation, grant funding eligibility, and/or research findings. In order to highlight the importance of operationalizing rural,…

Agriculture and Rurality: Beginning the "Final Separation"?

ERIC Educational Resources Information Center

Friedland, William H.

2002-01-01

When is a farm a farm? When is rural rural? Has the issue of the rural-urban continuum returned? Decades ago rural sociology worked itself into two blind alleys: rural-urban differences and attempts to define the rural-urban fringe. Although these conceptual problems eventually were exhausted, recent developments in California raise the…

A Closer Look at Rural-Urban Health Disparities: Associations Between Obesity and Rurality Vary by Geospatial and Sociodemographic Factors.

PubMed

Cohen, Steven A; Cook, Sarah K; Kelley, Lauren; Foutz, Julia D; Sando, Trisha A

2017-04-01

Obesity affects over one-third of older adults in the United States. Both aging and obesity contribute to an increased risk for chronic disease, early mortality, and additional health care utilization. Obesity rates are higher in rural areas than in urban areas, although findings are mixed. The objectives of this study are to assess potential nonlinearity in the association between rurality and obesity, and to evaluate the potential for socioeconomic status and geographic area to moderate the associations between rurality and obesity. Using a representative sample of adults aged 65 and above from the Behavioral Risk Factor Surveillance System, obesity (BMI ≥ 30 kg/m 2 ) was modeled against the primary exposure of rural-urban status, as measured by the Index of Relative Rurality. Binary logistic regression models were used to estimate the odds of obesity by rurality both as a continuous variable and by decile of rurality. Models were then stratified by per-capita income and state to assess potential moderation by these factors. The prevalence of obesity in older adults was highest in intermediate rurality areas (OR in rurality decile #5 1.134, 95% CI: 1.086-1.184) and lowest in the most rural and most urban areas. Obesity was highest in low- and middle-income areas, regardless of rural-urban status. In high-income areas, obesity among older adults was highest in areas of intermediate rurality and lowest in the most rural areas (OR 0.726, 95% CI: 0.606-0.870) and more urban areas, showing a J-shaped association. There were substantial differences in the associations between rurality and obesity in older adults among states. Associations between rurality and obesity varied by degree of rurality, socioeconomic status, and geography. Therefore, traditional "one-size-fits-all" approaches to reducing rural-urban health disparities in older adults may be more effective if tailored to the area-specific rural-urban gradients in health. © 2016 National Rural Health Association.

A comparison of the vending environment among three rural subtypes of secondary schools.

PubMed

Kehm, Rebecca; Davey, Cynthia S; Kubik, Martha Y; Nanney, Marilyn S

2018-01-01

The purpose of this study was to further explore the rural school food environment. This study assessed trends in prevalence of vending machines and vending items within and between Minnesota schools located in 3 rural subtypes: town/rural fringe, town/rural distant, and remote rural. Generalized estimating equation models were employed to analyze data from the 2006 through 2012 School Health Profiles Principal's Surveys (Profiles). All 3 rural subtypes had a statistically significant decrease in the prevalence of low nutrient energy dense (LNED) vending items between 2006 and 2012, with the exception of sports drinks. However, different vending practices were observed between rural subtypes, with town/rural fringe schools providing more LNED vending options and experiencing less positive change over time compared to town/rural distant and remote rural schools. Differences in vending machine practices emerge when rural schools are subtyped.

Training Medical Students for Rural, Underserved Areas: A Rural Medical Education Program in California.

PubMed

Eidson-Ton, W Suzanne; Rainwater, Julie; Hilty, Donald; Henderson, Stuart; Hancock, Christine; Nation, Cathryn L; Nesbitt, Thomas

2016-01-01

The Association of American Medical Colleges projects an increasing shortage of physicians in rural areas. Medical schools have developed specialty track programs to improve the recruitment and retention of physicians who can serve rural populations. One such program in California includes a variety of unique elements including outreach, admissions, rural clinical experiences, focused mentorship, scholarly and leadership opportunities, and engagement with rural communities. Preliminary outcomes demonstrate that this rural track program has achieved some success in the recruitment, retention, and training of students interested in future rural practice and in the placement of students in primary care residencies. Long-term outcomes, such as graduates entering rural practice, are still unknown, but will be monitored to assess the impact and sustainability of the rural program. This article illustrates the opportunities and challenges of training medical students for rural practice and provides lessons learned to inform newly-established and long standing rural medical education programs.

Rural development and urban migration: can we keep them down on the farm?

PubMed

Rhoda, R

1983-01-01

This study tests the hypothesis that rural development projects and programs reduce rural-urban migration. The author presents various factors in the social theories of migration, including those relating to origin and destination, intervening obstacles such as distance, and personal factors. 3 economic models of migration are the human capital or cost-benefit approach, the expected income model, and the intersectoral linkage model. Empirical studies of migration indicate that: 1) rural areas with high rates of out-migration tend to have high population densities or high ratios of labor to arable land, 2) distance inhibits migration, 3) rural-urban migration is positively correlated with family income level, and 4) selectivity differences in socioeconomic status between migrants and nonmigrants often are grouped into development packages which might include irrigation, new varieties of seed, subsidized credit, increased extension, and improved marketing arrangements. The migration impacts of some of these efforts are described: 1) land reform usually is expected to slow rural out-migration because it normally increases labor utilization in rural areas, but this is a limited effect, 2) migration effects of the Green Revolution technology are mainly in rural-rural migration, and 3) agricultural mechanization may stimulate rural-urban migration in the long run. Development of rural social services migh have various effects on rural-urban migration. Better rural education, which improves the chances of urban employment, will stimulate rural-urban migration, while successful rural family planning programs will have a negative effect in the long run as there will be reduced population pressure on arable land. Better rural health services might reduce the incentive for rural-urban migration as well. It is suggested that governments reconsider policies which rely on rural development to curb rural-urban migration and alleviate problems of urban poverty and underemployment.

Nature or nurture: the effect of undergraduate rural clinical rotations on pre-existent rural career choice likelihood as measured by the SOMERS Index.

PubMed

Somers, George T; Spencer, Ryan J

2012-04-01

Do undergraduate rural clinical rotations increase the likelihood of medical students to choose a rural career once pre-existent likelihood is accounted for? A prospective, controlled quasi-experiment using self-paired scores on the SOMERS Index of rural career choice likelihood, before and after 3 years of clinical rotations in either mainly rural or mainly urban locations. Monash University medical school, Australia. Fifty-eight undergraduate-entry medical students (35% of the 2002 entry class). The SOMERS Index of rural career choice likelihood and its component indicators. There was an overall decline in SOMERS Index score (22%) and in each of its components (12-41%). Graduating students who attended rural rotations were more likely to choose a rural career on graduation (difference in SOMERS score: 24.1 (95% CI, 15.0-33.3) P<0.0001); however, at entry, students choosing rural rotations had an even greater SOMERS score (difference: 27.1 (95% CI, 18.2-36.1) P<0.0001). Self-paired pre-post reductions in likelihood were not affected by attending mainly rural or urban rotations, nor were there differences based on rural background alone or sex. While rural rotations are an important component of undergraduate medical training, it is the nature of the students choosing to study in rural locations rather than experiences during the course that is the greater influence on rural career choice. In order to improve the rural medical workforce crisis, medical schools should attract more students with pre-existent likelihood to choose a rural career. The SOMERS Index was found to be a useful tool for this quantitative analysis. © 2012 The Authors. Australian Journal of Rural Health © 2012 National Rural Health Alliance Inc.

Rural women caregivers in Canada.

PubMed

Crosato, Kay E; Leipert, Beverly

2006-01-01

Informal caregiving within rural contexts in Canada is increasing. This is due in part to a number of factors related to the restructuring of the Canadian health care system, the regionalization of services to urban locations, the increased population of people 65 years and older, and the desire of this population to age within their rural homes. Most often, the informal caregiving role is assumed by rural women. Women tend to fall into the role of informal caregiver to elders because of the many societal and gender expectations and values that are present within the rural culture. The purpose of this literature review is to identify the context in which women provide care for an elder in rural Canada. Illustrating these issues will help to uncover challenges and barriers rural women face when providing care and highlight recommendations and implications for rural women caregivers and nurses employed within rural settings. Many rural women share similar caregiving experiences as urban informal caregivers, but rural women are faced with additional challenges in providing quality care for an elder. Rural women caregivers are faced with such issues as limited access to adequate and appropriate healthcare services, culturally incongruent health care, geographical distance from regionalized centers and health services, transportation challenges, and social/geographical isolation. In addition to these issues, many rural women are faced with the multiple role demands that attend being a wife, mother, caregiver and employee. The pile up of these factors leaves rural women caregivers susceptible to additional stresses and burn out, with limited resources on which to depend. Through reviewing pertinent literature, appropriate implications and recommendations can be made that may assist rural women caregivers and rural nurses. Nurses working within rural communities are in ideal settings to work collaboratively in building supportive relationships with rural women in order to promote the health and wellbeing of caregivers, as well as the elders for which they provide care. More research is needed regarding rural women and their caregiving experiences of elders. In addition, rural and remote courses and practicums should be made available to nursing students in order to encourage them and to support them in nursing careers in rural settings, thereby providing rural women caregivers with additional appropriate and consistent healthcare services. Also, governments and policy makers should consider the rural context and the challenges that are associated with providing care to an elder in a rural setting to ensure that rural women caregivers and their care recipients are well supported within their rural communities.

The influence of loan repayment on rural healthcare provider recruitment and retention in Colorado.

PubMed

Renner, Daniel M; Westfall, John M; Wilroy, Lou Ann; Ginde, Adit A

2010-01-01

There is an ongoing shortage of rural healthcare providers relative to urban healthcare providers worldwide. Many strategies have been implemented to increase the distribution of rural healthcare providers, and financial incentives such as loan repayment programs have become popular means to both recruit and retain healthcare providers in rural communities. Studies detailing the effects of such programs on rural provider recruitment and retention are limited. The objective of this study was to assess the influence of loan repayment and other factors on the recruitment and retention of healthcare providers in rural Colorado, USA, and to compare the motivations and attitudes of these rural providers with their urban counterparts. A survey was sent to 122 healthcare providers who had participated in one of three loan repayment programs in Colorado between the years of 1992 and 2007: the Colorado Health Professional Loan Repayment Program; the Colorado Rural Outreach Program; and the Dental Loan Repayment Program of Colorado. Differentiation between rural and urban communities was accomplished by using the Rural Urban Commuting Area Codes developed by the University of Washington's Rural Health Research Center and Economic Research Service. Statistical analysis was performed using STATA from StataCorp. Of the 93 respondents included in the study, 57 worked in rural communities and 36 worked in urban communities during their programs. Of the rural participants, 74% were already working in or intending to work in an eligible community when they were made aware of the loan repayment program. Of those planning to work in a rural community regardless of any loan repayment option, 42% reported that the loan repayment program had an important influence on the specific community in which they chose to practice. Of the rural participants already working in a rural community, 38% reported loan repayment as being an important factor in their retention. The most important factors the rural providers cited for their recruitment were the location of the community, scope of practice, and family fit with the community. The most important factors for the urban providers were the location of the community, salary, and scope of practice. Of the rural providers, 36% attended rural high schools, while 9% of urban providers attended rural high schools. Of the rural providers who were planning on practicing in a rural area regardless of any loan repayment option, 37% had attended rural high schools. Rural participants most often left their communities because their families wanted to move, personal or professional isolation, and dissatisfaction with the medical community. Of rural participants 22% cited the desire for a higher income as an important reason to leave their communities, while the desire for a higher income was the most commonly cited reason for the urban providers. Rural retention rates were not influenced by past attendance at rural high schools or by intention to practice in a rural community regardless of loan repayment. Loan repayment programs targeting rural Colorado usually enroll providers who would have worked in a rural area regardless of loan repayment opportunities, but are likely to play a role in providers' choice of specific rural community for practice. They also appear to have a limited but important influence on rural provider retention, though financial concerns are generally less influential for non-retained rural providers than are family preferences and professional dissatisfaction.

Validity of Medical Student Questionnaire Data in Prediction of Rural Practice Choice and Its Association With Service Orientation.

PubMed

Shannon, C Ken; Jackson, Jodie

2015-01-01

The validity of medical student projection of, and predictors for, rural practice and the association of a measure of service orientation, projected practice accessibility to the indigent, were investigated. West Virginia (WV) medical student online pre- and postrural rotation questionnaire data were collected during the time period 2001-2009. Of the 1,517 respondent students, submissions by 1,271 met the time interval criterion for inclusion in analyses. Subsequent WV licensing data were available for 461 in 2013. These 2 databases were used to assess for validity of projection of rural practice, for predictors of rural practice, and for student projected accessibility of the future practice to indigent patients. There were statistically significant associations between both pre- and postrotation projections of rural practice and subsequent rural practice. The most significant independent predictors of rural practice were student rural background, reported primary care intent, prediction of rural practice and projection of greater accessibility of the future practice to indigent patients. For scoring of practice access, there were trends for higher scoring by rural students and rural practitioners, with greater pre-post increases for those with urban hometowns. This study demonstrates the utility of medical student questionnaires for projections of numbers of future rural physicians. It suggests that students with a rural background, rural practice intent, or greater service orientation are more likely to enter rural practice. It also suggests that students, particularly those with urban hometowns, are influenced by rural rotation experiences in forecasting greater practice accessibility and in entering rural practice. © 2015 National Rural Health Association.

Rural Roots: News, Information, and Commentary from the Rural School and Community Trust, 2002.

ERIC Educational Resources Information Center

Yaunches, Alison, Ed.; Loveland, Elaina, Ed.

2002-01-01

This document contains the six issues of "Rural Roots" published bimonthly in 2002. A newsletter of the Rural School and Community Trust, "Rural Roots" provides news, information, and commentary from the Rural Trust and highlights the wide variety of place-based education work happening in rural schools and communities across…

75 FR 36349 - Announcement of Rural Cooperative Development Grant Application Deadlines

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-25

... DEPARTMENT OF AGRICULTURE Rural Business-Cooperative Service Announcement of Rural Cooperative Development Grant Application Deadlines AGENCY: Rural Business-Cooperative Service, USDA. ACTION: Notice of...: Overview Federal Agency: Rural Business-Cooperative Service (RBS). Funding Opportunity Title: Rural...

Rural considerations in establishing network adequacy standards for qualified health plans in state and regional health insurance exchanges.

PubMed

Talbot, Jean A; Coburn, Andrew; Croll, Zach; Ziller, Erika

2013-06-01

The Affordable Care Act (ACA) requires Health Insurance Exchanges (HIEs) to specify network adequacy standards for the Qualified Health Plans (QHPs) they offer to consumers. This article examines rural issues surrounding network adequacy standards, and offers recommendations for crafting standards that optimize rural access. This policy analysis reviews ACA requirements for QHP network adequacy standards, considering Medicaid managed care and Medicare Advantage (MA) standards as models. We analyze the implications of stringent vs flexible access standards in terms of how choices might affect health plans' participation in rural markets and rural enrollees' access to care. Finally, we propose strategies for designing standards with the degree of flexibility most likely to benefit rural consumers. A traditional approach to safeguarding rural access is to impose strict network adequacy standards on plans in rural areas. However, if strict standards prove difficult to meet due to rural provider scarcity, they might diminish QHPs' willingness to serve rural areas. Thus, they could exacerbate rather than alleviate rural access problems. To benefit rural communities, network adequacy standards must be strong enough to provide real protections for beneficiaries, yet flexible enough to accommodate rural delivery system constraints and remain attainable for QHPs. Useful strategies to achieve this balance might include: adjusting standards according to degrees of rurality and rural utilization norms; counting midlevel clinicians toward fulfillment of patient-provider ratios; and allowing plans to ensure rural access through delivery system innovations such as telehealth. © 2013 National Rural Health Association.

The role of rural nurse managers in supporting new graduate nurses in rural practice.

PubMed

Lea, Jackie; Cruickshank, Mary

2017-04-01

To investigate the nature and timing of support available to new graduate nurses within a rural transition to practice programme. For new graduates in rural practice successful transition is complicated by the unique role of the rural nurse, staff ratios and resources within rural environments. Little is known about the support needs of graduates working in rural health services, or who is best placed to provide support during their transition. This was a qualitative case study, using individual interviews with new graduate nurses at 3, 6 and 9 months milestones during a 12-month rural transition to practice programme plus interviews with experienced rural nurses who were employed in rural health agencies where the new graduate nurses were employed. Graduates in rural health services rely on nurse unit managers and nurse managers for feedback, support and debriefing, provision of emotional support, advocacy, openness, encouragement and protection from organisational requests and demands during the transition to rural nursing practice. Nurse managers play an important role in rural health services in the provision of support for new graduate nurses. As clinical leaders rural nurse managers and nurse unit managers, have an important role in facilitating the successful entry and retention of new graduate nurses into the rural nursing workforce. © 2016 John Wiley & Sons Ltd.

Tolerance of ambiguity, perfectionism and resilience are associated with personality profiles of medical students oriented to rural practice.

PubMed

Eley, Diann S; Leung, Janni K; Campbell, Narelle; Cloninger, C Robert

2017-05-01

Resilience, coping with uncertainty and learning from mistakes are vital characteristics for all medical disciplines - particularly rural practice. Levels of coping constructs were examined in medical students with and without a rural background or an interest in rural practice. Cross-sectional surveys identified two personality profiles, and their association with levels of Tolerance of Ambiguity, Resilience, Perfectionism-High Standards and Concern over mistakes as constructs indicative of coping. Medical students (N = 797) were stratified by rural background and degree of rural interest. Mediation analysis tested the effect of personality profile on levels of the coping constructs. More (72%) rural background students had Profile 1 which was associated with higher levels of Tolerance of Ambiguity, High standards, and Resilience, but lower Concern over mistakes. Non-rural background students reporting a strong rural interest also had Profile 1 (64%) and similar levels of coping constructs. Personality profile mediated the association between rural interest and levels of coping constructs regardless of background. Having a rural background or strong rural interest are associated with a personality profile that indicates a better capacity for coping. Personality may play a part in an individual's interest in rural practice. Rural workforce initiatives through education should encourage and nurture students with a genuine interest in rural practice - regardless of background.

Uptake of Free HPV Vaccination among Young Women: A Comparison of Rural versus Urban Rates

ERIC Educational Resources Information Center

Crosby, Richard A.; Casey, Baretta R.; Vanderpool, Robin; Collins, Tom; Moore, Gregory R.

2011-01-01

Purpose: To contrast rates of initial HPV vaccine uptake, offered at no cost, between a rural clinic, a rural community college, and an urban college clinic and to identify rural versus urban differences in uptake of free booster doses. Methods: Young rural women attending rural clinics (n = 246), young women attending a rural community college (n…

Rurality and Rural Education: Discourses Underpinning Rurality and Rural Education Research in South African Postgraduate Education Research 1994-2004

ERIC Educational Resources Information Center

Nkambule, T.; Balfour, R. J.; Pillay, G.; Moletsane, R.

2011-01-01

Historically, rurality and rural education have been marginalised bodies of knowledge in South Africa. The post-1994 era has seen an emerging government concern to address the continuing interplay between poverty, HIV/AIDS, underdevelopment, and underachievement in schools categorised as rural. To address these concerns, scholars in South African…

77 FR 4885 - Rural Business Investment Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-01

...-AA80 Rural Business Investment Program AGENCY: Rural Business-Cooperative Service and Rural Utilities... several technical amendments to correct the Rural Business Investment Program (RBIP) regulation, including one to conform to the 2008 Farm Bill provision that allows a Rural Business Investment Company two...

Development Strategy for Mobilecommunications Market in Chinese Rural Area

NASA Astrophysics Data System (ADS)

Zhang, Liwei; Zhang, Yanjun; Xu, Liying; Li, Daoliang

Based on full analysis of rural mobile communication market, in order to explore mobile operators in rural areas of information services for sustainable development model, this paper presents three different aspects, including rural mobile communications market demand, the rural market for mobile communications business model and development strategies for rural mobile communications market research business. It supplies some valuable references for operators to develop rural users rapidly, develop the rural market effectively and to get access to develop a broad space.

Rural-Urban Differences in Late-Stage Breast Cancer: Do Associations Differ by Rural-Urban Classification System?

PubMed Central

Pruitt, Sandi L; Eberth, Jan M; Morris, E Scott; Grinsfelder, David B; Cuate, Erica L

2016-01-01

Introduction Rural residence is associated with later stage of breast cancer diagnosis in some but not all prior studies. The lack of a standardized definition of rural residence may contribute to these mixed findings. We characterize and compare multiple definitions of rural vs. non-rural residence to provide guidance regarding choice of measures and to further elucidate rural disparities in breast cancer stage at diagnosis. Methods We used Texas Cancer Registry data of 120,738 female breast cancer patients ≥50 years old diagnosed between 1995–2009. We defined rural vs. non-rural residence using 7 different measures and examined their agreement using Kappa statistics. Measures were defined at various geographic levels: county, ZIP code, census tract, and census block group. Late-stage was defined as regional or distant disease. For each measure, we tested the association of rural residence and late-stage cancer with unadjusted and adjusted logistic regression. Covariates included: age; patient race/ethnicity; diagnosis year; census block group-level mammography capacity; and census tract-level percent poverty, percent Hispanic, and percent Black. Results We found moderate to high levels of agreement between measures of rural vs. non-rural residence. For 72.9% of all patients, all 7 definitions agreed as to rural vs. non-rural residence. Overall, 6 of 7 definitions demonstrated an adverse association between rural residence and late-stage disease in unadjusted and adjusted models (Adjusted OR Range = 1.09–1.14). Discussion Our results document a clear rural disadvantage in late-stage breast cancer. We contribute to the heterogeneous literature by comparing varied measures of rural residence. We recommend use of the census tract-level Rural Urban Commuting Area Codes in future cancer outcomes research where small area data are available. PMID:27158685

Utilising a collective case study system theory mixed methods approach: a rural health example

PubMed Central

2014-01-01

Background Insight into local health service provision in rural communities is limited in the literature. The dominant workforce focus in the rural health literature, while revealing issues of shortage of maldistribution, does not describe service provision in rural towns. Similarly aggregation of data tends to render local health service provision virtually invisible. This paper describes a methodology to explore specific aspects of rural health service provision with an initial focus on understanding rurality as it pertains to rural physiotherapy service provision. Method A system theory-case study heuristic combined with a sequential mixed methods approach to provide a framework for both quantitative and qualitative exploration across sites. Stakeholder perspectives were obtained through surveys and in depth interviews. The investigation site was a large area of one Australian state with a mix of rural, regional and remote communities. Results 39 surveys were received from 11 locations within the investigation site and 19 in depth interviews were conducted. Stakeholder perspectives of rurality and workforce numbers informed the development of six case types relevant to the exploration of rural physiotherapy service provision. Participant perspective of rurality often differed with the geographical classification of their location. The numbers of onsite colleagues and local access to health services contributed to participant perceptions of rurality. Conclusions The complexity of understanding the concept of rurality was revealed by interview participants when providing their perspectives about rural physiotherapy service provision. Dual measures, such as rurality and workforce numbers, provide more relevant differentiation of sites to explore specific services, such rural physiotherapy service provision, than single measure of rurality as defined by geographic classification. The system theory-case study heuristic supports both qualitative and quantitative exploration in rural health services research. PMID:25066241

Utilising a collective case study system theory mixed methods approach: a rural health example.

PubMed

Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

2014-07-28

Insight into local health service provision in rural communities is limited in the literature. The dominant workforce focus in the rural health literature, while revealing issues of shortage of maldistribution, does not describe service provision in rural towns. Similarly aggregation of data tends to render local health service provision virtually invisible. This paper describes a methodology to explore specific aspects of rural health service provision with an initial focus on understanding rurality as it pertains to rural physiotherapy service provision. A system theory-case study heuristic combined with a sequential mixed methods approach to provide a framework for both quantitative and qualitative exploration across sites. Stakeholder perspectives were obtained through surveys and in depth interviews. The investigation site was a large area of one Australian state with a mix of rural, regional and remote communities. 39 surveys were received from 11 locations within the investigation site and 19 in depth interviews were conducted. Stakeholder perspectives of rurality and workforce numbers informed the development of six case types relevant to the exploration of rural physiotherapy service provision. Participant perspective of rurality often differed with the geographical classification of their location. The numbers of onsite colleagues and local access to health services contributed to participant perceptions of rurality. The complexity of understanding the concept of rurality was revealed by interview participants when providing their perspectives about rural physiotherapy service provision. Dual measures, such as rurality and workforce numbers, provide more relevant differentiation of sites to explore specific services, such rural physiotherapy service provision, than single measure of rurality as defined by geographic classification. The system theory-case study heuristic supports both qualitative and quantitative exploration in rural health services research.

RETOS EN LA INTERVENCIÓN CON ADOLESCENTES PUERTORRIQUEÑOS/AS QUE MANIFIESTAN COMPORTAMIENTO SUICIDA*

PubMed Central

Vélez, Yovanska Duarté; Dávila, Paloma Torres; Hernández, Samariz Laboy

2015-01-01

Presentamos un estudio de caso de una adolescente puertorriqueña con comportamiento suicida. Esta comenzó una Terapia Socio Cognitivo-Conductual para el Comportamiento Suicida (TSCC-CS) de tipo ambulatorio luego de una hospitalización por intento suicida. La TSCC-CS incorpora una perspectiva ecológica y de desarrollo a la terapia cognitivo-conductual. Inicialmente mostró baja autoestima y severos síntomas depresivos y de ansiedad. Al finalizar el tratamiento, manifestó un cambio significativo en su sintomatología clínica y evidenció una mejoría en sus destrezas de manejo. No presentó ideas suicidas durante meses previos, ni durante el seguimiento. El análisis de este caso permitió realizar cambios en el protocolo de tratamiento, particularmente en las sesiones de familia y de comunicación con el fin de aumentar la viabilidad del tratamiento. PMID:26702337

Consentimiento informado: una praxis dialogica para la investigacion

PubMed Central

Mondragon-Barrios, Liliana

2009-01-01

El consentimiento informado es un proceso, en el que una persona acepta participar en una investigation, conociendo los riesgos, beneficios, consecuencias o problemas que se puedan presenter durante el desarrollo de la misma. El objetivo de este trabajo es reunir las caracteristicas del proceso de consentimiento informado (PCI) pare que su discernimiento y cumplimiento posibilite el ejercicio etc° dialogico, reflexivo y responsable del investigador. Se presentan los resultados de una extensa revision de les elementos del PCI, desde sus cornponentes hasta su fundamento etico y legal, incluyendo los mites y realidades que existen sobre el formato de consentimiento informado come recurso legal de protection. El consentimiento informado no es un formato establecido que los investigadores repliquen, se trata de que la praxis del PCI sea una tarea cotidiana dentro de la investigation con seres humanos, como comunicaciOn deliberative y critica, responsable y comprometida entre dos agentes morales, investigador-investigado. PMID:19507477

Social accountability in medical education--an Australian rural and remote perspective.

PubMed

Worley, Paul; Murray, Richard

2011-01-01

Australia's medical education system is undergoing a socially motivated transformation focused on improving access to medical care for rural and remote communities. A rural and remote backbone of Rural Clinical Schools (RCS), University Departments of Rural Health, regional medical schools, and the postgraduate college, ACRRM, have enabled community responsive innovation and partnerships with rural health services that once would have been difficult to imagine. This article argues that this transformation is succeeding because of the passionate leadership of rural medical and community leaders, government seed funding to encourage rural medicine as an academic discipline, rigorous research and consultation that underpinned each step of the innovation pathway, and a political campaign to invest in rural medical education as a form of rural social capital.

Fruit Flies of the Genus Anastrepha (Diptera: Tephritidae) From Some Localities of Paraguay: New Records, Checklist, and Illustrated Key

PubMed Central

Arias, Osmar René; Fariña, Nelson Librado; Lopes, Gleidyane Novaes; Uramoto, Keiko; Zucchi, Roberto Antonio

2014-01-01

Abstract This study deals with fruit flies of the genus Anastrepha Schiner (Diptera: Tephritidae) collected in McPhail traps in the municipalities of Concepción, Belén, Horqueta, Loreto (state of Concepción) and Santa Rosa (state of Misiones), Paraguay. In total, 17 species were captured, 9 of which are new records for Paraguay. All morphological characters used for species identification are illustrated. RESUMEN. Se estudió las especies de moscas de las frutas del género Anastrepha Schiner (Diptera: Tephritidae), colectadas en trampas tipo McPhail en las localidades de Concepción, Belén, Horqueta (Departamento de Concepción) y Santa Rosa (Departamento de Misiones). En total fueron capturadas 17 especies, de las cuales nueve especies corresponden a nuevos registros para el Paraguay. Todos los caracteres morfológicos para la identificación de las especies fueron ilustrados. PMID:25525098

Incorporating Geographic Information Systems (GIS) into program evaluation: lessons from a rural medicine initiative.

PubMed

Booza, Jason C; Bridge, Patrick D; Neale, Anne Victoria; Schenk, Maryjean

2010-01-01

To address the shortage of physicians practicing in rural areas of Michigan, the Wayne State University School of Medicine developed an integrated rural core curriculum to interest students in rural practice careers. Here we focus on the evaluation strategy used to determine the extent to which students in the new rural medicine interest group who self-identified as selecting a rural clerkship or externship did secure a clinical training experience in a rural setting. Three measures of rurality were compared to determine whether students were placed in rural training settings: (1) the percentage of the county living in rural areas; (2) a county-level dichotomous measure of rural/nonrural; and (3) a dichotomous measure based on urban area boundaries within the county. Practice address and geographic data were integrated into geographic information systems software, which we used to map out rural characteristics of Michigan counties through a process called thematic mapping; this shows characteristic variation by color-shading geographic features. In addition, reference maps were created showing the boundaries of urban areas and metropolitan/micropolitan areas. Once these processes were completed, we overlaid the practice location on the contextual-level geographic features to produce a visual representation of the relationship between student placement and rural areas throughout the state. The outcome of student placement in rural practices varied by the definition of rural. We concluded that, although students were not placed in the most rural areas of Michigan, they received clerkship or externship training near rural areas or in semirural areas. This process evaluation had a direct impact on program management by highlighting gaps in preceptor recruitment. A greater effort is being made to recruit physicians for more rural areas of the state rather than urban and semirural areas. Geographic information systems mapping also defined levels of ruralism for students to help them make informed selections of training sties. This is especially important for students who are not sure about a rural experience and might be discouraged by placement in a remote rural area.

Definition of "rural" determines the placement outcomes of a rural medical education program: analysis of Jichi Medical University graduates.

PubMed

Matsumoto, Masatoshi; Inoue, Kazuo; Kajii, Eiji

2010-01-01

To show the impact of changing the definition of what is "rural" on the outcomes of a rural medical education program. A cross-sectional sample of 643 graduates under obligatory rural service and 1,699 graduates after serving their obligation, all from Jichi Medical University (JMU), a binding rural education program in Japan, were used as the data source. Communities were divided into decile groups according to population density, and the cut-off for "rural/nonrural" was altered in order to study its impact on the data. The rural practice rate of obliged graduates had its peak in the decile groups with the lowest population densities, while the peak rates of postobligation graduates and non-JMU physicians were at the decile groups with the highest population densities. Rural practice rates of all of the 3 groups of physicians increased with the increase in inclusiveness of rural definition. The ratio of rural practice rate of obliged graduates to that of non-JMU physicians ("relative effectiveness") increased remarkably with the increase in exclusiveness of rural definition. The relative effectiveness of postobligation graduates did not substantially increase after the cut-off exceeded a certain point of exclusiveness. Definition of "rural" largely determined the rural practice rate and relative effectiveness of JMU graduates. The results suggest that results of past outcome studies of rural medical education programs are potentially biased depending on how rural is defined.

Preparing Physicians for Rural-Based Primary Care Practice: A Preliminary Evaluation of Rural Training Initiatives at OSU-COM.

PubMed

Wheeler, Denna L; Hackler, Jeffrey B

2017-05-01

The physician shortage in Oklahoma coupled with geographic maldistribution of primary care physicians limits access to care in rural and underserved areas. One of the most effective strategies to recruit and retain physicians in rural areas is to create undergraduate and graduate medical education training sites in these locations. Oklahoma State University Center for Health Sciences College of Osteopathic Medicine has implemented a rural training program that begins with early recruitment of rural high school students, introduces medical students to rural practice options through rural clinical training opportunities, and provides opportunities to remain in rural Oklahoma for residency training through ongoing graduate medical education development. The purpose of this article is to provide a case study of the development of the college's Rural Medical Track. Preliminary findings indicate that rural-based clinical training for third- and fourth-year students strengthens performance on standardized tests.

Rural and Urban Youth Programs.

ERIC Educational Resources Information Center

Backman, Kenneth; And Others

This publication provides a variety of information on prevention and intervention programs for rural and urban children and adolescents. Drawing from a rural sociological perspective, the introductory paper defines "rural," discusses rural-urban economic and social differences, and lists indicators of risk for rural youth. It discusses the extent…

'Living the rural experience-preparation for practice': The future proofing of sustainable rural midwifery practice through midwifery education.

PubMed

Kensington, Mary; Rankin, Jean; Gilkison, Andrea; Daellenbach, Rea; Crowther, Susan; Deery, Ruth; Davies, Lorna

2018-06-05

Rural practice presents unique challenges and skill requirements for midwives. New Zealand and Scotland face similar challenges in sustaining a rural midwifery workforce. This paper draws from an international multi-centre study exploring rural midwifery to focus on the education needs of student midwives within pre-registration midwifery programmes in order to determine appropriate preparation for rural practice. The mixed-methods study was conducted with 222 midwives working in rural areas in New Zealand (n = 145) and Scotland (n = 77). Midwives' views were gathered through an anonymous online survey and online discussion forums. Descriptive analysis was used for quantitative data and thematic analysis was conducted with qualitative data. 'Future proofing rural midwifery practice' using education was identified as the overarching central theme in ensuring the sustainability of rural midwives, with two associated principle themes emerging (i) 'preparation for rural practice' and (ii) 'living the experience and seeing the reality'. The majority of participants agreed that pre-registration midwifery programmes should include a rural placement for students and rural-specific education with educational input from rural midwives. This study provides insight into how best to prepare midwives for rural practice within pre-registration midwifery education, in order to meet the needs of midwives and families in the rural context. Copyright © 2018 Elsevier Ltd. All rights reserved.

Postinfectious bronchiolitis obliterans

PubMed

2018-06-01

La bronquiolitis obliterante es una enfermedad pulmonar crónica infrecuente y grave producto de una lesión del tracto respiratorio inferior. En nuestro país, es más frecuente observarla secundaria a una lesión viral grave, en especial, por adenovirus. La bronquiolitis obliterante se caracteriza por la oclusión parcial o total del lumen de los bronquiolos respiratorios y terminales por tejido inflamatorio y fibrosis, que produce la obstrucción crónica de la vía aérea. Este consenso discute el estado actual del conocimiento en las diferentes áreas de la bronquiolitis obliterante secundaria a una lesión infecciosa.

Una visita en Sud America

NASA Astrophysics Data System (ADS)

1982-09-01

Oisfrute de una estadfa en el Hotel La Silla, el mejor hotel de Sud America con su tan unica atmosfera extraterrestre! Los espera su calificado personal de experimentados hoteleros, jefes de cocina, etc., ansiosos todos de satisfacer sus deseos hasta el mas mfnimo detalle. Naturalmente nuestro espacioso restaurant de tres estrellas ofrece un completo surtido de exquisitas comidas y deliciosos tragos (conocedores usualmente eligen "Oelicia Orion" 0 "Centauro Especial"). EI servicio cempleto durante 24 horas incluye nuestra ya mundialmente famosa "Cena de medianoche para los miradores de estrellas", por eso - no olvide: No pierda la oportunidad de una estadfa en EL HOTEL LA SILLA - una experiencia maravillosa!

Poverty in the Rural United States.

ERIC Educational Resources Information Center

Dudenhefer, Paul

1993-01-01

The 1990 Rural Sociological Society's Task Force on Persistent Rural Poverty describes rural poverty, comparing it to urban poverty; rejects human-capital, economic-organization, and culture-of-poverty theories of rural poverty and proposes research on 10 other theories; and discusses rural policy and its inequitable emphasis on farmers. (KS)

CHANGING SCHOOL NEEDS IN RURAL AREAS.

ERIC Educational Resources Information Center

RHODES, ALVIN E.

AS THE RURAL ECONOMY HAS BECOME MORE AFFECTED BY AUTOMATION, RURAL SOCIETY HAS BECOME MORE INDUSTRIAL. FARM POPULATION AND THE NUMBER OF FARMS HAVE DECREASED, WHILE NON-FARM RURAL POPULATION HAS INCREASED. THE CHANGING RURAL SCENE IS REFLECTED IN CHANGES IN RURAL EDUCATION. EDUCATIONAL OPPORTUNITIES HAVE GREATLY INCREASED DUE TO SCHOOL…

Delinquent Behavior of Dutch Rural Adolescents

ERIC Educational Resources Information Center

Weenink, Don

2011-01-01

This article compares Dutch rural and non-rural adolescents' delinquent behavior and examines two social correlates of rural delinquency: communal social control and traditional rural culture. The analyses are based on cross-sectional data, containing 3,797 participants aged 13-18 (48.7% females). The analyses show that rural adolescents are only…

Increasing Caring and Reducing Violence in Rural Schools.

ERIC Educational Resources Information Center

Schroth, Gwen; Fishbaugh, Mary Susan

This paper briefly reviews the literature on violence in rural schools and communities, as well as the causes of rural crime and violence. General demographic and economic characteristics of rural communities are listed, followed by facts on rural school enrollments, achievement, and funding. Recent changes in rural communities that might…

Training For Rural Practice: The Way Ahead.

ERIC Educational Resources Information Center

Doolan, Thomas; Nichols, Anna

This report describes a program initiated in 1992 to provide appropriate training for rural physicians and to address the shortage of physicians in rural Australia. Rural medical practice differs dramatically from urban practice in that there is limited access to specialist services in rural areas, thus requiring rural practitioners to be…

Rural Area Revitalization Act of 1987; and the Rural Development Reorganization Act of 1987. Hearing on H.R. 1800 and H.R. 2026 before the Subcommittee on Conservation, Credit, and Rural Development of the Committee on Agriculture. House of Representatives, One Hundredth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Agriculture.

Testimony of H.R. 1800, the Rural Area Revitalization Act, and H.R. 2026, the Rural Development Reorganization Act focuses on the need for federal attention to rural problems other than agriculture. The Rural Area Revitalization Act authorizes expansion of capital available for lending in rural areas, a grant program of $25 million per year for…

Strengthening training in rural practice in Germany: new approach for undergraduate medical curriculum towards sustaining rural health care.

PubMed

Holst, Jens; Normann, Oliver; Herrmann, Markus

2015-01-01

After decades of providing a dense network of quality medical care, Germany is facing an increasing shortage of medical doctors in rural areas. Current graduation rates of generalists do not counterbalance the loss due to retirement. Informed by international evidence, different strategies to ensure rural medical care are under debate, including innovative teaching approaches during undergraduate training. The University of Magdeburg in Saxony-Anhalt was the first medical school in Germany to offer a rural elective for graduate students. During the 2014 summer semester, 14 medical students attended a two-weekend program in a small village in Northern Saxony-Anhalt that allowed them to become more familiar with a rural community and rural health issues. The elective course raised a series of relevant topics for setting up rural practice and provided students with helpful insight into living and working conditions in rural practice. Preliminary evaluations indicate that the rural medicine course allowed medical students to reduce pre-existing concerns and had positive impact on their willingness to set up a rural medical office after graduation. Even short-term courses in rural practice can help reduce training-related barriers that prevent young physicians from working in rural areas. Undergraduate medical training is promising to attenuate the emerging undersupply in rural areas.

Characteristics of Queensland physicians and the influence of rural exposure on practice location.

PubMed

Runge, C E; MacKenzie, A; Loos, C; Waller, M; Gabbett, M; Mills, R; Eley, D

2016-08-01

The Queensland branch of the Royal Australasian College of Physicians (RACP) commissioned this study to update their workforce profile and examine rural practice. The present investigation aimed to describe characteristics of Queensland physicians and determine the influence of childhood and training locations on current rural practice. A cross-sectional online survey, conducted 4 July-4 November 2013, was administered to Fellows of The RACP, Queensland. Descriptive statistics report characteristics and logistic regression analyses identify associations and interactions. The outcome measure was current practice location using the Australian Standard Geographic Classification - Remoteness Area. Data were obtained for 633 physicians. Their average age was 49.5 years, a third was female and a quarter was in rural practice. Rural practice was associated with a rural childhood (odds ratio (OR) (95% confidence interval, CI) 1.89 (1.10, 3.27) P = 0.02) and any time spent as an intern (OR 4.07 (2.12, 7.82) P < 0.001) or registrar (OR 4.00 (2.21, 7.26) P < 0.001) in a rural location. Physicians with a rural childhood and rural training were most likely to be in rural practice. However, those who had a metropolitan childhood and a rural internship were approximately five times more likely to be working in rural practice than physicians with no rural exposure (OR 5.33 (1.61, 17.60) P < 0.01). The findings demonstrate the positive effect of rural vocational training on rural practice. A prospective study would determine if recent changes to the Basic Physician Training Pathway and the Basic Paediatric Training Network (more rural training than previous pathways) increases the rate of rural practice. © 2016 Royal Australasian College of Physicians.

A Comparison of Mental Health, Substance Use, and Sexual Risk Behaviors Between Rural and Non-Rural Transgender Persons

PubMed Central

HORVATH, KEITH J.; IANTAFFI, ALEX; SWINBURNE-ROMINE, REBECCA; BOCKTING, WALTER

2014-01-01

The aim of this study was to compare the mental health, substance use, and sexual risk behaviors of rural and non-rural transgender persons. Online banner advertisements were used to recruit 1,229 self-identified rural and non-rural transgender adults (18+ years) residing in the United States. Primary findings include significant differences in mental health between rural and non-rural transmen; relatively low levels of binge drinking across groups, although high levels of marijuana use; and high levels of unprotected sex among transwomen. The results confirm that mental and physical health services for transgender persons residing in rural areas are urgently needed. PMID:24380580

A comparison of mental health, substance use, and sexual risk behaviors between rural and non-rural transgender persons.

PubMed

Horvath, Keith J; Iantaffi, Alex; Swinburne-Romine, Rebecca; Bockting, Walter

2014-01-01

The aim of this study was to compare the mental health, substance use, and sexual risk behaviors of rural and non-rural transgender persons. Online banner advertisements were used to recruit 1,229 self-identified rural and non-rural transgender adults (18+ years) residing in the United States. Primary findings include significant differences in mental health between rural and non-rural transmen; relatively low levels of binge drinking across groups, although high levels of marijuana use; and high levels of unprotected sex among transwomen. The results confirm that mental and physical health services for transgender persons residing in rural areas are urgently needed.

Rural exposure during medical education and student preference for future practice location - a case of Botswana.

PubMed

Arscott-Mills, Tonya; Kebaabetswe, Poloko; Tawana, Gothusang; Mbuka, Deogratias O; Makgabana-Dintwa, Orabile; Sebina, Kagiso; Kebaetse, Masego; Mokgatlhe, Lucky; Nkomazana, Oathokwa

2016-06-10

Botswana's medical school graduated its first class in 2014. Given the importance of attracting doctors to rural areas the school incorporated rural exposure throughout its curriculum. This study explored the impact of rural training on students' attitudes towards rural practice. The University of Botswana family medicine rural training sites, Maun and Mahalapye. The study used a mixed-methods design. After rural family medicine rotations, third- and fifth-year students were invited to complete a questionnaire and semi-structured interview. Data were analysed using descriptive statistics and thematic analysis. The thirty-six participants' age averaged 23 years and 48.6% were male. Thirtythree desired urban practice in a public institution or university. Rural training did not influence preferred future practice location. Most desired specialty training outside Botswana but planned to practice in Botswana. Professional stagnation, isolation, poorly functioning health facilities, dysfunctional referral systems, and perceived lack of learning opportunities were barriers to rural practice. Lack of recreation and poor infrastructure were personal barriers. Many appreciated the diversity of practice and supportive staff seen in rural practice. Several considered monetary compensation as an enticement for rural practice. Only those with a rural background perceived proximity to family as an incentive to rural practice. The majority of those interviewed plan to practice in urban Botswana, however, they did identify factors that, if addressed, may increase rural practice in the future. Establishing systems to facilitate professional development, strengthening specialists support, and deploying doctors near their home towns are strategies that may improve retention of doctors in rural areas.Keyords: rural health, student perceptions.

Rural Education: A Proud Heritage & a Bright Future. Proceedings of the Annual Rural and Small Schools Conference (8th, Manhattan, Kansas, October 27-28, 1986).

ERIC Educational Resources Information Center

Horn, Jerry, Ed.; Parmley, Fran, Ed.

This collection of 5 major papers and 32 abstracts covers a range of issues surrounding rural education. In the first paper, Glen Shaw, a rural Minnesota schools administrator, contends economic and technological changes have threatened rural jobs and the rural way of life. Anecdotes and statistics are employed to define rural problems and to urge…

Rural Stress: Myths and Realities.

ERIC Educational Resources Information Center

Hansen, Thomas D.; McIntire, Walter G.

A comparison between the common myths of "rural existence" and the documented realities of rural living explodes the myth that rural living is generally stress free, shows that life stress in rural settings can have deleterious effects on the function of individual and family, and provides a basis for exploring some implications of rural stress…

An Inquiry into Rural Dwellers' Opinions about Living Conditions in Urban and Rural Places.

ERIC Educational Resources Information Center

Azarkh, Emilia Davidovna; Korel, Liudmila Vasilyevna

Utilizing data derived from a questionnaire survey of the rural population of Novosibirsk province in the USSR, the following hypothesis was tested: the attitude of rural inhabitants toward urban and rural conditions is characterized by a considerable preponderance of positive evaluations of dominant rural conditions and transient urban conditions…

The New Vocationalism in Rural Locales.

ERIC Educational Resources Information Center

Theobald, Paul

This paper critiques current "school-to-work" practices in rural schools. A look at the rural context reveals that rural workers are more likely to be unemployed and are paid less than workers elsewhere, resulting in high rural poverty. In addition, many kinds of rural decline (in services, transportation, job availability) are tied to…

What is Happening in Rural Education Today: A Status Report.

ERIC Educational Resources Information Center

Tamblyn, Lewis R.

Arrayed by size of place, the U.S. rural population consitutes 31.4 percent of total U.S. population. Unfortunately, "rural" and "rural education" are often discussed as if they were separate entities. Actually they are inextricably interwoven, for those very factors which describe rurality very much determine rural education. Documenting the…

Profiles in Rural Economic Development: A Guidebook of Selected Successful Rural Area Initiatives.

ERIC Educational Resources Information Center

Thomas, Margaret G.

This guidebook presents 64 profiles of successful economic development initiatives in the small towns and rural areas of 37 states. Intended for use by rural and small town leaders and rural economic development specialists, the guide provides ideas, encouragement, and an "insider perspective" on alternative rural development strategies.…

THE EFFECT OF RURALITY ON THE EDUCATION OF RURAL YOUTH.

ERIC Educational Resources Information Center

CHARLES, EDGAR B.

THE PHENONMENON OF RURALITY OCCURS ALONG A RURAL-URBAN CONTINUUM, WITH THE DEGREE OF RURALITY DEPENDING UPON ENVIRONMENTAL, OCCUPATIONAL, AND SOCIO-CULTURAL CONSIDERATIONS. A HIGH DEGREE OF RURALITY IS LIKELY TO EXIST IN AREAS WHERE POPULATION CENTERS DO NOT EXCEED 2,500 PERSONS, OCCUPATIONS ARE PRIMARILY BASED ON NATURAL RESOURCE AND/OR LAND…

Rural America at a Glance. Rural Development Research Report.

ERIC Educational Resources Information Center

Economic Research Service (USDA), Washington, DC.

This report highlights the most recent indicators of social and economic conditions in rural areas for use in developing rural policies and programs. The economic expansion of the 1990s greatly benefited rural economies. Rural areas attracted both urban residents and immigrants. Hispanics accounted for over 25 percent of nonmetropolitan population…

Regenerating Rural Social Space? Teacher Education for Rural-Regional Sustainability

ERIC Educational Resources Information Center

Reid, Jo-Anne; Green, Bill; Cooper, Maxine; Hastings, Wendy; Lock, Graeme; White, Simone

2010-01-01

The complex interconnection among issues affecting rural-regional sustainability requires an equally complex program of research to ensure the attraction and retention of high-quality teachers for rural children. The educational effects of the construction of the rural within a deficit discourse are highlighted. A concept of rural social space is…

The Perceived Importance of University Presence in Rural Australia

ERIC Educational Resources Information Center

Drummond, Aaron; Halsey, R. John; van Breda, Marja

2011-01-01

The present study investigated rural residents' perceived importance of university presence in rural, regional and remote Australia. The present data indicate that the presence of university in rural areas is perceived as highly important by both rural and urban citizens. Results indicate that rural residents perceive that there is a need for…

Investing in People: The Human Capital Needs of Rural America. Rural Studies Series.

ERIC Educational Resources Information Center

Beaulieu, Lionel J., Ed.; Mulkey, David, Ed.

This book provides an overview of existing human resource conditions in rural America; examines key economic, social, and technological forces shaping the future viability of rural areas; describes human capital issues for rural women and minority groups; and outlines strategies to strengthen rural human capital resources. Chapters are: (1)…

Homeless Children: Addressing the Challenge in Rural Schools. ERIC Digest.

ERIC Educational Resources Information Center

Vissing, Yvonne M.

Despite stereotypes to the contrary, homelessness is as prevalent in rural as urban areas. This digest examines the implications of homelessness for rural children and youth and discusses possible actions by rural educators. An estimated half of the rural homeless are families with children. Compared to urban counterparts, rural homeless families…

Reconnecting Rural America. Report on Rural Intercity Passenger Transportation.

ERIC Educational Resources Information Center

Stommes, Eileen S.

This report summarizes the results of three regional symposia held during 1987-88 to gather grassroots information about rural passenger transportation needs across the country. The first section describes the structural transformation of rural America in the 1980s: (1) the rural economy; (2) rural population trends; (3) impact of information…

Teaching in Rural Schools.

ERIC Educational Resources Information Center

Woofter, Thomas Jackson

Published in 1917, this book overviews rural schooling during the early 1900s and was written to address the problems of rural teaching and to serve as an introductory guide for rural teachers. Specifically, the book aimed to bring attention to the needs of rural life and the possible contributions of the rural school, to describe effective…

Education for Rural Development: Embedding Rural Dimensions in Initial Teacher Preparation

ERIC Educational Resources Information Center

Masinire, Alfred; Maringe, Felix; Nkambule, Thabisile

2014-01-01

In South Africa, rural education and development are issues of social justice, especially in places that were previously established as homelands. This article presents some of the tensions that are inherent in the conceptions of rurality, rural education and the possibility of sustainable rural education and development. We propose the notion of…

Connecting College Learners with Rural Entrepreneurship Opportunities: The Rural Entrepreneurship Teaching Unit

ERIC Educational Resources Information Center

Frazier, Barbara J.; Niehm, Linda S.; Stoel, Leslie

2012-01-01

The Rural Entrepreneurship Teaching Unit (RETU) is designed to acquaint university retailing and hospitality majors with rural entrepreneurship opportunities. The unit is an outcome of a federal grant focused on the contribution of the local retail sector to rural community resilience. The RETU integrates knowledge regarding rural development,…

Some Enlightenments of "Beautiful Rural Construction" on Rural Energy Policy in Beijing—Applying Informatization Means

NASA Astrophysics Data System (ADS)

Zhi, Wang; Kongan, Wu

2018-06-01

"Beautiful rural construction" is a systematic project, rural energy is one of the important contents of its construction. In accordance with the concept of eco-friendly construction, Beijing carried out a thorough "structural adjustment of rural energy optimization," "Earthquake energy-saving projects of rural housing" and other measures. By conventional heating technology research in Beijing 13 counties and 142 villages, we predict the future of rural energy will further the implementation of solar heating, electric heating and other new green energy technologies. It is suggested to establish the "Beijing Rural Information Service Platform" and "Beautiful Rural Information Resource Bank" through the means of informatization, which will greatly strengthen the regulation and control of rural people-land relationship and realize the systematic optimization, making the cities and villages have. Space for human survival and sustainable development.

From expert generalists to ambiguity masters: using ambiguity tolerance theory to redefine the practice of rural nurses.

PubMed

Knight, Kaye; Kenny, Amanda; Endacott, Ruth

2016-06-01

To redefine the practice of rural nurses and describe a model that conceptualises the capabilities and characteristics required in the rural environment. The way in which the practice of rural nurses has been conceptualised is problematic. Definitions of rural nursing have been identified primarily through the functional context of rural health service delivery. The expert generalist term has provided a foundation theory for rural nurses with understandings informed by the scope of practice needed to meet service delivery requirements. However, authors exploring intrinsic characteristics of rural nurses have challenged this definition, as it does not adequately address the deeper, intangible complexities of practice required in the rural context. Despite this discourse, an alternative way to articulate the distinctive nature of rural nursing practice has eluded authors in Australia and internationally. A theoretical paper based on primary research. The development of the model was informed by the findings of a study that explored the nursing practice of managing telephone presentations in rural health services in Victoria, Australia. The study involved policy review from State and Federal governments, nursing and medical professional bodies, and five rural health services; semi-structured interviews with eight Directors of Nursing, seven registered nurses and focus group interviews with eight registered nurses. An ambiguity tolerance model drawn from corporate global entrepreneurship theory was adapted to explain the findings of the study. The adapted model presents capabilities and characteristics used by nurses to successfully manage the ambiguity of providing care in the rural context. Redefining the practice of rural nurses, through an adapted theory of ambiguity tolerance, highlights nursing characteristics and capabilities required in the rural context. This perspective offers new ways of thinking about the work of rural nurses, rural nurse policy, education, recruitment, retention and clinical governance. A greater understanding of rural nurse practice will assist in achieving positive care outcomes in an environment with competing stakeholder needs, and limited resources and options for care. © 2016 John Wiley & Sons Ltd.

Why doctors choose small towns: a developmental model of rural physician recruitment and retention.

PubMed

Hancock, Christine; Steinbach, Alan; Nesbitt, Thomas S; Adler, Shelley R; Auerswald, Colette L

2009-11-01

Shortages of health care professionals have plagued rural areas of the USA for more than a century. Programs to alleviate them have met with limited success. These programs generally focus on factors that affect recruitment and retention, with the supposition that poor recruitment drives most shortages. The strongest known influence on rural physician recruitment is a "rural upbringing," but little is known about how this childhood experience promotes a return to rural areas, or how non-rural physicians choose rural practice without such an upbringing. Less is known about how rural upbringing affects retention. Through twenty-two in-depth, semi-structured interviews with both rural- and urban-raised physicians in northeastern California and northwestern Nevada, this study investigates practice location choice over the life course, describing a progression of events and experiences important to rural practice choice and retention in both groups. Study results suggest that rural exposure via education, recreation, or upbringing facilitates future rural practice through four major pathways. Desires for familiarity, sense of place, community involvement, and self-actualization were the major motivations for initial and continuing small-town residence choice. A history of strong community or geographic ties, either urban or rural, also encouraged initial rural practice. Finally, prior resilience under adverse circumstances was predictive of continued retention in the face of adversity. Physicians' decisions to stay or leave exhibited a cost-benefit pattern once their basic needs were met. These results support a focus on recruitment of both rural-raised and community-oriented applicants to medical school, residency, and rural practice. Local mentorship and "place-specific education" can support the integration of new rural physicians by promoting self-actualization, community integration, sense of place, and resilience. Health policy efforts to improve the physician workforce must address these complexities in order to support the variety of physicians who choose and remain in rural practice.

A qualitative study of medical students in a rural track: views on eventual rural practice.

PubMed

Roseamelia, Carrie; Greenwald, James L; Bush, Tiffany; Pratte, Morgan; Wilcox, Jessica; Morley, Christopher P

2014-04-01

Rural tracks (RTs) exist within medical schools across the United States. These programs often target those students from rural areas and those with primary care career interests, given that these factors are robust predictors of eventual rural practice. However, only 26% to 64% of graduates from RTs enter eventual rural practice. We conducted a qualitative, exploratory study of medical students enrolled in one school's RT, examining their interests in rural training, specialization, and eventual rural practice, via open coding of transcripts from focus groups and in-depth individual interviews, leading to identification of emerging themes. A total of 16 out of 54 eligible first- and second-year preclinical medical students participated in focus group sessions, and a total of seven out of 17 eligible third- and fourth-year medical students participated in individual interviews. Analyses revealed the recognition of a "Rural Identity," typical characteristics, and the importance of "Program Fit" and "Intentions for Practice" that trended toward family medicine specialization and rural practice. However, nuances within the comments reveal incomplete commitment to rural practice. In many cases, student preference for rural practice was driven largely by a disinterest in urban practice. Students with rural and primary care practice interests are often not perfectly committed to rural practice. However, RTs may provide a haven for such students within medical school.

Rural Young People and Society: A Crisis of Attitudes

ERIC Educational Resources Information Center

Gur'ianova, M. P.

2013-01-01

Research on rural youth in Russia shows that keeping qualified and ambitious young people in the rural economy will require creating conditions for young people to exercise initiative in the rural economy and diminishing the gap in quality of life between rural and urban environments. Only in this way can the pessimism of rural youth be overcome.

Reaching Our Potential: Rural Education in the 90s. Conference Proceedings. Rural Education Symposium (Nashville, Tennessee, March 17-20, 1991).

ERIC Educational Resources Information Center

Lee, Mun Ho, Ed.

This proceedings contains approximately 92 presentations focusing on rural education and rural special education. Topics include: meeting the needs of handicapped and disabled students in rural areas; education and inservice training of special education teachers; teacher cooperation models; higher education of at-risk students; rural teacher…

Reaching Rural Handicapped Children: The Transportation Situation in Rural Service Delivery. Making It Work in Rural Communities. A Rural Network Monograph.

ERIC Educational Resources Information Center

Tucker, Jamie; And Others

Almost everyone who responded to three transportation surveys of rural Handicapped Children's Early Education Program (HCEEP) projects identified transportation as a critical problem in the delivery of services to handicapped children in rural areas. Transportation problems encountered were attributed to environmental/geographic factors,…

Rural Roots: News, Information, and Commentary from the Rural School and Community Trust, 2000-2001.

ERIC Educational Resources Information Center

Westra, Kathryn E., Ed.; Yaunches, H. Alison, Ed.

2001-01-01

This document contains the first eight issues of "Rural Roots"--two published in 2000 and six published bimonthly in 2001. A newsletter of the Rural School and Community Trust, "Rural Roots" provides news, information, and commentary from the Rural Trust and highlights the wide variety of place-based education work happening in…

Education in Rural America: Object or Instrumentality of Rural Development.

ERIC Educational Resources Information Center

Hobbs, Daryl

Rural schools have had a traditional role as major vehicles of rural economic development. During the rapid economic changes of the 20th century rural schools supplied the literate migrants who flocked to the cities to become the human capital for urban based expansion. Rural schools also provided the literate farmers who stayed at home and…

Arguing for Rural Health in Medicare: A Progressive Rhetoric for Rural America

ERIC Educational Resources Information Center

Ricketts, Thomas C.

2004-01-01

Rural health policy is the laws, regulations, rules, and interpretations that benefit or affect health and health care for rural populations. This paper examines how rural health policy is viewed in the broader field of public policy, discusses the role of advocacy in developing rural health policy, and suggests ways to make that advocacy more…

A Brighter Future for Rural America? Strategies for Communities and States.

ERIC Educational Resources Information Center

John, DeWitt; And Others

This book outlines the competitive challenge facing rural America and discusses signs of hope for the rural economy. It reports some "secrets of success" in 16 rural farm belt counties that have gained employment while most rural areas are losing jobs. It also describes new state initiatives to help rural communities and lists operating…

Beyond the Conventional Wisdom: Rural Development As If Australia's Rural People Really Mattered. Background Paper.

ERIC Educational Resources Information Center

Sher, Jonathan; Sher, Katrina Rowe

This paper proposes a framework for developing a national rural development policy in Australia. Some common relevant misconceptions are that rural Australia and rural Australians are peripheral to the national economy and the nation's future, that farmers and farming communities are the alpha and omega of rural Australia, and that whatever is…

How Rural America Sees Its Future. The Main Street Economist: Commentary on the Rural Economy.

ERIC Educational Resources Information Center

Barkema, Alan D.; Drabenstott, Mark

To gain a perspective on rural America's future, seven roundtables consisting of seven rural stakeholder groups were convened. Four groups of challenges facing rural areas emerged. The rural business environment was considered the source of greatest challenge. Agriculture concerns included low profits and access to world markets. The effects of…

Rural Teacher Identity and Influencing Factors in Western China

ERIC Educational Resources Information Center

Mingren, Zhao; Shiquan, Fu

2018-01-01

The quality of rural teachers is a key factor affecting the quality of rural education. A better understanding of rural teachers is the basis for strengthening their development. It is possible to obtain a more holistic understanding of rural teachers' work and life through their identity. Based on a wealth of case-based information, rural teacher…

Exploring the Influence of Social Determinants, Social Capital, and Health Expertise on Health and the Rural Church.

PubMed

Plunkett, Robyn; Leipert, Beverly; Olson, Joanne

2016-09-01

In rural communities, religious places can significantly shape health for individuals, families, and communities. Rural churches are prominent community centers in rural communities and are deeply woven into rural culture. Thus, health influences arising from the rural church likely have health implications for the greater community. This article explores health influences emerging from rural churches using social determinants of health, social capital, and health expertise. Although nurses are important health resources for all populations, their value in rural areas may be exceedingly significant. The contribution of nurses to church-based health capital in rural communities may be quite significant and underestimated, although it remains poorly understood. © The Author(s) 2015.

An Interprofessional Rural Health Education Program

PubMed Central

MacDowell, Martin; Schriever, Allison E.; Glasser, Michael; Schoen, Marieke D.

2012-01-01

Objectives. To develop, implement, and assess an interprofessional rural health professions program for pharmacy and medical students. Design. A recruitment and admissions process was developed that targeted students likely to practice in rural areas. Pharmacy students participated alongside medical students in completing the Rural Health Professions program curriculum, which included monthly lecture sessions and assignments, and a capstone clinical requirement in the final year. Assessment. Fourteen pharmacy students and 33 medical students were accepted into the program during the first 2 years of the Rural Health Professions program. Approximately 90% of the rural health professions students were originally from rural areas. Conclusions. The rural health professions program is an interprofessional approach to preparing healthcare providers to practice in rural communities. PMID:23275664

Supporting new graduate nurses making the transition to rural nursing practice: views from experienced rural nurses.

PubMed

Lea, Jackie; Cruickshank, Mary

2015-10-01

To present the findings from the experienced rural nurse participants of a larger study that explored the transitional experiences of newly graduated nurses making the role transition in rural health care facilities in Australia. There are specific and unique aspects of rural nursing practice that influence the nature and timing of support for new graduate nurses that have not been explored or acknowledged as influencing the new graduate nurses' experience of transition. Specifically, the difficulties and challenges that experienced rural nurses face in providing effective and timely support for new graduate nurses who are making the transition to rural nursing practice is yet to be explored. Using a qualitative case study framework, this study specifically aimed to investigate and describe the nature and timing of support required during the transition to nursing practice that is specific for the rural context and capacity. Individual in-depth interviews were conducted with 16 experienced rural nurses who, at the time of the study, worked with new graduate nurses in the rural practice environment. The findings from this study showed that the provision of timely on-ward support for new graduates making the transition to rural nursing practice is affected and influenced by the skill mix and staffing allocation within the rural environment. As well, there is a lack of awareness by rural nurses of how to meet the on-ward support needs of new graduate nurses. This study has identified the specific and unique aspects of the rural nurse's role and responsibilities for which the new graduate nurse requires incremental learning and intensive clinical support. The findings can be used by rural health services and experienced rural registered nurses to assist in implementing adequate and timely support for new graduate nurses. © 2015 John Wiley & Sons Ltd.

Exposing some important barriers to health care access in the rural USA.

PubMed

Douthit, N; Kiv, S; Dwolatzky, T; Biswas, S

2015-06-01

To review research published before and after the passage of the Patient Protection and Affordable Care Act (2010) examining barriers in seeking or accessing health care in rural populations in the USA. This literature review was based on a comprehensive search for all literature researching rural health care provision and access in the USA. Pubmed, Proquest Allied Nursing and Health Literature, National Rural Health Association (NRHA) Resource Center and Google Scholar databases were searched using the Medical Subject Headings (MeSH) 'Rural Health Services' and 'Rural Health.' MeSH subtitle headings used were 'USA,' 'utilization,' 'trends' and 'supply and distribution.' Keywords added to the search parameters were 'access,' 'rural' and 'health care.' Searches in Google Scholar employed the phrases 'health care disparities in the USA,' inequalities in 'health care in the USA,' 'health care in rural USA' and 'access to health care in rural USA.' After eliminating non-relevant articles, 34 articles were included. Significant differences in health care access between rural and urban areas exist. Reluctance to seek health care in rural areas was based on cultural and financial constraints, often compounded by a scarcity of services, a lack of trained physicians, insufficient public transport, and poor availability of broadband internet services. Rural residents were found to have poorer health, with rural areas having difficulty in attracting and retaining physicians, and maintaining health services on a par with their urban counterparts. Rural and urban health care disparities require an ongoing program of reform with the aim to improve the provision of services, promote recruitment, training and career development of rural health care professionals, increase comprehensive health insurance coverage and engage rural residents and healthcare providers in health promotion. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Hand therapy services for rural and remote residents: Results of a survey of Australian occupational therapists and physiotherapists.

PubMed

Kingston, Gail A; Williams, Gary; Judd, Jenni; Gray, Marion A

2015-04-01

The aim of this study was to explore how interventions were provided to meet the needs of rural/remote residents who have had a traumatic hand injury, including the coordination of services between rural/remote and metro/regional therapists. Barriers to providing services, use of technology and professional support provided to therapists in rural/remote areas were also explored. Cross-sectional survey. Metropolitan/regional and rural/remote public health facilities in Australia. Occupational therapists and physiotherapists who provide hand therapy to rural/remote patients. Quantitative and qualitative questionnaire responses analysed with descriptive statistics and inductive analysis. There were 64 respondents out of a possible 185. Over half of rural/remote respondents provided initial splinting and exercise prescriptions, and over 85% reported that they continued with exercise protocols. Videoconferencing technology for patient intervention and clinical review was used by 39.1% respondents. Barriers to providing services in rural/remote locations included transport, travelling time, limited staff, and lack of expert knowledge in hand injuries or rural/remote health care. Four major themes emerged from the open-ended questions: working relationships, patient-centred care, staff development and education, and rural and remote practice. The use of technology across Australia to support rural/remote patient intervention requires attention to achieve equity and ease of use. Flexible and realistic goals and interventions should be considered when working with rural/remote patients. A shared care approach between metropolitan/regional and rural/remote therapists can improve understanding of rural/remote issues and provide support to therapists. Further research is recommended to determine the suitability of this approach when providing hand therapy to rural/remote residents. © 2015 National Rural Health Alliance Inc.

The Urban-Rural Disparity in Nursing Home Quality Indicators: The Case of Facility-Acquired Contractures

PubMed Central

Bowblis, John R; Meng, Hongdao; Hyer, Kathryn

2013-01-01

Objective To identify and quantify the sources of the urban-rural disparity in facility-acquired contracture rates in nursing homes. Data Sources Survey inspection data of U.S. nursing homes from 1999 to 2008 and standardized national rural definition file from the Rural-Urban Commuting Area Codes. Study Design We estimated regressions of facility-level contracture rate as a function of urban-rural categories (urban, micropolitan, small rural town, and isolated small rural town) and other related facility characteristics to identify size of the urban-rural disparity. We used Blinder–Oaxaca decomposition techniques to determine the extent to which the disparity is attributable to the differences in facility and aggregate resident characteristics. Principal Findings Rural nursing homes have higher contracture rates than urban nursing homes. About half of the urban-rural disparity is explained by differences in observable characteristics among urban and rural nursing homes. Differences in staffing levels explain less than 5 percent of the disparity, case-mix explains 6–8 percent, and structure and operational characteristics account for 10–22 percent of the disparity. Conclusion While a lower level and quality of staffing are a concern for rural nursing homes, facility structure and funding sources explain a larger proportion of the urban-rural disparity in the quality of care. PMID:22670847

The urban-rural disparity in nursing home quality indicators: the case of facility-acquired contractures.

PubMed

Bowblis, John R; Meng, Hongdao; Hyer, Kathryn

2013-02-01

To identify and quantify the sources of the urban-rural disparity in facility-acquired contracture rates in nursing homes. Survey inspection data of U.S. nursing homes from 1999 to 2008 and standardized national rural definition file from the Rural-Urban Commuting Area Codes. We estimated regressions of facility-level contracture rate as a function of urban-rural categories (urban, micropolitan, small rural town, and isolated small rural town) and other related facility characteristics to identify size of the urban-rural disparity. We used Blinder-Oaxaca decomposition techniques to determine the extent to which the disparity is attributable to the differences in facility and aggregate resident characteristics. Rural nursing homes have higher contracture rates than urban nursing homes. About half of the urban-rural disparity is explained by differences in observable characteristics among urban and rural nursing homes. Differences in staffing levels explain less than 5 percent of the disparity, case-mix explains 6-8 percent, and structure and operational characteristics account for 10-22 percent of the disparity. While a lower level and quality of staffing are a concern for rural nursing homes, facility structure and funding sources explain a larger proportion of the urban-rural disparity in the quality of care. © Health Research and Educational Trust.

Selecting, Adapting, and Implementing Evidence-based Interventions in Rural Settings: An Analysis of 70 Community Examples.

PubMed

Smith, Tina Anderson; Adimu, Tanisa Foxworth; Martinez, Amanda Phillips; Minyard, Karen

2016-01-01

This paper explores how communities translate evidence-based and promising health practices to rural contexts. A descriptive, qualitative analysis was conducted using data from 70 grantees funded by the Federal Office of Rural Health Policy to implement evidence-based health practices in rural settings. Findings were organized using The Interactive Systems Framework for Dissemination and Implementation. Grantees broadly interpreted evidence-based and promising practices, resulting in the implementation of a patchwork of health-related interventions that fell along a spectrum of evidentiary rigor. The cohort faced common challenges translating recognized practices into rural community settings and reported making deliberate modifications to original models as a result. Opportunities for building a more robust rural health evidence base include investments to incentivize evidence-based programming in rural settings; rural-specific research and theory-building; translation of existing evidence using a rural lens; technical assistance to support rural innovation; and prioritization of evaluation locally.

Health and sustainability of rural communities.

PubMed

Ryan-Nicholls, K D

2004-01-01

The challenges associated with rural and remote health have been widely acknowledged by rural communities and the health care community for some time now. However, it is only recently that any concerted effort has begun to address these difficulties. The aim of this paper was to examine the issue of rural health and sustainability internationally with a particular emphasis on the Canadian context. This paper used a framework to: articulate the nature of rural health and sustainability; examine the historical, socio-cultural, ethical, legal, economic and political aspects of rural health and sustainability; delineate the importance and significance of rural health and sustainability to Canadian citizens, and analyze progress made in relation to rural health and sustainability. This paper concludes by cautioning that rural health and sustainability can only be enhanced by innovative strategies that employ both capacity building partnerships with rural people that are supported overall, by adequate funding allocation.

Rural/Nonrural Differences in College Attendance Patterns.

PubMed

Byun, Soo-Yong; Irvin, Matthew J; Meece, Judith L

Using data from the National Education Longitudinal Study of 1988, this study documented college attendance patterns of rural youth in terms of the selectivity of first postsecondary institution of attendance, the timing of transition to postsecondary education, and the continuity of enrollment. The study also examined how these college attendance patterns among rural students differed from those among their non-rural counterparts and which factors explained these rural/nonrural differences. Results showed that rural youth were less likely than their nonrural counterparts to attend a selective institution. In addition, rural youth were more likely to delay entry to postsecondary education, compared to their urban counterparts. Finally, rural students were less likely than their urban counterparts to be continuously enrolled in college. Much of these rural/nonrural disparities in college attendance patterns were explained by rural/nonrural differences in socioeconomic status and high school preparation. Policy implications, limitations of the study, and future research directions are also discussed.

Does Missed Care in Isolated Rural Hospitals Matter?

PubMed

Smith, Jessica G

2018-06-01

Missed care is associated with adverse outcomes such as patient falls and decreased nurse job satisfaction. Although studied in populations of interest such as neonates, children, and heart failure patients, there are no studies about missed care in rural hospitals. Reducing care omissions in rural hospitals might help improve rural patient outcomes and ensure that rural hospitals can remain open in an era of hospital reimbursement dependent on care outcomes, such as through value-based purchasing. Understanding the extent of missed nursing care and its implications for rural populations might provide crucial information to alert rural hospital administrators and nurses about the incidence and influence of missed care on health outcomes. Focusing on missed care within rural hospitals and other rural health care settings is important to address the specific health needs of aging rural U.S. residents who are isolated from high-volume, urban health care facilities.

Rural/Nonrural Differences in College Attendance Patterns

PubMed Central

Byun, Soo-yong; Irvin, Matthew J.; Meece, Judith L.

2014-01-01

Using data from the National Education Longitudinal Study of 1988, this study documented college attendance patterns of rural youth in terms of the selectivity of first postsecondary institution of attendance, the timing of transition to postsecondary education, and the continuity of enrollment. The study also examined how these college attendance patterns among rural students differed from those among their non-rural counterparts and which factors explained these rural/nonrural differences. Results showed that rural youth were less likely than their nonrural counterparts to attend a selective institution. In addition, rural youth were more likely to delay entry to postsecondary education, compared to their urban counterparts. Finally, rural students were less likely than their urban counterparts to be continuously enrolled in college. Much of these rural/nonrural disparities in college attendance patterns were explained by rural/nonrural differences in socioeconomic status and high school preparation. Policy implications, limitations of the study, and future research directions are also discussed. PMID:25983357

Una búsqueda de la identidad regional em Astrometria

NASA Astrophysics Data System (ADS)

Abad, C.

2003-11-01

La idea sobre una reunión latino-americana que congregara a las personas que desarrollan su trabajo en el área de la astrometría, se gestó a partir de una de las reuniones que el proyecto QUEST realizaba anualmente en Mérida (Venezuela). El proyecto QUEST (Quasars Equatorial Survey Team) celebraba su IV Reunión Anual, en la cual se hacía una revisón de la marcha del proyecto durante el último año. Además, se exponían los logros científicos y técnicos alcanzados hasta el momento y se planificaba el futuro del mismo para el período anual siguiente.

Rural-urban differences of neonatal mortality in a poorly developed province of China.

PubMed

Yi, Bin; Wu, Li; Liu, Hong; Fang, Weimin; Hu, Yang; Wang, Youjie

2011-06-18

The influence of rural-urban disparities in children's health on neonatal death in disadvantaged areas of China is poorly understood. In this study of rural and urban populations in Gansu province, a disadvantaged province of China, we describe the characteristics and mortality of newborn infants and evaluated rural-urban differences of neonatal death. We analyzed all neonatal deaths in the data from the Surveillance System of Child Death in Gansu Province, China from 2004 to 2009. We calculated all-cause neonatal mortality rates (NMR) and cause-specific death rates for infants born to rural or urban mothers during 2004-09. Rural-urban classifications were determined based on the residence registry system of China. Chi-square tests were used to compare differences of infant characteristics and cause-specific deaths by rural-urban maternal residence. Overall, NMR fell in both rural and urban populations during 2004-09. Average NMR for rural and urban populations was 17.8 and 7.5 per 1000 live births, respectively. For both rural and urban newborn infants, the four leading causes of death were birth asphyxia, preterm or low birth weight, congenital malformation, and pneumonia. Each cause-specific death rate was higher in rural infants than in urban infants. More rural than urban neonates died out of hospital or did not receive medical care before death. Neonatal mortality declined dramatically both in urban and rural groups in Gansu province during 2004-09. However, profound disparities persisted between rural and urban populations. Strategies that address inequalities of accessibility and quality of health care are necessary to improve neonatal health in rural settings in China.

Ageing of the baby boomer generation: how demographic change will impact on city and rural GP and nursing workforce.

PubMed

Schofield, D J; Page, S L; Lyle, D M; Walker, T J

2006-01-01

To compare the impact of ageing on the GP and nursing rural and city workforce. Cohort analysis of Australian Bureau of Statistics census data. The data was used to examine the age distribution of the city and rural GP and nursing workforce; patterns of attrition for those 50 years and over; and the impact of changes in working hours. The rural GP and nursing workforce is significantly older than their city counterparts (p<0.001) with the 'baby boomer' generation making up 52% of city GPs but 59% of rural GPs in 2001. While a large proportion of city and rural GPs continued to work past the age of 65 years, rural GPs left the workforce at a significantly younger age than city doctors (p<0.001). Rural nurses are older than their city peers (p<0.001) but retire at an older age than city nurses (p<0.001). In 1986, a significantly higher proportion of rural GPs in all age cohorts worked more than 41 hours per week compared with their city counterparts (p<0.001). By 2001, rural 'generation X' GPs were no more likely to work long hours than those in the city (p<0.001). However, significantly more rural than city 'baby boomers' continued to work long hours. Rural GPs are retiring faster than city GPs and strategies to attract rural GPs and nurses will be critical to ensure adequate rural health care and that current rural workforce shortage do not worsen.

Sociodemographic and environmental correlates of active commuting in rural America.

PubMed

Fan, Jessie X; Wen, Ming; Kowaleski-Jones, Lori

2015-01-01

This research investigated participation rates in 3 modes of active commuting (AC) and their sociodemographic and physical environmental correlates in rural America. The 2000 Census supplemented with other data sets were used to analyze AC rates in percentage of workers walking, biking, and taking public transportation to work in 14,209 nonmetropolitan rural tracts identified by RUCA codes, including 4,067 small rural and 10,142 town-micropolitan rural tracts. Sociodemographic and physical environmental variables were correlated with 3 AC modes simultaneously using Seemingly Unrelated Regression for nonmetro rural, and for small rural and town-micropolitan rural separately. The average AC rates in rural tracts were 3.63%, 0.26%, and 0.56% for walking, biking, and public transportation to work, respectively, with small rural tracts having a higher rate of walking but lower rates of biking and public transportation to work than town-micropolitan tracts. In general, better economic well-being was negatively associated with AC but percentage of college-educated was a positive correlate. Population density was positively associated with AC but greenness and proximity to parks were negative correlates. However, significant differences existed for different AC modes, and between small rural and town-micropolitan rural tracts. Sociodemographic factors explained more variance in AC than physical environmental factors but the detailed relationships were complex, varying by AC mode and by degree of rurality. Any strategy to promote AC in rural America needs to be sensitive to the population size of the area and assessed in a comprehensive manner to avoid a "one size fits all" approach. © 2014 National Rural Health Association.

Rural Industry Clustering Towards Transitional Rural-Urban Interface

NASA Astrophysics Data System (ADS)

Nugroho, P.

2018-05-01

Rural industrialization seems to be attractive for policymakers looking for counter-urbanization efforts – and nowadays peri-urbanization forces – in line with growing decentralized autonomy of local Indonesian authorities. To promote better rural development, an extended growth pole strategy has been introduced as well as an agropolitan approach and its derivatives. In fact, there is little evidence for their success; rural autonomy remains elusive instead. However, institutional capacity of rural authorities and organizations still fails to deliver rural development initiatives properly. This research was aimed at examining this issue by looking at rural industry clustering in the Greater Solo Region, Indonesia as a response against extended urbanization in peripheral regions. The study focused on batik industry clustering in the rural periphery of Solo City, which provides a transitional rural-urban interface necessary to drive rural independence. Having inherited the batik tradition underpinned by an agriculture-led peasant society, the rural batik industrialization has reinforced the socio-economic transition from a purely agrarian society to a mixed rural-urban society. This study employed an explanatory sequential mixed-method approach, where a quantitative spatial analysis was used to identify the expansion of urbanized areas in villages, and a qualitative case study analysis to figure out the socio-economic shift in rural livelihoods. The results showed that physical spatial changes in these villages do not conform to the socio-economic change into an urban industrial society in a substantial way. Rather, the local villagers preserve an informal economy to support the existence of a mixed rural-urban livelihood.

Optimizing Telehealth Strategies for Subspecialty Care: Recommendations from Rural Pediatricians

PubMed Central

Demirci, Jill R.; Bogen, Debra L.; Mehrotra, Ateev; Miller, Elizabeth

2015-01-01

Abstract Background: Telehealth offers strategies to improve access to subspecialty care for children in rural communities. Rural pediatrician experiences and preferences regarding the use of these telehealth strategies for children's subspecialty care needs are not known. We elicited rural pediatrician experiences and preferences regarding different pediatric subspecialty telehealth strategies. Materials and Methods: Seventeen semistructured telephone interviews were conducted with rural pediatricians from 17 states within the United States. Interviewees were recruited by e-mails to a pediatric rural health listserv and to rural pediatricians identified through snowball sampling. Themes were identified through thematic analysis of interview transcripts. Institutional Review Board approval was obtained. Results: Rural pediatricians identified several telehealth strategies to improve access to subspecialty care, including physician access hotlines, remote electronic medical record access, electronic messaging systems, live video telemedicine, and telehealth triage systems. Rural pediatricians provided recommendations for optimizing the utility of each of these strategies based on their experiences with different systems. Rural pediatricians preferred specific telehealth strategies for specific clinical contexts, resulting in a proposed framework describing the complementary role of different telehealth strategies for pediatric subspecialty care. Finally, rural pediatricians identified additional benefits associated with the use of telehealth strategies and described a desire for telehealth systems that enhanced (rather than replaced) personal relationships between rural pediatricians and subspecialists. Conclusions: Rural pediatricians described complementary roles for different subspecialty care telehealth strategies. Additionally, rural pediatricians provided recommendations for optimizing individual telehealth strategies. Input from rural pediatricians will be crucial for optimizing specific telehealth strategies and designing effective telehealth systems. PMID:25919585

Long-Term Trends in Black and White Mortality in the Rural United States: Evidence of a Race-Specific Rural Mortality Penalty.

PubMed

James, Wesley; Cossman, Jeralynn S

2017-01-01

The rural mortality penalty-growing disparities in rural-urban macro-level mortality rates-has persisted in the United States since the mid 1980s. Substantial intrarural differences exist: rural places of modest population size, close to urban areas, experience a greater mortality burden than the most rural locales. This research builds on recent findings by examining whether a race-specific rural mortality penalty exists; that is, are some rural areas more detrimental to black and/or white mortality than others? Using data from the Compressed Mortality File from 1968 to 2012, we calculate annual age-adjusted, race-specific mortality rates for all rural-urban regions designated by the Rural-Urban Continuum Codes. Indicators for population, socioeconomic status, and health infrastructure, as a proxy for access to care, are used as predictors of race-specific mortality in multivariable regression models. Three important results emerge from this analysis: (1) there is a substantial mortality disadvantage for both black and white rural Americans, (2) the most advantageous regions of mortality for blacks exhibit higher mortality than the most disadvantageous regions for whites, and (3) access to health care is a much stronger predictor of white mortality than black mortality. The rural mortality penalty is evident in race-specific mortality trends over time, with an added disadvantage in black mortality. The rate of mortality improvement for rural blacks and whites lags behind their same-race, urban counterparts, creating a diverging gap in race-specific mortality trends in rural America. © 2016 National Rural Health Association.

What do beginning students, in a rurally focused medical course, think about rural practice?

PubMed

Young, Louise; Lindsay, Daniel B; Ray, Robin A

2016-12-07

Medical schools may select students for their attitudes towards rural medical practice, yet the rural-urban disparity in availability of medical practitioners and services has not diminished in recent times despite government initiatives and increasing numbers being trained for a career in medicine. One medical school, with a focus on rural and remote medicine, aims to select students with positive perceptions for rural medical practice. A research project collected data on the perceptions of these medical students in the first week of their medical studies. Students completed a low stakes essay on the life and work of a rural doctor. Initially, this formed part of a literacy assessment to determine any students requiring remediation. All students were asked if they would consent to their essay being reviewed for a research project. Data was obtained from those students who consented and handed their essays in for review. The 103 student essays underwent thematic analysis and sentences were coded into three main themes of rural lifestyle, doctor role and rural practice. Second level themes were further elicited and results were quantified according to whether they were positive or negative. Positive themes included rural lifestyle, doctor role, views of doctor, impact on community, broader work and skills knowledge, and better relationships with community and patients. Negative themes included doctor's health, pressure on doctor, family problems, greater workload, privacy and confidentiality issues, cultural issues, isolation, limited resources and financial impacts. Quantitisation of this data was used to transform essay sentences into a numerical form which allowed statistical analysis and comparison of perceptions using Z tests. No significant differences on the number of positive and negative responses for rural lifestyle and rural practice were found. The rural doctor role had a significantly more positive than negative views. Significant differences were found for positive views of the rural doctor role and negative views of rural practice. Participants from a capital city background reported a significantly higher percentage of responses related to negative views of rural practice than their regional and rural counterparts. Students from capital city areas had significantly more negative views about the rural doctor role, especially related to workload, limited resources and isolation than students from rural and regional areas. Students entering medical school already have both positive and negative views about the life and work of a rural doctor. Those students from capital city areas have significantly more negative views despite being selected to enter a medical course with a rural focus based on their expressed rural perceptions. Further work is required to refine selection criteria and the year level experiences and learning opportunities which may positively influence student perceptions about rural medical practice to overcome early negative perceptions at the beginning of medical school.

75 FR 41695 - Rural Microentrepreneur Assistance Program; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-19

... DEPARTMENT OF AGRICULTURE Rural Business-Cooperative Service 7 CFR Part 4280 RIN 0570-AA71 Rural Microentrepreneur Assistance Program; Correction AGENCY: Rural Business-Cooperative Service, USDA. ACTION... of rural microenterprises. This document has an incorrect definition of ``nonprofit entity...

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2012-06-14

... Information Collection Activity; Comment Request AGENCY: Rural Utilities Service, USDA. ACTION: Notice and... 35, as amended), the United States Department of Agriculture (USDA) Rural Development administers rural utilities programs through the Rural Utilities Service. The USDA Rural Development invites...

The changing rural environment and the relationship between health services and rural development.

PubMed Central

Cordes, S M

1989-01-01

Author summarizes today's changing rural America and the challenges that health services researchers and policymakers face in relating the rural environment to the problems and possibilities of rural health services delivery. PMID:2917874

Application of the Rural Development Index to Analysis of Rural Regions in Poland and Slovakia

ERIC Educational Resources Information Center

Michalek, Jerzy; Zarnekow, Nana

2012-01-01

The main purpose of this research was to construct a multi-dimensional (composite) index measuring the overall level of rural development and quality of life in individual rural regions of a given EU country. In the Rural Development Index (RDI) the rural development domains are represented by hundreds of partial socio-economic, environmental,…

Rural Community and Rural Resilience: What Is Important to Farmers in Keeping Their Country Towns Alive?

ERIC Educational Resources Information Center

McManus, Phil; Walmsley, Jim; Argent, Neil; Baum, Scott; Bourke, Lisa; Martin, John; Pritchard, Bill; Sorensen, Tony

2012-01-01

Many studies have highlighted the phenomenon of rural decline in parts of the developed world, summarised as a loss in agricultural employment leading to a decline in the number and size of rural settlements. This study of small towns in part of Australia's inland rural "heartland" employs the concepts of interactional rural community of…

An Analysis of North Carolina's Rural Health Problems as Perceived by County Rural Development Panels.

ERIC Educational Resources Information Center

Hamilton, Vance E., Comp.

A State Task Force on Rural Health was formed (January 1973) by the State Rural Development Committee to identify and analyze major rural health problems in North Carolina and to recommend alleviation strategies. The Task Force submitted open-ended questionnaires to members of the County Rural Development Panels to secure their perceptions of…

"How to Be a Rural Man": Young Men's Performances and Negotiations of Rural Masculinities

ERIC Educational Resources Information Center

Bye, Linda Marie

2009-01-01

This paper is concerned with young rural men and how they "do" identity politics living in a rural area of Norway. Focusing on how masculinity and rurality are constructed and interrelated in young men's narratives of living in a remote community, it is identified that young rural men reproduce, negotiate and transform local discourses…

Rural America's Stake in the Digital Economy. The Main Street Economist: Commentary on the Rural Economy.

ERIC Educational Resources Information Center

Staihr, Brian

This first article in a series on telecommunications in rural America provides an overview of several key telecommunication issues facing rural regions. High speed data services known as broadband have the potential to make rural areas less isolated and improve the rural quality of life, but physical barriers, sparse population density, and few…

Undergraduate Rural Medical Education Program Development: Focus Group Consultation with the NRHA Rural Medical Educators Group

ERIC Educational Resources Information Center

Downey, Laura H.; Wheat, John R.; Leeper, James D.; Florence, Joseph A.; Boulger, James G.; Hunsaker, Matt L.

2011-01-01

Context: Over a decade ago, leaders in rural medical education established the Rural Medical Educators (RME) Group, an interest group within the National Rural Health Association, to support faculty in rural medical education programs. This group has convened an annual RME conclave since 2006. In 2008, this conclave convened 15 national leaders in…

SOS--Satisfied or Stuck, Why Older Rural Residents Stay Put: Aging in Place or Stuck in Place in Rural Utah

ERIC Educational Resources Information Center

Erickson, Lance D.; Call, Vaughn R. A.; Brown, Ralph B.

2012-01-01

As rural communities undergo substantial demographic and economic changes, understanding the migration intentions and their antecedents of rural elderly persons becomes increasingly important. Using data drawn from a survey of adults from 24 rural Utah communities conducted in 2008, we examine whether rural residents 60 years of age or older plan…

Rural Runaways: Rurality and Its Implications for Services to Children and Young People Who Run Away

ERIC Educational Resources Information Center

Franks, Myfanwy; Goswami, Haridhan

2010-01-01

This article debates options for service provision to young rural runaways in the UK. Using data drawn from two national surveys and follow-on qualitative studies, the authors trace urban myths of rurality and their effects on runaway provision. The authors review models of rural refuge, systemic advocacy and mobile services for rural runaways.…

College Talk and the Rural Economy: Shaping the Educational Aspirations of Rural, First-Generation Students

ERIC Educational Resources Information Center

Tieken, Mara Casey

2016-01-01

The college-going rates of rural students lag behind those of more urban students, a gap likely due, in part, to rural students' lower educational aspirations. These lower aspirations appear to be tied to the dilemma that higher education presents for many rural students: whether to remain in their rural home, working in traditional trades and…

Platform for Rural America. Revised at the National Conference on Rural America (3rd, December 5-7, 1977).

ERIC Educational Resources Information Center

Rural America, Inc., Washington, DC.

Recommendations which emerged from the Second and Third National Conferences on Rural America are presented in this revised platform of principles and policy recommendations for rural America. Major goal of the document is to find practical solutions to problems facing rural people so that strategies of rural revitalization and action can be…

The Many Faces of Ephraim: In Search of A Functional Typology of Rural Areas.

ERIC Educational Resources Information Center

Whitaker, William H.

The literature of social work and rural sociology lacks conceptualization of the term "rural" and treats the term imprecisely. According to a 1960 survey, authors dealing with rural/urban differences do not agree on the attributes of "rural." However, if the rural concept is to be a useful analytical tool and guide to social work practice, its…

A Hard Look at USDA's Rural Development Programs. The Report of the Rural Revitalization Task Force to the Secretary of Agriculture.

ERIC Educational Resources Information Center

Department of Agriculture Graduate School, Washington, DC.

This report addresses current economic conditions in rural America and offers recommendations about the role the United States Department of Agriculture (USDA) can play in providing rural development. The Task Force identifies issues for rural policy in the 1990's focusing on economic development. Current rural programs are described and…

Keeping School in Rural America: A New Paradigm for Rural Education and Community Development.

ERIC Educational Resources Information Center

Haas, Toni

This paper differentiates between the "old story" of rural education and the emerging "new story." It describes the tradition (old story) in which rural education is related to the local and national economies and lays out fragments of the new story, a paradigm that combines rural education and the rural economy in a way that strengthens them…

Pedagogy of the Rural: Implications of Size on Conceptualisations of Rural

ERIC Educational Resources Information Center

Walker-Gibbs, Bernadette; Ludecke, Michelle; Kline, Jodie

2015-01-01

This paper proposes a concept of Pedagogy of the Rural that draws together current rural education theory and practice to illustrate the complexities of rural space and place often overlooked in teacher education more broadly. We firstly examine notions of size, and then we explore how this impacts on the ways in which teachers in rural locations…

Recruitment and Retention of Rural Physicians: Outcomes from the Rural Physician Associate Program of Minnesota

ERIC Educational Resources Information Center

Halaas, Gwen Wagstrom; Zink, Therese; Finstad, Deborah; Bolin, Keli; Center, Bruce

2008-01-01

Context: Founded in 1971 with state funding to increase the number of primary care physicians in rural Minnesota, the Rural Physician Associate Program (RPAP) has graduated 1,175 students. Third-year medical students are assigned to primary care physicians in rural communities for 9 months where they experience the realities of rural practice with…

Meeting Increasing Demands for Rural General Surgeons.

PubMed

Mccarthy, Mary C; Bowers, Howard E; Campbell, Damon M; Parikh, Priti P; Woods, Randy J

2015-12-01

Dynamic assessment of the effective surgical workforce recommends 27,300 general surgeons in 2030; 2,525 more than are presently being trained. Rural shortages are already critical and there has been insufficient preparation for this need. A literature review of the factors influencing the choice of rural practice was performed. A systematic search was conducted of PubMed and the Web of Science to identify applicable studies in rural practice, surgical training, and rural general surgery. These articles were reviewed to identify the pertinent reports. The articles chosen for review are directed to four main objectives: 1) description of the challenges of rural practice, 2) factors associated with the choice of rural practice, 3) interventions to increase interest and preparation for rural practice, and 4) present successful rural surgical practice models. There is limited research on the factors influencing surgeons in the selection of rural surgery. The family practice literature suggests that physicians are primed for rural living through early experience, with reinforcement during medical school and residency, and retained through community involvement, and personal and professional satisfaction. However, more research into the factors drawing surgeons specifically to rural surgery, and keeping them in the community, is needed.

The rural and the rotund? A critical interpretation of food deserts and rural adolescent obesity in the Canadian context.

PubMed

McPhail, Deborah; Chapman, Gwen E; Beagan, Brenda L

2013-07-01

Resting on the notion that rural spaces are "food deserts," rural adolescents are increasingly regarded as a "problem population" in Western obesity narratives. Using qualitative data gleaned from interviews with 51 teenage participants from rural areas across Canada, this paper focuses on the ways in which obesity is constructed as a rural disease in the Canadian context, demonstrating in particular how discourses of food deserts and related rural obesity rely on classist imaginings of obesity as a working-class embodiment. The paper will further question the understanding of the rural as a food desert, showing the ways in which rural teens acquire fresh, healthy foods in part through an informal economy of food growing and sharing. Copyright © 2013 Elsevier Ltd. All rights reserved.

How do the definitions of urban and rural matter for transportation safety? Re-interpreting transportation fatalities as an outcome of regional development processes.

PubMed

McAndrews, Carolyn; Beyer, Kirsten; Guse, Clare E; Layde, Peter

2016-12-01

Urban and rural places are integrated through economic ties and population flows. Despite their integration, most studies of road safety dichotomize urban and rural places, and studies have consistently demonstrated that rural places are more dangerous for motorists than urban places. Our study investigates whether these findings are sensitive to the definition of urban and rural. We use three different definitions of urban-rural continua to quantify and compare motor vehicle occupant fatality rates per person-trip and person-mile for the state of Wisconsin. The three urban-rural continua are defined by: (1) popular impressions of urban, suburban, and rural places using a system from regional economics; (2) population density; and (3) the intensity of commute flows to core urbanized areas. In this analysis, the three definitions captured different people and places within each continuum level, highlighting rural heterogeneity. Despite this heterogeneity, the three definitions resulted in similar fatality rate gradients, suggesting a potentially latent "rural" characteristic. We then used field observations of urban-rural transects to refine the definitions. When accounting for the presence of higher-density towns and villages in rural places, we found that low-density urban places such as suburbs and exurbs have fatality rates more similar to those in rural places. These findings support the need to understand road safety within the context of regional development processes instead of urban-rural categories. Copyright © 2016 Elsevier Ltd. All rights reserved.

Improved thrombin binding aptamer by incorporation of a single unlocked nucleic acid monomer

PubMed Central

Pasternak, Anna; Hernandez, Frank J.; Rasmussen, Lars M.; Vester, Birte; Wengel, Jesper

2011-01-01

A 15-mer DNA aptamer (named TBA) adopts a G-quadruplex structure that strongly inhibits fibrin-clot formation by binding to thrombin. We have performed thermodynamic analysis, binding affinity and biological activity studies of TBA variants modified by unlocked nucleic acid (UNA) monomers. UNA-U placed in position U3, U7 or U12 increases the thermodynamic stability of TBA by 0.15–0.50 kcal/mol. In contrast, modification of any position within the two G-quartet structural elements is unfavorable for quadruplex formation. The intramolecular folding of the quadruplexes is confirmed by Tm versus ln c analysis. Moreover, circular dichroism and thermal difference spectra of the modified TBAs displaying high thermodynamic stability show bands that are characteristic for antiparallel quadruplex formation. Surface plasmon resonance studies of the binding of the UNA-modified TBAs to thrombin show that a UNA monomer is allowed in many positions of the aptamer without significantly changing the thrombin-binding properties. The biological effect of a selection of the modified aptamers was tested by a thrombin time assay and showed that most of the UNA-modified TBAs possess anticoagulant properties, and that the construct with a UNA-U monomer in position 7 is a highly potent inhibitor of fibrin-clot formation. PMID:20870750

The Rural Bellwether.

ERIC Educational Resources Information Center

Walker, Sherry Freeland, Ed.

2001-01-01

This theme issue of "State Education Leader" contains eight articles on rural education. "The Rural Bellwether" (Kathy Christie) discusses declining enrollment in rural schools, rural problems with teacher shortages and special education funding, issues related to school size and school district size, and distance learning…

77 FR 26735 - Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-07

... AGENCY: Rural Utilities Service, USDA. ACTION: Notice and request for comments. SUMMARY: In accordance... Department of Agriculture (USDA) Rural Development administers rural utilities programs through the Rural Utilities Service (RUS). The USDA Rural Development invites comments on the following information...

Rural medical education in Europe: the relevance of the Australian experience.

PubMed

Hays, Richard B

2007-01-01

The drive to increase recognition of the different health care needs of rural communities has been more successful in North America and Australia than in Europe. This success has translated into political support for a range of education, workforce and service model initiatives that appear to be effective in providing a better prepared and supported healthcare workforce in rural communities, providing services through specifically developed delivery models, all with the aim of improving the quality of health care for rural people. The reasons for the differences between Europe and nations with greater success appear to relate to: the absence of a clear, shared definition of rurality across a very diverse group of nations within Europe, and a weaker coalition of interests advocating rural health issues. As a result, although very similar rural health issues are present in Europe, governments are not particularly supportive of initiatives aimed specifically at rural health and so rural medical education is much less well developed. This article explores how the rural health movement in Europe might build on success elsewhere to develop and successfully promote locally relevant models of rural medical education.

Adaptación al español y validación de criterio de una escala para la tamización de problemas emocionales y del comportamiento en la primera infancia.

PubMed

Cano, Luz Helena; Acosta, María Natalia; Pulido, Adriana

2018-05-01

Introducción. La detección temprana del riesgo de problemas emocionales y del comportamiento en niños puede contribuir al desarrollo de estrategias que promuevan la salud mental desde la primera infancia. En Colombia no existe una herramienta validada para dicha detección.Objetivos. Seleccionar, adaptar y establecer la validez de criterio de una escala de tamización de problemas emocionales y del comportamiento en niños menores de seis años.Materiales y métodos. A partir de una revisión de la literatura y un consenso de expertos, se seleccionó la herramienta Early Childhood Screening Assessment (ECSA). Posteriormente, se llevó a cabo su adaptación lingüística y se determinó la validez de criterio mediante una curva de características de recibidor-operador (Receiver Operating Characteristic, ROC), y se la comparó con el cuestionario Child Behavior Checklist (CBCL 1,5-5). En el estudio participaron 206 cuidadores de niños entre el año y medio y los seis años de edad de la ciudad de Tunja y el municipio de Sopó.Resultados. La puntuación del ECSA presentó una buena correlación con la puntuación t total del CBCL 1,5-5 (ro de Spearman=0,75; p<0,01). La escala ECSA tuvo una sensibilidad de 86 % y una especificidad de 82 % al establecer un punto de corte de 24 para la población estudiada.Conclusión. En este primer estudio de adaptación y validación de la versión en español de la escala ECSA, se detectaron buenos valores de sensibilidad y especificidad para la tamización de problemas emocionales y del comportamiento en la primera infancia.

Gender-specific association between urinary sodium excretion and body composition: Analysis of the 2008-2010 Korean National Health and Nutrition Examination Surveys.

PubMed

Huh, Ji Hye; Lim, Jung Soo; Lee, Mi Young; Chung, Choon Hee; Shin, Jang Yel

2015-07-01

Few studies have reported the relationship between sarcopenia and the estimated amount of sodium excreted in 24 h, as measured by the spot urine test (E24UNA), in a community-dwelling cohort. We investigated the gender specific association between E24UNA values and body composition indices. Data from a total of 7162 participants (3545 men and 3617 postmenopausal women) aged 45 years or older were obtained from multiple Korea National Health and Nutrition Examination Surveys (2008-2010) and analyzed. The total amount of sodium excreted in the urine in a 24-h period was estimated with spot urine specimens. Sarcopenia was defined as an appendicular skeletal muscle mass divided by body weight (ASM/Wt) that was less than 1 standard deviation below the sex-specific mean for young adults. E24UNA values were positively correlated with body mass index, waist circumference, total fat mass, and blood pressure; in contrast, E24UNA values were negatively correlated with ASM/Wt in both sexes. Compared with those in the lowest E24UNA tertile, participants in the highest E24UNA tertile were at higher risk for sarcopenia (men: odds ratio (OR)=1.3 [95% confidence interval (CI)=1.07-1.59]; women: OR=1.41 [95% CI=1.16-1.73]). Further classification of subjects with sarcopenia into sarcopenic obese and sarcopenic nonobese groups revealed that the highest E24UNA values were found in the sarcopenic obese group; this difference was statistically significant. The next highest levels were found in the sarcopenic nonobese group, followed by the nonsarcopenic group. This trend was observed in both sexes. High E24UNA values were independently associated with both sarcopenia and obesity in Korean individuals older than 45 years. These results suggest that high salt intake may have a deleterious effect on body composition. Copyright © 2015. Published by Elsevier Inc.

Urine sodium excretion increased slightly among U.S. adults between 1988 and 2010.

PubMed

Pfeiffer, Christine M; Hughes, Jeffery P; Cogswell, Mary E; Burt, Vicki L; Lacher, David A; Lavoie, Donna J; Rabinowitz, Daniel J; Johnson, Clifford L; Pirkle, James L

2014-05-01

Little information is available on temporal trends in sodium intake in the U.S. population using urine sodium excretion as a biomarker. Our aim was to assess 1988-2010 trends in estimated 24-h urine sodium (24hUNa) excretion among U.S. adults (age 20-59 y) participating in the cross-sectional NHANES. We used subsamples from a 1988-1994 convenience sample, a 2003-2006 one-third random sample, and a 2010 one-third random sample to comply with resource constraints. We estimated 24hUNa excretion from measured sodium concentrations in spot urine samples by use of calibration equations (for men and women) derived from the International Cooperative Study on Salt, Other Factors, and Blood Pressure study. Estimated 24hUNa excretion increased over the 20-y period [1988-1994, 2003-2006, and 2010; means ± SEMs (n): 3160 ± 38.4 mg/d (1249), 3290 ± 29.4 mg/d (1235), and 3290 ± 44.4 mg/d (525), respectively; P-trend = 0.022]. We observed significantly higher mean estimated 24hUNa excretion in each survey period (P < 0.001) for men compared with women (31-33%) and for persons with a higher body mass index (BMI; 32-35% for obese vs. normal weight) or blood pressure (17-26% for hypertensive vs. normal blood pressure). After adjusting for age, sex, and race-ethnicity, temporal trends in mean estimated 24hUNa excretion remained significant (P-trend = 0.004). We observed no temporal trends in mean estimated 24hUNa excretion among BMI subgroups, nor after adjusting for BMI. Although several limitations apply to this analysis (the use of a convenience sample in 1988-1994 and using estimated 24hUNa excretion as a biomarker of sodium intake), these first NHANES data suggest that mean estimated 24hUNa excretion increased slightly in U.S. adults over the past 2 decades, and this increase may be explained by a shift in the distribution of BMI.

Rural Education: A Hope for the Future. Proceedings of the Annual Rural and Small Schools Conference (9th, Manhattan, Kansas, October 26-27, 1987).

ERIC Educational Resources Information Center

Parmley, Fran, Ed.

This collection of conference papers covers various aspects of rural education in changing times. The conference focused on changes and innovations in rural education and on reasons why rural educators can be optimistic. The proceedings report includes brief papers and workshop summaries on topics ranging from rural public relations to…

Transcending an Urban-Rural Divide: Rural Youth's Resistance to Townization and Schooling, a Case Study of a Middle School in Northwest China

ERIC Educational Resources Information Center

Lou, Jingjing

2011-01-01

Based on an ethnographic study in a rural middle school in Northwest China, the author explores how the transition of the rural countryside, specifically townization, has challenged the urban-rural dichotomy being reproduced in and by formal schooling. Rural students express criticism of the chaos, pollution, and corruption they have experienced…

Rural Youth in Asia. Report of the CCA Rural Youth Study Group (Sibu, Malaysia, March 14-19, 1976).

ERIC Educational Resources Information Center

1977

Historical causes of rural poverty and general recommendations for work among rural youth in India, Malaysia, Philippines, Sri Lanka, and Thailand are presented in this summary of national reports given before the Rural Youth Study Group in 1976. In addition to study papers on each country, the volume contains an introduction on rural youth and…

43 CFR 404.58 - Do rural water projects authorized before the enactment of the Rural Water Supply Act of 2006...

Code of Federal Regulations, 2010 CFR

2010-10-01

... the enactment of the Rural Water Supply Act of 2006 have to comply with the requirements in this rule... RECLAMATION, DEPARTMENT OF THE INTERIOR RECLAMATION RURAL WATER SUPPLY PROGRAM Miscellaneous § 404.58 Do rural water projects authorized before the enactment of the Rural Water Supply Act of 2006 have to comply with...

Definition of "Rural" Determines the Placement Outcomes of a Rural Medical Education Program: Analysis of Jichi Medical University Graduates

ERIC Educational Resources Information Center

Matsumoto, Masatoshi; Inoue, Kazuo; Kajii, Eiji

2010-01-01

Purpose: To show the impact of changing the definition of what is "rural" on the outcomes of a rural medical education program. Methods: A cross-sectional sample of 643 graduates under obligatory rural service and 1,699 graduates after serving their obligation, all from Jichi Medical University (JMU), a binding rural education program in…

50 CFR Figure 4 to Subpart E of... - Prince William Sound Rural and Non-Rural Areas

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Prince William Sound Rural and Non-Rural Areas 4 Figure 4 to Subpart E of Part 300 Wildlife and Fisheries INTERNATIONAL FISHING AND RELATED... to Subpart E of Part 300—Prince William Sound Rural and Non-Rural Areas ER04NO09.010 [74 FR 57110...

50 CFR Figure 4 to Subpart E of... - Prince William Sound Rural and Non-Rural Areas

Code of Federal Regulations, 2014 CFR

2014-10-01

... 50 Wildlife and Fisheries 11 2014-10-01 2014-10-01 false Prince William Sound Rural and Non-Rural Areas 4 Figure 4 to Subpart E of Part 300 Wildlife and Fisheries INTERNATIONAL FISHING AND RELATED... to Subpart E of Part 300—Prince William Sound Rural and Non-Rural Areas ER04NO09.010 [74 FR 57110...

50 CFR Figure 4 to Subpart E of... - Prince William Sound Rural and Non-Rural Areas

Code of Federal Regulations, 2013 CFR

2013-10-01

... 50 Wildlife and Fisheries 11 2013-10-01 2013-10-01 false Prince William Sound Rural and Non-Rural Areas 4 Figure 4 to Subpart E of Part 300 Wildlife and Fisheries INTERNATIONAL FISHING AND RELATED... to Subpart E of Part 300—Prince William Sound Rural and Non-Rural Areas ER04NO09.010 [74 FR 57110...

50 CFR Figure 4 to Subpart E of... - Prince William Sound Rural and Non-Rural Areas

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 11 2012-10-01 2012-10-01 false Prince William Sound Rural and Non-Rural Areas 4 Figure 4 to Subpart E of Part 300 Wildlife and Fisheries INTERNATIONAL FISHING AND RELATED... to Subpart E of Part 300—Prince William Sound Rural and Non-Rural Areas ER04NO09.010 [74 FR 57110...

50 CFR Figure 4 to Subpart E of... - Prince William Sound Rural and Non-Rural Areas

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 9 2011-10-01 2011-10-01 false Prince William Sound Rural and Non-Rural Areas 4 Figure 4 to Subpart E of Part 300 Wildlife and Fisheries INTERNATIONAL FISHING AND RELATED... to Subpart E of Part 300—Prince William Sound Rural and Non-Rural Areas ER04NO09.010 [74 FR 57110...

Research on the evaluation method of rural hollowing based on RS and GIS technology: a case study of the Ningxia Hui autonomous region in China

NASA Astrophysics Data System (ADS)

Yin, Kai; Wen, MeiPing; Zhang, FeiFei; Yuan, Chao; Chen, Qiang; Zhang, Xiupeng

2016-10-01

With the acceleration of urbanization in China, most rural areas formed a widespread phenomenon, i.e., destitute village, labor population loss, land abandonment and rural hollowing. And it formed a unique hollow village problem in China finally. The governance of hollow village was the objective need of the development of economic and social development in rural area for Chinese government, and the research on the evaluation method of rural hollowing was the premise and basis of the hollow village governance. In this paper, several evaluation methods were used to evaluate the rural hollowing based on the survey data, land use data, social and economic development data. And these evaluation indexes were the transition of homesteads, the development intensity of rural residential areas, the per capita housing construction area, the residential population proportion in rural area, and the average annual electricity consumption, which can reflect the rural hollowing degree from the land, population, and economy point of view, respectively. After that, spatial analysis method of GIS was used to analyze the evaluation result for each index. Based on spatial raster data generated by Kriging interpolation, we carried out re-classification of all the results. Using the fuzzy clustering method, the rural hollowing degree in Ningxia area was reclassified based on the two spatial scales of county and village. The results showed that the rural hollowing pattern in the Ningxia Hui Autonomous Region had a spatial distribution characteristics that the rural hollowing degree was obvious high in the middle of the study area but was low around the study area. On a county scale, the specific performances of the serious rural hollowing were the higher degree of extensive land use, and the lower level of rural economic development and population transfer concentration. On a village scale, the main performances of the rural hollowing were the rural population loss and idle land. The evaluation method of rural hollowing constructed in this paper can effectively carry out a comprehensive degree zoning of rural hollowing, which can make orderly decision support plans of hollow village governance for the government.

Outcomes of Australian rural clinical schools: a decade of success building the rural medical workforce through the education and training continuum.

PubMed

Greenhill, Jennene A; Walker, Judi; Playford, Denese

2015-01-01

The establishment of the rural clinical schools funded through the Commonwealth Department of Health and Ageing (now Department of Health) Rural Clinical Training and Support program over a decade ago has been a significant policy initiative in Australian rural health. This article explores the impacts of this policy initiative and presents the wide range of educational innovations contextualised to each rural community they serve. This article reviews the achievements of the Australian rural clinical and regional medical schools (RCS/RMS) through semi-structured interviews with the program directors or other key informants. The questions and responses were analysed according to the funding parameters to ascertain the numbers of students, types of student placements and range of activities undertaken by each university program. Sixteen university medical schools have established 18 rural programs, creating an extensive national network of RCS and RMS in every state and territory. The findings reveal extensive positive impacts on rural and regional communities, curriculum innovation in medical education programs and community engagement activities. Teaching facilities, information technology, video-conferencing and student accommodation have brought new infrastructure to small rural towns. Rural clinicians are thriving on new opportunities for education and research. Clinicians continue to deliver clinical services and some have taken on formal academic positions, reducing professional isolation, improving the quality of care and their job satisfaction. This strategy has created many new clinical academics in rural areas, which has retained and expanded the clinical workforce. A total of 1224 students are provided with high-quality learning experiences for long-term clinical placements. These placements consist of a year or more in primary care, community and hospital settings across hundreds of rural and remote areas. Many programs offer longitudinal integrated clerkships; others offer block rotations in general practice and specialist clinics. Nine universities established programs prior to 2004, and these well-established programs are finding graduates who are returning to rural practice. Universities are required to have 25% of the students from a rural background. University admission policies have changed to encourage more applications from rural students. This aspect of the policy implements the extensive research evidence that rural-origin students are more likely to become rural practitioners. Additional capacity for research in RCS has influenced the rural health agenda in fields including epidemiology, population health, Aboriginal health, aged care, mental health and suicide prevention, farming families and climate change. There are strong research partnerships with rural workforce agencies, research centres for early career researchers and PhD students. The RCS policy initiative has vastly increased opportunities for medical students to have long-term clinical placements in rural health services. Over a decade since the policy has been implemented, graduates are being attracted to rural practice because they have positive learning experiences, good infrastructure and support within rural areas. The study shows the RCS initiative sets the stage for a sustainable future Australian rural medical workforce now requiring the development of a seamless rural clinical training pipeline linking undergraduate and postgraduate medical education.

Effect of medicare payment on rural health care systems.

PubMed

McBride, Timothy D; Mueller, Keith J

2002-01-01

Medicare payments constitute a significant share of patient-generated revenues for rural providers, more so than for urban providers. Therefore, Medicare payment policies influence the behavior of rural providers and determine their financial viability. Health services researchers need to contribute to the understanding of the implications of changes in fee-for-service payment policy, prospects for change because of the payment to Medicare+Choice risk plans, and implications for rural providers inherent in any restructuring of the Medicare program. This article outlines the basic policy choices, implications for rural providers and Medicare beneficiaries, impacts of existing research, and suggestions for further research. Topics for further research include implications of the Critical Access Hospital program, understanding how changes in payment to rural hospitals affect patient care, developing improved formulas for paying rural hospitals, determining the payment-to-cost ratio for physicians, measuring the impact of changes in the payment methodology used to pay for services delivered by rural health clinics and federally qualified health centers, accounting for the reasons for differences in historical Medicare expenditures across rural counties and between rural and urban counties, explicating all reasons for Medicare+Choice plans withdrawing from some rural areas and entering others, measuring the rural impact of proposals to add a prescription drug benefit to the Medicare program, and measuring the impact of Medicare payment policies on rural economies.

Recruitment and retention of rural physicians: outcomes from the rural physician associate program of Minnesota.

PubMed

Halaas, Gwen Wagstrom; Zink, Therese; Finstad, Deborah; Bolin, Keli; Center, Bruce

2008-01-01

Founded in 1971 with state funding to increase the number of primary care physicians in rural Minnesota, the Rural Physician Associate Program (RPAP) has graduated 1,175 students. Third-year medical students are assigned to primary care physicians in rural communities for 9 months where they experience the realities of rural practice with hands-on participation, mentoring, and one-to-one teaching. Students complete an online curriculum, participate in online discussion with fellow students, and meet face-to-face with RPAP faculty 6 times during the 9-month rotation. Projects designed to bring value to the community, including an evidence-based practice and community health assessment, are completed. To examine RPAP outcomes in recruiting and retaining rural primary care physicians. The RPAP database, including moves and current practice settings, was examined using descriptive statistics. On average, 82% of RPAP graduates have chosen primary care, and 68% family medicine. Of those currently in practice, 44% have practiced in a rural setting all of the time, 42% in a metropolitan setting and 14% have chosen both, with more than 50% of their time in rural practice. Rural origin has only a small association with choosing rural practice. RPAP data suggest that the 9-month longitudinal experience in a rural community increases the number of students choosing primary care practice, especially family medicine, in a rural setting.

7 CFR 22.204 - Rural development committees.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 1 2011-01-01 2011-01-01 false Rural development committees. 22.204 Section 22.204 Agriculture Office of the Secretary of Agriculture RURAL DEVELOPMENT COORDINATION Roles and Responsibilities of Federal Government § 22.204 Rural development committees. State rural development committees...

7 CFR 22.204 - Rural development committees.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 1 2010-01-01 2010-01-01 false Rural development committees. 22.204 Section 22.204 Agriculture Office of the Secretary of Agriculture RURAL DEVELOPMENT COORDINATION Roles and Responsibilities of Federal Government § 22.204 Rural development committees. State rural development committees...

Recruitment and retention of rural nursing students: a retrospective study.

PubMed

Bigbee, Jeri; Mixon, Diana

2013-01-01

The shortage of registered nurses is an issue globally, but particularly in rural and remote areas. Previous research in medicine suggests that recruiting students from rural backgrounds is an effective strategy to enhance the supply of rural healthcare providers. This strategy has not been widely adopted or evaluated in nursing. The purpose of this study was to compare rural and urban nursing students in relation to application, admission, and retention/graduation trends at a metropolitan state university in the Pacific Northwest area of the USA. A retrospective longitudinal descriptive design was used, analyzing existing data from 2005 to 2010. The sample included 1283 applicants, accepted students, and graduates. Rural-urban classification was made using rural urban commuting area (RUCA) codes based on high school zip codes, identifying 356 (28%) rural and 927 (72%) urban individuals. The data were analyzed quantitatively, assessing demographic characteristics along with application, admission and retention/graduation rates. The analysis indicated no significant differences between the rural and urban samples in relation to age, gender, parents' level of education, income, or retention rates. The acceptance rate for rural students (66.3%) was significantly lower than for urban students (73.1%) (p=0.015). When rural subgroups (isolated, small rural and large rural) were examined, the isolated group (n=61) had the highest acceptance rate of any rural or urban group (75%). This group was the least ethnically diverse (95% Caucasian), was the least likely to be first-generation college (22%), had the highest percentage of females (85%) and had the highest entering grade point average (3.65 on a four-point scale). In contrast, the subgroup including individuals from large rural communities (n=182) had the lowest acceptance rate (64%), the lowest retention rate 85%, the lowest entering grade point average (3.42), and the highest percentage of first-generation college individuals (50.9%). The findings suggest that students from rural backgrounds achieve similar levels of success in nursing education, despite lower acceptance rates, when compared with urban students. Addressing issues related to lower acceptance rates for rural nursing students, including targeted recruitment and support efforts with students interested in pursuing nursing at the junior and senior high school levels, may be indicated. Further research is indicated to explore differences among rural subgroups in relation to preparation for and achievement in nursing education. Greater research attention is also needed to assess if nursing students from rural backgrounds tend to practice in rural areas more than students from urban backgrounds, similar to previous research in medicine. Because students tend to practice near their place of education, nursing education programs may need to consider locating outside of large urban areas to promote rural practice. Inclusion of rural content and clinical experiences within nursing curricula is also recommended.

Increased vulnerability of rural children on antiretroviral therapy attending public health facilities in South Africa: a retrospective cohort study

PubMed Central

2010-01-01

Background A large proportion of the 340,000 HIV-positive children in South Africa live in rural areas, yet there is little sub-Saharan data comparing rural paediatric antiretroviral therapy (ART) programme outcomes with urban facilities. We compared clinical, immunological and virological outcomes between children at seven rural and 37 urban facilities across four provinces in South Africa. Methods We conducted a retrospective cohort study of routine data of children enrolled on ART between November 2003 and March 2008 in three settings, namely: urban residence and facility attendance (urban group); rural residence and facility attendance (rural group); and rural residents attending urban facilities (rural/urban group). Outcome measures were: death, loss to follow up (LTFU), virological suppression, and changes in CD4 percentage and weight-for-age-z (WAZ) scores. Kaplan-Meier estimates, logrank tests, multivariable Cox regression and generalized estimating equation models were used to compare outcomes between groups. Results In total, 2332 ART-naïve children were included, (1727, 228 and 377 children in the urban, rural and rural/urban groups, respectively). At presentation, rural group children were older (6.7 vs. 5.6 and 5.8 years), had lower CD4 cell percentages (10.0% vs. 12.8% and 12.7%), lower WAZ scores (-2.06 vs. -1.46 and -1.41) and higher proportions with severe underweight (26% vs.15% and 15%) compared with the urban and rural/urban groups, respectively. Mortality was significantly higher in the rural group and LTFU significantly increased in the rural/urban group. After 24 months of ART, mortality probabilities were 3.4% (CI: 2.4-4.8%), 7.7% (CI: 4.5-13.0%) and 3.1% (CI: 1.7-5.6%) p = 0.0137; LTFU probabilities were 11.5% (CI: 9.3-14.0%), 8.8% (CI: 4.5-16.9%) and 16.6% (CI: 12.4-22.6%), p = 0.0028 in the urban, rural and rural/urban groups, respectively. The rural group had an increased adjusted mortality probability, adjusted hazards ratio 2.41 (CI: 1.25-4.67) and the rural/urban group had an increased adjusted LTFU probability, aHR 2.85 (CI: 1.41-5.79). The rural/urban group had a decreased adjusted probability of virological suppression compared with the urban group at any timepoint on treatment, adjusted odds ratio 0.67 (CI: 0.48-0.93). Conclusions Rural HIV-positive children are a vulnerable group, exhibiting delayed access to ART and an increased risk of poor outcomes while on ART. Expansion of rural paediatric ART programmes, with future research exploring improvements to rural health system effectiveness, is required. PMID:21108804

Factors influencing medical students' motivation to practise in rural areas in low-income and middle-income countries: a systematic review

PubMed Central

Zwanikken, Prisca A C; Pokharel, Paras K; Scherpbier, Albert J

2017-01-01

Objectives There is a shortage of doctors working in rural areas all over the world, especially in low-income and middle-income countries. The choice to practise medicine in a rural area is influenced by many factors. Motivation developed as a medical student is one key determinant of this choice. This study explores influences on medical students' motivation to practise in rural areas of low-income and middle-income countries following graduation. Design A systematic review was conducted to identify influences on medical students' motivation to work in rural areas in low-income and middle-income countries. Papers reporting influences on motivation were included, and content analysis was conducted to select the articles. Articles not published in English were excluded from this review. Results A rural background (ie, being brought up in a rural area), training in rural areas with a community-based curriculum, early exposure to the community during medical training and rural location of medical school motivate medical students to work in rural areas. Perceived lack of infrastructure, high workload, poor hospital management and isolation are among the health facility factors that demotivate medical students for medical practice in rural areas. Conclusions Medical school selection criteria focusing on a rural background factor and medical education curriculum focusing on rural area are more relevant factors in low-income and middle-income countries. The factors identified in this review may assist the planners, medical educators and policymakers in low-income and middle-income countries in designing relevant interventions to positively influence rural choices where the shortage of rural physicians is an ongoing and increasing concern. PMID:28232465

Rural roadway safety perceptions among rural teen drivers living in and outside of towns.

PubMed

Ramirez, Marizen; Roth, Lisa; Young, Tracy; Peek-Asa, Corinne

2013-01-01

To compare perceptions about rural road and general driving behaviors between teens who live in- and out-of-town from rural communities in Iowa. A cross-sectional survey was conducted with 160 teens anticipating their Intermediate License within 3 months upon enrollment into this study. Self-administered surveys were used to collect demographics and driving exposures (eg, frequency of driving, age when first drove unsupervised). Two Likert scales were included to measure agreement with safe driving behaviors on rural roads and general safe driving behaviors (eg, speeding, seat belt use). T-tests were calculated comparing mean composite scores between in- and out-of-town teens, and between mean rural road and general driving safety attitude scores. A linear regression multivariable model was constructed to identify predictors of the rural road score. While the majority of teens endorsed rural road and general safe driving behaviors, up to 40% did not. Thirty-two percent did not believe the dangers of animals on rural roads, and 40% disagreed that exceeding the speed limit is dangerous. In-town teens were less safety conscious about rural road hazards with a significantly lower mean composite score (4.4) than out-of-town teens (4.6); mean scores for general driving behaviors were similar. Living out-of-town and owning one's own car were significant predictors of increased rural road safety scores. Rural, in-town teens have poorer safety attitudes about rural roadway hazards compared with out-of-town teens. Interventions that involve education, parental supervision, and practice on rural roads are critical for preventing teen crashes on rural roads. No claim to original US government works.

Rural Healthy People 2020: New Decade, Same Challenges.

PubMed

Bolin, Jane N; Bellamy, Gail R; Ferdinand, Alva O; Vuong, Ann M; Kash, Bita A; Schulze, Avery; Helduser, Janet W

2015-01-01

The health of rural America is more important than ever to the health of the United States and the world. Rural Healthy People 2020's goal is to serve as a counterpart to Healthy People 2020, providing evidence of rural stakeholders' assessment of rural health priorities and allowing national and state rural stakeholders to reflect on and measure progress in meeting those goals. The specific aim of the Rural Healthy People 2020 national survey was to identify rural health priorities from among the Healthy People 2020's (HP2020) national priorities. Rural health stakeholders (n = 1,214) responded to a nationally disseminated web survey soliciting identification of the top 10 rural health priorities from among the HP2020 priorities. Stakeholders were also asked to identify objectives within each national HP2020 priority and express concerns or additional responses. Rural health priorities have changed little in the last decade. Access to health care continues to be the most frequently identified rural health priority. Within this priority, emergency services, primary care, and insurance generate the most concern. A total of 926 respondents identified access as the no. 1 rural health priority, followed by, no. 2 nutrition and weight status (n = 661), no. 3 diabetes (n = 660), no. 4 mental health and mental disorders (n = 651), no. 5 substance abuse (n = 551), no. 6 heart disease and stroke (n = 550), no. 7 physical activity and health (n = 542), no. 8 older adults (n = 482), no. 9 maternal infant and child health (n = 449), and no. 10 tobacco use (n = 429). © 2015 The Authors The Journal of Rural Health published by Wiley Periodicals, Inc. on behalf of National Rural Health Association.

Interest in rural clinical school is not enough: Participation is necessary to predict an ultimate rural practice location.

PubMed

Playford, Denese; Puddey, Ian B

2017-08-01

Rural exposure during medical school is associated with increased rural work after graduation. How much of the increase in rural workforce by these graduates is due to pre-existing interest and plans to work rurally and how much is related to the extended clinical placement is not known. This cohort study compared the employment location of medical graduates who professed no rural interest as undergraduates (negative control), with those who applied but did not participate in Rural Clinical School of Western Australia (RCSWA) (positive control), and those who applied and participated in RCSWA (participants). All 1026 University of Western Australia students who had an opportunity to apply for a year-long rotation in RCSWA from 2004 to 2010, and who had subsequently graduated by the end of 2011, were included. Graduates' principal workplace location (AHPRA, Feb 2014). The three groups differed significantly in their graduate work locations (χ 2 = 39.2, P < 0.001). In multivariate analysis, only being of older age at graduation (OR 2.28 (95% CI 1.40, 3.72), P = 0.001), being from a rural background (OR 2.99 (95% CI 1.85, 4.85), P < 0.001), being a recipient of a Medical Rural Bonded Scholarship (OR 3.36 (95% CI 1.68, 6.73, P = 0.001) and actually participating in the RCSWA remained significantly related to rural work (OR 3.10 (95% CI 1.95, 4.93), P < 0.001). After accounting for other factors relating to rural work, RCSWA graduates were three times more likely to work rurally than either control group. These data suggest that RCSWA has a significant independent effect on rural workforce. © 2016 National Rural Health Alliance Inc.

A study on the stakeholder of holistic rural tourism: A case of Yangzhou

NASA Astrophysics Data System (ADS)

Gao, Yuanheng; Wang, Yan

2017-10-01

Holistic rural tourism is an important model to rural economy; however, there are a number of issues in the developing of the holistic rural tourism, one of the most prominent problems is the interests of community residents cannot be guaranteed. From the perspective of the stakeholders, the article describes the main stakeholders in the development of holistic rural tourism and analyzes the demands of different stakeholders' interests. The paper summarizes the principles of distribution mechanism of holistic rural tourism interests. Finally, it proposes the primary distribution mechanism and re-distribution mechanism of holistic rural tourism interests to provide some inspiration for the interest distribution in the sustainable development of holistic rural tourism.

Fuzzy Comprehensive Evaluation of Rural Information Poverty in China - - Case Study of Hebei Province

NASA Astrophysics Data System (ADS)

Sun, Guizhen; Wang, Shuanjun; Li, Yaqing; Wang, Huijun

Information poverty is a new form of poverty in information society. With the growing information-gap between urban and rural areas, information poverty is prevailing in the vast rural areas in China. It is largely restricted the new rural construction and the social harmonious development of villages and towns and must be resolved. The evaluation of rural information poverty is the premise to resolve it. In order to estimate the problem, index system of rural informatization evaluation of Hebei province was designed by means of Delphi. Then, according to the survey of farmers' information demand, AHP and FCE were used to estimate rural information poverty of Hebei province. The purpose of this study is to provide a new operational approach in evaluating or solving rural information poverty and constructing rural informatization in China.

"Deprivation" and "the Rural": An Investigation into Contradictory Discourses.

ERIC Educational Resources Information Center

Woodward, Rachel

1996-01-01

Rural respondents in the (English) Rural Lifestyles Project frequently denied rural "deprivation" through representations of rural areas as problem-free and idyllic, portrayals of deprivation as an individual fault, and constructions of deprivation as an urban feature. Argues that normative constructions of "deprivation"…

Rural Pennsylvanians--A Troubled People.

ERIC Educational Resources Information Center

Hillman, Arnold

This report presents the problems of rural Pennsylvania and proposes solutions to those problems. Because the news media does not systematically report on rural situations, the public lacks awareness concerning the problems in rural Pennsylvania. Rural problems include high unemployment rates, high welfare expenditures, out migration, low…

Rural Electric Youth Tour Packet.

ERIC Educational Resources Information Center

National Rural Electric Cooperative Association, Washington, DC.

This packet of materials provides information about tours for rural secondary students in Washington, D.C., sponsored jointly by the National Rural Electric Cooperative Association (NRECA), state rural electric cooperatives, and statewide associations of rural electric systems. Since 1958 this program has selected high school students to visit…

Gender, Class and Rurality: Australian Case Studies

ERIC Educational Resources Information Center

Bryant, Lia; Pini, Barbara

2009-01-01

The interrelationship between gender and class in rural spaces has received little attention. While rural scholars have focused on the implications for class from processes of gentrification and agricultural and rural restructuring, these analyses have remained largely ungendered. Similarly, feminist rural studies have rarely explored subjectivity…

Using the theory of reasoned action to model retention in rural primary care physicians.

PubMed

Feeley, Thomas Hugh

2003-01-01

Much research attention has focused on medical students', residents', and physicians' decisions to join a rural practice, but far fewer studies have examined retention of rural primary care physicians. The current review uses Fishbein and Ajzen's Theory of Reasoned Action (TRA) to organize the literature on the predictors and correlates of retention of rural practicing physicians. TRA suggests turnover behavior is directly predicted by one's turnover intentions, which are, in turn, predicted by one's attitudes about rural practice and perceptions of salient others' (eg, spouse's) attitudes about rural practice and rural living. Narrative literature review of scholarship in predicting and understanding predictors and correlates of rural physician retention. The TRA model provides a useful conceptual model to organize the literature on rural physician retention. Physicians' subjective norms regarding rural practice are an important source of influence in the decision to remain or leave one's position, and this relation should be more fully examined in future research.

Development of a Rural Health Framework: Implications for Program Service Planning and Delivery

PubMed Central

White, Deanna

2013-01-01

Purpose: To describe the development and application of an evidence-based Rural Health Framework to guide rural health program, policy and service planning. Methods: A literature review of rural health programs, focusing on health promotion, chronic disease prevention and population health, was conducted using several bibliographic databases. Findings: Thirty papers met the criteria for review, describing chronic disease interventions and public health policies in rural settings. Twenty-one papers demonstrated effective intervention programs and highlighted potential good practices for rural health programs, which were used to define key elements of a Rural Health Framework. Conclusions: The Rural Health Framework was applied to an influenza immunization program to demonstrate its utility in assisting public health providers to increase uptake of the vaccine. This Rural Health Framework provides an opportunity for program planners to reflect on the key issues facing rural communities to ensure the development of policies and strategies that will prudently and effectively meet population health needs. PMID:23968625

Rural Education in Iowa: A Collection of Papers [from the Invitational Rural Education Conference (Cedar Falls, IA, April 7-9, 1989)]. Monograph Series, Volume I, Number 1.

ERIC Educational Resources Information Center

Jackson, Dale R., Ed.

This volume contains short papers and commentaries from a conference on rural education in Iowa. Prefatory notes compare the characteristics of Iowa rural students and rural schools to those of the North Central states in general, and discuss two rural education issues repeatedly identified at the conference--equity of educational opportunities…

Strategies of Rural Development in Asia--A Discussion. Summary of Discussion, Research Studies and Country Statements Presented to the Seminar on Approaches to Rural Development in Asia (Malaysia, May-June, 1975).

ERIC Educational Resources Information Center

Inayatullah, C., Ed.

A 10-day seminar for senior government officials concerned with making rural development policies in selected Asian countries focused on programs adopted by various Asian governments to tackle rural development problems. To compare various approaches, seven indicators of rural development were used: agricultural productivity; rural employment;…

Urban-rural differences in self-reported limiting long-term illness in Scotland.

PubMed

Levin, Kate A

2003-12-01

Previous research suggests that there are significant differences in health between urban and rural areas. The aim of this study is to describe the pattern and magnitude of urban-rural variation in health in Scotland and to examine the factors associated with health inequalities in urban and rural areas. The data used in this study were limiting long-term illness (LLTI) and socio-economic data collected by the 1991 Census. A rurality indicator was created using Scottish Household Survey rurality classifications. Multilevel Poisson regression modelling was carried out with LLTI as a health indicator for each type of rurality within Scotland. A variety of socio-economic factors were investigated for each rurality. Areas with the highest Standardized Illness Ratios (SIRs) (>125) are predominantly urban whereas the lowest SIRs (<75) are found in both urban and rural areas. Rural communities are more heterogeneous than urban areas in terms of their social make-up with relation to health; however, when these areas are split according to minor road length and different socio-economic factors are added, the model fit for each new model is improved and the reduction in total variation is comparable with that of the urban models. These findings suggest that rural areas should not be treated as a homogeneous group but should be subdivided into rural types.

Climate shocks and rural-urban migration in Mexico: Exploring nonlinearities and thresholds.

PubMed

Nawrotzki, Raphael J; DeWaard, Jack; Bakhtsiyarava, Maryia; Ha, Jasmine Trang

2017-01-01

Adverse climatic conditions may differentially drive human migration patterns between rural and urban areas, with implications for changes in population composition and density, access to infrastructure and resources, and the delivery of essential goods and services. However, there is little empirical evidence to support this notion. In this study, we investigate the relationship between climate shocks and migration between rural and urban areas within Mexico. We combine individual records from the 2000 and 2010 Mexican censuses (n=683,518) with high-resolution climate data from Terra Populus that are linked to census data at the municipality level (n=2,321). We measure climate shocks as monthly deviation from a 30-year (1961-1990) long-term climate normal period, and uncover important nonlinearities using quadratic and cubic specifications. Satellite-based measures of urban extents allow us to classify migrant-sending and migrant-receiving municipalities as rural or urban to examine four internal migration patterns: rural-urban, rural-rural, urban-urban, and urban-rural. Among our key findings, results from multilevel models reveal that each additional drought month increases the odds of rural-urban migration by 3.6%. In contrast, the relationship between heat months and rural-urban migration is nonlinear. After a threshold of ~34 heat months is surpassed, the relationship between heat months and rural-urban migration becomes positive and progressively increases in strength. Policy and programmatic interventions may therefore reduce climate induced rural-urban migration in Mexico through rural climate change adaptation initiatives, while also assisting rural migrants in finding employment and housing in urban areas to offset population impacts.

Climate shocks and rural-urban migration in Mexico: Exploring nonlinearities and thresholds

PubMed Central

Nawrotzki, Raphael J.; DeWaard, Jack; Bakhtsiyarava, Maryia; Ha, Jasmine Trang

2016-01-01

Adverse climatic conditions may differentially drive human migration patterns between rural and urban areas, with implications for changes in population composition and density, access to infrastructure and resources, and the delivery of essential goods and services. However, there is little empirical evidence to support this notion. In this study, we investigate the relationship between climate shocks and migration between rural and urban areas within Mexico. We combine individual records from the 2000 and 2010 Mexican censuses (n=683,518) with high-resolution climate data from Terra Populus that are linked to census data at the municipality level (n=2,321). We measure climate shocks as monthly deviation from a 30-year (1961-1990) long-term climate normal period, and uncover important nonlinearities using quadratic and cubic specifications. Satellite-based measures of urban extents allow us to classify migrant-sending and migrant-receiving municipalities as rural or urban to examine four internal migration patterns: rural-urban, rural-rural, urban-urban, and urban-rural. Among our key findings, results from multilevel models reveal that each additional drought month increases the odds of rural-urban migration by 3.6%. In contrast, the relationship between heat months and rural-urban migration is nonlinear. After a threshold of ~34 heat months is surpassed, the relationship between heat months and rural-urban migration becomes positive and progressively increases in strength. Policy and programmatic interventions may therefore reduce climate induced rural-urban migration in Mexico through rural climate change adaptation initiatives, while also assisting rural migrants in finding employment and housing in urban areas to offset population impacts. PMID:28435176

Sociodemographic and Environmental Correlates of Active Commuting in Rural America

PubMed Central

Fan, Jessie X.; Wen, Ming; Kowaleski-Jones, Lori

2014-01-01

Purpose This research investigated participation rates in 3 modes of active commuting (AC) and their sociodemographic and physical environmental correlates in rural America. Methods The 2000 Census supplemented with other datasets were used to analyze AC rates in percentage of workers walking, biking, and taking public transportations to work in 14,209 nonmetropolitan rural tracts identified by RUCA codes, including 4,067 small rural and 10,142 town-micropolitan rural tracts. Sociodemographic and physical environmental variables were correlated with 3 AC modes simultaneously using Seemingly Unrelated Regression for nonmetro rural, and for small rural and town-micropolitan rural separately. Findings The average AC rates in rural tracts were 3.63%, 0.26%, and 0.56% for walking, biking, and public transportation to work, respectively, with small rural tracts having a higher rate of walking but lower rates of biking and public transportation to work than town-micropolitan tracts. In general, better economic well-being was negatively associated with AC but percentage of college-educated was a positive correlate. Population density was positively associated with AC but greenness and proximity to parks were negative correlates. However, significant differences existed for different AC modes, and between small rural and town-micropolitan rural tracts. Conclusions Sociodemographic factors explained more variance in AC than physical environmental factors but the detailed relationships were complex, varying by AC mode and by degree of rurality. Any strategy to promote AC in rural America needs to be sensitive to the population size of the area and assessed in a comprehensive manner to avoid a “one size fits all” approach. PMID:25066252

The old age health security in rural China: where to go?

PubMed

Dai, Baozhen

2015-11-04

The huge number of rural elders and the deepening health problems (e.g. growing threats of infectious diseases and chronic diseases etc.) place enormous pressure on old age health security in rural China. This study aims to provide information for policy-makers to develop effective measures for promoting rural elders' health care service access by examining the current developments and challenges confronted by the old age health security in rural China. Search resources are electronic databases, web pages of the National Bureau of Statistics of China and the National Health and Family Planning Commission of China on the internet, China Population and Employment Statistics Yearbook, China Civil Affairs' Statistical Yearbook and China Health Statistics Yearbooks etc. Articles were identified from Elsevier, Wiley, EBSCO, EMBASE, PubMed, SCI Expanded, ProQuest, and National Knowledge Infrastructure of China (CNKI) which is the most informative database in Chinese. Search terms were "rural", "China", "health security", "cooperative medical scheme", "social medical assistance", "medical insurance" or "community based medical insurance", "old", or "elder", "elderly", or "aged", "aging". Google scholar was searched with the same combination of keywords. The results showed that old age health security in rural China had expanded to all rural elders and substantially improved health care service utilization among rural elders. Increasing chronic disease prevalence rates, pressing public health issues, inefficient rural health care service provision system and lack of sufficient financing challenged the old age health security in rural China. Increasing funds from the central and regional governments for old age health security in rural China will contribute to reducing urban-rural disparities in provision of old age health security and increasing health equity among rural elders between different regions. Meanwhile, initiating provider payment reform may contribute to improving the efficiency of rural health care service provision system and promoting health care service access among rural elders.

Supporting nurses' transition to rural healthcare environments through mentorship.

PubMed

Rohatinsky, Noelle K; Jahner, Sharleen

2016-01-01

The global shortage of rural healthcare professionals threatens the access these communities have to adequate healthcare resources. Barriers to recruitment and retention of nurses in rural facilities include limited resources, professional development opportunities, and interpersonal ties to the area. Mentorship programs have been used to successfully recruit and retain rural nurses. This study aimed to explore (i) employee perceptions of mentorship in rural healthcare organizations, (ii) the processes involved in creating mentoring relationships in rural healthcare organizations, and (iii) the organizational features supporting and inhibiting mentorship in rural healthcare organizations. This study was conducted in one rural health region in Saskatchewan, Canada. Volunteer participants who were employed at one rural healthcare facility were interviewed. A semi-structured interview guide that focused on exploring and gaining an understanding of participants' perceptions of mentorship in rural communities was employed. Data were analyzed using interpretive description methodology, which places high value on participants' subjective perspective and knowledge of their experience. All seven participants were female and employed as registered nurses or licensed practical nurses. Participants recognized that the rural environment offered unique challenges and opportunities for the transition of nurses new to rural healthcare. Participants believed mentorships facilitated this transition and were vital to the personal and professional success of new employees. Specifically, their insights indicated that this transition was influenced by three factors: rural community influences, organizational influences, and mentorship program influences. Facilitators for mentorships hinged on the close working relationships that facilitated the development of trust. Barriers to mentorship included low staff numbers, limited selection of volunteer mentors, and lack of mentorship education. The rural community context clearly presents challenges for the transition of nurses. Participants described mentorship as a vital component to personal and professional success of new employees in rural areas. The findings of this qualitative exploratory study inform the development of creative and supportive ways to establish mentorships to address the challenges specifically associated with integration of nurses into rural practice.

Impact of the Rural Clinical School of Western Australia on work location of medical graduates.

PubMed

Playford, Denese E; Evans, Sharon F; Atkinson, David N; Auret, Kirsten A; Riley, Geoffrey J

2014-02-03

To determine whether completing a year of the Rural Clinical School of Western Australia (RCSWA) program is associated with entering the rural medical workforce. Cohort study of graduates from the University of Western Australia who completed Year 5 of medical school between 2002 and 2009, comparing work location (identified from the Australian Health Practitioner Regulation Agency database in March-June 2013) between those who participated in the RCSWA (RCSWA graduates) and those who did not (controls). Rural or urban work location of graduates. Of 1116 eligible graduates, 1017 (91.1%) could be traced and were included in the study. Of 258 RCSWA graduates, 42 (16.3%) were working rurally compared with 36 of 759 controls (4.7%). Of 195 RCSWA graduates from urban backgrounds, 29 (14.9%) were working rurally compared with 26 of 691 urban-background controls (3.8%). Of 63 rural-background RCSWA graduates, 13 (20.6%) were working rurally, compared with 10 of 68 rural-background controls (14.7%). Using logistic regression, RCSWA participation had a strong relationship with working rurally (rural-background RCSWA graduates: odds ratio [OR], 7.5; 95% CI, 3.5-15.8; urban-background RCSWA graduates: OR, 5.1; 95% CI, 2.9-9.1). Rural background without RCSWA participation (OR, 4.2; 95% CI, 1.8-9.2) and older age (age in 2012, 30-39 years: OR, 2.2; 95% CI, 1.3-3.7 v ≥ 40 years: OR, 6.6; 95% CI, 2.8-15.0) were also significant factors for working rurally. Participation in the RCSWA is strongly associated with greater likelihood of working rurally. Graduates from urban backgrounds who participated in the RCSWA were much more likely to work in rural areas than those who did not. These data substantiate the RCSWA as an effective rural workforce strategy.

The Impact of Agribusiness on Rural Education.

ERIC Educational Resources Information Center

Theobald, Paul

The dramatic growth of multinational agribusiness corporations has led to all types of rural decline--social, demographic, institutional, and environmental. Historically, rural inhabitants and rural land have been abused and neglected in the name of progress. Rural development efforts often attract small assembly or light manufacturing plants that…

75 FR 44757 - Notice of Funding Availability (NOFA) Inviting Applications for the Rural Microentrepreneur...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-29

... DEPARTMENT OF AGRICULTURE Rural Business-Cooperative Service Notice of Funding Availability (NOFA) Inviting Applications for the Rural Microentrepreneur Assistance Program AGENCY: Rural Business-Cooperative.... Canales, Administrator, Rural Business-Cooperative Service. [FR Doc. 2010-18639 Filed 7-28-10; 8:45 am...

Redefining Rurality: Cosmopolitanism, Whiteness, and the New Latino Diaspora

ERIC Educational Resources Information Center

Sierk, Jessica

2017-01-01

In mainstream discourse, rural generally implies white, while urban signifies not-white. However, what happens when "rural" communities experience demographic change? This paper examines how students from a rural, New Latino Diaspora community in a Midwestern state complicate traditional notions of rurality. Data from participant…

Remote Possibilities: Rural Children's Educational Aspirations

ERIC Educational Resources Information Center

Howley, Caitlin W.

2006-01-01

To better understand the influence of rural context on youth's life chances, this study takes up the question of rural children's educational aspirations. The experience of rural life may, as some claim, limit students' educational aspirations. Yet there are indications that rural communities simultaneously generate important social benefits that…

Mental Health Issues in Rural Nursing.

ERIC Educational Resources Information Center

Babich, Karen S., Comp.

Five papers cover recent developments in rural mental health nursing. "Rural Mental Health Care: A Survey of the Research" (Karen Babich) chronicles recent interest in understanding the rural population's character and the nature of mental health services needed by and provided to rural America. Lauren Aaronson ("Using Health…

Changes & Challenges for Rural Schools.

ERIC Educational Resources Information Center

Blair, Leslie Asher, Ed.

2001-01-01

This theme issue of the newsletter SEDLetter contains articles about the challenges facing rural youth, communities, and schools, and the ways that rural schools are meeting those challenges. "When Rural Traditions Really Count" (Ullik Rouk) outlines the rural situation with regard to adolescent substance abuse, youth gangs, teen pregnancy,…

7 CFR 1940.589 - Rural Business Enterprise Grants.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 13 2013-01-01 2013-01-01 false Rural Business Enterprise Grants. 1940.589 Section..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... Loan and Grant Program Funds § 1940.589 Rural Business Enterprise Grants. (a) Amount available for...

7 CFR 1940.593 - Rural Business Opportunity Grants.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 13 2013-01-01 2013-01-01 false Rural Business Opportunity Grants. 1940.593 Section..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... Loan and Grant Program Funds § 1940.593 Rural Business Opportunity Grants. (a) Amount available for...

7 CFR 1940.593 - Rural Business Opportunity Grants.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 13 2014-01-01 2013-01-01 true Rural Business Opportunity Grants. 1940.593 Section..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... Loan and Grant Program Funds § 1940.593 Rural Business Opportunity Grants. (a) Amount available for...

7 CFR 1940.589 - Rural Business Enterprise Grants.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 13 2012-01-01 2012-01-01 false Rural Business Enterprise Grants. 1940.589 Section..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... Loan and Grant Program Funds § 1940.589 Rural Business Enterprise Grants. (a) Amount available for...

7 CFR 1940.593 - Rural Business Opportunity Grants.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 13 2012-01-01 2012-01-01 false Rural Business Opportunity Grants. 1940.593 Section..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... Loan and Grant Program Funds § 1940.593 Rural Business Opportunity Grants. (a) Amount available for...

7 CFR 1940.589 - Rural Business Enterprise Grants.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 13 2014-01-01 2013-01-01 true Rural Business Enterprise Grants. 1940.589 Section..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... Loan and Grant Program Funds § 1940.589 Rural Business Enterprise Grants. (a) Amount available for...

Postgraduate Medical Education for Rural Family Practice in Canada.

ERIC Educational Resources Information Center

Rourke, James T. B.

2000-01-01

To produce more rural physicians, the College of Family Physicians of Canada recommends providing earlier and more extensive rural medicine experience for all undergraduate medical students, developing rural postgraduate training programs, providing third-year optional special and advanced rural family-medicine skills training, and making advanced…

Education for Rural Practice: A Saga of Pipelines and Plumbers. Commentary.

ERIC Educational Resources Information Center

Norris, Thomas E.

2000-01-01

Current efforts to address the severe and worsening shortage of rural physicians include attracting and preparing rural students for medical school, enhancing medical school curricula, and placing and retaining rural physicians. Recommendations include creating incentives for successful rural training programs, encouraging innovation in rural…

Investigating Rural Teachers' Professional Development, Instructional Knowledge, and Classroom Practice

ERIC Educational Resources Information Center

Glover, Todd A.; Nugent, Gwen C.; Chumney, Frances L.; Ihlo, Tanya; Shapiro, Edward S.; Guard, Kirra; Koziol, Natalie; Bovaird, Jim

2016-01-01

Teachers Speak was a national survey study designed to investigate the characteristics of rural elementary school teachers' existing professional development; differences in professional development practices between rural and non-rural settings; and the potential influence of professional development characteristics on rural teachers' knowledge,…

7 CFR 1940.589 - Rural Business Enterprise Grants.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 13 2010-01-01 2009-01-01 true Rural Business Enterprise Grants. 1940.589 Section... Loan and Grant Program Funds § 1940.589 Rural Business Enterprise Grants. (a) Amount available for..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF...

Swings and Roundabouts: Working as a Rural Academic.

ERIC Educational Resources Information Center

Ellis, Bronwyn; Boxall, Dianne; Dollard, Maureen; Sawyer, Janet

An Australian study explored the implications of being a rural academic; distinguishing features of rural academics' work; perceptions of rural academics held by themselves and others; and contributions rural academics make to their institutions, disciplines, and communities. Interviews were conducted with 24 faculty members from 2 Australian…

Rural-Urban Connections.

ERIC Educational Resources Information Center

Perkins, Daniel F.; LaGreca, Anthony J.; Mullis, Ronald L.

This publication combines three papers on rural and urban youth issues. "Key Issues Facing Rural Youth" (Daniel F. Perkins) notes that rural adolescents share the same concerns and exhibit the same problem behaviors as their urban counterparts. But in addition, geographic isolation presents problems unique to rural areas. A framework is proposed…

Workplace Learning in Rural Contexts

ERIC Educational Resources Information Center

Reardon, Robert F.; Brooks, Ann K.

2008-01-01

Many people perceive rural America as being an almost completely agricultural, farming, or ranching economy. In fact, less than 7 percent of rural employment is in agriculture; service industries account for over half, and service and manufacturing together account for more than 66 percent of employment in rural areas. Rural regions take 50…

7 CFR 25.301 - Selection factors for designation of nominated rural areas.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 1 2012-01-01 2012-01-01 false Selection factors for designation of nominated rural areas. 25.301 Section 25.301 Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES... rural areas. In choosing among nominated rural areas eligible for designation as Empowerment Zone...

7 CFR 25.301 - Selection factors for designation of nominated rural areas.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 1 2013-01-01 2013-01-01 false Selection factors for designation of nominated rural areas. 25.301 Section 25.301 Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES... rural areas. In choosing among nominated rural areas eligible for designation as Empowerment Zone...

7 CFR 25.301 - Selection factors for designation of nominated rural areas.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 1 2014-01-01 2014-01-01 false Selection factors for designation of nominated rural areas. 25.301 Section 25.301 Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES... rural areas. In choosing among nominated rural areas eligible for designation as Empowerment Zone...

The Rural Texas Environment: A Profile of Stressors.

ERIC Educational Resources Information Center

Mountain, Karen; and Others

Questionnaire data from 168 rural residents of Atacosa, Cass, Freestone, Scurry, and Upton counties, 153 health and human services providers and interviews with 125 residents of 25 rural communities identified and described stressors in the rural Texas environment. Rural Texans viewed economic problems (money, lack of jobs, poverty, working…

Rural Governments in the Municipal Bond Market.

ERIC Educational Resources Information Center

Palumbo, George; Sacks, Seymour

The differential interest costs to rural governments associated with borrowing in the tax-exempt bond market is a function of the advantageous position of several large partially rural counties and the dominance of school district borrowing in rural communities, rather than a disadvantage of predominantly rural governments. This conclusion is the…

Rural Gifted Education: A Comprehensive Literature Review

ERIC Educational Resources Information Center

Lawrence, Barbara Kent

2009-01-01

This review of literature about gifted rural education reveals not only important information but the need for further work. The concepts presented have applicability that is not exclusively rural, but they derive from studies done with rural students and take rural culture, history, and circumstances into account. Understanding the context of…

76 FR 22608 - Notice of a Public Meeting on the Rural Energy for America Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-22

... DEPARTMENT OF AGRICULTURE Rural Business-Cooperative Service 7 CFR Part 4280 Notice of a Public Meeting on the Rural Energy for America Program AGENCY: Rural Business-Cooperative Service, USDA. ACTION: Notice of public meeting. SUMMARY: The Rural Business-Cooperative Service (RBS) will hold two...

Psychology and Rural America: Current Status and Future Directions.

ERIC Educational Resources Information Center

Murray, J. Dennis; Keller, Peter A.

1991-01-01

Rural people constitute about one-fourth of the U.S. population; their special mental health needs have largely been neglected. Psychologists are needed to practice in rural areas, to develop rural service models, and to support the development of state and federal policies that address rural needs. (DM)

76 FR 52305 - Notice of Funding Availability: Section 515 Multi-Family Housing Preservation Revolving Loan Fund...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-22

... DEPARTMENT OF AGRICULTURE Rural Housing Service Notice of Funding Availability: Section 515 Multi...: Rural Housing Service, USDA. ACTION: Notice. SUMMARY: The Rural Housing Service of Rural Development..., Financial and Loan Analyst, Multi-Family Housing, U.S. Department of Agriculture, Rural Housing Service...

Researching Rural Places: On Social Justice and Rural Education

ERIC Educational Resources Information Center

Roberts, Philip; Green, Bill

2013-01-01

This paper explores some of the political and methodological challenges involved in researching rural education. It begins by outlining the situation in Australia regarding the relationship between social justice and rural education. It first describes the disadvantages experienced by many rural communities and presents an analysis of rural…

Toward a Comprehensive Rural Development Policy.

ERIC Educational Resources Information Center

Knutson, Ronald D.; And Others

Rural development is broader than just agriculture. Farm policy cannot solve rural community problems. Rural problems are sufficiently unique to require special emphasis and special programs. Since rural development has a broader focus than the local community, its problems need to be addressed by all levels of government as well as the private…

The Relationship of Rurality and Education Accountability Outcomes.

ERIC Educational Resources Information Center

Peevely, Gary; Ray, John R.

This paper examines accountability outcomes of Tennessee school districts, comparing rural versus urban districts and litigant versus nonlitigant districts from a 1993 fiscal equity lawsuit. School districts were assigned a measure of rurality using the Cleland Rurality Index, and comparisons were made among the 29 low-rurality districts, 66…

Rural Values and Concensus(sic).

ERIC Educational Resources Information Center

England, J. Lynn; And Others

Sample populations from 15 Intermountain West communities (representative of population, ethnic, and employment variety) were surveyed to test the following hypotheses: (1) there is a greater degree of consensus in rural than in non-rural communities; (2) there are differences between values in rural and non-rural communities; (3) a model…

7 CFR 25.301 - Selection factors for designation of nominated rural areas.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 1 2010-01-01 2010-01-01 false Selection factors for designation of nominated rural areas. 25.301 Section 25.301 Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES... rural areas. In choosing among nominated rural areas eligible for designation as Empowerment Zone...

Sources of Inequities in Rural America: Implications for Research.

ERIC Educational Resources Information Center

Fujimoto, Isao; Zone, Martin

The paper identifies the basic factors affecting rural development and the social consequences of rural policies and structural changes in agriculture; it also suggests research areas relating some of these factors to what is happening in America's rural communities. Data sources such as congressional hearings, rural sociologists' critiques,…

Rural Health Issues. Keynote Address.

ERIC Educational Resources Information Center

Hart, Gary

Medical students that come from rural areas are more likely to return to rural areas to practice, but rural students apply for medical school at half the rate of urban students. Factors that contribute to this problem are the lack of rural representation on medical school selection committees; centralization of medical education facilities in…

A Practical Approach to Rural Drug Abuse Programming.

ERIC Educational Resources Information Center

Rozelle, George R.; And Others

1980-01-01

Reviews characteristics of rural drug abuse and general considerations for rural service delivery. Describes the Prevention Project, a rural drug abuse program in Florida, and explains its development, philosophy, and teaching techniques, including a basic educational module for use with rural youth. Includes recommendations for similar programs.…

7 CFR 2.45 - Deputy Under Secretary for Rural Economic and Community Development.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the Under Secretary for Rural Development § 2.45 Deputy Under Secretary for Rural Economic and... Under Secretary for Rural Economic and Community Development, to be exercised only during the absence or... may hereafter be delegated to the Under Secretary for Rural Economic and Community Development. ...

7 CFR 3555.209 - Rural Energy Plus loans.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 15 2014-01-01 2014-01-01 false Rural Energy Plus loans. 3555.209 Section 3555.209... AGRICULTURE GUARANTEED RURAL HOUSING PROGRAM (Eff. 9-1-14) Underwriting the Property § 3555.209 Rural Energy Plus loans. Loans guaranteed under Rural Energy Plus provisions are for the purchase of energy...

Rural Health Care Delivery: Hard Times, Hard Changes.

ERIC Educational Resources Information Center

McLaughlin, Judith

Rural America is undergoing rapid and confusing change which impacts on the role of rural health educators and practitioners. Although rural life has been romanticized, rural areas have emergencies and accidents remote from professional assistance, occupational diseases, high infant and maternal mortality rates, and the same high incidence of…

Pennsylvania's Rural Homeless Reality.

ERIC Educational Resources Information Center

Center for Rural Pennsylvania, Harrisburg.

The Center for Rural Pennsylvania analyzed data from the Pennsylvania Department of Public Welfare concerning rural homelessness for fiscal years 1997 through 1999. Findings indicate that rural Pennsylvania has a homeless population and it is growing. In 1999, more than 21,700 clients received homeless assistance in rural areas, 44 percent of whom…

Nature, Types and Scale of Rural Development.

ERIC Educational Resources Information Center

Hill, Frances

The issue of rural development has been surrounded by a number of debates regarding its nature, types, and scale. Included among the sources of controversy relating to rural development are the following areas: (1) the relation between rural development and rural industrialization, (2) the distribution of benefits and costs associated with…

Louisiana Annual Rural Manpower Report. ES-225, 1972.

ERIC Educational Resources Information Center

Louisiana State Dept. of Employment Security, Baton Rouge

The Rural Manpower Service Section of the Louisiana Department of Employment Security provided recruitment, placement, and other Employment Service programs to the agricultural and rural non-agricultural populations. Goals of the Rural Manpower Service were to: serve the agricultural workers and rural population in accordance with existing Federal…

7 CFR 25.503 - Rural areas.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 1 2011-01-01 2011-01-01 false Rural areas. 25.503 Section 25.503 Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES Special Rules § 25.503 Rural areas. (a) What constitutes “rural”. A rural area may consist of any area that lies outside...

7 CFR 25.301 - Selection factors for designation of nominated rural areas.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 1 2011-01-01 2011-01-01 false Selection factors for designation of nominated rural areas. 25.301 Section 25.301 Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES... rural areas. In choosing among nominated rural areas eligible for designation as Empowerment Zone...

Rural Life and Education: A Study of the Rural-School Problem As a Phase of the Rural-Life Problem. Revised Edition.

ERIC Educational Resources Information Center

Cubberley, Ellwood Patterson

Published in 1922, this book examines changes in rural life during the 19th century, and resulting problems and effects on rural schooling in the early 20th century. The book suggests that by the early 20th century, rural schools had lost their former importance to the community and were far behind compared to the progress of urban schools. The…

[The rural-urban nature and geographical nature of patterns of internal migration].

PubMed

Raczynski, D

1981-07-01

The rural-urban nature and geographical patterns of internal migration in Chile are studied. The magnitude, nature, and relative importance of rural-urban, interurban, inter-rural, and urban-rural movements in the country are examined, with a focus on the impact of internal migration on urbanization and on the demographic growth of cities and rural areas. Rural and urban differentials in propensity to migrate and in the capacity to attract and retain population are investigated using 1970 census data on migratory flows to and from the Santiago metropolitan area and those directed to other parts of the country.

Practice locations of longitudinal integrated clerkship graduates: a matched-cohort study.

PubMed

Myhre, Douglas L; Bajaj, Sameer; Woloschuk, Wayne

2016-01-01

Longitudinal integrated clerkships (LICs) have been introduced as an innovative model to impart medical education. In Canada, most LIC experiences are situated in rural communities. Studies have reported equivalence in graduates from rural LICs and traditional rotation-based clerkships (RBCs) in their performance in residency, as well as in national medical licensure examinations. We sought to determine the impact of rural LICs in terms of practice location of graduates. A matched cohort was developed on the basis of student background and sex to compare practice location of rural LIC and RBC graduates. We used the χ(2) test to assess the association between type of clerkship stream and practice location. We found an association between participation in a rural LIC and rural practice location. Rural LIC programs play an important role in introducing students to rural medicine and may be an effective tool in responding to the shortage of rural practitioners.

Rural origin and exposure drives Ghanaian midwives reported future practice.

PubMed

Lori, Jody R; Livingston, Laura; Eagle, Megan; Rominski, Sarah; Nakua, Emmanuel Kweku; Agyei-Baffour, Peter

2014-09-01

A primary cause of Ghana's higher than global average maternal mortality rate is limited access to maternal care in rural areas. To date, few studies have examined how rural background/training of midwives impacts their future willingness to work in remote areas. The purpose of this paper is to describe the relationship between Ghanaian student midwife place of origin and rural training on their willingness to choose a future rural practice location. A cross-sectional computer-based survey was completed by 238 final year Ghanaian midwifery students from two public midwifery training schools located in urban Ghana between October and December 2009. The relationship between rural exposure and willingness to work in rural Ghana was analyzed using independent t-test, chi-square, and bivariate logistic regression. Participants who experienced a rural rotation (OR: 1.51, 95% CI: 0.71, 3.22) and those born in a rural area (OR: 2.24, 95% CI: 0.74, 6.75) resulted in greater odds ratio to choose rural practice following graduation. This study indicates an association between midwifery students' place of origin and training and their willingness to practice in a rural area after graduation.

A Persistent Disparity: Smoking in Rural Sexual and Gender Minorities.

PubMed

Bennett, Keisa; McElroy, Jane A; Johnson, Andrew O; Munk, Niki; Everett, Kevin D

2015-03-01

Sexual and gender minorities (SGM) smoke cigarettes at higher rates than the general population. Historically, research in SGM health issues was conducted in urban populations and recent population-based studies seldom have sufficient SGM participants to distinguish urban from rural. Given that rural populations also tend to have a smoking disparity, and that many SGM live in rural areas, it is vitally important to understand the intersection of rural residence, SGM identity, and smoking. This study analyzes the patterns of smoking in urban and rural SGM in a large sample. We conducted an analysis of 4280 adult participants in the Out, Proud, and Healthy project with complete data on SGM status, smoking status, and zip code. Surveys were conducted at 6 Missouri Pride Festivals and online in 2012. Analysis involved descriptive and bivariate methods, and multivariable logistic regression. We used GIS mapping to demonstrate the dispersion of rural SGM participants. SGM had higher smoking proportion than the non-SGM recruited from these settings. In the multivariable model, SGM identity conferred 1.35 times the odds of being a current smoker when controlled for covariates. Rural residence was not independently significant, demonstrating the persistence of the smoking disparity in rural SGM. Mapping revealed widespread distribution of SGM in rural areas. The SGM smoking disparity persists among rural SGM. These communities would benefit from continued research into interventions targeting both SGM and rural tobacco control measures. Recruitment at Pride Festivals may provide a venue for reaching rural SGM for intervention.

A qualitative study of recruitment barriers, motivators, and community-based strategies for increasing clinical trials participation among rural and urban populations.

PubMed

Friedman, Daniela B; Foster, Caroline; Bergeron, Caroline D; Tanner, Andrea; Kim, Sei-Hill

2015-01-01

Participation in clinical trials (CTs) is low among rural communities. Investigators report difficulty recruiting rural individuals for CTs. The study purpose was to identify recruitment barriers, motivators, and strategies to help increase access to and participation in CTs in rural and urban communities. Qualitative focus groups/interviews. Rural and urban counties in one southeastern state. Two hundred twelve African-American and white men and women ages 21+. Nineteen focus groups and nine interviews were conducted. Audio files were transcribed and organized into NVivo10. Recurring themes were examined by geographic location. Although similar barriers, motivators, and strategies were reported by urban and rural groups, perceptions regarding their importance varied. Recruitment barriers mentioned in both rural and urban groups included fear, side effects, limited understanding, limited time, and mistrust. Rural groups were more mindful of time commitment involved. Both rural and urban participants reported financial incentives as the top motivator to CT participation, followed by personal illness (urban groups) and benefits to family (rural groups). Recruitment strategies suggested by rural participants involved working with schools/churches and using word of mouth, whereas partnering with schools, word of mouth, and media were recommended most by urban groups. Perceived recruitment barriers, motivators, and strategies did not differ considerably between rural and urban groups. Major barriers identified by participants should be addressed in future CT recruitment and education efforts. Findings can inform recruitment and communication strategies for reaching both urban and rural communities.

Does Core Area Theory Apply to STIs in Rural Environments?

PubMed Central

Gesink, Dionne C; Sullivan, Ashleigh B; Norwood, Todd; Serre, Marc L; Miller, William C

2012-01-01

Background Our objective was to determine the extent to which geographical core areas for gonorrhea and syphilis are located in rural areas, as compared to urban areas. Methods Incident gonorrhea (January 1, 2005 to December 31, 2010) and syphilis (January 1, 1999 to December 31, 2010) rates were estimated and mapped by census tract and quarter. Rurality was measured using percent rural and rural-urban commuting area (RUCA; rural, small town, micropolitan, or urban). SaTScan was used to identify spatiotemporal clusters of significantly elevated rates of infection. Clusters lasting five years or longer were considered core areas; clusters of shorter duration were considered outbreaks. Clusters were overlaid on maps of rurality and qualitatively assessed for correlation. Results Twenty gonorrhea core areas were identified; 65% in urban centers, 25% in micropolitan areas, and the remaining 10% were geographically large capturing combinations of urban, micropolitan, small town and rural environments. Ten syphilis core areas were identified with 80% in urban centers and 20% capturing two or more RUCAs. All ten of the syphilis core areas (100%) overlapped with gonorrhea core areas. Conclusions Gonorrhea and syphilis rates were high for rural parts of North Carolina; however, no core areas were identified exclusively for small towns or rural areas. The main pathway of rural STI transmission may be through the interconnectedness of urban, micropolitan, small town and rural areas. Directly addressing STIs in urban and micropolitan communities may also indirectly help address STI rates in rural and small town communities. PMID:23254115

Association between self-efficacy, career interest and rural career intent in Australian medical students with rural clinical school experience

PubMed Central

Isaac, Vivian; Walters, Lucie; McLachlan, Craig S

2015-01-01

Objectives To investigate medical student's self-efficacy at the time of finishing their rural clinical school (RCS) placement and factors associated with self-efficacy. Secondary aims are to explore whether interest levels or self-efficacy are associated with rural or remote career intentions. Design, setting and participants A cross-sectional study of medical students who had completed their RCS term in 17 Australian universities. Data were derived from the 2013 Federation of Rural Australian Medical Educators (FRAME) evaluation survey. Questionnaire responses were analysed from 653 medical students from regional Australia. All 732 students who completed their RCS term in 2013 were invited to participate. Primary and secondary outcome measures Rural self-efficacy: Six questions to measure self-efficacy beliefs in rural medical practice, based on the sources of self-efficacy described by Bandura. Rural career intention: Students were asked to identify their preferred location for future practice. The options were, Capital or Major City; Inner regional city or large town; Smaller town and very remote area. Results Questionnaire responses were analysed from 653 medical students from regional Australia (response rate 89.2%). 83.8% of all students recalled an increase in their interest levels for rural medicine as a result of their RCS experience. Actual career intention to work in a regional area or rural area was 60.2%. Bivariate analyses showed female gender (p=0.003), rural background (p<0.001), an RCS preference for clinical training (p<0.001) and general practice intentions (p=0.004) were factors associated with higher levels of self-efficacy. Logistic regression analyses showed that self-efficacy was independently associated with increased interest in rural medicine (OR 1.4 (95% CI 1.3 to 1.5)) and rural career intent (OR 1.2 (95% CI 1.1 to 1.3)). (Model included gender, rural background, preference for RCS, generalist intent, rural practice interest and self-efficacy). Conclusions Self-efficacy is associated with increased interest levels for rural medicine and rural medical career intent. PMID:26671960

Association between self-efficacy, career interest and rural career intent in Australian medical students with rural clinical school experience.

PubMed

Isaac, Vivian; Walters, Lucie; McLachlan, Craig S

2015-12-15

To investigate medical student's self-efficacy at the time of finishing their rural clinical school (RCS) placement and factors associated with self-efficacy. Secondary aims are to explore whether interest levels or self-efficacy are associated with rural or remote career intentions. A cross-sectional study of medical students who had completed their RCS term in 17 Australian universities. Data were derived from the 2013 Federation of Rural Australian Medical Educators (FRAME) evaluation survey. Questionnaire responses were analysed from 653 medical students from regional Australia. All 732 students who completed their RCS term in 2013 were invited to participate. Rural self-efficacy: Six questions to measure self-efficacy beliefs in rural medical practice, based on the sources of self-efficacy described by Bandura. Rural career intention: Students were asked to identify their preferred location for future practice. The options were, Capital or Major City; Inner regional city or large town; Smaller town and very remote area. Questionnaire responses were analysed from 653 medical students from regional Australia (response rate 89.2%). 83.8% of all students recalled an increase in their interest levels for rural medicine as a result of their RCS experience. Actual career intention to work in a regional area or rural area was 60.2%. Bivariate analyses showed female gender (p=0.003), rural background (p<0.001), an RCS preference for clinical training (p<0.001) and general practice intentions (p=0.004) were factors associated with higher levels of self-efficacy. Logistic regression analyses showed that self-efficacy was independently associated with increased interest in rural medicine (OR 1.4 (95% CI 1.3 to 1.5)) and rural career intent (OR 1.2 (95% CI 1.1 to 1.3)). (Model included gender, rural background, preference for RCS, generalist intent, rural practice interest and self-efficacy). Self-efficacy is associated with increased interest levels for rural medicine and rural medical career intent. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

What role can the rural pipeline play in the recruitment and retention of rural allied health professionals?

PubMed

Durey, Angela; Haigh, Margaret; Katzenellenbogen, Judith M

2015-01-01

People living in rural areas have poorer health than their urban counterparts with higher morbidity and mortality rates and lower life expectancy. Challenges attracting health professionals to work in rural locations in Australia and elsewhere have been well- documented. In response, the idea of a rural pipeline emerged in the medical literature as a career pathway for doctors, conceptualised as a career continuum starting at school and ending in a committed, appropriately trained and supported rural doctor. This article draws on the literature to consider how the concept of a rural pipeline can be used to enhance recruitment and retention of allied health professionals (AHPs) in Australia. The complexity of the issue is taken into account, acknowledging the diverse professional, organisational and social needs within and between AHPs and their different career pathways. With this in mind, the rural pipeline is adapted and extended to focus on AHPs who enter at any stage of their career to work in rural areas. Barriers to recruitment and retention require multifaceted strategies to encourage and support AHPs at various stages along the pipeline to enter, and remain in, rural practice. Findings from the literature identify discrete themes within and between AHPs about factors influencing their rural recruitment and retention choices and include career stage at entry to rural practice, age, gender, social context, professional support, organisational environment and public-private practice mix in service delivery. These findings underscored the development of an extended rural pipeline adapted to specifically target AHPs. This flexible framework of entry to rural practice can be applied at any stage of their career and includes suggestions of strategies to support retention. Evidence from studies of rural AHPs suggests a flexible approach to recruitment and retention is needed that takes into account the complexity of the issue. The extended rural pipeline adapted to AHPs avoids a one-size-fits-all approach. Instead, it offers a more nuanced approach that addresses the diversity within and between professions and reflects the different stages at which AHPs enter rural practice that can inform recruitment and retention strategies that better meet their needs.

Spatiotemporal Discordance in Five Common Measures of Rurality for US Counties and Applications for Health Disparities Research in Older Adults.

PubMed

Cohen, Steven A; Kelley, Lauren; Bell, Allison E

2015-01-01

Rural populations face numerous barriers to health, including poorer health care infrastructure, access to care, and other sociodemographic factors largely associated with rurality. Multiple measures of rurality used in the biomedical and public health literature can help assess rural-urban health disparities and may impact the observed associations between rurality and health. Furthermore, understanding what makes a place truly "rural" versus "urban" may vary from region to region in the US. The objectives of this study are to compare and contrast five common measures of rurality and determine how well-correlated these measures are at the national, regional, and divisional level, as well as to assess patterns in the correlations between the prevalence of obesity in the population aged 60+ and each of the five measures of rurality at the regional and divisional level. Five measures of rurality were abstracted from the US Census and US Department of Agriculture (USDA) to characterize US counties. Obesity data in the population aged 60+ were abstracted from the Behavioral Risk Factor Surveillance System (BRFSS). Spearman's rank correlations were used to quantify the associations among the five rurality measurements at the national, regional, and divisional level, as defined by the US Census Bureau. Geographic information systems were used to visually illustrate temporal, spatial, and regional variability. Overall, Spearman's rank correlations among the five measures ranged from 0.521 (percent urban-urban influence code) to 0.917 (rural-urban continuum code-urban influence code). Notable discrepancies existed in these associations by Census region and by division. The associations between measures of rurality and obesity in the 60+ population varied by rurality measure used and by region. This study is among the first to systematically assess the spatial, temporal, and regional differences and similarities among five commonly used measures of rurality in the US. There are important, quantifiable distinctions in defining what it means to be a rural county depending on both the geographic region and the measurement used. These findings highlight the importance of developing and selecting an appropriate rurality metric in health research.

Pathways to rural family practice at Memorial University of Newfoundland

PubMed Central

Rourke, James; O’Keefe, Danielle; Ravalia, Mohamed; Moffatt, Scott; Parsons, Wanda; Duggan, Norah; Stringer, Katherine; Jong, Michael; Walsh, Kristin Harris; Hippe, Janelle

2018-01-01

Abstract Objective To assess Memorial University of Newfoundland’s (MUN’s) commitment to a comprehensive pathways approach to rural family practice, and to determine the national and provincial effects of applying this approach. Design Analysis of anonymized secondary data. Setting Canada. Participants Memorial’s medical degree (MD) graduates practising family medicine in Newfoundland and Labrador as of January 2015 (N = 305), MUN’s 2011 and 2012 MD graduates (N = 120), and physicians who completed family medicine training programs in Canada between 2004 and 2013 and who were practising in Canada 2 years after completion of their postgraduate training (N = 8091). Main outcome measures National effect was measured by the proportion of MUN’s family medicine program graduates practising in rural Canada compared with those from other Canadian family medicine training programs. Provincial effect was measured by the location of MUN’s MD graduates practising family medicine in Newfoundland and Labrador as of January 2015. Commitment to a comprehensive pathways approach to rural family practice was measured by anonymized geographic data on admissions, educational placements, and practice locations of MUN’s 2011 and 2012 MD graduates, including those who completed family medicine residencies at MUN. Results Memorial’s comprehensive pathways approach to training physicians for rural practice was successful on both national and provincial levels: 26.9% of MUN family medicine program graduates were in a rural practice location 2 years after exiting their post-MD training from 2004 to 2013 compared with the national rate of 13.3% (national effect); 305 of MUN’s MD graduates were practising family medicine in Newfoundland and Labrador as of 2015, with 36% practising in rural areas (provincial effect). Of 114 MD students with known background who graduated in 2011 and 2012, 32% had rural backgrounds. Memorial’s 2011 and 2012 MD graduates spent 20% of all clinical placement weeks in rural areas; of note, 90% of all first-year placements and 95% of third-year family medicine clerkship placements were rural. For the 25 MUN 2011 and 2012 MD graduates who also completed family medicine residencies at MUN, 38% of family medicine placement weeks were spent in rural communities or rural towns. Of the 30 MUN 2011 and 2012 MD graduates practising family medicine in Canada as of January 2015, 42% were practising in rural communities or rural towns; 73% were practising in Newfoundland and Labrador and half of those were in rural communities and rural towns. Conclusion A comprehensive rural pathways approach that includes recruiting rural students and exposing all medical students to extensive rural placements and all family medicine residents to rural family practice training has resulted in more rural generalist physicians in family practice in Newfoundland and Labrador and across Canada. PMID:29540400

Pathways to rural family practice at Memorial University of Newfoundland.

PubMed

Rourke, James; O'Keefe, Danielle; Ravalia, Mohamed; Moffatt, Scott; Parsons, Wanda; Duggan, Norah; Stringer, Katherine; Jong, Michael; Walsh, Kristin Harris; Hippe, Janelle

2018-03-01

To assess Memorial University of Newfoundland's (MUN's) commitment to a comprehensive pathways approach to rural family practice, and to determine the national and provincial effects of applying this approach. Analysis of anonymized secondary data. Canada. Memorial's medical degree (MD) graduates practising family medicine in Newfoundland and Labrador as of January 2015 (N = 305), MUN's 2011 and 2012 MD graduates (N = 120), and physicians who completed family medicine training programs in Canada between 2004 and 2013 and who were practising in Canada 2 years after completion of their postgraduate training (N = 8091). National effect was measured by the proportion of MUN's family medicine program graduates practising in rural Canada compared with those from other Canadian family medicine training programs. Provincial effect was measured by the location of MUN's MD graduates practising family medicine in Newfoundland and Labrador as of January 2015. Commitment to a comprehensive pathways approach to rural family practice was measured by anonymized geographic data on admissions, educational placements, and practice locations of MUN's 2011 and 2012 MD graduates, including those who completed family medicine residencies at MUN. Memorial's comprehensive pathways approach to training physicians for rural practice was successful on both national and provincial levels: 26.9% of MUN family medicine program graduates were in a rural practice location 2 years after exiting their post-MD training from 2004 to 2013 compared with the national rate of 13.3% (national effect); 305 of MUN's MD graduates were practising family medicine in Newfoundland and Labrador as of 2015, with 36% practising in rural areas (provincial effect). Of 114 MD students with known background who graduated in 2011 and 2012, 32% had rural backgrounds. Memorial's 2011 and 2012 MD graduates spent 20% of all clinical placement weeks in rural areas; of note, 90% of all first-year placements and 95% of third-year family medicine clerkship placements were rural. For the 25 MUN 2011 and 2012 MD graduates who also completed family medicine residencies at MUN, 38% of family medicine placement weeks were spent in rural communities or rural towns. Of the 30 MUN 2011 and 2012 MD graduates practising family medicine in Canada as of January 2015, 42% were practising in rural communities or rural towns; 73% were practising in Newfoundland and Labrador and half of those were in rural communities and rural towns. A comprehensive rural pathways approach that includes recruiting rural students and exposing all medical students to extensive rural placements and all family medicine residents to rural family practice training has resulted in more rural generalist physicians in family practice in Newfoundland and Labrador and across Canada. Copyright© the College of Family Physicians of Canada.

Residence in Rural Areas of the United States and Lung Cancer Mortality. Disease Incidence, Treatment Disparities, and Stage-Specific Survival.

PubMed

Atkins, Graham T; Kim, Taeha; Munson, Jeffrey

2017-03-01

There is increased lung cancer mortality in rural areas of the United States. However, it remains unclear to what extent rural-urban differences in disease incidence, stage at diagnosis, or treatment explain this finding. To explore the relationship between smoking rates, lung cancer incidence, and lung cancer mortality in populations across the rural-urban continuum and to determine whether survival is decreased in rural patients diagnosed with lung cancer and whether this is associated with rural-urban differences in stage at diagnosis or the treatment received. We conducted a retrospective cohort study of 348,002 patients diagnosed with lung cancer between 2000 and 2006. Data from metropolitan, urban, suburban, and rural areas in the United States were obtained from the Surveillance, Epidemiology, and End Results program database. County-level population estimates for 2003 were obtained from the U.S. Census Bureau, and corresponding estimates of smoking prevalence were obtained from published literature. The exposure was rurality, defined by the rural-urban continuum code area linked to each cohort participant by county of residence. Outcomes included lung cancer incidence, mortality, diagnostic stage, and treatment received. Lung cancer mortality increased with rurality in a dose-dependent fashion across the rural-urban continuum. The most rural areas had almost twice the smoking prevalence and lung cancer incidence of the largest metropolitan areas. Rural patients diagnosed with stage I non-small cell lung cancer underwent fewer surgeries (69% vs. 75%; P < 0.001) and had significantly reduced median survival (40 vs. 52 mo; P = 0.0006) compared with the most urban patients. Stage at diagnosis was similar across the rural-urban continuum, as was median survival for patients with stages II-IV lung cancer. Higher rural smoking rates drive increased disease incidence and per capita lung cancer mortality in rural areas of the United States. There were no rural-urban discrepancies in diagnostic stage, suggesting similar access to diagnostic services. Rural patients diagnosed with stage I non-small cell lung cancer had shorter survival, which may reflect disparities in access to surgical care. No survival difference for patients with advanced-stage lung cancer is attributed to lack of effective treatment during the time period of this study.

Association between rural clinical clerkship and medical students’ intentions to choose rural medical work after graduation: A cross-sectional study in western China

PubMed Central

Zhu, Bin; Mao, Ying

2018-01-01

Background A large number of programs have been implemented in many countries to increase the healthcare workforce recruitment in rural and remote areas. Rural early exposure programs for medical students have been shown to be effective strategies. However, no related studies have been reported before in China. This study was carried out to determine the association between medical students’ participation in rural clinical clerkships and their intentions to choose rural medical work after graduation from western medical schools in China. Methods Based on a two-stage random sampling method, the cross-sectional survey was carried out in ten western provinces in China. A brief questionnaire filled in by medical students was used for data collection. A total of 4278 medical students participated in the study. The response rate was approximately 90.34%. Pearson’s chi-squared tests and binary logistic regression analyses were performed for data analyses. Results Approximately 52.0% of medical students disclosed intentions to work in rural medical institutions after graduation. Only one in five participants had experience with a rural clinical clerkship. Rural clinical clerkships were significantly associated with medical students’ intentions to work in rural medical institutions (OR: 1.24, 95%CI: 1.05–1.46); further analyses indicated that such clerkships only had a significant impact among the medical students with an urban background (OR: 2.10, 95%CI: 1.48–2.97). In terms of the sociodemographic characteristics, younger age, low level of parental education, majoring in general practice, and studying in low-level medical schools increased the odds of having intentions to engage in rural medical work among medical students; however, rural origins was the only positive univariate predictor. In addition, the predictors of intentions to choose rural medical work were different between medical students with a rural background and those with an urban background. Conclusions Rural clinical clerkship is likely to increase the odds of having intentions to work in rural medical institutions after graduation among medical students in western China, especially for those with an urban background. Related policy makers could consider developing compulsory rural clerkship programs and implement them among medical students to increase early rural exposure. PMID:29608624

Association between rural clinical clerkship and medical students' intentions to choose rural medical work after graduation: A cross-sectional study in western China.

PubMed

Liu, Jinlin; Zhu, Bin; Mao, Ying

2018-01-01

A large number of programs have been implemented in many countries to increase the healthcare workforce recruitment in rural and remote areas. Rural early exposure programs for medical students have been shown to be effective strategies. However, no related studies have been reported before in China. This study was carried out to determine the association between medical students' participation in rural clinical clerkships and their intentions to choose rural medical work after graduation from western medical schools in China. Based on a two-stage random sampling method, the cross-sectional survey was carried out in ten western provinces in China. A brief questionnaire filled in by medical students was used for data collection. A total of 4278 medical students participated in the study. The response rate was approximately 90.34%. Pearson's chi-squared tests and binary logistic regression analyses were performed for data analyses. Approximately 52.0% of medical students disclosed intentions to work in rural medical institutions after graduation. Only one in five participants had experience with a rural clinical clerkship. Rural clinical clerkships were significantly associated with medical students' intentions to work in rural medical institutions (OR: 1.24, 95%CI: 1.05-1.46); further analyses indicated that such clerkships only had a significant impact among the medical students with an urban background (OR: 2.10, 95%CI: 1.48-2.97). In terms of the sociodemographic characteristics, younger age, low level of parental education, majoring in general practice, and studying in low-level medical schools increased the odds of having intentions to engage in rural medical work among medical students; however, rural origins was the only positive univariate predictor. In addition, the predictors of intentions to choose rural medical work were different between medical students with a rural background and those with an urban background. Rural clinical clerkship is likely to increase the odds of having intentions to work in rural medical institutions after graduation among medical students in western China, especially for those with an urban background. Related policy makers could consider developing compulsory rural clerkship programs and implement them among medical students to increase early rural exposure.

Interest in rural medicine among osteopathic residents and medical students.

PubMed

Colegrove, Dustin J; Whitacre, Brian E

2009-01-01

This study examines US osteopathic residents' and medical students' attitudes and willingness to practice in rural medicine. The multiple aims of this study were to determine: (1) if there are any significant differences in interest in rural medicine among various levels of training; (2) the relative age, gender, and race of those who are intending to pursue a career in rural health; and (3) whether a number of demographic characteristics (age, race, year of study) or participation in a rural elective significantly impacted the students' and residents' interest in practicing in a rural area. In particular, differences between osteopathic students and residents are emphasized, because few previous studies have focused on this topic. De-identified, cross-sectional, descriptive techniques utilizing 2 distinct web-based electronic surveys were used in this study. Each survey was sent electronically to medical students and physicians-in-training. Statistical methods included means, frequencies, and t-tests to determine significant differences among groups. Logistic regression was used to determine the impact of various factors on overall rural interest for each group. A total of 161 students from two osteopathic colleges completed and submitted the survey as well as 51 residents/fellows from a variety of training programs. Approximately 43% of the student respondents and 67% of residents expressed an intention of practicing rural medicine. Several notable differences were found among the opinions of students and residents, particularly regarding the perceived prestige of rural physicians. Among medical students, overall interest in rural practice decreased in years 2 to 4; however, there was a positive influence if the students were aged 34 years or over. As expected, being raised in a rural area had a positive impact on rural interest. Additional findings included the lack of significance for gender or race, and the positive influence of taking a rural elective. For residents, some results are similar, although interest in rural medicine actually increased with time. It is imperative that osteopathic medical schools recruit individuals who will be most likely to pursue rural medicine, and then train them to provide health access for rural populations. Further, financial incentives are important to both students and residents, suggesting that 'loan forgiveness' programs or scholarships may be useful in promoting rural location. In order to facilitate the training of individuals who will likely pursue rural medicine, there must be institutional dedication to this goal.

Ruralization of students' horizons: insights into Australian health professional students' rural and remote placements.

PubMed

Smith, Tony; Cross, Merylin; Waller, Susan; Chambers, Helen; Farthing, Annie; Barraclough, Frances; Pit, Sabrina W; Sutton, Keith; Muyambi, Kuda; King, Stephanie; Anderson, Jessie

2018-01-01

Health workforce shortages have driven the Australian and other Western governments to invest in engaging more health professional students in rural and remote placements. The aim of this qualitative study was to provide an understanding of the lived experiences of students undertaking placements in various nonmetropolitan locations across Australia. In addition to providing their suggestions to improve rural placements, the study provides insight into factors contributing to positive and negative experiences that influence students' future rural practice intentions. Responses to open-ended survey questions from 3,204 students from multiple health professions and universities were analyzed using two independent methods applied concurrently: manual thematic analysis and computerized content analysis using Leximancer software. The core concept identified from the thematic analysis was "ruralization of students' horizons," a construct representing the importance of preparing health professional students for practice in nonmetropolitan locations. Ruralization embodies three interrelated themes, "preparation and support," "rural or remote health experience," and "rural lifestyle and socialization," each of which includes multiple subthemes. From the content analysis, factors that promoted students' rural practice intentions were having a "positive" practice experience, interactions with "supportive staff," and interactions with the "community" in general. It was apparent that "difficulties," eg, with "accommodation," "Internet" access, "transport," and "financial" support, negatively impacted students' placement experience and rural practice intentions. The study findings have policy and practice implications for continuing to support students undertaking regional, rural, and remote placements and preparing them for future practice in nonmetropolitan locations. This study may, therefore, further inform ongoing strategies for improving rural placement experiences and enhancing rural health workforce recruitment, retention, and capacity building.

Factors affecting rural volunteering in palliative care - an integrated review.

PubMed

Whittall, Dawn; Lee, Susan; O'Connor, Margaret

2016-12-01

To review factors shaping volunteering in palliative care in Australian rural communities using Australian and International literature. Identify gaps in the palliative care literature and make recommendations for future research. A comprehensive literature search was conducted using Proquest, Scopus, Sage Premier, Wiley online, Ovid, Cochran, Google Scholar, CINAHL and Informit Health Collection. The literature was synthesised and presented in an integrated thematic narrative. Australian Rural communities. While Australia, Canada, the United States (US) and the United Kingdom (UK) are leaders in palliative care volunteer research, limited research specifically focuses on volunteers in rural communities with the least occurring in Australia. Several interrelated factors influence rural palliative care provision, in particular an increasingly ageing population which includes an ageing volunteer and health professional workforce. Also current and models of palliative care practice fail to recognise the innumerable variables between and within rural communities such as distance, isolation, lack of privacy, limited health care services and infrastructure, and workforce shortages. These issues impact palliative care provision and are significant for health professionals, volunteers, patients and caregivers. The three key themes of this integrated review include: (i) Geography, ageing rural populations in palliative care practice, (ii) Psychosocial impact of end-end-of life care in rural communities and (iii) Palliative care models of practice and volunteering in rural communities. The invisibility of volunteers in rural palliative care research is a concern in understanding the issues affecting the sustainability of quality palliative care provision in rural communities. Recommendations for future Australian research includes examination of the suitability of current models of palliative care practice in addressing the needs of rural communities; the recruitment, training, ongoing education and support of volunteers in rural palliative care provision to ensure equitable care for all communities in Australia regardless of location. © 2016 National Rural Health Alliance Inc.

Ruralization of students’ horizons: insights into Australian health professional students’ rural and remote placements

PubMed Central

Cross, Merylin; Waller, Susan; Chambers, Helen; Farthing, Annie; Barraclough, Frances; Pit, Sabrina W; Sutton, Keith; Muyambi, Kuda; King, Stephanie; Anderson, Jessie

2018-01-01

Introduction Health workforce shortages have driven the Australian and other Western governments to invest in engaging more health professional students in rural and remote placements. The aim of this qualitative study was to provide an understanding of the lived experiences of students undertaking placements in various nonmetropolitan locations across Australia. In addition to providing their suggestions to improve rural placements, the study provides insight into factors contributing to positive and negative experiences that influence students’ future rural practice intentions. Methods Responses to open-ended survey questions from 3,204 students from multiple health professions and universities were analyzed using two independent methods applied concurrently: manual thematic analysis and computerized content analysis using Leximancer software. Results The core concept identified from the thematic analysis was “ruralization of students’ horizons,” a construct representing the importance of preparing health professional students for practice in nonmetropolitan locations. Ruralization embodies three interrelated themes, “preparation and support,” “rural or remote health experience,” and “rural lifestyle and socialization,” each of which includes multiple subthemes. From the content analysis, factors that promoted students’ rural practice intentions were having a “positive” practice experience, interactions with “supportive staff,” and interactions with the “community” in general. It was apparent that “difficulties,” eg, with “accommodation,” “Internet” access, “transport,” and “financial” support, negatively impacted students’ placement experience and rural practice intentions. Conclusions The study findings have policy and practice implications for continuing to support students undertaking regional, rural, and remote placements and preparing them for future practice in nonmetropolitan locations. This study may, therefore, further inform ongoing strategies for improving rural placement experiences and enhancing rural health workforce recruitment, retention, and capacity building. PMID:29430183

An Examination of Past and Current Influences of Rurality on Lesbians' Overweight/Obesity Risks.

PubMed

Barefoot, K Nikki; Warren, Jacob C; Smalley, K Bryant

2015-06-01

The purpose of our study was to separately examine past (i.e., rural or non-rural background) and present (i.e., current rural or urban location) influences of rurality on the weight status and diet/exercise behaviors of lesbians. A total of 895 lesbians participated in the online study. Participants were surveyed regarding their rurality status, weight/height, and diet/exercise patterns. A 2×2 (location×background) ANCOVA was conducted to explore influences of rurality on body mass index (BMI), while controlling for age, race, and education. Chi-square analyses were used to examine the relationship between dimensions of rurality and diet/exercise behaviors. There was a significant main effect of current location on BMI. No significant interaction between location and background on BMI was found nor was there a significant main effect of background. Lesbians currently living in rural areas were on average obese (M=30.61), with significantly higher BMIs than urban-residing lesbians (M=28.53). The only significant differences that emerged for lesbians' diet/exercise patterns were for current location-more rural-residing lesbians reported they never engage in exercise in comparison to their urban-residing counterparts, with a greater percentage of urban-residing lesbians reporting frequent exercise. Rural lesbians were also more likely to report a diet high in protein. Findings suggest that current rather than past influences of rurality may have a significant impact on lesbians' weight and diet/exercise behaviors and highlight significant obesity-related health disparities for rural-residing lesbians. These findings offer support for the development of culturally-appropriate healthy diet/exercise and weight promotion efforts that are accessible to rural lesbians.

Development of the Nursing Community Apgar Questionnaire (NCAQ): a rural nurse recruitment and retention tool.

PubMed

Prengaman, M P; Bigbee, J L; Baker, E; Schmitz, D F

2014-01-01

Health professional shortages are a significant issue throughout the USA, particularly in rural communities. Filling nurse vacancies is a costly concern for many critical access hospitals (CAH), which serve as the primary source of health care for rural communities. CAHs and rural communities have strengths and weaknesses that affect their recruitment and retention of rural nurses. The purpose of this study was to develop a tool that rural communities and CAHs can utilize to assess their strengths and weaknesses related to nurse recruitment and retention. The Nursing Community Apgar Questionnaire (NCAQ) was developed based on an extensive literature review, visits to multiple rural sites, and consultations with rural nurses, rural nurse administrators and content experts. A quantitative interview tool consisting of 50 factors that affect rural nurse recruitment and retention was developed. The tool allows participants to rate each factor in terms of advantage and importance level. The tool also includes three open-ended questions for qualitative analysis. The NCAQ was designed to identify rural communities' and CAHs' strengths and challenges related to rural nurse recruitment and retention. The NCAQ will be piloted and a database developed for CAHs to compare their results with those in the database. Furthermore, the NCAQ results may be utilized to prioritize resource allocation and tailor rural nurse recruitment and retention efforts to highlight a community's strengths. The NCAQ will function as a useful real-time tool for CAHs looking to assess and improve their rural nurse recruitment and retention practices and compare their results with those of their peers. Longitudinal results will allow CAHs and their communities to evaluate their progress over time. As the database grows in size, state, regional, and national results can be compared, trends may be discovered and best practices identified.

Rural health network development: public policy issues and state initiatives.

PubMed

Casey, M M; Wellever, A; Moscovice, I

1997-02-01

Rural health networks are a potential way for rural health care systems to improve access to care, reduce costs, and enhance quality of care. Networks provide a means for rural providers to contract with managed care organizations, develop their own managed care entities, share resources, and structure practice opportunities to support recruitment and retention of rural physicians and other health care professionals. The results of early network development initiatives indicate a need for state officials and others interested in encouraging network development to agree on common rural health network definitions, to identify clearly the goals of network development programs, and to document and analyze program outcomes. Future network development efforts need to be much more comprehensive if they are to have a significant impact on rural health care. This article analyzes public policy issues related to integrated rural health network development, discusses current efforts to encourage network development in rural areas, and suggests actions that states may take if they desire to support rural health network development. These actions include adopting a formal rural health network definition, providing networks with alternatives to certain regulatory requirements, and providing incentives such as matching grants, loans, or technical assistance. Without public sector support for networks, managed care options may continue to be unavailable in many less densely populated rural areas of the country, and locally controlled rural health networks are unlikely to develop as an alternative to the dominant pattern of managed care expansion by large urban entities. Implementation of Medicare reform legislation could provide significant incentives for the development of rural health networks, depending on the reimbursement provisions, financial solvency standards, and antitrust exemptions for provider-sponsored networks in the final legislation and federal regulations.

Salt intake and the validity of a salt intake assessment system based on a 24-h dietary recall method in pregnant Japanese women.

PubMed

Satoh, Michihiro; Tanno, Yumi; Hosaka, Miki; Metoki, Hirohito; Obara, Taku; Asayama, Kei; Hoshi, Kazuhiko; Suzuki, Masakuni; Mano, Nariyasu; Imai, Yutaka

2015-01-01

Information regarding salt intake in pregnant women in Japan is limited. An electronic system for the assessment of salt intake using a 24-h dietary recall method has been developed in Japan. The objectives of the present study were to investigate salt intake in pregnant women and to compare the salt intake estimated by the electronic salt intake assessment system with that measured by 24-h urinary salt excretion (24-hUNaCl). Data were collected on 24-hUNaCl and salt intake estimated by the salt intake assessment system for 35 pregnant Japanese women at approximately 20 weeks of gestation. The adjusted 24-hUNaCl (24-hUNaCl/[the number of urinations during the examination day--the number of missing urine collections] × the number of urinations during the examination day, g/day) was used as a standard. The mean adjusted 24-hUNaCl was 7.7 ± 2.5 g/day, and mean systolic/diastolic blood pressure values were 106.1 ± 8.6/62.8 ± 6.5 mmHg. The adjusted 24-hUNaCl was significantly correlated with the salt intake estimated by the salt intake assessment system (r = 0.47, p = 0.004). Bland-Altman analysis showed no significant mean difference (adjusted 24-hUNaCl--salt intake estimated by the assessment system = -0.36 g/day, p = 0.4) and no significant proportional bias (p = 0.1). These results suggest that pregnant women in Japan restrict their salt intake, at least when they are being examined for salt intake. They also suggest that repeated use of the described system may be useful in estimating salt intake in pregnant women.

Free the Globe. (Spanish Title: Liberar al Globo Terráqueo.) Soltar o Globo Terrestre

NASA Astrophysics Data System (ADS)

Gangui, Alejandro

2014-07-01

The parallel globe is an old device, very simple and ingenious that, when systematically employed in astronomy classes, becomes a teaching tool with great potential. Properly oriented according to the local meridian, this instrument allows us to follow the shadows in any region of the Earth that is illuminated by the Sun, as well as offering a clear view of the terminator, the line that divides the day and the night on our planet. With knowledge of the shadows, it is possible to estimate the latitude of a site and to infer local solar time anywhere in the planet's sunlit hemisphere. Furthermore, by using the parallel globe we may understand simply the existence of regions in which objects sometimes do not cast shadows, and also other regions which, on the contrary, sometimes become "long-shadow" countries. In this work, we first review the device and the basics of its assembly and operation. In the second part, we describe in detail some activities targeted to facilitate its use in the classroom, which our research group has been developing during teacher training workshops. El globo terráqueo paralelo es un dispositivo antiguo, muy simple e ingenioso que empleado en forma sistemática en las clases de astronomía se convierte en una herramienta didáctica de gran potencialidad. Orientado adecuadamente de acuerdo al meridiano local, este instrumento permite seguir las sombras en cualquier región de la Tierra que esté iluminada por el Sol, además de ofrecer una visualización clara del terminador, la línea en rápido movimiento que divide el día de la noche en nuestro planeta. Con el conocimiento de las sombras, es posible estimar la latitud de un sitio e inferir la hora solar local en cualquier lugar del hemisferio iluminado del planeta. Además, mediante el empleo del globo terráqueo paralelo se puede comprender de manera simple que existan regiones donde los objetos a veces no proyectan sombras y otras, por el contrario, que a veces se convierten en "países de las sombras largas". En este trabajo, primeramente reseñamos el dispositivo, sus fundamentos básicos de armado y funcionamiento. En la segunda parte, describimos en detalle algunas actividades que facilitan su empleo en el aula y que hemos venido desarrollando en talleres de formación docente en nuestro grupo de investigación. O globo terrestre paralelo é um antigo dispositivo, muito simples e criativo que, empregado de forma sistemática nas aulas de astronomia, converte-se em uma ferramenta didática de grande potencialidade. Orientado adequadamente de acordo com o meridiano local, esse instrumento permite acompanhar as sombras em qualquer região da Terra que esteja iluminada pelo Sol, além de oferecer uma visualização clara do terminadouro, a linha que divide o dia da noite em nosso planeta. Com o conhecimento das sombras, é possível estimar a latitude de uma localidade e inferir a hora solar local em qualquer lugar do hemisfério iluminado do planeta. Além disso, mediante o emprego do globo terrestre paralelo, pode-se compreender, de maneira simples, que existem regiões onde os objetos às vezes não projetam sombras e outras, pelo contrário, que às vezes se convertem em "países das sombras longas". Neste trabalho, primeiramente, descrevemos o dispositivo, seus fundamentos básicos de construção e funcionamento. Na segunda parte, descrevemos em detalhes algumas atividades que facilitam seu emprego na aula e que temos desenvolvido em oficinas de formação docente em nosso grupo de pesquisa.

Investigation and Control Mode of Domestic Pollution in Rural Areas of Guangxi Province

NASA Astrophysics Data System (ADS)

Duan, Chunyi; Chen, Hong

2018-01-01

Due to the unbalanced economic development and scattered residence in rural areas, it was difficult to adopt a centralized approach in rural environmental governance. Based on the survey results of the present situation of rural environment in Guangxi and the analysis of the pollution characteristics in rural areas, the control mode of domestic pollution suitable for rural areas was obtained. Based on this research, a demonstration project of Guangxi’s administrative village was selected.

Rural physician assistants: a survey of graduates of MEDEX Northwest.

PubMed Central

Larson, E H; Hart, L G; Hummel, J

1994-01-01

Graduates of MEDEX Northwest, the physician assistant training program at the University of Washington, were surveyed to describe differences between physician assistants practicing in rural settings and those practicing in urban settings. Differences in demography, satisfaction with practice and community, practice history, and practice content were explored. Of the 341 traceable graduates, 295 (86.5 percent) responded to the mail survey. Although rural- and urban-practicing physician assistants are remarkably similar in most respects--income, hours worked, levels of practice satisfaction, for example--those in rural primary care reported performing a much wider range of medical and administrative tasks than those in urban practice. Half of the physician assistants who grew up in small towns were practicing in rural places compared with 18 percent of those from large towns. The broader scope of practice available to primary care physician assistants in rural areas may be of particular interest to those considering rural careers, to people who train physician assistants, and to rural communities trying to recruit and retain physician assistants. Results also suggest that recruitment of students for rural practice should focus on rural residents. Some problems that rural practitioners are more likely to face than urban ones, such as unreasonable night call schedules and lack of acknowledgement and respect for them as professionals, need to be addressed if rural communities are to be able to attract and retain physician assistants. PMID:7908746

Creating a new rural pharmacy workforce: Development and implementation of the Rural Pharmacy Health Initiative.

PubMed

Scott, Mollie Ashe; Kiser, Stephanie; Park, Irene; Grandy, Rebecca; Joyner, Pamela U

2017-12-01

An innovative certificate program aimed at expanding the rural pharmacy workforce, increasing the number of pharmacists with expertise in rural practice, and improving healthcare outcomes in rural North Carolina is described. Predicted shortages of primary care physicians and closures of critical access hospitals are expected to worsen existing health disparities. Experiential education in schools and colleges of pharmacy primarily takes place in academic medical centers and, unlike experiential education in medical schools, rarely emphasizes the provision of patient care in rural U.S. communities, where chronic diseases are prevalent and many residents struggle with poverty and poor access to healthcare. To help address these issues, UNC Eshelman School of Pharmacy developed the 3-year Rural Pharmacy Health Certificate program. The program curriculum includes 4 seminar courses, interprofessional education and interaction with medical students, embedding of each pharmacy student into a specific rural community for the duration of training, longitudinal ambulatory care practice experiences, community engagement initiatives, leadership training, development and implementation of a population health project, and 5 pharmacy practice experiences in rural settings. The Rural Pharmacy Health Certificate program at UNC Eshelman School of Pharmacy seeks to transform rural pharmacy practice by creating a pipeline of rural pharmacy leaders and teaching a unique skillset that will be beneficial to healthcare systems, communities, and patients. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

The experience of psychiatry training in rural NSW.

PubMed

Nash, Louise; Hickie, Catherine; Clark, Scott; Karageorge, Aspasia; Kelly, Patrick J; Earle, Maree

2014-10-01

To examine the experience of psychiatry training in rural New South Wales. All rural trainees in New South Wales and key psychiatrists involved in their training were invited to complete a survey in May-July 2013. Responses were received from 26 out of 44 rurally placed psychiatry trainees (57% response rate) and 37 out of 55 psychiatrists involved in training in a rural area (67% response rate). Positive and negative aspects of rural training were reported. In general, trainees reported positive experiences regarding supervision, consultant input and their Site Coordinator of training. Their experience of other aspects of training and education in rural areas was often negative with 52% of trainees feeling at a disadvantage due to fewer registrar peers and 60% feeling educationally isolated. Difficulty progressing through training, workforce shortages, difficulty accessing formal aspects of training and limited options for advanced training were reported. Metropolitan trainees on rotation to rural terms receive accommodation, travel and an increase in wage from the rural Local Health District. Rural trainees on rotation to the city for their mandatory subspecialty training receive no such support. There are many challenges for rural trainees. Support from the Royal Australian and New Zealand College of Psychiatrists and state and federal governments to enhance the rural training experience is vital. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Infection prevention needs assessment in Colorado hospitals: rural and urban settings.

PubMed

Reese, Sara M; Gilmartin, Heather; Rich, Karen L; Price, Connie S

2014-06-01

The purpose of our study was to conduct a needs assessment for infection prevention programs in both rural and urban hospitals in Colorado. Infection control professionals (ICPs) from Colorado hospitals participated in an online survey on training, personnel, and experience; ICP time allocation; and types of surveillance. Responses were evaluated and compared based on hospital status (rural or urban). Additionally, rural ICPs participated in an interview about resources and training. Surveys were received from 62 hospitals (77.5% response); 33 rural (75.0% response) and 29 urban (80.6% response). Fifty-two percent of rural ICPs reported multiple job responsibilities compared with 17.2% of urban ICPs. Median length of experience for rural ICPs was 4.0 years compared with 11.5 years for urban ICPs (P = .008). Fifty-one percent of rural ICPs reported no access to infectious disease physicians (0.0% urban) and 81.8% of rural hospitals reported no antimicrobial stewardship programs (31.0% urban). Through the interviews it was revealed that priorities for rural ICPs were training and communication. Our study revealed numerous differences between infection prevention programs in rural versus urban hospitals. An infection prevention outreach program established in Colorado could potentially address the challenges faced by rural hospital infection prevention departments. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

A new model to understand the career choice and practice location decisions of medical graduates.

PubMed

Stagg, P; Greenhill, J; Worley, P S

2009-01-01

Australian medical education is increasingly influenced by rural workforce policy. Therefore, understanding the influences on medical graduates' practice location and specialty choice is crucial for medical educators and medical workforce planners. The South Australian Flinders University Parallel Rural Community Curriculum (PRCC) was funded by the Australian Government to help address the rural doctor workforce shortage. The PRCC was the first community based medical education program in Australia to teach a full academic year of medicine in South Australian rural general practices. The aim of this research was to identify what factors influence the career choices of PRCC graduates. A retrospective survey of all contactable graduates of the PRCC was undertaken. Quantitative data were analysed using SPSS 14.0 for Windows. Qualitative data were entered into NVIVO 7 software for coding, and analysed using content analysis. Usable data were collected from 46 of the 86 contactable graduates (53%). More than half of the respondents (54%) reported being on a rural career path. A significant relationship exists between being on a rural career pathway and making the decision prior to or during medical school (p = 0.027), and between graduates in vocational training who are on an urban career path and making a decision on career specialty after graduation from medical school (p = .004). Graduates in a general practice vocational training program are more likely to be on a rural career pathway than graduates in a specialty other than general practice (p = .003). A key influence on graduates' practice location is geographic location prior to entering medical school. Key influences on graduates choosing a rural career pathway are: having a spouse/partner with a rural background; clinical teachers and mentors; the extended rural based undergraduate learning experience; and a specialty preference for general practice. A lack of rural based internships and specialist training places is influencing both urban- and rural-origin graduates to practise in urban locations. Further analysis of graduates' career pathway choices (rural or urban) and geographic background (rural or urban) was conducted. This resulted in the development of a new model, 'The Four Qs Model'. This model consists of four quadrants derived from the variables career pathway choice (rural or urban) and geographic background (rural or urban). Clustering of consistent demographic and qualitative trends unique to each quadrant was demonstrated. The distinctive clustering that emerged from the data resulted in the quadrants being renamed 'The True Believers', 'The Convertibles' 'The Frustrated' and 'The Metro Docs'. The PRCC is influencing graduates to choose a rural career path. The PRCC program affirms the career preferences of rural origin students while graduates with little rural exposure prior to the PRCC report being positively influenced to pursue a rural career path. The Four Qs Model is a useful model in that it demonstrates consistent themes in the characteristics of PRCC graduates and assists understanding of why they choose a rural medical career. This could be relevant to the selection of medical students into rural medical education programs and in the construction of rural curricula. The model also offers a useful framework for further research in this field.

7 CFR 4284.502 - Policy.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... Rural cooperative development grants will be used to facilitate the creation or retention of jobs in rural areas through the development of new rural cooperatives, Value-Added processing and rural...

Rural Matters: The Rural Challenge News, 1997-2000.

ERIC Educational Resources Information Center

Rural Matters: The Rural Challenge News, 2000

2000-01-01

This document contains the 10 quarterly issues of "Rural Matters: The Rural Challenge News," published from Fall 1997 to Winter 2000 (the final issue). This newsletter focused on projects funded by the Annenberg Rural Challenge, as well as research summaries and opinion pieces on the benefits of small schools, place-based education, and…

Village Schools in England: At the Heart of Their Community?

ERIC Educational Resources Information Center

Bagley, Carl; Hillyard, Sam

2011-01-01

Recent debates within UK rural studies have stressed the shifting interplay of economic, social, political and cultural forces, with a concomitant blurring as to what constitutes rural living, rural spaces and even rural occupations. This article situates the rural school within this social, cultural and political landscape and attends to the…

Problems and Issues in Rural Community Mental Health: A Review.

ERIC Educational Resources Information Center

Solomon, Gary

After years of neglect, rural community mental health is becoming a legitimate area of specialization. Although the number of problems readily visible in rural mental health may appear to be inordinate, probabilities are that the difficulties found in rural locales are quantitatively no different than those found in non-rural areas. The…

Rural Ageing in the United States: Trends and Contexts

ERIC Educational Resources Information Center

Glasgow, Nina; Brown, David L.

2012-01-01

This paper examines rural population ageing in the United States with a particular focus on the contrasting contexts in which older rural residents live. We compare the characteristics of the older population by rural versus urban residence, and explore challenges and opportunities associated with the ageing of rural baby boomers. The United…

Delaware's Rural Assistance Council Promotes the Rural Agenda in the First State.

ERIC Educational Resources Information Center

VanSciver, James H.

The Delaware Research for Better Schools Rural Assistance Council's (RAC) mission is to develop a rural assistance agenda for the state. The Council stated four objectives: (1) identifying the most pressing needs of Delaware's rural schools and school districts; (2) developing plans, in cooperation with appropriate state organizations, for…

42 CFR 405.2462 - Payment for rural health clinic and Federally qualified health center services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for rural health clinic and Federally... AND DISABLED Rural Health Clinic and Federally Qualified Health Center Services Payment for Rural Health Clinic and Federally Qualified Health Center Services § 405.2462 Payment for rural health clinic...

Mathematics Course-Taking in Rural High Schools

ERIC Educational Resources Information Center

Anderson, Rick; Chang, Beng

2011-01-01

Using data from the 2005 NAEP High School Transcript Study, this paper examines the mathematics course-taking of rural high school students. Although several studies indicate rural high school students' mathematics achievement is comparable to that of students in non-rural high schools, the mathematics course-taking patterns of rural and non-rural…

What Is Rural? Revised

ERIC Educational Resources Information Center

US Department of Agriculture, 2016

2016-01-01

Many people have definitions for the term rural, but seldom are these rural definitions in agreement. For some, rural is a subjective state of mind. For others, rural is an objective quantitative measure. In this brief report the United States Department of Agriculture presents the following information along with helpful links for the reader: (1)…

Rural Special Education Quarterly, Volume 5, Nos. 1-4, Spring-Fall 1984, Winter 1985.

ERIC Educational Resources Information Center

Rural Special Education Quarterly, 1985

1985-01-01

Four newsletter issues examine aspects of rural special education. Issue number one considers the generic problems or solutions in rural special education leadership, the need for innovative preservice preparation for rural educators, preservice training for Native American professionals and paraprofessionals, a model for rural early intervention,…

Seeing Strengths in a Rural School: Educators' Conceptions of Individual and Environmental Resilience Factors

ERIC Educational Resources Information Center

McMahon, Brenda

2015-01-01

This qualitative study of educators' understandings of resilience contributes to ongoing rural school research that examines educators' beliefs about, and attitudes toward, rural students whom are at-risk and factors that impact rural school success. Semi-structured interviews were conducted with teachers and administrators in one rural Florida…

A Charter for Improved Rural Youth Transition.

ERIC Educational Resources Information Center

South Dakota State Advisory Committee to the U.S. Commission on Civil Rights.

The Charter is intended to help shed light on rural youths' transition from education to work, and results from the 1977-78 activities of eight rural councils of the Work-Education Consortium. Recognizing the wide diversity of definitions for rural and nonmetropolitan, and understanding that rural youth are faced with economic and educational…

A Potpourri of Issues Relevant to Rural and Minority Women in the Southwest.

ERIC Educational Resources Information Center

Amodeo, Luiza B.; And Others

Focusing on issues and concerns pertaining to teaching and counseling rural women and minority women living in rural environments, the four papers aim to promote a better understanding and more realistic picture of conditions affecting rural/minority women. "Factors Influencing Educational and Occupational Choices of Rural/Minority…

7 CFR 1940.956 - State rural economic development review panel.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 13 2010-01-01 2009-01-01 true State rural economic development review panel. 1940... Rural Development Programs § 1940.956 State rural economic development review panel. (a) General. In order for a State to become or remain an eligible State, the State must have a rural economic...

Racial/Ethnic Minorities in Rural Areas: Progress and Stagnation, 1980-90.

ERIC Educational Resources Information Center

Swanson, Linda L., Ed.

Rural minorities lag behind rural Whites and urban minorities on many crucial economic and social measures. This collection of 10 papers examines rural Black, Hispanic, Native American, and Asian and Pacific Islander populations and their economic well-being in the 1980s, an economically difficult decade for rural areas. Results show minimal…

Rural Schools and Communities: How Globalization Influences Rural School and Community Collaboration

ERIC Educational Resources Information Center

Butler, Thomas

2008-01-01

This study examined how a rural school district and the communities in which the district belonged collaborated on a community development initiative. This dissertation examined the opportunities and constraints rural communities are facing and the role that a rural school system could play in increasing social and economic sustainability of rural…

Persistent Poverty in Rural America. Rural Studies Series.

ERIC Educational Resources Information Center

Rural Sociological Society, Bozeman, MT.

In this volume, the Rural Sociological Society Task Force on Persistent Rural Poverty analyzes the leading explanations of persistent rural poverty and points out new directions in theory that should provide a firmer foundation for antipoverty policies and programs. Written by over 50 leading social scientists, the Task Force report explains that…

Rural Communities in an Advanced Industrial Society: Dilemmas and Opportunities.

ERIC Educational Resources Information Center

Blakely, Edward J.

The major features previously used to define rural life now fail to describe much of rural America, as changes that place rural areas in the vanguard of American society are manifest in rural landscape, institutions, economic activity, and life. The principal policy thrusts of modernization and urbanization and the related theories of product…

Improving Rural Cancer Patients' Outcomes: A Group-Randomized Trial

ERIC Educational Resources Information Center

Elliott, Thomas E.; Elliott, Barbara A.; Regal, Ronald R.; Renier, Colleen M.; Haller, Irina V.; Crouse, Byron J.; Witrak, Martha T.; Jensen, Patricia B.

2004-01-01

Significant barriers exist in the delivery of state-of-the-art cancer care to rural populations. Rural providers' knowledge and practices, their rural health care delivery systems, and linkages to cancer specialists are not optimal; therefore, rural cancer patient outcomes are less than achievable. Purpose: To test the effects of a strategy…

Rural Communities: Human and Symbolic Capital Development, Fields Apart.

ERIC Educational Resources Information Center

Atkin, Chris

2003-01-01

Considers the nature of rurality as a social construct and implications for policymakers considering lifelong education in developed economies of the world. Discussion focuses on three key questions: (1) what is rurality?; (2) what effect has rurality on cultural identity; and (3) what are rural and urban young people's perceptions of formal…

7 CFR 1940.565 - Section 502 subsidized Rural Housing loans.

Code of Federal Regulations, 2011 CFR

2011-01-01

... percentage of the National number of rural occupied substandard units, (2) State's percentage of the National rural population, (3) State's percentage of the National rural population in places of less than 2,500 population, (4) State's percentage of the National number of rural households between 50 and 80 percent of...

7 CFR 1940.565 - Section 502 subsidized Rural Housing loans.

Code of Federal Regulations, 2010 CFR

2010-01-01

... percentage of the National number of rural occupied substandard units, (2) State's percentage of the National rural population, (3) State's percentage of the National rural population in places of less than 2,500 population, (4) State's percentage of the National number of rural households between 50 and 80 percent of...

Defining Rural in Gifted Education Research: Methodological Challenges and Paths Forward

ERIC Educational Resources Information Center

Kettler, Todd; Puryear, Jeb S.; Mullet, Dianna R.

2016-01-01

Definitions of rurality in education research are inconsistent, making generalization across studies difficult at best. We review published research in rural education between 2005 and 2015 (n = 17) and characterize the way each defined rural. A common technique for classifying rural schools is the National Center for Educational Statistics (NCES)…

Trends in Rural and Urban Deliveries and Vaginal Births: California 1998-2002

ERIC Educational Resources Information Center

Hughes, Susan; Zweifler, John A.; Garza, Alvaro; Stanich, Matthew A.

2008-01-01

Context: Pregnant women in rural areas may give birth in either rural or urban hospitals. Differences in outcomes between rural and urban hospitals may influence patient decision making. Purpose: Trends in rural and urban obstetric deliveries and neonatal and maternal mortality in California were compared to inform policy development and patient…

7 CFR 1940.956 - State rural economic development review panel.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 13 2014-01-01 2013-01-01 true State rural economic development review panel. 1940... Rural Development Programs § 1940.956 State rural economic development review panel. (a) General. In order for a State to become or remain an eligible State, the State must have a rural economic...

7 CFR 1940.968 - Rural Economic Development Review Panel Grant (Panel Grant).

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 13 2013-01-01 2013-01-01 false Rural Economic Development Review Panel Grant (Panel... of Certain Rural Development Programs § 1940.968 Rural Economic Development Review Panel Grant (Panel... associated with a State rural economic development review panel. (b) Objective. The objective of the Panel...

7 CFR 1940.956 - State rural economic development review panel.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 13 2013-01-01 2013-01-01 false State rural economic development review panel. 1940... Rural Development Programs § 1940.956 State rural economic development review panel. (a) General. In order for a State to become or remain an eligible State, the State must have a rural economic...

7 CFR 1940.956 - State rural economic development review panel.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 13 2012-01-01 2012-01-01 false State rural economic development review panel. 1940... Rural Development Programs § 1940.956 State rural economic development review panel. (a) General. In order for a State to become or remain an eligible State, the State must have a rural economic...

7 CFR 1940.956 - State rural economic development review panel.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 13 2011-01-01 2009-01-01 true State rural economic development review panel. 1940... Rural Development Programs § 1940.956 State rural economic development review panel. (a) General. In order for a State to become or remain an eligible State, the State must have a rural economic...

Elements of a Sustainable Rural Policy.

ERIC Educational Resources Information Center

Pulver, Glen C.

If a new and effective rural policy is to be crafted, policymakers must realize that rural America has changed a great deal in recent years. To be sustainable, rural policy must be flexible enough to accommodate continuing changes in global structure; be sufficiently targeted to address the unique concerns found in diverse rural situations;…

Gender and Rural Employment: A View from Latin America

ERIC Educational Resources Information Center

Ballara, Marcela

2007-01-01

The paper focuses on women employment in rural areas and its impacts in food security. The presentation includes data on rural women employment and its different labour strategies: temporary work, non agriculture rural employment and permanent rural employment. Poverty alleviation and its impact on families as well as implications in the economic…

Quality of Diabetes Mellitus Care by Rural Primary Care Physicians

ERIC Educational Resources Information Center

Tonks, Stephen A.; Makwana, Sohil; Salanitro, Amanda H.; Safford, Monika M.; Houston, Thomas K.; Allison, Jeroan J.; Curry, William; Estrada, Carlos A.

2012-01-01

Purpose: To explore the relationship between degree of rurality and glucose (hemoglobin A1c), blood pressure (BP), and lipid (LDL) control among patients with diabetes. Methods: Descriptive study; 1,649 patients in 205 rural practices in the United States. Patients' residence ZIP codes defined degree of rurality (Rural-Urban Commuting Areas…

Strengthening the Rural Carolinas: A Conceptual Framework for the Program for the Rural Carolinas.

ERIC Educational Resources Information Center

MDC, Inc., Chapel Hill, NC.

The Duke Endowment's Program for the Rural Carolinas is a 5-year effort to assist the revitalization of rural communities. Guiding principles of the program are that the rural Carolinas matter, this generation of workers matters, effective community development involves the entire community, solutions must be locally determined, healthy…

Toward a More Holistic Evaluation Approach for Rural Development

ERIC Educational Resources Information Center

Miyoshi, Koichi

2013-01-01

The discussion on and development of a holistic evaluation approach for rural development will be indispensable to improving and enriching the lives of rural people. This approach can be developed by considering the conceptualization of community policy structure in rural areas, the localization of policy structure in the rural community, and the…

The Lifeworld Makes Mathematics Education Rural: Implications for Math Education Research.

ERIC Educational Resources Information Center

Howley, Craig

The great challenge for rural education scholars is explaining what relevance the rural circumstance might have to schooling, a task especially difficult in the case of mathematics education. This paper argues that the rural lifeworld makes math education rural and suggests implications for research based on that statement. The lifeworld is the…

Journal of the Assembly of Rural Teachers of English (ARTE), 1993.

ERIC Educational Resources Information Center

Journal of the Assembly of Rural Teachers of English (ARTE), 1993

1993-01-01

The 1993 issue of this annual journal contains five articles about rural education by rural English teachers. "Rural: The Only Place To Be" (Craig Akey) speaks of a personal commitment to rural education, presents examples of prose and poetry by junior and senior high school students in an innovative "outdoor literature"…

Health Careers Education for Rural Primary Schoolchildren

ERIC Educational Resources Information Center

Gorton, Susan M.

2011-01-01

International and national studies have reported that health professionals who grew up in a rural area are more likely to return to work in a rural area than their urban raised counterparts. The chronic severe shortage of health professionals in rural and remote Australia has meant inequitable health care for rural and remote communities and a…

Maternal mobility across the rural-urban divide: empirical data from coastal Kenya

PubMed Central

Molyneux, C S; Mung’ala-Odera, V; Harpham, T; Snow, R W

2013-01-01

This paper describes the mobility patterns, rural-urban linkages and household structures for a low-income neighbourhood on the outskirts of Mombasa, Kenya’s main port, and a rural settlement 60 kilometres away. Drawing on interviews with a sample of mothers resident in each location, it documents their perceptions of the advantages and disadvantages of rural and urban life, and shows the continuous interchange between the two areas. It also highlights how most rural to urban migrants are familiar with urban environments before moving and how, having moved, many maintain strong rural ties. The ways in which households are split across rural and urban areas is influenced by intra-household relations and by household efforts to balance the income-earning opportunities in town, the relatively low cost of living in rural areas and future family security. This produces dramatic differences between and among rural and urban mothers and suggests a need for policy makers and planners to recognize diversity and to build upon complex livelihood strategies that span the rural-urban divide. PMID:23814409

The changes of densities and patterns of roads and rural buildings: a case study on Dongzhi Yuan of the Loess Plateau, China.

PubMed

Bi, Xiaoli; Wang, Hui; Ge, Jianping

2010-05-01

Roads and buildings are considered as primary causes of rural landscape changes. In this study, linear regression models were used to analyze the dynamic influences of environmental factors and variables on roads and rural buildings from 1979 to 2005 in Dongzhi Yuan (tableland) of the Loess Plateau, China. The relationship between roads and rural buildings and their effects on Dongzhi Yuan are discussed also. The results showed that three environmental factors (topography, land cover, and development level) explained roads better than rural buildings referring densities and patterns. The environmental variables significantly related to roads have decreased, whereas those related to rural buildings have increased over time. Among these significant variables, percent of farmland mostly determined the densities and patterns of both roads and rural buildings. There was significant correlation between roads and rural buildings in terms of density and pattern. In addition, roads and rural buildings have increased greatly in gully areas of this region. Therefore, more attention should be paid to planning of roads and rural buildings in Dongzhi Yuan.

An Individual-based Rurality Measure and Its Health Application: A Case Study of Latino Immigrants in North Florida, USA

PubMed Central

Mao, Liang; Stacciarini, Jeanne-Marie R.; Smith, Rebekah; Wiens, Brenda

2015-01-01

Rurality has been frequently noted by researchers as pathways to understand human health in rural and remote areas. Current measures of rurality are mostly oriented to places, not individuals, and have not accounted for individual mobility, thus inappropriate for studying health and well-being at an individual level. This research proposed a new concept of individual-based rurality by integrating personal activity spaces. A feasible method was developed to quantify individuals’ rural experience using household travel surveys and geographic information systems (GIS). For illustration, the proposed method was applied to understand the well-being and social isolation among rural Latino immigrants, who had participated in a community-based participatory research (CBPR) study in North Florida, USA. The resulting individuals’ rurality indices were paired with their scores of well-being and social isolation to identify potential associations. The correlation analysis showed that the proposed rurality can be related to the social isolation, mental and physical well-being of individuals in different gender groups, and hence could be a suitable tool to investigate rural health issues. PMID:26615336

We cannot staff for 'what ifs': the social organization of rural nurses' safeguarding work.

PubMed

MacKinnon, Karen

2012-09-01

Rural nurses play an important role in the provision of maternity care for Canadian women. This care is an important part of how rural nurses safeguard the patients who receive care in small rural hospitals. This study utilized institutional ethnography as an approach for describing rural nursing work and for exploring how nurses' work experiences are socially organized. Rural nurses advocated for safe healthcare environments by ensuring that skilled nurses were available for every shift, day and night, at their local hospital. Rural nurses noted that this work was particularly difficult for the provision of maternity care. This article explores two threads or cues to institutional organization that were identified in our interviews and observations; namely staffing and safety standards, and the need for flexibility in staffing in small rural hospitals. Rural nurses' concerns about ensuring that skilled nurses are available in small rural hospitals do not enter into current management discourses that focus on efficiency and cost savings or find a home within current discourses of patient safety 'competencies'. © 2011 Blackwell Publishing Ltd.

7 CFR 4290.130 - Identified Rural Areas.

Code of Federal Regulations, 2010 CFR

2010-01-01

... specific Rural Area or Areas in which it intends to make Developmental Venture Capital investments and... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE RURAL BUSINESS INVESTMENT COMPANY (âRBICâ) PROGRAM...

Student perception about working in rural United States/Canada after graduation: a study in an offshore Caribbean medical school.

PubMed

Shankar, P Ravi; Dubey, Arun K; Nandy, Atanu; Herz, Burton L; Little, Brian W

2014-01-01

Rural residents of the United States (US) and Canada face problems in accessing healthcare. International medical graduates (IMGs) play an important role in delivering rural healthcare. IMGs from Caribbean medical schools have the highest proportion of physicians in primary care.  Xavier University School of Medicines admits students from the US, Canada and other countries to the undergraduate medical (MD) course and also offers a premedical program. The present study was conducted to obtain student perception about working in rural US/Canada after graduation.   The study was conducted among premedical and preclinical undergraduate medical (MD) students during October 2014. The questionnaire used was modified from a previous study. Semester of study, gender, nationality, place of residence and occupation of parents were noted. Information about whether students plan to work in rural US/Canada after graduation, possible reasons why doctors are reluctant to work in rural areas, how the government can encourage rural practice, possible problems respondents anticipate while working in rural areas were among the topics studied. Ninety nine of the 108 students (91.7%) participated. Forty respondents were in favor of working in rural US/Canada after graduation. Respondents mentioned good housing, regular electricity, water supply, telecommunication facilities, and schools for education of children as important conditions to be fulfilled. The government should provide higher salaries to rural doctors, help with loan repayment, and provide opportunities for professional growth.  Potential problems mentioned were difficulty in being accepted by the rural community, problems in convincing patients to follow medical advice, lack of exposure to rural life among the respondents, and cultural issues. About 40% of respondents would consider working in rural US/Canada. Conditions required to be fulfilled have been mentioned above. Graduates from Caribbean medical schools have a role in addressing rural physician shortage. Similar studies in other offshore Caribbean medical schools are required as Caribbean IMGs make an important contribution to the rural US and Canadian health workforce.

Factors influencing medical students' motivation to practise in rural areas in low-income and middle-income countries: a systematic review.

PubMed

Budhathoki, Shyam Sundar; Zwanikken, Prisca A C; Pokharel, Paras K; Scherpbier, Albert J

2017-02-22

There is a shortage of doctors working in rural areas all over the world, especially in low-income and middle-income countries. The choice to practise medicine in a rural area is influenced by many factors. Motivation developed as a medical student is one key determinant of this choice. This study explores influences on medical students' motivation to practise in rural areas of low-income and middle-income countries following graduation. A systematic review was conducted to identify influences on medical students' motivation to work in rural areas in low-income and middle-income countries. Papers reporting influences on motivation were included, and content analysis was conducted to select the articles. Articles not published in English were excluded from this review. A rural background (ie, being brought up in a rural area), training in rural areas with a community-based curriculum, early exposure to the community during medical training and rural location of medical school motivate medical students to work in rural areas. Perceived lack of infrastructure, high workload, poor hospital management and isolation are among the health facility factors that demotivate medical students for medical practice in rural areas. Medical school selection criteria focusing on a rural background factor and medical education curriculum focusing on rural area are more relevant factors in low-income and middle-income countries. The factors identified in this review may assist the planners, medical educators and policymakers in low-income and middle-income countries in designing relevant interventions to positively influence rural choices where the shortage of rural physicians is an ongoing and increasing concern. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Rural-urban differences in objective and subjective measures of physical activity: findings from the National Health and Nutrition Examination Survey (NHANES) 2003-2006.

PubMed

Fan, Jessie X; Wen, Ming; Kowaleski-Jones, Lori

2014-08-21

Lower levels of physical activity among rural relative to urban residents have been suggested as an important contributor to rural-urban health disparity; however, empirical evidence is sparse. We examined rural-urban differences in 4 objective physical activity measures (2 intensity thresholds by 2 bout lengths) and 4 subjective measures (total, leisure, household, and transportation) in a nationally representative sample of participants in the National Health and Nutrition Examination Survey (NHANES) 2003-2006. The sample comprised 5,056 adults aged 20 to 75 years. Rural-Urban Commuting Area (RUCA) codes were matched with NHANES subjects to identify urban status and 2 types of rural status. Rural-urban and within-rural differences in physical activity were estimated without and with controls for demographic and socioeconomic variables. Rural residents were less active than urban residents in high-intensity long bout (2,020 counts per minute threshold and 10 miniutes or longer bout length) accelerometer-measured physical activity (42.5 ± 6.2 min/wk vs 55.9 ± 2.8 min/wk) but the difference disappeared with a lower-intensity threshold (760 counts per minute). Rural residents reported more total physical activity than urban residents (438.3 ± 35.3min/wk vs 371.2 ± 12.5 min/wk), with differences primarily attributable to household physical activity. Within rural areas, micropolitan residents were less active than residents in smaller rural areas. Controlling for other variables reduced the size of the differences. The direction and significance of rural-urban difference in physical activity varied by the method of physical activity measurement, likely related to rural residents spending more time in low-intensity household physical activity but less time in high-intensity physical activity. Micropolitan residents were substantially less active than residents in smaller rural areas, indicating that physical activity did not vary unidirectionally with degree of urbanization.

Thoughts on Beijing's Long-Term Rural Infrastructure Management and Protection Issues from the Perspective of the Government to Effectively Perform Their Duties

NASA Astrophysics Data System (ADS)

Wang, Z.

To strengthen rural infrastructure management, give full play to the role of benefit of infrastructure, it has important significance for promoting the development of rural economy and society. Protection-use and facility energy-use issues are outstanding during Beijing rural infrastructure management. The comprehensive and detailed analysis of the cause of the problems put forward the concrete feasible countermeasures from the government to fulfill the effective function to rural infrastructure: A clear property ownership; Implementation of special funds audit system of the rural infrastructure management; Implementation of rural infrastructure maintenance and management assessment methods and so on.

The influence of rural clinical school experiences on medical students' levels of interest in rural careers.

PubMed

Isaac, Vivian; Watts, Lisa; Forster, Lesley; McLachlan, Craig S

2014-08-28

Australian Rural Clinical School (RCS) programmes have been designed to create experiences that positively influence graduates to choose rural medical careers. Rural career intent is a categorical evaluation measure and has been used to assess the Australian RCS model. Predictors for rural medical career intent have been associated with extrinsic values such as students with a rural background. Intrinsic values such as personal interest have not been assessed with respect to rural career intent. In psychology, a predictor of the motivation or emotion for a specific career or career location is the level of interest. Our primary aims are to model over one year of Australian RCS training, change in self-reported interest for future rural career intent. Secondary aims are to model student factors associated with rural career intent while attending an RCS. The study participants were medical students enrolled in a RCS in the year 2013 at the University of New South Wales (UNSW) and who completed the newly developed self-administered UNSW Undergraduate Destinations Study (UDS) questionnaire. Data were collected at baseline and after one year of RCS training on preferred location for internship, work and intended specialty. Interest for graduate practice location (career intent) was assessed on a five-variable Likert scale at both baseline and at follow-up. A total of 165 students completed the UDS at baseline and 150 students after 1 year of follow-up. Factors associated with intent to practise in a rural location were rural background (χ2 = 28.4, P < 0.001), two or more previous years at an RCS (χ2 = 9.0, P = 0.003), and preference for a rural internship (χ2 = 17.8, P < 0.001). At follow-up, 41% of participants who originally intended to work in a metropolitan location at baseline changed their preference and indicated a preference for a rural location. The level of interest in intended practice location was significantly higher for those intending to work in a rural area than those with intention to work in a metropolitan (urban area) location (t = -3.1, P = 0.002). Initial rural career location intention was associated with increased interest levels after 1 year of follow-up (paired t = -2.3, P = 0.02). When evaluating the success of RCS outcomes with respect to rural workforce destination, both rural practice intentions and level of interest are key factors related to projected career destination. RCS experience can positively influence practice intent (toward rural practice) and interest levels (toward greater interest in rural practice).

Opting for rural practice: the influence of medical student origin, intention and immersion experience.

PubMed

Playford, Denese; Ngo, Hanh; Gupta, Surabhi; Puddey, Ian B

2017-08-21

To compare the influence of rural background, rural intent at medical school entry, and Rural Clinical School (RCS) participation on the likelihood of later participation in rural practice. Analysis of linked data from the Medical School Outcomes Database Commencing Medical Students Questionnaire (CMSQ), routinely collected demographic information, and the Australian Health Practitioner Regulation Agency database on practice location. University of Western Australia medical students who completed the CMSQ during 2006-2010 and were practising medicine in 2016. Medical practice in rural areas (ASGC-RAs 2-5) during postgraduate years 2-5. Full data were available for 508 eligible medical graduates. Rural background (OR, 3.91; 95% CI, 2.12-7.21; P < 0.001) and experience in an RCS (OR, 1.93; 95% CI, 1.05-3.54; P = 0.034) were significant predictors of rural practice in the multivariate analysis of all potential factors. When interactions between intention, origin, and RCS experience were included, RCS participation significantly increased the likelihood of graduates with an initial rural intention practising in a rural location (OR, 3.57; 95% CI, 1.25-10.2; P = 0.017). The effect of RCS participation was not significant if there was no pre-existing intention to practise rurally (OR, 1.38; 95% CI, 0.61-3.16; P = 0.44). For students who entered medical school with the intention to later work in a rural location, RCS experience was the deciding factor for realising this intention. Background, intent and RCS participation should all be considered if medical schools are to increase the proportion of graduates working rurally.

Joys and challenges of relationships in Scotland and New Zealand rural midwifery: A multicentre study.

PubMed

Crowther, Susan; Deery, Ruth; Daellenbach, Rea; Davies, Lorna; Gilkison, Andrea; Kensington, Mary; Rankin, Jean

2018-04-21

Globally there are challenges meeting the recruitment and retention needs for rural midwifery. Rural practice is not usually recognised as important and feelings of marginalisation amongst this workforce are apparent. Relationships are interwoven throughout midwifery and are particularly evident in rural settings. However, how these relationships are developed and sustained in rural areas is unclear. To study the significance of relationships in rural midwifery and provide insights to inform midwifery education. Multi-centre study using online surveys and discussion groups across New Zealand and Scotland. Descriptive and template analysis were used to organise, examine and analyse the qualitative data. Rural midwives highlighted how relationships with health organisations, each other and women and their families were both a joy and a challenge. Social capital was a principal theme. Subthemes were (a) working relationships, (b) respectful communication, (c) partnerships, (d) interface tensions, (e) gift of time facilitates relationships. To meet the challenges of rural practice the importance of relationship needs acknowledging. Relationships are created, built and sustained at a distance with others who have little appreciation of the rural context. Social capital for rural midwives is thus characterised by social trust, community solidarity, shared values and working together for mutual benefit. Rural communities generally exhibit high levels of social capital and this is key to sustainable rural midwifery practice. Midwives, educationalists and researchers need to address the skills required for building social capital in rural midwifery practice. These skills are important in midwifery pre- and post-registration curricula. Copyright © 2018 Australian College of Midwives. All rights reserved.

Ice and the outback: Patterns and prevalence of methamphetamine use in rural Australia.

PubMed

Roche, Ann; McEntee, Alice

2017-08-01

This study investigated whether lifetime and recent methamphetamine use (including crystal methamphetamine) differed among city, regional and rural residents and whether particular subpopulations were more at-risk. Secondary analyses of the last three National Drug Strategy Household Surveys and corresponding Alcohol and Other Drug Treatment Services National Minimum Data Sets (AODTS NMDS). Australian general population. Australians who completed the 2007 (n = 22 519), 2010 (n = 25 786) and 2013 (n = 23 512) NDSHS (aged 14 + ); and treatment episodes where the principal drug of concern was recorded in the 2006/2007 (n = 139 808), 2009/2010 (n = 139 608) and 2012/2013 (n = 154 489) AODTS NMDS. To determine whether rural Australians were more likely to use methamphetamine than non-rural counterparts. Lifetime and recent methamphetamine and recent crystal methamphetamine use were significantly higher among rural than other Australians. Significantly more rural men and employed rural Australians used methamphetamine than their city, regional or Australian counterparts. Rural Australians aged 18-24 and 25-29 years were significantly more likely to have used methamphetamine in their lifetime than city or Australian residents. Rural Australians aged 18-24 years were significantly more likely to have recently used crystal methamphetamine. Interventions tailored to address the specific and unique circumstances of rural settings are required to reduce and prevent methamphetamine use, particularly crystal methamphetamine. Scope exists to focus prevention efforts on rural workplaces and primary care settings. Greater understanding of the higher prevalence of methamphetamine use in rural areas is required, plus implementation of comprehensive strategies and optimised treatment utilisation. © 2016 National Rural Health Alliance Inc.

The longer term impact of a novel rural mental health recruitment strategy: A quasi-experimental study.

PubMed

Sutton, Keith P; Maybery, Darryl; Patrick, Kent J

2015-12-01

This study examines the longer term impact of the Gippsland Mental Health Vacation School program, an initiative designed to orientate preregistration allied health and nursing students to rural mental health employment and career opportunities. Student participants from vacation schools held from July 2010 to August 2013 were invited to complete on-line surveys prior to, immediately following and 6 months after the event. Participant rating of Interest in rural work, mental health work and rural mental health work and responses to the student attitudes to rural practice and life questionnaire were analyzed using repeated measure analyses of variance. There was a large and significant positive increase in pre to post scores for student interest and attitudes to working in and career in the rural mental health sector. These gains in interest and attitudes fell away by approximately 50% in the six months following the program. The changes in attitudes toward rural work remained significant six months after the program, while attitudes to rural life at six months following the program were not-significantly different to the preprogram scores. The findings highlight that although a short term program designed to attract students to rural mental health work can positively change participants' interest in and attitudes toward rural work and life, the change diminishes over time. However, interest in rural work and career and rural work attitudes generally maintain significant improvement in the longer term. These differential findings have important implications for developing strategies to overcome rural mental health workforce shortages. © 2015 Wiley Publishing Asia Pty Ltd.

Supports for medical students during rural clinical placements: factors associated with intention to practise in rural locations.

PubMed

King, Katherine R; Purcell, Rachael A; Quinn, Stephen J; Schoo, Adrian M; Walters, Lucie K

2016-01-01

Through rural clinical schools (RCSs), medical students may undertake an extended block of clinical training in rural Australia. The premise of these placements is that meaningful rural exposure will facilitate rural career uptake. RCSs offer a range of supports to facilitate student engagement in the program. This study aims to analyse RCS students' perceptions of these supports and impact on intentions to work rurally. Between September 2012 and January 2013 RCS students were invited to complete questions regarding perceptions of student support, as a part of the annual Federation of Australian Medical Educators survey. Multivariable logistic regression was used to identify associations between supports and intentions for rural internship or career. There were 454 participants. A majority of students (n=349, 79.1%) felt well supported by their RCS. Students from a rural background (odds ratio (OR)=1.64 (95% confidence interval (CI):1.13-2.38)), or who indicated that their placement had a positive impact on their wellbeing (OR=1.38 (95%CI:1.07-1.80)), were more likely to intend to complete a rural internship. Those who felt socially isolated were less likely to elect this (OR=0.82 (0.70-0.97)). Outcomes were similar for those indicating a preference for rural or remote practice after completing training. Student perceptions of supports offered by RCSs were generally very positive. Perceptions of financial support were not predictive of rural career intent. Although this does not negate the importance of providing appropriate financial supports, it does demonstrate that student wellbeing is a more important recruitment factor for rural practice.

Contributors to the Excess Stroke Mortality in Rural Areas in the United States.

PubMed

Howard, George; Kleindorfer, Dawn O; Cushman, Mary; Long, D Leann; Jasne, Adam; Judd, Suzanne E; Higginbotham, John C; Howard, Virginia J

2017-07-01

Stroke mortality is 30% higher in the rural United States. This could be because of either higher incidence or higher case fatality from stroke in rural areas. The urban-rural status of 23 280 stroke-free participants recruited between 2003 and 2007 in the REGARDS study (Reasons for Geographic and Racial Differences in Stroke) was classified using the Rural-Urban Commuting Area scheme as residing in urban, large rural town/city, or small rural town or isolated areas. The risk of incident stroke was assessed using proportional hazards analysis, and case fatality (death within 30 days of stroke) was assessed using logistic regression. Models were adjusted for demographics, traditional stroke risk factors, and measures of socioeconomic status. After adjustment for demographic factors and relative to urban areas, stroke incidence was 1.23-times higher (95% confidence intervals, 1.01-1.51) in large rural town/cities and 1.30-times higher (95% confidence intervals, 1.03-1.62) in small rural towns or isolated areas. Adjustment for risk factors and socioeconomic status only modestly attenuated this association, and the association became marginally nonsignificant ( P =0.071). There was no association of rural-urban status with case fatality ( P >0.47). The higher stroke mortality in rural regions seemed to be attributable to higher stroke incidence rather than case fatality. A higher prevalence of risk factors and lower socioeconomic status only modestly contributed to the increased risk of incident stroke risk in rural areas. There was no evidence of higher case fatality in rural areas. © 2017 American Heart Association, Inc.

Opioid Overdose Experience, Risk Behaviors, and Knowledge in Drug Users from a Rural versus an Urban Setting.

PubMed

Dunn, Kelly E; Barrett, Frederick S; Yepez-Laubach, Claudia; Meyer, Andrew C; Hruska, Bryce J; Petrush, Kathy; Berman, Suzan; Sigmon, Stacey C; Fingerhood, Michael; Bigelow, George E

2016-12-01

Opioid use is highly prevalent in the United States and there has been an increased incidence in the rate of opioid-related overdose. While evidence suggests there are substantial differences in opioid use among rural versus urban settings, the rate of overdose and corresponding frequency of opioid overdose risk behaviors and overdose knowledge between rural and urban settings have not been examined. Individuals with opioid use disorder from rural (N=98) and urban (N=247) settings completed a self-report survey regarding their lifetime history of overdose and overdose risk behaviors. Participants also completed the Brief Opioid Overdose Knowledge (BOOK) questionnaire, a 12-item self-report measure of opioid overdose knowledge. Overall, 35.6% of participants had experienced an overdose, and prevalence of overdose was significantly higher (p<.01) among rural (45.9%) vs. urban (31.6%) participants, though fewer rural participants reported past 30-day risk behaviors. There were few differences observed between the subset of rural and urban participants who had experienced an overdose, and fewer rural participants with a history of overdose reported past 30-day risk behaviors. Both rural and urban participants performed poorly on the BOOK, though the percent of correct responses was lowest among rural participants with a history of overdose. Results demonstrate higher rates of overdose among rural opioid users, though rural participants were less likely to report recent risk behaviors. Results also suggest that knowledge regarding key factors related to opioid overdose is severely lacking, particularly among rural opioid users, which could be a potential target for future intervention efforts.

Rural Development Reorganization Act of 1984; and the U.S. Department of Agriculture's Rural Development Policy Report. Hearing before the Subcommittee on Conservation, Credit, and Rural Development of the Committee on Agriculture, House of Representatives, Ninety-Eighth Congress, Second Session on H.R. 5024.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Agriculture.

Testimonies were heard in reference to the administration's annual rural development policy report and H.R. 5024, the Rural Development Reorganization Act of 1984. The bill provides that the Department of Agriculture shall be known as the Department of Agriculture and Rural Development, transfers the administration of certain conservation programs…

The Economic Evolution of Rural America. Hearings before the Subcommittee on Agriculture and Transportation of the Joint Economic Committee. Congress of the United States, Ninety-Ninth Congress, First Session (May 22, June 13, June 19, July 1, 1985). Part 2.

ERIC Educational Resources Information Center

Joint Economic Committee, Washington, DC.

Part 2 of this congressional hearing contains the testimony and prepared statements of 31 witnesses on the topics of rural community resources, the rural labor force, rural finance, and rural education to assist the Subcommittee on Agriculture and Transportation in identifying the problems and potential of America's rural economy. With emphasis on…

[Not Available].

PubMed

Molina Villaverde, Raquel

2016-06-03

El cáncer es un problema sanitario de primera magnitud a escala mundial. Su tratamiento es uno de los mayores campos de innovación y desarrollo en medicina. La visión del cáncer como una enfermedad sistémica, heterogénea y de una elevada complejidad hace que los enfermos deban recibir una atención oncológica de calidad, proporcionada por equipos multidisciplinares altamente cualificados. Además de la gran incidencia de malnutrición en estos pacientes, la intervención nutricional precoz puede mejorar su pronóstico, aumentar la calidad de vida y disminuir la tasa de complicaciones de la enfermedad. Por ello, es necesaria una estrecha colaboración entre el oncólogo y el experto en nutrición.

Living and learning in a rural environment: a nursing student perspective.

PubMed

Pront, Leeanne; Kelton, Moira; Munt, Rebecca; Hutton, Alison

2013-03-01

This study investigates the influences on nursing student learning who live and learn in the same rural environment. A declining health workforce has been identified both globally and in Australia, the effects of which have become significantly apparent in the rural nursing sector. In support of rural educational programs the literature portrays rural clinical practice experiences as significant to student learning. However, there is little available research on what influences learning for the nursing student who studies in their own rural community. The aim of this study was to understand what influences student learning in the rural clinical environment. Through a multiple case study design five nursing students and two clinical preceptors from a rural clinical venue were interviewed. The interviews were transcribed and thematically analysed to identify factors that influenced student learning outcomes. The most significant influence on nursing student learning in the rural clinical environment was found to include the environment itself, the complex relationships unique to living and studying in a rural community along with the capacity to link theory to practice. The rural environment influences those in it, the demands placed on them, the relationships they form, the ability to promote learning and the time to teach and learn. Copyright © 2012. Published by Elsevier Ltd.

Non-Emergency Medical Transportation Needs of Middle-Aged and Older Adults: A Rural-Urban Comparison in Delaware, USA.

PubMed

Smith, Matthew Lee; Prohaska, Thomas R; MacLeod, Kara E; Ory, Marcia G; Eisenstein, Amy R; Ragland, David R; Irmiter, Cheryl; Towne, Samuel D; Satariano, William A

2017-02-10

Background : Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas. Methods : Data were analyzed from 39,194 NEMT users of LogistiCare-brokered services in Delaware residing in rural (68.3%) and urban (30.9%) areas. Multivariable logistic analyses compared trip characteristics by rurality designation. Results : Rural (37.2%) and urban (41.2%) participants used services more frequently for dialysis than for any other medical concern. Older age and personal accompaniment were more common and wheel chair use was less common for rural trips. The mean cost per trip was greater for rural users (difference of $2910 per trip), which was attributed to the greater distance per trip in rural areas. Conclusions : Among a sample who were eligible for subsidized NEMT and who utilized this service, rural trips tended to be longer and, therefore, higher in cost. Over 50% of trips were made for dialysis highlighting the need to address prevention and, potentially, health service improvements for rural dialysis patients.

Non-Emergency Medical Transportation Needs of Middle-Aged and Older Adults: A Rural-Urban Comparison in Delaware, USA

PubMed Central

Smith, Matthew Lee; Prohaska, Thomas R.; MacLeod, Kara E.; Ory, Marcia G.; Eisenstein, Amy R.; Ragland, David R.; Irmiter, Cheryl; Towne, Samuel D.; Satariano, William A.

2017-01-01

Background: Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas. Methods: Data were analyzed from 39,194 NEMT users of LogistiCare-brokered services in Delaware residing in rural (68.3%) and urban (30.9%) areas. Multivariable logistic analyses compared trip characteristics by rurality designation. Results: Rural (37.2%) and urban (41.2%) participants used services more frequently for dialysis than for any other medical concern. Older age and personal accompaniment were more common and wheel chair use was less common for rural trips. The mean cost per trip was greater for rural users (difference of $2910 per trip), which was attributed to the greater distance per trip in rural areas. Conclusions: Among a sample who were eligible for subsidized NEMT and who utilized this service, rural trips tended to be longer and, therefore, higher in cost. Over 50% of trips were made for dialysis highlighting the need to address prevention and, potentially, health service improvements for rural dialysis patients. PMID:28208610

A review of characteristics and outcomes of Australia's undergraduate medical education rural immersion programs.

PubMed

O'Sullivan, Belinda G; McGrail, Matthew R; Russell, Deborah; Chambers, Helen; Major, Laura

2018-01-31

A key strategy for increasing the supply of rural doctors is rurally located medical education. In 2000, Australia introduced a national policy to increase rural immersion for undergraduate medical students. This study aims to describe the characteristics and outcomes of the rural immersion programs that were implemented in Australian medical schools. Information about 19 immersion programs was sourced in 2016 via the grey and published literature. A scoping review of the published peer-reviewed studies via Ovid MEDLINE and Informit (2000-2016) and direct journal searching included studies that focused on outcomes of undergraduate rural immersion in Australian medical schools from 2000 to 2016. Programs varied widely by selection criteria and program design, offering between 1- and 6-year immersion. Based on 26 studies from 10 medical schools, rural immersion was positively associated with rural practice in the first postgraduate year (internship) and early career (first 10 years post-qualifying). Having a rural background increased the effects of rural immersion. Evidence suggested that longer duration of immersion also increases the uptake of rural work, including by metropolitan-background students, though overall there was limited evidence about the influence of different program designs. Most evidence was based on relatively weak, predominantly cross-sectional research designs and single-institution studies. Many had flaws including small sample sizes, studying internship outcomes only, inadequately controlling for confounding variables, not using metropolitan-trained controls and providing limited justification as to the postgraduate stage at which rural practice outcomes were measured. Australia's immersion programs are moderately associated with an increased rural supply of early career doctors although metropolitan-trained students contribute equal numbers to overall rural workforce capacity. More research is needed about the influence of student interest in rural practice and the duration and setting of immersion on rural work uptake and working more remotely. Research needs to be more nationally balanced and scaled-up to inform national policy development. Critically, the quality of research could be strengthened through longer-term follow-up studies, adjusting for known confounders, accounting for postgraduate stages and using appropriate controls to test the relative effects of student characteristics and program designs.

Measuring the attractiveness of rural communities in accounting for differences of rural primary care workforce supply.

PubMed

McGrail, Matthew R; Wingrove, Peter M; Petterson, Stephen M; Humphreys, John S; Russell, Deborah J; Bazemore, Andrew W

2017-01-01

Many rural communities continue to experience an undersupply of primary care doctor services. While key professional factors relating to difficulties of recruitment and retention of rural primary care doctors are widely identified, less attention has been given to the role of community and place aspects on supply. Place-related attributes contribute to a community's overall amenity or attractiveness, which arguably influence both rural recruitment and retention relocation decisions of doctors. This bi-national study of Australia and the USA, two developed nations with similar geographic and rural access profiles, investigates the extent to which variations in community amenity indicators are associated with spatial variations in the supply of rural primary care doctors. Measures from two dimensions of community amenity: geographic location, specifically isolation/proximity; and economics and sociodemographics were included in this study, along with a proxy measure (jurisdiction) of a third dimension, environmental amenity. Data were chiefly collated from the American Community Survey and the Australian Census of Population and Housing, with additional calculated proximity measures. Rural primary care supply was measured using provider-to-population ratios in 1949 US rural counties and in 370 Australian rural local government areas. Additionally, the more sophisticated two-step floating catchment area method was used to measure Australian rural primary care supply in 1116 rural towns, with population sizes ranging from 500 to 50 000. Associations between supply and community amenity indicators were examined using Pearson's correlation coefficients and ordinary least squares multiple linear regression models. It was found that increased population size, having a hospital in the county, increased house prices and affluence, and a more educated and older population were all significantly associated with increased workforce supply across rural areas of both countries. While remote areas were strongly linked with poorer supply in Australia, geographical remoteness was not significant after accounting for other indicators of amenity such as the positive association between workforce supply and coastal location. Workforce supply in the USA was negatively associated with fringe rural area locations adjacent to larger metropolitan areas and characterised by long work commutes. The US model captured 49% of the variation of workforce supply between rural counties, while the Australian models captured 35-39% of rural supply variation. These data support the idea that the rural medical workforce is maldistributed with a skew towards locating in more affluent and educated areas, and against locating in smaller, poorer and more isolated rural towns, which struggle to attract an adequate supply of primary care services. This evidence is important in understanding the role of place characteristics and rural population dynamics in the recruitment and retention of rural doctors. Future primary care workforce policies need to place a greater focus on rural communities that, for a variety of reasons, may be less attractive to doctors looking to begin or remain working there.

The Broadband Quandary for Rural America. The Main Street Economist: Commentary on the Rural Economy.

ERIC Educational Resources Information Center

Staihr, Brian

High speed data services known as broadband have the potential to make rural areas less isolated and improve the rural quality of life, but physical barriers, sparse population density, and few markets present significant obstacles to their deployment in rural areas. Broadband applications such as e-commerce, distance education, and telemedicine…

RURAL RECREATION ENTERPRISES FOR PROFIT, AN AID TO RURAL AREAS DEVELOPMENT.

ERIC Educational Resources Information Center

Department of Agriculture, Washington, DC.

MANY RURAL AREAS OF THE U.S. POSSESS ENOUGH SPACE AND NATURAL ATTRACTIONS TO SERVE AS A BASIS FOR ESTABLISHING EITHER PART OR FULL-TIME RECREATIONAL ENTERPRISES. MOST OUTDOOR LEISURE ACTIVITIES CENTER AROUND WATER, HUNTING AND FISHING, ADMIRING SCENERY, AND ENJOYING THE NATURAL RURAL LANDSCAPE. THUS THE DEVELOPMENT OF RURAL RECREATION RESOURCES IS…

Development of the Language Proficiency of Five- to Seven-Year-Olds in Rural Areas

ERIC Educational Resources Information Center

Poolman, B. G.; Leseman, P. P. M.; Doornenbal, J. M.; Minnaert, A. E. M. G.

2017-01-01

Rural children are a largely understudied population in language and literacy research, despite the fact that these children often enter school with delays in their language development. Since most rural areas suffered from so-called selective rural outmigration, many parents in rural areas are lower or middle educated. The home literacy climate,…

Rural Development: Problems and Advantages of Rural Locations for Industrial Plants.

ERIC Educational Resources Information Center

Bishop, C. E.; And Others

The problems and advantages of locating industry in a rural setting were discussed in this conference report. The 10 individual speeches covered: changes in employment and the labor force; problems and advantages of rural locations, rural labor, and site selection; the importance of involving the Black community; the nature of the food processing…

Natural Resource Dependence, Rural Development, and Rural Poverty. Rural Development Research Report Number 48.

ERIC Educational Resources Information Center

Deavers, Kenneth L.; Brown, David L.

Rural areas' population growth, location, level of economic activity and social well-being depend less on natural resource endowments than on such factors as transportation, communication, labor force characteristics, and urbanization. General causes of the 1970's urban-to-rural migration included fewer changes in the structure of agriculture,…

Rural Policy and the New Regional Economics: Implications for Rural America.

ERIC Educational Resources Information Center

Quigley, John M.

This paper discusses gross economic and demographic trends in rural and urban America during the past 30 years, the kinds of competitive advantages enjoyed by urban and rural regions, and insights offered by the new regional economics concerning exploitation of those advantages. The importance of agriculture has declined in rural areas, while that…

42 CFR 447.371 - Services furnished by rural health clinics.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Institutional and Noninstitutional Services Rural Health Clinic Services § 447.371 Services furnished by rural health clinics. The agency must pay for rural health clinic services, as defined in § 440.20(b) of this subchapter, and for other ambulatory services furnished by a rural health clinic, as defined in § 440.20(c...

Better Country: A Strategy for Rural Development in the 1980's.

ERIC Educational Resources Information Center

Department of Agriculture, Washington, DC.

The report of the 25-member National Advisory Council on Rural Development, appointed by the Secretary of Agriculture, defines rural needs and sets forth strategies for rural development in the 1980's. A review of the decade between 1970 and 1980 discusses rapid economic growth of rural areas, social progress, and changes in public service, and…

A Bibliography on Rural Development in Tanzania. MSU Rural Development Paper No. 3.

ERIC Educational Resources Information Center

Kocher, James E.; Fleisher, Beverly

Rural development is understood to mean both the increased productivity of agriculture and other rural economic activities and the enhancement of the material well-being of the rural people (who comprise about 90% of Tanzania's 16 million population) through education, improved health, and better nutrition. Seven hundred and sixty-one books,…

Cancer Mortality in Rural Appalachian Kentucky. Appalachian Data Bank Report #6.

ERIC Educational Resources Information Center

Tucker, Thomas C.; And Others

This report compares cancer mortality rates in rural Appalachian Kentucky with rates for rural non-Appalachian Kentucky and the U.S. white population. Rural Appalachian Kentucky differs from the rest of rural Kentucky in having a younger, poorer, less educated population with greater employment in mining as opposed to agriculture, and with less…

"They'd Never Hire a Girl": Vocational Education in Rural Secondary Schools.

ERIC Educational Resources Information Center

Dunne, Faith

Rural high school girls face a strong home-versus-career conflict stemming from traditional rural values and myths about women. They also face the reality of few local job opportunities, due to rural economic and value structures and to occupational sex-stereotyping. For the most part, rural secondary vocational education maintains its…

Girl Scouts: A Strong Ally for Rural Education.

ERIC Educational Resources Information Center

Ricard, Virginia B.

With much to offer rural girls as well as much to learn from them, Girl Scouting is trying to reach more girls and adults in rural areas. The challenges include economic setbacks for farming, unemployment, isolated populations, and changing rural culture. Along with the challenges are the many resources of rural areas and the congruence between…

The Diverse Social and Economic Structure of Nonmetropolitan America. Rural Development Research Report No. 49.

ERIC Educational Resources Information Center

Bender, Lloyd D.; And Others

Effective rural development planning depends on facts and analysis based, not on rural averages, but on the diverse social and economic structure of rural America. Programs tailored to particular types of rural economies may be more effective than generalized programs. Because of their unique characteristics, government policies and economic…

Social and Economic Trends in Rural America. The White House Rural Development Background Paper.

ERIC Educational Resources Information Center

Deavers, Kenneth L.; Brown, David L.

Emphasizing developmental problems caused by the rapid population and employment growth in rural America during the 1970's, this document describes social, economic, and governmental trends in rural America and suggests some federal policy choices that might be made in support of rural development. Problem areas and policy suggestions are…

The Carter Administration: Small Community and Rural Development Policy.

ERIC Educational Resources Information Center

Carter, Jimmy

The Carter Administration is adopting a Small Community and Rural Development Policy because: (1) rural America's human and natural resources are a mainstay of the nation's economy and way of life; (2) many rural areas are in the midst of significant economic and demographic change; (3) rural people and communities have greater unmet basic human…

Urban-Rural Disparities in Injury Mortality in China, 2006

ERIC Educational Resources Information Center

Hu, Guoqing; Baker, Susan P.; Baker, Timothy D.

2010-01-01

Context: Urban-rural disparity is an important issue for injury control in China. Details of the urban-rural disparities in fatal injuries have not been analyzed. Purpose: To target key injury causes that most contribute to the urban-rural disparity, we decomposed total urban-rural differences in 2006 injury mortality by gender, age, and cause.…

"Guanxi" and School Success: An Ethnographic Inquiry of Parental Involvement in Rural China

ERIC Educational Resources Information Center

Xie, Ailei; Postiglione, Gerard A.

2016-01-01

This study examines the differential patterns of school success of rural students as a result of China's market transition. The process dimension, how families from different social backgrounds within rural society get involved in rural schooling and how this contributes to the inequality of school success within rural society, is investigated.…

Predicting Rural Practice Using Different Definitions to Classify Medical School Applicants as Having a Rural Upbringing

ERIC Educational Resources Information Center

Owen, John A.; Conaway, Mark R.; Bailey, Beth A.; Hayden, Gregory F.

2007-01-01

Purpose: This study determines the relationship between a medical school applicant's rural background and the likelihood of rural practice using different definitions of rural background. Methods: Cohort study of 599 physicians who entered the University of Virginia School of Medicine in 1990-1995 and graduated in 1994-1999. The…

America's Forgotten Children: Child Poverty in Rural America.

ERIC Educational Resources Information Center

Nadel, Wendy; Sagawa, Shirley

This report draws on research, statistics, and the voices of rural young people to document the extent and causes of rural child poverty, and related problems and reasons for hope in specific focus areas. About 2.5 million rural children are chronically poor. Rural poverty is concentrated in central Appalachia, the deep South, the U.S.-Mexican…

A Survey of Professional Training and Certification of Rural Administrators and Rural Teachers in New Mexico.

ERIC Educational Resources Information Center

Tingley, Wayne

Teachers and administrators in rural New Mexico schools and preservice teachers at New Mexico State University were surveyed to determine components that could be included in teacher education programs to augment prospective rural teachers' skills and to ease problems of recruitment/retention of certified personnel in rural schools. Questionnaires…

Beyond Rural Idylls: Imperfect Lesbian Utopias at Michigan Womyn's Music Festival

ERIC Educational Resources Information Center

Browne, Kath

2011-01-01

Whilst rural idylls have dominated some discussions of rural social difference, little attention has been paid to rural utopias. Imagined, material and discursive experiences of utopian rural ideals are critically examined in this paper. It takes as its focus the Michigan Womyn's Music Festival--an annual US womyn-only festival--in order to…

In-Place Training: Optimizing Rural Health Workforce Outcomes through Rural-Based Education in Australia

ERIC Educational Resources Information Center

May, Jennifer; Brown, Leanne; Burrows, Julie

2018-01-01

The medical workforce shortfall in rural areas is a major issue influencing the nature of undergraduate medical education in Australia. Exposing undergraduates to rural life through rural clinical school (RCS) placements is seen as a key strategy to address workforce imbalances. We investigated the influence of an extended RCS placement and rural…

The Condition of Rural Education in Kentucky: A Profile.

ERIC Educational Resources Information Center

Coe, Pam; And Others

In Kentucky, 105 of 178 school districts, or 59%, are classified as rural. State law and administrative regulations presume that most school districts are both rural and isolated. The environment for rural schools in the state is heavily influenced by the fact that the majority of school districts are rural. Each school district must have a…

Rural-Specific Concerns and Strategies in the Budget Process

ERIC Educational Resources Information Center

Johnson, Jerry; Malhoit, Greg; Shope, Shane

2012-01-01

Nationally, rural students represent about a quarter of all students attending public school; nearly a third of all schools are located in rural areas. Those rural schools and students have a number of unique characteristics and needs. For example, the smaller size of many rural schools and districts can sometimes lead to per-pupil expenditures…

"Hey, I Saw Your Grandparents at Walmart": Teacher Education for Rural Schools and Communities

ERIC Educational Resources Information Center

Eppley, Karen

2015-01-01

This is a case study about how teacher education might better prepare rural teacher candidates for rural schools. Parents, teachers, community members, and students associated with a rural school described what is important in the preparation of teachers for today's rural schools. Their goals and wishes for their children's school and community…

Constructing and Reconstructing the "Rural School Problem": A Century of Rural Education Research

ERIC Educational Resources Information Center

Biddle, Catharine; Azano, Amy Price

2016-01-01

This chapter examines 100 years of rural education research in the context of the demographic, migratory, economic, and social changes that have affected rural America in the past century. The authors conducted a systematic review of the literature on rural teacher recruitment, retention, and training as a case study to examine the constancy and…

Medical Education and the Rural Health Crisis: A Personal Perspective from Experiences in Five States.

ERIC Educational Resources Information Center

Vanselow, Neal A.

1990-01-01

A solution to the rural health crisis will require not only changes in student selection, curriculum, and training location but also strengthening of the rural economy, improved reimbursement to rural hospitals and primary care physicians, and increased sensitivity among leaders of the medical profession to rural community and practitioner needs.…

Workforce Issues--Rural Illinois Hospital Chief Executive Officers' Perceptions of Provider Shortages and Issues in Rural Recruitment and Retention

ERIC Educational Resources Information Center

Glasser, Michael; Peters, Karen; MacDowell, Martin

2006-01-01

Background: It is important to assess rural health professions workforce needs and identify variables in recruitment and retention of rural health professionals. Purpose: This study examined the perspectives of rural hospital chief executive officers (CEOs) regarding workforce needs and their views of factors in the recruitment and retention…

Rural Schools, Rural Communities: An Alternative View of the Future. Keynote Address.

ERIC Educational Resources Information Center

Nachtigal, Paul M.

The urbanization and industrialization of a society based on commercial competitiveness has resulted in the marginalization of rural communities and the disempowerment of rural people. An alternative view of the future is needed, and rural schools have a part to play in creating it. Four sets of forces are driving society toward a different…

Red Rural, Blue Rural: The Geography of Presidential Voting in Rural America

ERIC Educational Resources Information Center

Scala, Dante J.; Johnson, Kenneth M.

2016-01-01

Political commentators routinely treat rural America as an undifferentiated bastion of strength for Republicans. In fact, rural America is a deceptively simple term describing a remarkably diverse collection of places encompassing nearly 75 percent of the U.S. land area and 50 million people. Voting trends in this vast area are far from…

Imaginary Gardens? Real Problems: An Analysis of Federal Information Sources on Rural Education.

ERIC Educational Resources Information Center

Parks, Gail; Sher, Jonathan P.

Comprehension of the current condition of rural education is essential to national education policy and program considerations, yet rural schools go unnoticed at the federal level because of a paucity of national rural data. The changing nature of rural population, the national mandate for equal educational opportunity, and the need for a timely…

Community Connections: Supporting Rural Youth with Disabilities Who Are Work-Bound

ERIC Educational Resources Information Center

Mahiko, Joy

2017-01-01

Although many public schools in the United States are located in rural areas, the literature on rural youth is extremely limited, and the literature on rural youth with disabilities is practically absent. The purpose of this study was to gather the perspectives of community partners regarding rural school-community partnerships and provide an…

The Role of Social Capital in Educational Aspirations of Rural Youth*

PubMed Central

Byun, Soo-yong; Meece, Judith L.; Irvin, Matthew J.; Hutchins, Bryan C.

2013-01-01

Drawing on a recent national survey of rural high school students, this study investigated the relationship between social capital and educational aspirations of rural youth. Results showed that various process features of family and school social capital were important to predict rural youth's educational aspirations beyond sociodemographic background. In particular, parents' and teachers' educational expectations for their child and student respectively were positively related to educational aspirations of rural youth. In addition, discussion with parents about college was positively related to educational aspirations of rural youth. On the other hand, there was little evidence to suggest that number of siblings and school proportions of students on free lunch and minority students are related to educational aspirations of rural youth, after controlling for the other variables. The authors highlight unique features of rural families, schools, and communities that may combine to explain the complexity of the role of social capital in shaping educational aspirations of rural youth. PMID:24039302

Towards equity and sustainability of rural and remote health services access: supporting social capital and integrated organisational and professional development.

PubMed

Schoo, Adrian; Lawn, Sharon; Carson, Dean

2016-04-02

Access to rural health services is compromised in many countries including Australia due to workforce shortages. The issues that consequently impact on equity of access and sustainability of rural and remote health services are complex. The purpose of this paper is to describe a number of approaches from the literature that could form the basis of a more integrated approach to health workforce and rural health service enhancement that can be supported by policy. A case study is used to demonstrate how such an approach could work. Disjointed health services are common in rural areas due to the 'tyranny of distance.' Recruitment and retention of health professionals in rural areas and access to and sustainability of rural health services is therefore compromised. Strategies to address these issues tend to have a narrow focus. An integrated approach is needed to enhance rural workforce and health services; one that develops, acknowledges and accounts for social capital and social relations within the rural community.

Economic aspects of rural sanitation in the United States of America*

PubMed Central

Hollis, Mark D.

1954-01-01

Although health conditions in the rural areas of the USA are comparatively good, they are inferior to those in the urban areas. An important reason for this inferiority is the fact that rural sanitation is less a social responsibility than an individual responsibility, which many rural families cannot finance. The rural culture imposes many handicaps on the rural family's health and wealth. Such handicaps may be moderated by sanitation and related social and economic measures, if the measures selected are appropriate to the local needs and resources, which may vary greatly. Although sanitation needs are common to all rural areas, the refinement and complexity of sanitation facilities and services cannot be uniform. Allowing for variable circumstances, however, the basic elements of rural sanitation in the USA can be realized within a generation. The probable net gains in farm productivity would seem to warrant support for a rural sanitation programme on economic grounds alone, if an economic market may be assumed for the increase in agricultural production. PMID:13160756

Rural long-term care work, gender, and restructuring.

PubMed

Leach, Belinda; Joseph, Gillian

2011-06-01

Restructuring--the introduction of changes that alter the way health care is delivered for maximum efficiency and least cost--layered with rurality and with rural gender ideologies and practices, results in rural long-term care settings that have particular consequences for the women working in them, and for the residents and communities that they serve. This research investigated how rurality affects the implementation of patient classification in Ontario long-term care homes. Methods involved interviews and focus groups with front-line long-term care workers, administrators, and key participants. The findings revealed that rural long-term care delivery takes place when a restructured work environment intersects with gender ideologies and practices that take on particular characteristics when developed and sustained in a rural context. These factors shape the labor market and working conditions for rural women. We argue that this produces a uniquely rural experience for long-term care workers and conclude that those implementing classification systems must consider contextual factors as well as practical and financial exigencies.

Globalisation, rural restructuring and health service delivery in Australia: policy failure and the role of social work?

PubMed

Alston, Margaret

2007-05-01

The impacts of globalisation and rural restructuring on health service delivery in rural Australia have been significant. In the present paper, it is argued that declining health service access represents a failure of policy. Rural communities across the world are in a state of flux, and Australia is no different: rural communities are ageing at faster rates than urban communities and young people are out-migrating in large numbers. During the past 5 years, rural Australia has also experienced a severe and widespread drought that has exacerbated rural poverty, and impacted on the health and well-being of rural Australians. Australian governments have responded to globalising forces by introducing neoliberal policy initiatives favouring market solutions and championing the need for self-reliance among citizens. The result for rural Australia has been a withdrawal of services at a time of increased need. This paper addresses the social work response to these changes.

Rural women in Africa and technological change: some issues.

PubMed

Date-bah, E; Stevens, Y

1981-01-01

The attempt is made in this discussion to highlight some of the important sociological and technical issues relating to rural women in Africa and technological change which appear to have been underplayed, misconceived or overlooked in the past. Attention is directed to the rural woman as a member of the family unit, the image of the rural man, rural women as a diversified group, community and national governmental commitment to rural technology innovations, the use of already existing traditional groups and institutions to effect rural technological change, and design specifications and shortcomings of equipment and tools (manufacturing costs, exploitation of locally available energy resources, the simplicity of the devices), and infrastructural and marketing problems. Numberous projects aimed at improving the lot of women in the rural areas have focused only on women, rather than the woman as a member of an extended as well as a nuclear family unit. Consequently, they have failed, for rural women do not exist or operate in isolation. It is difficult to believe the overall image in much of the literature that the husbands of rural women show no sympathy or regard for their wives. In the effort to attract investment to improve upon the position of rural women, reality should not be distorted with this one-sided view. Men should be involved in the technology planned for rural women, and the technological change should be planned and implemented in such a way that it results in an improvement in the relationship between the rural couple and generally between members of the rural family and between males and females in the village. Another problem is overgeneralization, and it must be recognized that considerable differentiation exists between rural women themselves. The importance of community, governmental and political commitment to rural technology innovations in order to ensure their success is neglected in the literature. The government and polictical leadership can do much to introduce improved technologies in the rural areas. The use of existing traditional institutions to bring about tecnological change in the rural areas needs to be stressed. Primary reasons why some of the improved devices introduced for use by rural women have been rejected include the following: the devices fail to meet the priority needs of the women and socioeconomic and cultural factors are not considered in their design. Most developing countries are without the required industries to produce the needed basic components. Exploitation of some of the available natural resources would make life much easier for rural women. As rural societies are usually imperfectly linked to bacly organized markets, infrastructural facilities, such as feeder roads, would have to be improved. The following are among the hypotheses suggested by this review: technological innovations linked to existing traditional skills and methods are likely to have easier acceptance in the rural areas than those divorced from these skills and methods; and technological innovations which are disseminated through existing traditional institutions and groups are likely to have easier acceptance. Guidelines for future research are included.

Work of female rural doctors.

PubMed

Wainer, Jo

2004-04-01

To identify the impact of family life on the ways women practice rural medicine and the changes needed to attract women to rural practice. Census of women rural doctors in Victoria in 2000, using a self-completed postal survey. General and specialist practice. Two hundred and seventy-one female general practitioners and 31 female specialists practising in Rural, Remote and Metropolitan Area Classifications 3-7. General practitioners are those doctors with a primary medical degree and without additional specialist qualifications. Interaction of hours and type of work with family responsibilities. Generalist and specialist women rural doctors carry the main responsibility for family care. This is reflected in the number of hours they work in clinical and non-clinical professional practice, availability for on-call and hospital work, and preference for the responsibilities of practice partnership or the flexibility of salaried positions. Most of the doctors had established a satisfactory balance between work and family responsibilities, although a substantial number were overworked in order to provide an income for their families or meet the needs of their communities. Thirty-six percent of female rural general practitioners and 56% of female rural specialists preferred to work fewer hours. Female general practitioners with responsibility for children were more than twice as likely as female general practitioners without children to be in a salaried position and less likely to be a practice partner. The changes needed to attract and retain women in rural practice include a place for everyone in the doctor's family, flexible practice structures, mentoring by women doctors and financial and personal recognition. Women make up less than a quarter of the rural general practice workforce and an even smaller percentage of the specialist rural medical workforce. As a result their experiences are not well articulated in research on rural medical practice and their needs are not well represented in policies and programs for rural doctors. The incoming cohort of rural general practitioners has a majority of women and it is essential that the practice styles and needs of women doctors are understood in order to attract and retain women in rural medicine. This survey identifies some of the effects of family responsibilities on the work practices of female rural doctors and the changes needed to the structure of rural practice to include the way women work.

Staff Movements

NASA Astrophysics Data System (ADS)

Huber, M. C. E.

1986-09-01

Los astronomos de ESO dedican una considerable parte de su tiempo a la preparacion de solicitudes para tiempo de observacion en La Silla. Sin embargo, debido a la gran demanda par los telescopios, se debe hacer una seleccion, aveces drastica, de los programas de observacion presentados. EI Comite de Programas de Observacion (OPC) tiene como tarea evaluar el merito cientifico de las solicitudes presentadas. Basada en las recomendaciones dei OPC, ESO prepara una Lista de Tiempos de Observacion en la cual distribuye el tiempo disponible en los telescopios a los programas mejor evaluados.

Contenedores: Aspectos tecnicos, biologicos y economicos

Treesearch

Tara Luna; Thomas D. Landis; R. Kasten Dumroese

2012-01-01

La elección del contenedor es una de las consideraciones más importantes al establecer un nuevo vivero o empezar a producir una especie nueva. El tipo y tamaño de contenedor no sólo determina la cantidad de agua y nutrientes minerales que están disponibles para el crecimiento de una planta, sino que también afecta otros aspectos operativos del vivero, como el tamaño de...

Rural Emergency Medical Services (EMS) and Trauma

MedlinePlus

... Toolkits Economic Impact Analysis Tool Community Health Gateway Sustainability Planning Tools Testing New Approaches Rural Health IT ... to the 2015 WWAMI Rural Health Research Center report, Prehospital Emergency Medical Services Personnel in Rural Areas: ...

Human transportation needs in rural Oklahoma.

DOT National Transportation Integrated Search

2012-09-01

Mobility is extremely important, especially in rural areas, which have dispersed populations and locations. : This study was conducted among rural minority populations to evaluate human transportation needs of the : underserved rural population in Ok...

The changing nature of rural health care.

PubMed

Ricketts, T C

2000-01-01

The rural health care system has changed dramatically over the past decade because of a general transformation of health care financing, the introduction of new technologies, and the clustering of health services into systems and networks. Despite these changes, resources for rural health systems remain relatively insufficient. Many rural communities continue to experience shortages of physicians, and the proportion of rural hospitals under financial stress is much greater than that of urban hospitals. The health care conditions of selected rural areas compare unfavorably with the rest of the nation. The market and governmental policies have attempted to address some of these disparities by encouraging network development and telemedicine and by changing the rules for Medicare payments to providers. The public health infrastructure in rural America is not well understood but is potentially the most fragile aspect of the rural health care continuum.

Medical residencies and increased admissions in rural hospitals with fewer than 200 beds.

PubMed

Connor, R A

2000-01-01

Medical education programs in general, and rural residency programs in particular, can be beneficial for rural hospitals. This study of 1,792 non-metropolitan statistical area, acute general hospitals with fewer than 200 beds from 1993 to 1996 was designed to help rural hospitals and communities to quantify the likely effects of rural residency programs on hospital admissions. Data came from the hospital Prospective Payment System minimum data set. The results show that additional residents at rural hospitals with fewer than 200 beds generally result in an increase of approximately 100 to 200 admissions per resident--more for smaller hospitals and fewer for larger hospitals. Because increased admissions generally improve the financial health and continued operation of rural hospitals, this study confirms the importance of education-based strategies in ensuring access to care in rural communities.

Residents' willingness-to-pay for attributes of rural health care facilities.

PubMed

Allen, James E; Davis, Alison F; Hu, Wuyang; Owusu-Amankwah, Emmanuel

2015-01-01

As today's rural hospitals have struggled with financial sustainability for the past 2 decades, it is critical to understand their value relative to alternatives, such as rural health clinics and private practices. To estimate the willingness-to-pay for specific attributes of rural health care facilities in rural Kentucky to determine which services and operational characteristics are most valued by rural residents. We fitted choice experiment data from 769 respondents in 10 rural Kentucky counties to a conditional logit model and used the results to estimate willingness-to-pay for attributes in several categories, including hours open, types of insurance accepted, and availability of health care professionals and specialized care. Acceptance of Medicaid/Medicare with use of a sliding fee scale versus acceptance of only private insurance was the most valued attribute. Presence of full diagnostic services, an emergency room, and 24-hour/7-day-per-week access were also highly valued. Conversely, the presence of specialized care, such as physical therapy, cancer care, or dialysis, was not valued. In total, respondents were willing to pay $225 more annually to support a hospital relative to a rural health clinic. Rural Kentuckians value the services, convenience, and security that rural hospitals offer, though they are not willing to pay more for specialized care that may be available in larger medical treatment centers. The results also inform which attributes might be added to existing rural health facilities to make them more valuable to local residents. © 2014 National Rural Health Association.

Rural medicine interest groups at McMaster University: a pilot study.

PubMed

Blau, Elaine M; Aird, Pamela; Dolovich, Lisa; Burns, Sheri; del Pilar-Chacon, Marie

2009-01-01

Although rural medicine interest groups (RMIGs) are prevalent in Canadian medical schools, there is little research on their contribution to rural education, training and careers. We explored 2 broad questions by means of an electronic survey to people who were RMIG participants at McMaster University from 2002 to 2007: 1) What are the experiences of undergraduate trainees in an RMIG? 2) What are the features of RMIGs that contribute to an interest in rural medicine? The survey itself contained 35 questions broken down into sections detailing demographics, involvement in RMIGs, RMIG features, core and elective experiences, careers and Canadian Resident Matching Service. Of the 63 participants who completed the survey, 13 (20.6%) were in postgraduate training and 50 (79.4%) were in undergraduate training. The mean (standard deviation) age of participants was 28.4 (6.5) years and 71.9% percent were female. Respondents indicated that rural placements had the most influence on their choice of specialty and rural interest. Of all the features and activities of the RMIG, rural medicine special events contributed the most to an interest in rural medicine (e.g., "rural medicine days"). At McMaster University, the responses of participants suggested that RMIG participation had more influence on career choice than did the medical school attended. Communities, government organizations, residency programs and others interested in improving access to rural physicians, will note the importance of RMIGs and the importance survey respondents gave to rural medicine special events and rural electives.

General dentist characteristics associated with rural practice location.

PubMed

McKernan, Susan C; Kuthy, Raymond A; Kavand, Golnaz

2013-08-01

To examine whether there is a difference in the likelihood that a general dentist practices in a rural location based on individual characteristics, including dental school attended, birth state, practice arrangement, sex, and age. All private practice, general dentists in Iowa were included in this study. Data were extracted from the year 2010 version of the Iowa Dentist Tracking System, which monitors practice patterns of active dentists. Rurality of primary office location, categorized using Rural-Urban Commuting Area codes, served as the outcome variable. Chi-square tests and multivariable logistic regression were used to explain associations between rural practice location and dentist characteristics. Fifteen percent of the state's population resided in isolated small rural towns, but only 8% of general dentists practiced here. Approximately 17% of dentists in isolated small rural towns were age 40 or younger, compared to 32% of dentists in urban areas. Among male dentists, those who were born in Iowa (P = .002) were older (P = .020), and graduated from dental schools other than the University of Iowa (P = .009) were more likely to practice in rural areas than were their counterparts. Conversely, among female dentists, solo practice (P = .016) was the only variable significantly associated with rural practice location. The dentist workforce in rural areas of Iowa is dominated by older males who were born in Iowa. As this generation retires and increasing numbers of women enter the profession, state policy makers and planners will need to monitor changing trends in the rural workforce. © 2013 National Rural Health Association.

Integrated rural development programs: a skeptical perspective.

PubMed

Ruttan, V W

1975-11-01

In examining integrated rural development programs the question that arises is why is it possible to identify several relatively successful small-scale or pilot rural development projects yet so difficult to find examples of successful rural development programs. 3 bodies of literature offer some insight into the morphology of rural development projects, programs, and processes: the urban-industrial impact hypothesis; the theory of induced technical change; and the new models of institutional change that deal with institution building and the economics of bureaucratic behavior. The urban-industrial impact hypothesis helps in the clarification of the relationships between the development of rural areas and the development of the total society of which rural areas are a part. It is useful in understanding the spatial dimensions of rural development where rural development efforts are likely to be most successful. Formulation of the hypothesis generated a series of empirical studies designed to test its validity. The effect of these studies has been the development of a rural development model in which the rural community is linked to the urban-industrial economy through a series of market relationships. Both the urban economy's rate of growth and the efficiency of the intersector product and factor markets place significant constraints on the possibilities of rural area development. It is not possible to isolate development processes in the contemporary rural community in a developing society from development processes in the larger society. The induced technical change theory provides a guide as to what must be done to gain access to efficient sources of economic growth, the new resources and incomes that are necessary to sustain rural development. Design of a successful rural development strategy involves a combination of technical and institutional change. The ability of rural areas to respond to the opportunities for economic growth generated by local urban-industrial development, or by the expansion of national and international markets, depends on the capacity for adaptive responses on the part of cultural, political, and economic institutions as well as on technical innovations which can generate substantial new income flows in response to the new economic opportunities. Improvements in the welfare of the rural population in poor regions will call for institutional innovations which effectively link urban and rural areas through a series of nonmarket and market relationships. A major implication of the models is that given the "markets" in which they operate, bureaucracies will be successful in capturing a relatively large share of the economic gains generated by their activities.

The study of the developing model of the rural timeshare tourism

NASA Astrophysics Data System (ADS)

Xu, Zhe; Tang, Beibei

2011-10-01

At present, the booming rural tourism, as a new tourism developing approach of the formation of the penetration and integration of the primary and tertiary industry, the agriculture and tourism, has played an increasingly important role in solving the "three rural" issue, speeding up the development of the new rural socialist, therefore the rural tourism products have got more concerning, gradually move closer from the sub-products of the tourism to the main product of the domestic tourism market. So the rural tourism innovating management and service model, upgrading the industry, meeting the fashion, feature, personalization and information needs of current people's rural leisure tourism, have very great theoretical significance and application values.

The Rural Context of Illicit Substance Offers: A Study of Appalachian Rural Adolescents

PubMed Central

Pettigrew, Jonathan; Miller-Day, Michelle; Krieger, Janice; Hecht, Michael L.

2015-01-01

Rural adolescents are at risk for early initiation and problematic substance use, but to date few studies have examined the rural context of substance use. To better understand substance offers in the rural context, semi-structured interviews were conducted with 118, 12-19 year old adolescents (M = 13.68, SD = 1.37) from Appalachian, rural school districts in Pennsylvania and Ohio. Interviews elicited stories about substance offer-response episodes including where offers occurred, who offered substances, and how youth gained access to illicit substances. Findings describe the settings in which substance offers and use occur for these rural adolescents and advance prevention efforts for tailoring health messages to this target population. PMID:25620838

Quality Education--The Rural Way. Proceedings of the Annual National Conference of People United for Rural Education (7th, Des Moines, Iowa, February 2-3, 1984).

ERIC Educational Resources Information Center

Losure, Joyce, Ed.; And Others

The 1984 conference proceedings consists of introductory material followed by 12 major addresses in 4 general sessions: "Building Partnerships in Rural Education," Robert M. Worthington; "Greetings from the National Rural Education Association," James D. Jess; "Excellence in Rural Education," Anne Campbell;…

High School Biology Evolution Learning Experiences in a Rural Context: A Case of and for Cultural Border Crossing

ERIC Educational Resources Information Center

Borgerding, Lisa A.

2017-01-01

Although the concept of "rural" is difficult to define, rural science education provides the possibility for learning centered upon a strong connection to the local community. Rural American adolescents tend to be more religious than their urban counterparts and less accepting of evolution than their non-rural peers. Because the status…

Coping with Rural Poverty: Economic Survival and Moral Capital in Rural America

ERIC Educational Resources Information Center

Sherman, Jennifer

2006-01-01

The experience of rural poverty is in many ways unique from that of urban poverty. In the rural setting, social cohesion creates pressure on the poor to behave in ways that are consistent with local values. This paper, based on qualitative research done in an isolated, rural Northern California community, argues that in this setting the survival…

Services for Children with Autism Spectrum Disorder: Comparing Rural and Non-Rural Communities

ERIC Educational Resources Information Center

Mello, Maria P.; Urbano, Richard C.; Goldman, Samantha E.; Hodapp, Robert M.

2016-01-01

This study compared service use for families of children with autism spectrum disorder (ASD) who live in rural vs. non-rural areas. Participants were 415 caregivers of children with ASD, of whom 101 (23.7%) lived in rural areas of a southeastern state. Participants completed an online survey regarding access and quality of different services. For…

Figuring It out on Their Own: How Rural Adult Online Students Negotiate Barriers to Learning Online

ERIC Educational Resources Information Center

Peich, Alysia

2017-01-01

The health of rural communities depends, in part, on the education level of rural adults. Economic vitality is impacted by degree completion, and the rate of degree completion by rural adults lags behind that of their urban and suburban counterparts. Low completion rates suggest that there are conditions for rural students that prevent them from…

National Rural Education Research Forum (Lake Placid, New York, October 16-17, 1987).

ERIC Educational Resources Information Center

National Rural Education Association, Fort Collins, CO.

The purpose of this forum was the assessment of how well current research is meeting the needs of rural educators. Individual papers presented at the forum are "Learning To Find the 'Niches': Rural Education and Vitalizing Rural Communities" by Daryl Hobbs with commentary by Richard Tulikangas; "Effective Rural Schools: Where Are We? Where Are We…

Research on Rural Ageing: Where Have We Got to and Where Are We Going in Europe?

ERIC Educational Resources Information Center

Burholt, Vanessa; Dobbs, Christine

2012-01-01

This paper examines the extent to which rural studies conducted in Europe (compared to other countries in the Global North) have addressed the phenomenon of rural ageing. Through a review of the literature published on rural ageing research in the last decade, it compares the research goals identified by the International Rural Ageing Project…

Rural Youth in the USA: Status, Needs, and Suggestions for Development.

ERIC Educational Resources Information Center

Kuvlesky, William P.

Studies on U.S. rural youth indicate current regional and ethnic diversity; limited rural-urban differences; and some limited social change in terms of values, needs, and aspirations. The size of the rural youth population is considerable (25,013,948 out of a total youth population of 93,313,518 in 1970). The majority of rural youth are white…

A Vanishing Rural School Advantage? Changing Urban/Rural Student Achievement Differences in Latin America and the Caribbean

ERIC Educational Resources Information Center

Luschei, Thomas F.; Fagioli, Loris P.

2016-01-01

In 1997, a cross-national assessment of educational achievement in Latin America and the Caribbean found that rural schools in Colombia outperformed urban schools in tests of reading and mathematics, except in very large cities. Given a long history of urban/rural inequality in the region, Colombia's rural school advantage attracted substantial…

50 CFR 100.15 - Rural determination process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... following guidelines: (1) A community or area with a population of 2,500 or less shall be deemed to be rural... populations above 2,500 but not more than 7,000 will be determined to be rural or non-rural. (3) A community with a population of more than 7,000 shall be presumed non-rural, unless such a community or area...

Cost Effective Delivery Strategies in Rural Areas: Programs for Young Handicapped Children. Vol. I. Making It Work in Rural Communities. A Rural Network Monograph.

ERIC Educational Resources Information Center

Black, Talbot, Ed.; Hutinger, Patricia, Ed.

Using a common format outlining program settings, agencies, children/families served, staff, services, delivery strategies, and program costs, descriptions of four cost-effective rural service delivery programs for young handicapped children provide evidence that good rural programs are affordable. The Early Lifestyle Program at King's Daughters'…

An Institutional Disposition that Requires Continual Perfection: The New Mechanism for Assured Funding for Rural Compulsory Education

ERIC Educational Resources Information Center

Hongyu, Zhou; Guowei, Liu

2008-01-01

On December 24, 2005, the State Council issued the Circular on Deepening the Rural Compulsory Education Assured Funding Mechanism Reform, initiating the prologue to free compulsory education in China. Following on the heels of China's annulment of rural taxes and the implementation of the new rural cooperative medical system, the rural compulsory…

43 CFR 404.9 - What types of infrastructure and facilities may be included in an eligible rural water supply...

Code of Federal Regulations, 2010 CFR

2010-10-01

... facilities may be included in an eligible rural water supply project? 404.9 Section 404.9 Public Lands... RURAL WATER SUPPLY PROGRAM Overview § 404.9 What types of infrastructure and facilities may be included in an eligible rural water supply project? A rural water supply project may include, but is not...

Securing Funding in Rural Programs for Young Handicapped Children. Making It Work in Rural Communities. A Rural Network Monograph.

ERIC Educational Resources Information Center

Garland, Corinne Welt, Comp.

The problem of securing funds to support programs for the young handicapped child is a major one for rural service providers. The process of securing funds from within the rural community itself should include nine steps: (1) defining the needy; (2) determining responsibility; (3) identifying resources; (4) considering the message; (5) choosing…

THE STATUS OF EDUCATION AND TRAINING OF RURAL YOUTH--THE IMPACT OF SOCIOECONOMIC CHANGE.

ERIC Educational Resources Information Center

CUSHMAN, M.L.

RURAL SCHOOLS HAVE GREATER EDUCATIONAL RESPONSIBILITIES THAN URBAN SCHOOLS BECAUSE THEY MUST ATTEMPT TO PREPARE YOUTH EITHER FOR RURAL OCCUPATIONS, IF THEY REMAIN IN THE RURAL COMMUNITY, OR FOR URBAN OCCUPATIONS, IF THEY MIGRATE. IT WOULD APPEAR THAT RURAL SCHOOLS ARE FAILING TO DO THIS, AS EVIDENCED BY THEIR HIGH DROPOUT RATE, LACK OF GUIDANCE…

Rural-Urban Migration in Sierra Leone: Determinants and Policy Implications. African Rural Economy Paper No. 13.

ERIC Educational Resources Information Center

Byerlee, Derek; And Others

Study objectives were to: increase the understanding of rural to urban migration processes in Africa and Sierra Leone; develop and test a theoretical schema and survey methodology for migration research; and evaluate the effects of policy on migration. The migration survey was conducted in rural areas, urban areas, and again in the rural areas…

National Congress on Rural Education Proceedings (1st, Traverse City, Michigan, October 11, 1992).

ERIC Educational Resources Information Center

Gregory, Leonard, Comp.

The first National Congress on Rural Education, organized and conducted in conjunction with the 84th annual convention of the National Rural Education Association, convened an assembly of 458 advocates of rural education which came together to analyze common problems that tend to disaffect education in rural America and to plan corrective action.…

The Rural Context of Illicit Substance Offers: A Study of Appalachian Rural Adolescents

ERIC Educational Resources Information Center

Pettigrew, Jonathan; Miller-Day, Michelle; Krieger, Janice; Hecht, Michael L.

2012-01-01

Rural adolescents are at risk for early initiation and problematic substance use, but to date few studies have examined the rural context of substance use. To better understand substance offers in the rural context, semi-structured interviews were conducted with 118, 12- to 19-year-old adolescents (M = 13.68, SD = 1.37) from Appalachian, rural…

Rural Roots, Urban Harvest, and Giving Back to the Land. Occasional Paper No. 8

ERIC Educational Resources Information Center

Schmidt, Martina

2004-01-01

This paper is the personal journey of one teacher from a rural childhood, through a small university, to a rural school, and eventually to the city. It contrasts the intense challenges that rural teachers and students face with the unique opportunities afforded them by virtue of being rural. It includes an attempt to piece together the factors…

Planning Frontiers in Rural America: Papers and Proceedings of the Boone Conference, Volume II (Boone, North Carolina, March 16-18, 1975).

ERIC Educational Resources Information Center

Gade, Ole, Ed.

Representing a broad segment of people interested in rural America, this document presents 16 speeches. Speeches on rural development implementation at Federal, state, and regional levels include: "The Rural Development Concept" (calls for a national rural development policy which provides for a multicommunity, regional framework strengthened by…

A Comparison of Health-Risk Behaviors of Rural Migrants with Rural Residents and Urban Residents in China

ERIC Educational Resources Information Center

Chen, Xinguang; Stanton, Bonita; Li, Xiaoming; Fang, Xiaoyi; Lin, Danhua; Xiong, Qing

2009-01-01

Objective: To determine whether rural-to-urban migrants in China are more likely than rural and urban residents to engage in risk behaviors. Methods: Comparative analysis of survey data between migrants and rural and urban residents using age standardized rate and multiple logistic regression. Results: The prevalence and frequency of tobacco…

DENTAL HEALTH STATUS AND DENTAL HEALTH SERVICES FOR RURAL YOUTH.

ERIC Educational Resources Information Center

DONNELLY, CHARLES J.

ALTHOUGH DENTAL PROBLEMS ARE COMMON IN BOTH RURAL AND URBAN AREAS, RURAL CHILDREN SEEM TO HAVE MORE DIFFICULTIES. THE REASONS FOR THIS APPEAR TO BE THAT THERE ARE FEWER DENTISTS PER CAPITA IN RURAL AREAS, AND THAT THE RURAL CHILD IS USUALLY EXPOSED TO A WATER SYSTEM LACKING FLUORIDATION, WHICH IS THE MOST EFFECTIVE WAY OF ADMINISTERING FLUORIDES.…

7 CFR 22.101 - The Rural Development Act of 1972 (Pub. L. 92-419).

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 1 2010-01-01 2010-01-01 false The Rural Development Act of 1972 (Pub. L. 92-419). 22.101 Section 22.101 Agriculture Office of the Secretary of Agriculture RURAL DEVELOPMENT COORDINATION General § 22.101 The Rural Development Act of 1972 (Pub. L. 92-419). The Rural Development Act of 1972...

A Logic Model for Coaching Experienced Rural Leaders: Lessons from Year One of a Pilot Program

ERIC Educational Resources Information Center

Lindle, Jane Clark; Della Sala, Matthew R.; Reese, Kenyae L.; Klar, Hans W.; Knoeppel, Robert Charles; Buskey, Frederick C.

2017-01-01

Rural schools dominate the United States, yet scant research exists on rural school leaders' development. Urban districts can transfer leaders to different locations, but rural districts, with few school sites, need leaders who stay and adapt to changing conditions. Mid-career rural leaders require a refreshed set of skills to carry school…

Rural and urban park visits and park-based physical activity.

PubMed

Shores, Kindal A; West, Stephanie T

2010-01-01

A physical activity disparity exists between rural and urban residents. Community parks are resources for physical activity because they are publicly provided, available at a low cost, and accessible to most residents. We examine the use of and physical activity outcomes associated with rural and urban parks. Onsite observations were conducted using the System for Observing Play and Recreation in Communities (SOPARC) at four rural and four urban parks. Momentary sampling scans were conducted four times per day for seven days at each site. A total of 6,545 park visitors were observed. Both rural and urban park visitors were observed more often at larger parks with paved trails and attended most often on weekends. Rural park visits were more frequent than urban park visits but rural visits were less physically active. Although similarities were observed between rural and urban park visits, differences suggest that findings from park and physical activity studies in urban areas should not be considered representative of their rural counterparts. Given that the majority of existing park and physical activity research has been undertaken in urban settings, the need for complementary research in rural settings has been made evident through this presentation of baseline descriptive data.

Building Energy Efficiency in Rural China

DOE Office of Scientific and Technical Information (OSTI.GOV)

Evans, Meredydd; Yu, Sha; Song, Bo

2014-04-01

Rural buildings in China now account for more than half of China’s total building energy use. Forty percent of the floorspace in China is in rural villages and towns. Most of these buildings are very energy inefficient, and may struggle to meet basic needs. They are cold in the winter, and often experience indoor air pollution from fuel use. The Chinese government plans to adopt a voluntary building energy code, or design standard, for rural homes. The goal is to build on China’s success with codes in urban areas to improve efficiency and comfort in rural homes. The Chinese governmentmore » recognizes rural buildings represent a major opportunity for improving national building energy efficiency. The challenges of rural China are also greater than those of urban areas in many ways because of the limited local capacity and low income levels. The Chinese government wants to expand on new programs to subsidize energy efficiency improvements in rural homes to build capacity for larger-scale improvement. This article summarizes the trends and status of rural building energy use in China. It then provides an overview of the new rural building design standard, and describes options and issues to move forward with implementation.« less

HIV/AIDS-related sexual risk behaviors among rural residents in China: potential role of rural-to-urban migration

PubMed Central

Li, Xiaoming; Zhang, Liying; Stanton, Bonita; Fang, Xiaoyi; Xiong, Qing; Lin, Danhua

2007-01-01

The relationship between rural-to-urban migration and the spread of HIV is well described, although most studies focus on sexual risk behaviors among rural-to-urban migrants at the urban destination areas. Few studies have examined the sexual risk behaviors of migrants who have returned from urban areas to their rural homes (“return migrants”) in comparison with those of local rural residents who have never migrated to cities (“non-migrants”). This study examines the potential association between rural-to-urban migration and sexual risk behaviors by comparing sexual risk behaviors between 553 return migrants and 441 non-migrants from same rural communities in China. Findings reveal that, after controlling for sociodemographic characteristics, return migrants in rural areas had higher levels of sexual risk, including unprotected sex, than non-migrants. Among return migrants, sexual risk behaviors were associated with age, gender, marital status, and number of different jobs they had previously held in the cities. These findings underscore the importance for HIV/AIDS education and prevention efforts targeting the migrant population in urban destinations as well as the return migrant population in rural areas. PMID:17967110

Surgical specialty procedures in rural surgery practices: implications for rural surgery training.

PubMed

Sticca, Robert P; Mullin, Brady C; Harris, Joel D; Hosford, Clint C

2012-12-01

Specialty procedures constitute one eighth of rural surgery practice. Currently, general surgeons intending to practice in rural hospitals may not get adequate training for specialty procedures, which they will be expected to perform. Better definition of these procedures will help guide rural surgery training. Current Procedural Terminology codes for all surgical procedures for 81% of North Dakota and South Dakota rural surgeons were entered into the Dakota Database for Rural Surgery. Specialty procedures were analyzed and compared with the Surgical Council on Resident Education curriculum to determine whether general surgery training is adequate preparation for rural surgery practice. The Dakota Database for Rural Surgery included 46,052 procedures, of which 5,666 (12.3%) were specialty procedures. Highest volume specialty categories included vascular, obstetrics and gynecology, orthopedics, cardiothoracic, urology, and otolaryngology. Common procedures in cardiothoracic and vascular surgery are taught in general surgical residency, while common procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology are usually not taught in general surgery training. Optimal training for rural surgery practice should include experience in specialty procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology. Copyright © 2012 Elsevier Inc. All rights reserved.

Relative professional roles in antenatal care: results of a survey in Scottish rural general practice.

PubMed

Farmer, Jane; Stimpson, Paul; Tucker, Janet

2003-11-01

There is evidence of variation and some ambiguity about self-perceived relative professional roles in antenatal care in the UK. There is little information about models of antenatal care provision in UK rural areas. In rural areas, in particular, women have limited choice in accessing health care professionals or alternative primary care delivery settings. In the light of a recent review of Scottish maternity services, it is important and timely to examine models of care and interprofessional working in antenatal care in rural areas. This study explores midwives' and GPs' perceptions about their relative professional roles in remote and rural general practice in Scotland. A questionnaire survey involving all 174 Scottish remote and rural general practices (using one definition of rurality) was conducted, followed by 20 interviews. At least one professional returned a completed questionnaire from 91% of rural practices. A number of areas of dissonance were noted between GPs' and midwives' perceptions of their roles in maternity care and, given the context of service provision, these may impact upon rural patients. Findings are relevant to wider debates on extending the primary care team and strengthening inter-disciplinary working, particularly in rural areas.

Active living for rural youth: addressing physical inactivity in rural communities.

PubMed

Yousefian, Anush; Ziller, Erika; Swartz, Jon; Hartley, David

2009-01-01

Rural youth are at greater risk than urban youth for obesity and physical inactivity. Active living research incorporates an ecological approach to promoting physical activity (PA) by recognizing that individual behavior, social environments, physical environments, and policies contribute to behavior change. Active living research and interventions have been limited primarily to urban settings. Because rural communities have unique environmental features and sociocultural characteristics, this project combines insights from current active living models with more focused consideration of the physical and social realities of rural areas. In this study, we report on our efforts to develop, test, and refine a conceptual model describing the interaction between the individual and the environment as it enhances or thwarts active living in rural communities. Our findings revealed a host of relevant "predisposing" and "enabling" factors, including sociodemographic, environmental, policy, and programmatic elements, that extend across the four domains of active living--transportation, recreation, occupation, and household. A one-size approach to PA promotion will not fit the needs of rural youth. Given the unique challenges that rural communities face, efforts to combat childhood obesity must consider rural residents a priority population. More research, interventions, and evaluations on ways to promote rural PA are needed.

Barriers to Rural Induced Abortion Services in Canada: Findings of the British Columbia Abortion Providers Survey (BCAPS)

PubMed Central

Norman, Wendy V.; Soon, Judith A.; Maughn, Nanamma; Dressler, Jennifer

2013-01-01

Background Rural induced abortion service has declined in Canada. Factors influencing abortion provision by rural physicians are unknown. This study assessed distribution, practice, and experiences among rural compared to urban abortion providers in the Canadian province of British Columbia (BC). Methods We used mixed methods to assess physicians on the BC registry of abortion providers. In 2011 we distributed a previously-published questionnaire and conducted semi-structured interviews. Results Surveys were returned by 39/46 (85%) of BC abortion providers. Half were family physicians, within both rural and urban cohorts. One-quarter (17/67) of rural hospitals offer abortion service. Medical abortions comprised 14.7% of total reported abortions. The three largest urban areas reported 90% of all abortions, although only 57% of reproductive age women reside in the associated health authority regions. Each rural physician provided on average 76 (SD 52) abortions annually, including 35 (SD 30) medical abortions. Rural physicians provided surgical abortions in operating rooms, often using general anaesthesia, while urban physicians provided the same services primarily in ambulatory settings using local anaesthesia. Rural providers reported health system barriers, particularly relating to operating room logistics. Urban providers reported occasional anonymous harassment and violence. Conclusions Medical abortions represented 15% of all BC abortions, a larger proportion than previously reported (under 4%) for Canada. Rural physicians describe addressable barriers to service provision that may explain the declining accessibility of rural abortion services. Moving rural surgical abortions out of operating rooms and into local ambulatory care settings has the potential to improve care and costs, while reducing logistical challenges facing rural physicians. PMID:23840578

Appropriate training and retention of community doctors in rural areas: a case study from Mali.

PubMed

Van Dormael, Monique; Dugas, Sylvie; Kone, Yacouba; Coulibaly, Seydou; Sy, Mansour; Marchal, Bruno; Desplats, Dominique

2008-11-18

While attraction of doctors to rural settings is increasing in Mali, there is concern for their retention. An orientation course for young practicing rural doctors was set up in 2003 by a professional association and a NGO. The underlying assumption was that rurally relevant training would strengthen doctors' competences and self-confidence, improve job satisfaction, and consequently contribute to retention. Programme evaluation distinguished trainees' opinions, competences and behaviour. Data were collected through participant observation, group discussions, satisfaction questionnaires, a monitoring tool of learning progress, and follow up visits. Retention was assessed for all 65 trainees between 2003 and 2007. The programme consisted of four classroom modules--clinical skills, community health, practice management and communication skills--and a practicum supervised by an experienced rural doctor. Out of the 65 trained doctors between 2003 and 2007, 55 were still engaged in rural practice end of 2007, suggesting high retention for the Malian context. Participants viewed the training as crucial to face technical and social problems related to rural practice. Discussing professional experience with senior rural doctors contributed to socialisation to novel professional roles. Mechanisms underlying training effects on retention include increased self confidence, self esteem as rural doctor, and sense of belonging to a professional group sharing a common professional identity. Retention can however not be attributed solely to the training intervention, as rural doctors benefit from other incentives and support mechanisms (follow up visits, continuing training, mentoring...) affecting job satisfaction. Training increasing self confidence and self esteem of rural practitioners may contribute to retention of skilled professionals in rural areas. While reorientations of curricula in training institutions are necessary, other types of professional support are needed. This experience suggests that professional associations dedicated to strengthening quality of care can contribute significantly to rural practitioners' morale.

Rural Patients with Severe Sepsis or Septic Shock who Bypass Rural Hospitals have Increased Mortality: An Instrumental Variables Approach

PubMed Central

Mohr, Nicholas M.; Harland, Karisa K.; Shane, Dan M.; Ahmed, Azeemuddin; Fuller, Brian M.; Ward, Marcia M.; Torner, James C.

2016-01-01

Objective To identify factors associated with rural sepsis patients’ bypassing rural emergency departments (EDs) to seek emergency care in larger hospitals, and to measure the association between rural hospital bypass and sepsis survival. Design, Setting, and Patients Cohort study of adults treated in EDs of a rural Midwestern state with severe sepsis or septic shock between 2005 and 2014, using administrative claims data. Patients residing ≥ 20 miles from a top-decile sepsis volume hospital and < 20 miles from a local hospital were included. Interventions Patients bypassing local rural hospitals to seek care in larger hospitals. Measurements and Main Results A total of 13,461 patients were included, and only 5.4% (n = 731) bypassed a rural hospital for their ED care. Patients who initially chose a top-decile sepsis volume hospital were younger (64.7 vs. 72.7 y, p<0.001) and were more likely to have commercial insurance (19.6% vs. 10.6%, p<0.001) than those who were seen initially at a local rural hospital. They were also more likely to have significant medical comorbidities, such as liver failure (9.9% vs 4.2%, p<0.001), metastatic cancer (5.9% vs 3.2%, p<0.001), and diabetes with complications (25.2% vs. 21.6%, p=0.024). Using an instrumental variables approach, rural hospital bypass was associated with a 5.6% increase (95%CI 2.2 – 8.9%) in mortality. Conclusions Most rural patients with sepsis seek care in local EDs, but demographic and disease-oriented factors are associated with rural hospital bypass. Rural hospital bypass is independently associated with increased mortality. PMID:27611977

Physical activity and cardiovascular risk factors among rural and urban groups and rural-to-urban migrants in Peru: a cross-sectional study

PubMed Central

Creber, Ruth M. Masterson; Smeeth, Liam; Gilman, Robert H.; Miranda, J. Jaime

2010-01-01

Objectives To compare physical activity and sedentary behavior patterns of rural-to-urban migrants in Peru versus lifetime rural and urban residents and to determine any associations between low physical activity and four cardiovascular risk factors: obesity (body mass index ≥ 30 kg/m2), systolic and diastolic blood pressure, hypertension, and metabolic syndrome. Methods The PERU MIGRANT (PEru’s Rural to Urban MIGRANTs) cross-sectional study was designed to measure physical activity among rural, urban, and rural-to-urban migrants with the International Physical Activity Questionnaire (IPAQ). Results The World Health Organization (WHO) age-standardized prevalence of low physical activity was 2.2% in lifetime rural residents, 32.2% in rural-to-urban migrants, and 39.2% in lifetime urban residents. The adjusted odds ratios for low physical activity were 21.43 and 32.98 for migrant and urban groups respectively compared to the rural group. The adjusted odds ratio for being obese was 1.94 for those with low physical activity. There was no evidence of an association between low physical activity and blood pressure levels, hypertension, or metabolic syndrome. Conclusions People living in a rural area had much higher levels of physical activity and lower risk of being overweight and obese compared to those living in an urban area of Lima. Study participants from the same rural area who had migrated to Lima had levels of physical inactivity and obesity similar to those who had always lived in Lima. Interventions aimed at maintaining higher levels of physical activity among rural-to-urban migrants may help reduce the epidemic of obesity in urban areas. PMID:20857014

Physical activity and cardiovascular risk factors among rural and urban groups and rural-to-urban migrants in Peru: a cross-sectional study.

PubMed

Masterson Creber, Ruth M; Smeeth, Liam; Gilman, Robert H; Miranda, J Jaime

2010-07-01

To compare physical activity and sedentary behavior patterns of rural-to-urban migrants in Peru versus lifetime rural and urban residents and to determine any associations between low physical activity and four cardiovascular risk factors: obesity (body mass index > 30 kg/m²), systolic and diastolic blood pressure, hypertension, and metabolic syndrome. The PERU MIGRANT (PEru's Rural to Urban MIGRANTs) cross-sectional study was designed to measure physical activity among rural, urban, and rural-to-urban migrants with the International Physical Activity Questionnaire (IPAQ). The World Health Organization (WHO) age-standardized prevalence of low physical activity was 2.2% in lifetime rural residents, 32.2% in rural-to-urban migrants, and 39.2% in lifetime urban residents. The adjusted odds ratios for low physical activity were 21.43 and 32.98 for migrant and urban groups respectively compared to the rural group. The adjusted odds ratio for being obese was 1.94 for those with low physical activity. There was no evidence of an association between low physical activity and blood pressure levels, hypertension, or metabolic syndrome. People living in a rural area had much higher levels of physical activity and lower risk of being overweight and obese compared to those living in an urban area of Lima. Study participants from the same rural area who had migrated to Lima had levels of physical inactivity and obesity similar to those who had always lived in Lima. Interventions aimed at maintaining higher levels of physical activity among rural-to-urban migrants may help reduce the epidemic of obesity in urban cities.

Preferred practice location at medical school commencement strongly determines graduates' rural preferences and work locations.

PubMed

Herd, Marie S; Bulsara, Max K; Jones, Michael P; Mak, Donna B

2017-02-01

To identify factors influencing whether Australian medical graduates prefer to, or actually, work rurally. Secondary analysis of longitudinal data from Medical Schools Outcomes Database (MSOD) using univariate and multivariate logistic regression. Twenty Australian medical schools. Australian or New Zealand citizens and Australian permanent residents who completed MSOD questionnaires between 2006 and 2013. Preferred and actual work locations 1 (PGY1) and 3 (PGY3) years postgraduation. Of 20 784 participants, 4028 completed a PGY1 or PGY3 questionnaire. Self-reported preference for rural practice location at medical school commencement was the most consistent independent predictor of whether a graduate would have a rural location preference at PGY1 (odds ratio (OR) 6.07, 95% confidence interval (CI) 4.91-7.51) and PGY3 (OR 7.95, 95% CI 4.93-12.84), and work rurally during PGY1 (OR 1.38, 95% CI 1.01-1.88) and PGY3 (OR 1.86, 95% CI 1.30-2.64). The effect of preferred practice location at medical school commencement is independent of, and enhances the effect of, rural background. Graduates of graduate-entry programs or with dependent children were less likely to have worked rurally during PGY1 and PGY3 respectively. The most consistent factor associated with rural preferences and work location was students' preferred location of practice at medical school commencement; this association is independent of, and enhances the effect of, rural background. Better understanding of what determines rural preference at medical school commencement and its influence on rural workplace outcomes beyond PGY3 is required to inform Australian medical school selection policies and rural health curricula. © 2016 National Rural Health Alliance Inc.

The impact of rural-exposure strategies on the intention of dental students and dental graduates to practice in rural areas: a systematic review and meta-analysis

PubMed Central

Suphanchaimat, Rapeepong; Cetthakrikul, Nisachol; Dalliston, Alexander; Putthasri, Weerasak

2016-01-01

Background and objectives The objective of this study was to assess the impact of strategies on the intention of dental students/graduates to practice in rural areas. The strategies included the recruitment of dental students from rural backgrounds and clinical rotations in rural areas during the training of dental students. Materials and methods The study undertook a systematic review and utilized meta-analysis to assess these strategies. International literature published between 2000 and 2015 was retrieved from three main search engines: Medline, Embase, and Scopus. The selected articles were scanned to extract the main content. The impact of the strategies was quantitatively assessed by meta-analysis, using the random-effect model. The pooled effect was reported in terms of odds ratios (ORs) with 95% confidence intervals. Sensitivity and subgroup analyses were performed. Publication bias was assessed by the Funnel plot and Egger’s test. Results Seven of the initially selected 897 articles were included for the full review. The majority of the selected articles had been published in developed countries. The meta-analysis results revealed that the pooled OR of rural exposure on the intention to practice in rural areas was approximately 4.1, statistically significant. Subgroup analysis showed that clinical rotations in rural areas tended to have a slightly greater influence on rural dental practice than recruiting students from rural backgrounds (OR 4.3 versus 4.2). There was weaker evidence of publication bias, which was derived from small-study effects. Conclusion Enrolling students with rural backgrounds and imposing compulsory clinical rotation in rural areas during their study appeared to be effective strategies in tackling the shortage and maldistribution of dentists in rural areas. PMID:27822134

Early-career work location of Memorial University medical graduates: Why the decline in rural practice?

PubMed

Mathews, Maria; Ryan, Dana; Samarasena, Asoka

2017-01-01

In a previous study, we found a decline in the proportion of Memorial University of Newfoundland (MUN) medical alumni practising in rural areas, particularly in Newfoundland and Labrador. The current study focused on the work location of recent graduates and examined the predictors of working in rural Canada and in rural Newfoundland and Labrador within the first 15 years following graduation. We linked data from graduating class lists and the alumni and postgraduate databases with Scott's Medical Database to create a record of all graduates from 1973 to 2008, including their work location. We identified differences and significant predictors for each outcome and then described and compared the characteristics of 4 cohorts of graduating classes. In their early career, 127/1113 (11.4%) MUN medical graduates were working in rural Canada, and 57 (5.1%) were working in rural Newfoundland and Labrador. Having a rural background and being a family physician were predictors of working in rural Canada, and having a rural background, doing at least part of the residency at MUN, being from Newfoundland and Labrador and being a family physician were predictors of working in rural Newfoundland and Labrador. Seventy-four (13.6%) and 33 (6.1%) of 1989-1998 graduates worked in rural Canada and rural Newfoundland and Labrador, respectively, compared to 53 (9.3%) and 24 (4.2%), respectively, of 1999-2008 graduates. The proportion of MUN medical graduates who worked in rural communities early in their career decreased among recent cohorts. The results show the impact of changes in the characteristics of MUN medical graduates, who increasingly opt for specialist practice and residency training outside the province, and the important role of local postgraduate training.

Comparison of domestic violence against women in urban versus rural areas of southeast Nigeria.

PubMed

Ajah, Leonard Ogbonna; Iyoke, Chukwuemeka Anthony; Nkwo, Peter Onubiwe; Nwakoby, Boniface; Ezeonu, Paul

2014-01-01

The perception and prevalence of domestic violence (DV) in rural areas is poorly understood; the result is that most efforts at eradicating this harmful practice are concentrated in urban areas. The objective of the study was to compare the burden and perception of DV among women living in rural and urban Igbo communities of southeast Nigeria. This was a comparative, cross-sectional study of women residing in rural and urban communities in Enugu, Nigeria, who had gathered for an annual religious meeting from August 1-7, 2011. Data analysis involved descriptive and inferential statistics and was conducted with the Statistical Package for Social Sciences, software version 17.0, at a 95% level of confidence. A total of 836 women who met the eligibility criteria participated in the survey. Of these, 376 were from Okpanku, a rural community, while 460 were from Ogui Nike, an urban community. The prevalence of DV among rural women was significantly higher than that among urban women (97% versus 81%, P<0.001). In particular, the prevalence of physical violence was significantly higher among rural women than among urban women (37.2% versus 23.5%; P=0.05). In contrast, rural and urban women did not differ significantly in the proportions that had experienced psychological or sexual violence. The proportion of women who believed that DV was excusable was significantly higher among rural dwellers than among urban dwellers (58.5% versus 29.6%; P=0.03). The burden of DV against women may be higher in rural communities than in urban communities in southeast Nigeria. More rural women perceived DV as excusable; this finding suggests that factors that sustain DV could be strong in rural areas. A comprehensive program to curb DV in this area may need to significantly involve the rural areas.

Planning for transportation in rural areas

DOT National Transportation Integrated Search

2001-07-01

The purpose of this document, Planning for Transportation in Rural Areas, is to provide a resource to rural planners, city and county engineers, stakeholders, local officials, and other decision-makers involved with developing rural transportation pl...

A national study into the rural and remote pharmacist workforce.

PubMed

Smith, Janie D; White, Col; Roufeil, Louise; Veitch, Craig; Pont, Lisa; Patel, Bhavini; Battye, Kristine; Luetsch, Karen; Mitchell, Chris

2013-01-01

As for many health professionals, distance presents an enormous challenge to pharmacists working in rural and remote Australia. Previous studies have identified issues relating to the size of the rural and remote pharmacist workforce, and a number of national initiatives have been implemented to promote the recruitment and retention of pharmacists in rural and remote locations. The aim of this study was to explore and describe the current rural and remote pharmacy workforce, and to identify barriers and drivers influencing rural and remote pharmacy practice. A mixed-methods approach was used, which comprised a qualitative national consultation and a quantitative rural and remote pharmacist workforce survey. Semi-structured interviews (n=83) and focus groups (n=15, 143 participants) were conducted throughout Australia in 2009 with stakeholders with an interest in rural and remote pharmacy, practising rural/remote pharmacists and pharmacy educators, and as well as with peak pharmacy organizations, to explore the issues associated with rural/remote practice. Based on the findings of the qualitative work a 45-item survey was developed to further explore the relevance of the issues identified in the qualitative consultation. All registered Australian pharmacists practising in non-urban locations (RRMA 3-7, n=3,300) were identified and invited to participate in the study, with a response rate of 23.4%. The main themes identified from the qualitative consultation were the impact of national increases in the pharmacist workforce on rural/remote practice; the role of the regional pharmacy schools in contributing to the rural/remote workforce; and the perceptions of differences in pharmacist roles in rural/remote practice. The survey indicated that pharmacists practising in rural and remote locations were older than the national average (55.8 years versus 40 years). Differences in their professional role were seen in different pharmacy sectors, with hospital pharmacists spending significantly more time on the delivery of professional services and education and teaching, but less time on medication supply than community pharmacists. Rural/remote pharmacists were generally found to be satisfied with their current role. The main 'satisfiers' reported were task variety, customer appreciation, use of advanced skills, appropriate remuneration, happiness in their work location, sound relationships with other pharmacists, a happy team and relationships with other health professionals. This study described the distribution, roles and factors affecting rural and remote pharmacy practice. While the results presented provide an extensive overview of the rural/remote workforce, a comparable national study comparing rural/remote and urban pharmacists would further contribute to this discussion. Knowledge on why pharmacists chose to work in a particular geographical location, or why pharmacists chose to leave a location would further enrich our knowledge on what drives and sustains the rural/remote pharmacist workforce.

Recruiting undergraduates to rural practice: what the students can tell us.

PubMed

Orpin, Peter; Gabriel, Michelle

2005-01-01

There are still large gaps in the evidence base for the effectiveness of Australian undergraduate rural coursework and placements programs designed to increase the numbers of health graduates choosing rural practice. This article reports on an online survey conducted in 2004 of health science students at the University of Tasmania, Australia, designed as a part of a long-term study to test coursework interventions by tracking students' attitudes to, and experience of, rural practice from course entry to eventual practice. All first and final year students in medicine, nursing and pharmacy in the Faculty of Health Science were invited to complete an online survey exploring the undergraduate experience of rural health. The survey was completed by 148 first year and 87 final year students, a response rate of 32.4% and 23.1% respectively. Over one-third (38.5%) of first years and 56.3% of final years indicated a general preference for rural life and practice and almost 90% expected to spend at least some of their career in rural practice. There was a statistically significant relationship between rural practice orientation and rural origin among first years, although this relationship was weaker among final years. Of first years, 82.4%, and 82.7% of final years appear to have made at least some commitment to a particular career path, and two-thirds to a particular practice environment. Rurally oriented first year students were significantly more committed to a career path than those without that orientation, although this did not hold for final years. When asked how much of their careers they expected to spend in capital city, rural, remote and/or overseas practice, both first and final year students' responses were notable for their spread. Few ruled rural or urban practice in or out entirely with most opting for middle range responses of 'most', 'about half' or 'part' of their career. Over half of both years expected to spend some time in remote practice and 75.1% of first years and 66.6% of final years some time in overseas practice. The factors rated most important in relation to career choice were those related directly to the realities of day-to-day professional practice--professional and peer support, work conditions and variety of work. Approximately three-quarters of those entering undergraduate education felt themselves to be at least 'somewhat informed' about rural practice but, apart from medical students, were little better informed by final year. The only perception of rural practice very widely shared (by more than 80% of respondents) was the possibility of developing better patient relations. Many of the other factors frequently identified as major issues in the rural practice literature--locality, flexibility, opportunities for further study, and spouse/partner and children's needs - while recognised by some, do not appear to loom large with undergraduates either in terms of career choice or perceptions of rural practice. Most final year students recalled receiving specific rural health training through rural placements and/or rural curriculum content. Overall recall of coursework was patchy, although placements were well-remembered and there was good support for increases in both. None of those who recalled undertaking rural coursework felt that it had influenced them towards a rural career and over two-thirds (n = 37, 69.8%) felt that this exposure had actually influenced them away from such a career. Three students reported that undertaking a rural placement influenced them towards, and 35 away from, a rural/remote career. The ultimate measure of the success of undergraduate interventions will be workforce changes over time. In the meantime more research is needed into undergraduate experience of rural health to provide the data needed for the careful design of coursework, detailed planning of the placement experience and long-term strategies to address those aspects of rural practice that are of most concern to these emerging health professionals.

A comparison of the workload of rural and urban primary care physicians in Germany: analysis of a questionnaire survey

PubMed Central

2011-01-01

Background Many western countries are facing an existing or imminent shortage of primary care physicians especially in rural areas. In Germany, working in rural areas is often thought to be associated with more working hours, a higher number of patients and a lower income than working in urban areas. These perceptions might be key reasons for the shortage. The aim of this analysis was to explore if working time, number of treated patients per week or proportion of privately insured patients vary between rural and urban areas in Germany using two different definitions of rurality within a sample of primary care physicians including general practitioners, general internists and paediatricians. Methods This is a secondary analysis of pre-collected data raised by a questionnaire that was sent to a representative random sample of 1500 primary care physicians chosen by data of the National Association of Statutory Health Insurance Physicians from all federal states in Germany. We employed two different methods of defining rurality; firstly, level of rurality as rated by physicians themselves (urban area, small town, rural area); secondly, rurality defined according to the Organisation for Economic Co-operation and Development. Results This analysis was based upon questionnaire data from 715 physicians. Primary care physicians in single-handed practices in rural areas worked on average four hours more per week than their urban counterparts (p < 0.05). Physicians' gender, the number of patients treated per week and the type of practice (single/group handed) were significantly related to the number of working hours. Neither the proportion of privately insured patients nor the number of patients seen per week differed significantly between rural and urban areas when applying the self-rated classification of rurality. Conclusion Overall this analysis identified few differences between urban and rural primary care physician working conditions. To counter future misdistribution of primary care, students should receive practical experience in rural areas to get more practical knowledge on working conditions. PMID:21988900

Not just a rural occurrence: differences in agricultural equipment crash characteristics by rural-urban crash site and proximity to town.

PubMed

Harland, Karisa K; Greenan, Mitchell; Ramirez, Marizen

2014-09-01

Although approximately one-third of agricultural equipment-related crashes occur near town, these crashes are thought to be a rural problem. This analysis examines differences between agricultural equipment-related crashes by their urban-rural distribution and distance from a town. Agricultural equipment crashes were collected from nine Midwest Departments of Transportation (2005-2008). Crash zip code was assigned as urban or rural (large, small and isolated) using Rural-Urban Commuting Areas. Crash proximity to a town was estimated with ArcGIS. Multivariable logistic regression was used to estimate the odds of crashing in an urban versus rural zip codes and across rural gradients. ANOVA analysis estimated mean distance (miles) from a crash site to a town. Over four years, 4444 crashes involved agricultural equipment. About 30% of crashes occurred in urban zip codes. Urban crashes were more likely to be non-collisions (aOR=1.69[1.24-2.30]), involve ≥2 vehicles (2 vehicles: aOR=1.58[1.14-2.20], 3+ vehicles: aOR=1.68[0.98-2.88]), occur in a town (aOR=2.06[1.73-2.45]) and within one mile of a town (aOR=1.65[1.40-1.95]) than rural crashes. The proportion of crashes within a town differed significantly across rural gradients (P<0.0001). Small rural crashes, compared to isolated rural crashes, were 1.98 (95%CI[1.28-3.06]) times more likely to be non-collisions. The distance from the crash to town differed significantly by the urban-rural distribution (P<0.0001). Crashes with agricultural equipment are unexpectedly common in urban areas and near towns and cities. Education among all roadway users, increased visibility of agricultural equipment and the development of complete rural roads are needed to increase road safety and prevent agricultural equipment-related crashes. Copyright © 2014 Elsevier Ltd. All rights reserved.

Rural versus urban academic hospital mortality following stroke in Canada.

PubMed

Fleet, Richard; Bussières, Sylvain; Tounkara, Fatoumata Korika; Turcotte, Stéphane; Légaré, France; Plant, Jeff; Poitras, Julien; Archambault, Patrick M; Dupuis, Gilles

2018-01-01

Stroke is one of the leading causes of death in Canada. While stroke care has improved dramatically over the last decade, outcomes following stroke among patients treated in rural hospitals have not yet been reported in Canada. To describe variation in 30-day post-stroke in-hospital mortality rates between rural and urban academic hospitals in Canada. We also examined 24/7 in-hospital access to CT scanners and selected services in rural hospitals. We included Canadian Institute for Health Information (CIHI) data on adjusted 30-day in-hospital mortality following stroke from 2007 to 2011 for all acute care hospitals in Canada excluding Quebec and the Territories. We categorized rural hospitals as those located in rural small towns providing 24/7 emergency physician coverage with inpatient beds. Urban hospitals were academic centres designated as Level 1 or 2 trauma centres. We computed descriptive data on local access to a CT scanner and other services and compared mean 30-day adjusted post-stroke mortality rates for rural and urban hospitals to the overall Canadian rate. A total of 286 rural hospitals (3.4 million emergency department (ED) visits/year) and 24 urban hospitals (1.5 million ED visits/year) met inclusion criteria. From 2007 to 2011, 30-day in-hospital mortality rates following stroke were significantly higher in rural than in urban hospitals and higher than the Canadian average for every year except 2008 (rural average range = 18.26 to 21.04 and urban average range = 14.11 to 16.78). Only 11% of rural hospitals had a CT-scanner, 1% had MRI, 21% had in-hospital ICU, 94% had laboratory and 92% had basic x-ray facilities. Rural hospitals in Canada had higher 30-day in-hospital mortality rates following stroke than urban academic hospitals and the Canadian average. Rural hospitals also have very limited local access to CT scanners and ICUs. These rural/urban discrepancies are cause for concern in the context of Canada's universal health care system.

Determinants of under-five mortality in rural and urban Kenya.

PubMed

Ettarh, R R; Kimani, J

2012-01-01

The disparity in under-five year-old mortality rates between rural and urban areas in Kenya (also reported in other in sub-Saharan African countries), is a critical national concern. The objective of this study was to investigate the influence of geographical location and maternal factors on the likelihood of mortality among under-five children in rural and urban areas in Kenya. Data from the 2008-2009 Kenya Demographic and Health Survey were used to determine mortality among under-five children (n=16,162) in rural and urban areas in the 5 years preceding the survey. Multivariate analysis was used to compare the influence of key risk factors in rural and urban areas. Overall, the likelihood of death among under-five children in the rural areas was significantly higher than that in the urban areas (p<0.05). Household poverty was a key predictor for mortality in the rural areas, but the influence of breastfeeding was similar in the two areas. The likelihood of under-five mortality was significantly higher in the rural areas of Coast, Nyanza and Western Provinces than in Central Province. The study shows that the determinants of under-five mortality differ in rural and urban areas in Kenya. Innovative and targeted strategies are required to address rural poverty and province-specific sociocultural factors in order to improve child survival in rural Kenya.

Identifying the need for curriculum change. When a rural training program needs reform.

PubMed

Whiteside, C; Pope, A; Mathias, R

1997-08-01

To identify what changes should be made in the University of British Columbia's rural family practice training program curriculum to help graduates be better prepared to practice. Two cross-sectional surveys via mailed questionnaires: one designed to measure physicians' self-reported preparedness for practice and the other to measure the importance of various rural family medicine components. Rural training program graduates and preceptors representing rural communities in British Columbia. Thirty-nine graduates of the rural training program between 1982 and 1991 and 14 community-based rural training program preceptors representing eight communities throughout the province participated in this study. Percentage of graduates of the rural program who reported themselves to be underprepared on each family practice item and preceptors' mean scores for the attributed importance to rural practice of each item on this questionnaire. A list of curriculum areas most in need of reform was created. This list included trauma, counseling skills, radiology, vacuum extraction, fracture care, exercising community leadership, cost-effective use of diagnostic tests, using community health resources, obtaining hospital privileges, ophthalmology, dermatology, otolaryngology, personal and professional growth, relationships with other physicians, and personnel issues. Using both the level of graduates' self-reported underpreparedness and the attributed importance of elements of rural practice, as indicated by the preceptor survey, we developed a list of the areas of the rural training program curriculum most in need of reform.

Health care utilization patterns for young children in rural counties of the I-95 corridor of South Carolina.

PubMed

McElligott, James T; Summer, Andrea P

2013-01-01

The objective of this study was to assess health care utilization patterns for young children with Medicaid insurance in the rural counties of the I-95 corridor in South Carolina relative to other regions of the state. We hypothesize that young children received less well care and higher levels of tertiary care in the rural counties along the I-95 corridor (I-95) of South Carolina. A Medicaid cohort of children less than 3 years of age was used to compare Early, Periodic, Diagnosis, Screening and Treatment (EPSDT) visits; preventable emergency department (ED) visits; and inpatient visits between I-95, other rural and urban county groupings. The adjusted odds of a child having had 80% of the recommended EPSDT visits were reduced for I-95 compared to other rural counties. The odds of a preventable inpatient or ED visit were increased for all rural counties, with the highest rates in the other rural counties. Children accessed well care less in the I-95 corridor compared to other rural areas of South Carolina. Rural children accessed tertiary care more often than urban children, a finding most prominent outside the I-95 corridor, likely attributable to more available access of tertiary care in rural counties outside the I-95 corridor. © 2012 National Rural Health Association.

Trend differences in men and women in rural and urban U.S. settings.

PubMed

Cepeda-Benito, A; Doogan, N J; Redner, R; Roberts, M E; Kurti, A N; Villanti, A C; Lopez, A A; Quisenberry, A J; Stanton, C A; Gaalema, D E; Keith, D R; Parker, M A; Higgins, S T

2018-04-05

Smoking prevalence is declining at a slower rate in rural than urban settings in the United States (U.S.), and known predictors of smoking do not readily account for this trend difference. Given that socioeconomic and psychosocial determinants of health disparities accumulate in rural settings and that life-course disadvantages are often greater in women than men, we examined whether smoking trends are different for rural and urban men and women. We used yearly cross-sectional data (n = 303,311) from the U.S. National Survey on Drug Use and Health (NSDUH) from 2007 through 2014 to compare cigarette smoking trends in men and women across rural and urban areas. Current smoking status was modelled using logistic regression controlling for confounding risk factors. Regression derived graphs predicting unadjusted prevalence estimates and 95% confidence bands revealed that whereas the smoking trends of rural men, urban men, and urban women significantly declined from 2007 to 2014, the trend for rural women was flat. Controlling for demographic, socioeconomic and psychosocial predictors of smoking did not explain rural women's significantly different trend from those of the other three groups. Rural women lag behind rural men, urban men and urban women in decreasing smoking, a health disparity finding that supports the need for tobacco control and regulatory policies and interventions that are more effective in reducing smoking among rural women. Copyright © 2018 Elsevier Inc. All rights reserved.

Rural Men's Health, Health Information Seeking, and Gender Identities: A Conceptual Theoretical Review of the Literature.

PubMed

Hiebert, Bradley; Leipert, Beverly; Regan, Sandra; Burkell, Jacquelyn

2018-07-01

Beginning as early as 2009, recent shifts in Canadian health care delivery indicate that access to health information is essential to promote and maintain a healthy population. It is important to understand how and where various populations, such as underresourced rural populations, access health information so that public health agencies can develop and deliver appropriate information with, for, and in these contexts. There is a paucity of research that specifically examines how rural Canadian men seek health information; therefore, this review aimed to conceptualize this process based on three dynamic key constructs: health patterns of rural Canadians, health information-seeking behaviors, and rural gender identities. This conceptual theoretical literature review included 91 articles at the intersection of these three constructs. Discussion focuses on how residing in a rural region influences men's health and health care access. Health information-seeking behaviors are discussed in terms of social networks and framed with a rural context. Connell's theory of masculinity provides a useful approach to dissecting how rural men's gender identities influence their health attitudes, and how such attitudes are embedded in rural social and cultural norms. Each major construct-health in rural Canada, health information seeking, and rural gender identities-is discussed to highlight how specific embodiments of masculinity may promote and inhibit men's health information-seeking and positive health behaviors.

Physician recruitment and retention in rural and underserved areas.

PubMed

Lee, Dane M; Nichols, Tommy

2014-01-01

The purpose of this paper is to identify the challenges when recruiting and retaining rural physicians and to ascertain methods that make rural physician recruitment and retention successful. There are studies that suggest rural roots is an important factor in recruiting rural physicians, while others look at rural health exposure in medical school curricula, self-actualization, community sense and spousal perspectives in the decision to practice rural medicine. An extensive literature review was performed using Academic Search Complete, PubMed and The Cochrane Collaboration. Key words were rural, rural health, community hospital(s), healthcare, physicians, recruitment, recruiting, retention, retaining, physician(s) and primary care physician(s). Inclusion criteria were peer-reviewed full-text articles written in English, published from 1997 and those limited to USA and Canada. Articles from foreign countries were excluded owing to their unique healthcare systems. While there are numerous articles that call for special measures to recruit and retain physicians in rural areas, there is an overall dearth. This review identifies several articles that suggest recruitment and retention techniques. There is a need for a research agenda that includes valid, reliable and rigorous analysis regarding formulating and implementing these strategies. Rural Americans are under-represented when it comes to healthcare and what research there is to assist recruitment and retention is difficult to find. This paper identify the relevant research and highlights key strategies.

Is there an urban advantage in child survival in sub-saharan Africa? Evidence from 18 countries in the 1990s.

PubMed

Bocquier, Philippe; Madise, Nyovani Janet; Zulu, Eliya Msiyaphazi

2011-05-01

Evidence of higher child mortality of rural-to-urban migrants compared with urban nonmigrants is growing. However, less attention has been paid to comparing the situation of the same families before and after they migrate with the situation of urban-to-rural migrants. We use DHS data from 18 African countries to compare child mortality rates of six groups based on their mothers' migration status: rural nonmigrants; urban nonmigrants; rural-to-urban migrants before and after they migrate; and urban-to-rural migrants before and after they migrate. The results show that rural-to-urban migrants had, on average, lower child mortality before they migrated than rural nonmigrants, and that their mortality levels dropped further after they arrived in urban areas. We found no systematic evidence of higher child mortality for rural-to-urban migrants compared with urban nonmigrants. Urban-to-rural migrants had higher mortality in the urban areas, and their move to rural areas appeared advantageous because they experienced lower or similar child mortality after living in rural areas. After we control for known demographic and socioeconomic correlates of under-5 mortality, the urban advantage is greatly reduced and sometimes reversed. The results suggest that it may not be necessarily the place of residence that matters for child survival but, rather, access to services and economic opportunities.

Characteristics and career intentions of Scottish rural and urban GP registrars: cause for concern?

PubMed

Ross, S; Gillies, J C

1999-01-01

To investigate the differences between the characteristics and career intentions of GP registrars in urban and rural areas, and to make recommendations to reduce a potential work force crisis in rural practice. Postal survey. All general practices in Scotland. In February 1996, 40/196 (20%) of urban and 45/150 (30%) of rural GP registrar places available in Scotland, were vacant (chi 2 = 4.22, df = 1, p = 0.02). Postal questionnaires were sent to all 261 GP registrars in post. Of 235 respondents (90%), the majority wished to remain in general practice (63% of urban and 53% of rural registrars), but only 22% of urban and 18% of rural registrars intended to apply for principal posts immediately after training. Fewer urban (8%) than rural registrars (21%) stated an intention to go abroad to work after training. Rural registrars tended to want to work in rural areas, and vice versa. Part-time and job-sharing were attractive employment options for both groups, and more flexible career structures were favoured by over 80%. Though much more attention has been paid to recruitment in inner cities, the findings from this study suggest that in Scotland difficulties in finding principals may occur first in rural areas. As general practitioners have an extended role in rural areas, including that of emergency care, shortages could have a serious impact on patient care.

Developing rural palliative care: validating a conceptual model.

PubMed

Kelley, Mary Lou; Williams, Allison; DeMiglio, Lily; Mettam, Hilary

2011-01-01

The purpose of this research was to validate a conceptual model for developing palliative care in rural communities. This model articulates how local rural healthcare providers develop palliative care services according to four sequential phases. The model has roots in concepts of community capacity development, evolves from collaborative, generalist rural practice, and utilizes existing health services infrastructure. It addresses how rural providers manage challenges, specifically those related to: lack of resources, minimal community understanding of palliative care, health professionals' resistance, the bureaucracy of the health system, and the obstacles of providing services in rural environments. Seven semi-structured focus groups were conducted with interdisciplinary health providers in 7 rural communities in two Canadian provinces. Using a constant comparative analysis approach, focus group data were analyzed by examining participants' statements in relation to the model and comparing emerging themes in the development of rural palliative care to the elements of the model. The data validated the conceptual model as the model was able to theoretically predict and explain the experiences of the 7 rural communities that participated in the study. New emerging themes from the data elaborated existing elements in the model and informed the requirement for minor revisions. The model was validated and slightly revised, as suggested by the data. The model was confirmed as being a useful theoretical tool for conceptualizing the development of rural palliative care that is applicable in diverse rural communities.

A sense of place: rural training at a regional medical school campus.

PubMed

Crump, William J; Barnett, Darel; Fricker, Steve

2004-01-01

Traditionally, rural students experience urban disruption during the many years of education and training in urban environments before choosing a practice site. Regional rural campuses that allow students to live and work in small towns during the last 2 years of medical school are one strategy to address this issue. To report the results of the first 10 years of a rural campus in western Kentucky, including response to difficulties filling openings for third- and fourth-year medical students at the campus. A survey was sent to all 76 students who had shown interest in the rural campus, asking them to prioritize the important issues in their campus choice. Students not choosing the rural campus placed a higher priority on large-city amenities, better opportunities for their spouse, and proximity to family in eastern and central Kentucky. Students who chose the rural campus placed a higher priority on one-on-one clinical training and interest in small town life. For the rural clinical campus to reach its potential, more rural students from the western part of the state must be admitted to medical school and then choose this campus. Strategies to reinforce the sense of place among rural students focus on experiential programs in rural areas. Initial results suggest that medical educators should consider geography more carefully when designing approaches to address physician maldistribution.

Analysis of rural public transit in Alabama.

DOT National Transportation Integrated Search

2013-05-01

As rural America continues to age, access to basic necessities and health care will continue to strain rural transit providers. The state of Alabama has numerous Rural Public Transportation Providers, and while every provider is unique, each ca...

Investigation of the impacts of rural development on Iowa's secondary road systems.

DOT National Transportation Integrated Search

2010-09-01

"Today, many of Iowas counties are experiencing an increase in rural development. Two specific types of development were focused on : for this research: rural residential subdivisions and livestock production operations. Rural residential developm...

Investigation of the impacts of rural development on Iowa's secondary road systems.

DOT National Transportation Integrated Search

2010-09-01

Today, many of Iowas counties are experiencing an increase in rural development. Two specific types of development were focused on : for this research: rural residential subdivisions and livestock production operations. Rural residential developme...

Rural Health Care and Interdisciplinary Education.

ERIC Educational Resources Information Center

LaSala, Kathleen B.; Hopper, Sandra K.; Rissmeyer, David J.; Shipe, Diane P. S.

1997-01-01

James Madison University's undergraduate course, Interdisciplinary Rural Primary Health Care, addresses the shortage of professionals in rural areas, increases student awareness of the needs of rural populations, and helps students try out career choices in this area. (SK)

Rural Active Living: A Call to Action.

PubMed

Umstattd Meyer, M Renée; Moore, Justin B; Abildso, Christiaan; Edwards, Michael B; Gamble, Abigail; Baskin, Monica L

2016-01-01

Rural residents are less physically active than their urban counterparts and disproportionately affected by chronic diseases and conditions associated with insufficient activity. While the ecological model has been successful in promoting and translating active living research in urban settings, relatively little research has been conducted in rural settings. The resulting research gap prohibits a comprehensive understanding and application of solutions for active living in rural America. Therefore, the purpose of this article was to assess the evidence base for an ecological model of active living for rural populations and outline key scientific gaps that inhibit the development and application of solutions. Specifically, we reexamined the 4 domains conceptualized by the model and suggest that there is a dearth of research specific to rural communities across all areas of the framework. Considering the limited rural-specific efforts, we propose areas that need addressing to mobilize rural active living researchers and practitioners into action.

Cognition and Context: Rural-Urban Differences in Cognitive Aging Among Older Mexican Adults.

PubMed

Saenz, Joseph L; Downer, Brian; Garcia, Marc A; Wong, Rebeca

2017-04-01

To describe differences in cognitive functioning across rural and urban areas among older Mexican adults. We include respondents aged 50+ in the 2012 Mexican Health and Aging Study (MHAS). Cognitive functioning by domain is regressed as a function of community size. The role of educational attainment in explaining rural/urban differences in cognitive functioning is examined. Respondents residing in more rural areas performed worse across five cognitive domains. The majority, but not all, of the association between community size and cognitive functioning was explained by lower education in rural areas. Respondents residing in more rural areas were disadvantaged in terms of cognitive functioning compared with those residing in more urban areas. Poorer cognitive functioning in late life may be the result of historical educational disadvantage in rural areas or selection through migration from rural to urban regions for employment.

Rural Active Living: A Call to Action

PubMed Central

Meyer, M. Renée Umstattd; Moore, Justin B.; Abildso, Christiaan; Edwards, Michael B.; Gamble, Abigail; Baskin, Monica L.

2015-01-01

Rural residents are less physically active than their urban counterparts and disproportionately affected by chronic diseases and conditions associated with insufficient activity. While the ecological model has been successful in promoting and translating active living research in urban settings, relatively little research has been conducted in rural settings. The resulting research gap prohibits a comprehensive understanding and application of solutions for active living in rural America. Therefore, the purpose of this paper was to assess the evidence-base for an ecological model of active living for rural populations and outline key scientific gaps that inhibit the development and application of solutions. Specifically, we reexamined the four domains conceptualized by the model and suggest there is a dearth of research specific to rural communities across all areas of the framework. Considering the limited rural-specific efforts, we propose areas that need addressing in order to mobilize rural active living researchers and practitioners into action. PMID:26327514

Old age security in rural China: there is a long way to go.

PubMed

Dai, Bao-Zhen; Zhou, Lu-Lin; Mei, Y John

2013-11-01

We aimed to examine the current developments and challenges confronted by old age security in rural China. This study is based on the data from PubMed, Elsevier, Wiley, EBSCO, EMBASE, SCI Expanded, ProQuest, Google, and CNKI which is the most informative database in Chinese. Articles were selected with the search terms "rural", "China", "old", "older", or "elder", "elderly", or "aged", "aging", "security", "culture", "value", "medical insurance" or "community based medical insurance" or "cooperative medical scheme". Related websites and yearbooks were searched as well. The socio-economic development has made the burden of traditional care for the rural elderly heavier than ever, and new challenges are emerging in rural communities, such as poor economic, deteriorating natural environment and health crisis. The governments should improve the scale and caliber of rural old age security and strengthen regulations with great efforts in developing the rural economy and protecting the natural environment of rural communities.

Rural physicians, rural networks, and free market health care in the 1990s.

PubMed

Rosenthal, T C; James, P; Fox, C; Wysong, J; FitzPatrick, P G

1997-01-01

The changes brought about by managed care in America's urban communities will have profound effects on rural physicians and hospitals. The rural health care market characterized by small, independent group practices working with community hospitals is being offered affiliations with large, often urban-based health care organizations. Health care is evolving into a free market system characterized by large networks of organizations capable of serving whole regions. Rural provider-initiated networks can assure local representation when participating in the new market and improve the rural health infrastructure. Although an extensive review of the literature from 1970 to 1996 reveals little definitive research about networks, many rural hospitals have embraced networking as one strategy to unify health care systems with minimal capitalization. These networks, now licensed in Minnesota and New York, offer rural physicians the opportunity to team up with their community hospital and enhance local health care accessibility.

Living with breast cancer: the influence of rurality on women's suffering and resilience. a postmodern feminist inquiry.

PubMed

Rogers-Clark, Cath

This paper focuses on rural living as a dimension of women's experiences of living through breast cancer. The findings presented emanate from a feminist narrative research project that examined the experiences of rural women from south-west Queensland who were long-term survivors of breast cancer. This project aimed to listen, report and interpret rural women's stories of resilience in surviving breast cancer and moving on with their lives. The participants reported that there were both positive and negative aspects of living in a rural setting, especially when ill. Eight of the nine participants, however, felt strongly that the positive aspects of rural living outweighed the difficulties. This suggests that rurality in the context of health and illness must be considered as a multifaceted dimension, with resources to support cancer survivors building on the existing strengths in rural communities.

Correlation between increased urinary sodium excretion and decreased left ventricular diastolic function in patients with type 2 diabetes mellitus.

PubMed

Kagiyama, Shuntaro; Koga, Tokushi; Kaseda, Shigeru; Ishihara, Shiro; Kawazoe, Nobuyuki; Sadoshima, Seizo; Matsumura, Kiyoshi; Takata, Yutaka; Tsuchihashi, Takuya; Iida, Mitsuo

2009-10-01

Increased salt intake may induce hypertension, lead to cardiac hypertrophy, and exacerbate heart failure. When elderly patients develop heart failure, diastolic dysfunction is often observed, although the ejection fraction has decreased. Diabetes mellitus (DM) is an established risk factor for heart failure. However, little is known about the relationship between cardiac function and urinary sodium excretion (U-Na) in patients with DM. We measured 24-hour U-Na; cardiac function was evaluated directly during coronary catheterization in type 2 DM (n = 46) or non-DM (n = 55) patients with preserved cardiac systolic function (ejection fraction > or = 60%). Cardiac diastolic and systolic function was evaluated as - dp/dt and + dp/dt, respectively. The average of U-Na was 166.6 +/- 61.2 mEq/24 hour (mean +/- SD). In all patients, stepwise multivariate regression analysis revealed that - dp/dt had a negative correlation with serum B-type natriuretic peptide (BNP; beta = - 0.23, P = .021) and U-Na (beta = - 0.24, P = .013). On the other hand, + dp/dt negatively correlated with BNP (beta = - 0.30, P < .001), but did not relate to U-Na. In the DM-patients, stepwise multivariate regression analysis showed that - dp/dt still had a negative correlation with U-Na (beta = - 0.33, P = .025). The results indicated that increased urinary sodium excretion is associated with an impairment of cardiac diastolic function, especially in patients with DM, suggesting that a reduction of salt intake may improve cardiac diastolic function.

ENVEJECIMIENTO, SALUD Y ECONOMÍA: La Encuesta Nacional sobre Salud y Envejecimiento en México*

PubMed Central

2017-01-01

RESUMEN México vive una transición demográfica en la cual el porcentaje de la población mayor de 50 años de edad crece aceleradamente como resultado de un aumento considerable en la esperanza de vida. Dicha población tiene necesidades particulares que deben ser tomadas en cuenta en la formulación de políticas, sobre todo en materia de acceso a servicios de salud y seguridad social. En este artículo presentamos una descripción general de la Encuesta Nacional de Salud y Envejecimiento (Enasem), un estudio de panel que comenzó en 2001 y que ofrece una oportunidad única para abordar temas demográficos y económicos complejos por medio de la exploración de las características personales, transferencias socioeconómicas e indicadores de salud para una muestra de 15 186 adultos de edad media y avanzada. También presentamos los resultados más relevantes de diferentes estudios que han utilizado la Enasem hasta la fecha. Nuestra revisión indica que México enfrenta desafíos considerables para satisfacer la demanda de servicios médicos para una población que es amenazada por una creciente presencia de enfermedades crónicas, sobre todo para la población de edad avanzada que no cuenta con cobertura de seguro médico. PMID:29375164

Building Research Capacity of Medical Students and Health Professionals in Rural Communities: Leveraging a Rural Clinical School's Resources to Conduct Research Skills Workshops

ERIC Educational Resources Information Center

Lasserre, Kaye E.; Moffatt, Jennifer J.

2013-01-01

The paper reports on a project where the objective was for the Rural Clinical School, The University of Queensland, Australia, to design an acceptable model of research skills workshops for medical students and rural health professionals. Eight, interactive research skills workshops focused on skill development were conducted in rural Queensland,…

Project '80, Rural Michigan Now and In 1980; Highlights and Summary. Research Report 37.

ERIC Educational Resources Information Center

Ferris, John N.

Project '80 is designed to answer three questions: (1) What will rural Michigan be like in 1980? (2) What can be done to change the course of events in directing Michigan's rural economy? and (3) What do rural people want it to be like in 1980? Faculty members prepared 50 discussion papers which were reviewed by leaders in rural areas and…

Paths to Work in Rural Places: Key Findings and Lessons from the Impact Evaluation of the Future Steps Rural Welfare-to-Work Program. Final Report

ERIC Educational Resources Information Center

Meckstroth, Alicia; Burwick, Andrew; Ponza, Michael; Marsh, Shawn; Novak, Tim; Phillips, Shannon; Diaz-Tena, Nuria; Ng, Judy

2006-01-01

Helping low-income families in rural areas find gainful employment and achieve economic self-sufficiency is an ongoing policy concern. The Rural Welfare-to-Work Strategies demonstration is using rigorous experimental designs to build knowledge about how to help low-income families in rural areas strive toward sustained employment and…

Issues Affecting Rural Communities. Proceedings of an International Conference Held by the Rural Education Research and Development Centre (Townsville, Queensland, Australia, July 10-15, 1994).

ERIC Educational Resources Information Center

McSwan, D., Ed.; McShane, M., Ed.

This proceedings contains approximately 100 conference papers and workshop summaries on rural health, education, and community development. The majority of the papers are concerned with conditions in rural Australia; about 20 examine rural issues in the United States; while a smaller number cover Canada, New Zealand, and European countries. A…

43 CFR 404.10 - Are there certain types of infrastructure and facilities that may not be included in a rural...

Code of Federal Regulations, 2010 CFR

2010-10-01

... and facilities that may not be included in a rural water supply project? 404.10 Section 404.10 Public... RECLAMATION RURAL WATER SUPPLY PROGRAM Overview § 404.10 Are there certain types of infrastructure and facilities that may not be included in a rural water supply project? Yes. A rural water supply project may...

The Rural Arena: The Diversity of Protest in Rural England

ERIC Educational Resources Information Center

Reed, Matt

2008-01-01

In the past 15-20 years, the rural areas of England have been used by a wide diversity of groups as the stage for their protest activities. Some have argued that this is due the rise of a rural social movement; this paper contends that rural areas have become both available and advantageous as the locale of protest through a range of interlocking…

Why Invest in Rural America--And How? A Critical Public Policy Question for the 21st Century.

ERIC Educational Resources Information Center

Stauber, Karl N.

Current rural policies at both the federal and state levels do not meet the needs of rural people and communities; they are designed for the past, not the future. Agricultural subsidies absorb most federal resources directed to rural areas, with no evidence of benefits for rural communities. The continuing state-level pursuit of low-wage,…

Pedagogy of the Rural as a Lens for Understanding Beginning Teachers' Identity and Positionings in Rural Schools

ERIC Educational Resources Information Center

Walker-Gibbs, Bernadette; Ludecke, Michelle; Kline, Jodie

2018-01-01

Pedagogy of the Rural is an approach to capture the complexities of rural space and place by challenging simple understandings of what it means to be a teacher in rural settings. Using Harré's positioning theory, Baudrillard's concepts of simulation and simulacra, and Lefebvre's space and economic geographies to form a composite theory through…

Othering the Rural: About the Construction of Rural Masculinities and the Unspoken Urban Hegemonic Ideal in Swedish Media

ERIC Educational Resources Information Center

Stenbacka, Susanne

2011-01-01

Studies within the field of rural geography have lately to a noticeable extent enriched the theme of the creation of masculinities and femininities focussing on social constructions of the rural, as well as social constructions of gender. In this study I aim to discuss some expressed discourses of the rural in order to illuminate the power…

Creating New Economic Opportunities: The Competitive Advantages of Rural America in the Next Century.

ERIC Educational Resources Information Center

Isserman, Andrew M.

Much of today's rural America will be the fastest growing part of the nation in the next half century. The spread of large cities and the creation of new ones, the addition of almost 30 million senior citizens, and immigration into rural areas are powerful forces contributing to the development of rural America. Rural areas are competitive in a…

Looking to the States for New Rural Policies. The Main Street Economist: Commentary on the Rural Economy.

ERIC Educational Resources Information Center

Drabenstott, Mark; Sheaff, Katharine

In the past, rural America often relied on Washington for policy responses to its challenges, but federal policy has been slow to adapt to the broad changes taking place in so many rural communities. New approaches to rural policy have taken root in some states. Georgia's OneGeorgia Authority will oversee a series of economic development programs…

Schooling and Factors Affecting Decisions on Schooling by Household Members in the Rural Areas of Turkey

ERIC Educational Resources Information Center

Olgun, Akin; Gumus, Sevtap Guler; Adanacioglu, Hakan

2010-01-01

Despite the fact that rural education has always been one of the most important means of rural development, it has been ignored in many developing countries, with the result that rural development has not achieved great success. The problems of education in rural areas are not only related to the amount the country spends on education or to the…

Attracting and retaining health workers in rural areas: investigating nurses’ views on rural posts and policy interventions

PubMed Central

2010-01-01

Background Kenya has bold plans for scaling up priority interventions nationwide, but faces major human resource challenges, with a lack of skilled workers especially in the most disadvantaged rural areas. Methods We investigated reasons for poor recruitment and retention in rural areas and potential policy interventions through quantitative and qualitative data collection with nursing trainees. We interviewed 345 trainees from four purposively selected Medical Training Colleges (MTCs) (166 pre-service and 179 upgrading trainees with prior work experience). Each interviewee completed a self-administered questionnaire including likert scale responses to statements about rural areas and interventions, and focus group discussions (FGDs) were conducted at each MTC. Results Likert scale responses indicated mixed perceptions of both living and working in rural areas, with a range of positive, negative and indifferent views expressed on average across different statements. The analysis showed that attitudes to working in rural areas were significantly positively affected by being older, but negatively affected by being an upgrading student. Attitudes to living in rural areas were significantly positively affected by being a student at the MTC furthest from Nairobi. During FGDs trainees raised both positive and negative aspects of rural life. Positive aspects included lower costs of living and more autonomy at work. Negative issues included poor infrastructure, inadequate education facilities and opportunities, higher workloads, and inadequate supplies and supervision. Particular concern was expressed about working in communities dominated by other tribes, reflecting Kenya’s recent election-related violence. Quantitative and qualitative data indicated that students believed several strategies could improve rural recruitment and retention, with particular emphasis on substantial rural allowances and the ability to choose their rural location. Other interventions highlighted included provision of decent housing, and more rapid career advancement. However, recently introduced short term contracts in named locations were not favoured due to their lack of pension plans and job security. Conclusions This study identified a range of potential interventions to increase rural recruitment and retention, with those most favored by nursing students being additional rural allowances, and allowing choice of rural location. Greater investment is needed in information systems to evaluate the impact of such policies. PMID:20594367

Student perception about working in rural United States/Canada after graduation: a study in an offshore Caribbean medical school

PubMed Central

Shankar, P Ravi; Dubey, Arun K; Nandy, Atanu; Herz, Burton L; Little, Brian W

2015-01-01

Introduction: Rural residents of the United States (US) and Canada face problems in accessing healthcare. International medical graduates (IMGs) play an important role in delivering rural healthcare. IMGs from Caribbean medical schools have the highest proportion of physicians in primary care.  Xavier University School of Medicines admits students from the US, Canada and other countries to the undergraduate medical (MD) course and also offers a premedical program. The present study was conducted to obtain student perception about working in rural US/Canada after graduation.   Methods: The study was conducted among premedical and preclinical undergraduate medical (MD) students during October 2014. The questionnaire used was modified from a previous study. Semester of study, gender, nationality, place of residence and occupation of parents were noted. Information about whether students plan to work in rural US/Canada after graduation, possible reasons why doctors are reluctant to work in rural areas, how the government can encourage rural practice, possible problems respondents anticipate while working in rural areas were among the topics studied. Results: Ninety nine of the 108 students (91.7%) participated. Forty respondents were in favor of working in rural US/Canada after graduation. Respondents mentioned good housing, regular electricity, water supply, telecommunication facilities, and schools for education of children as important conditions to be fulfilled. The government should provide higher salaries to rural doctors, help with loan repayment, and provide opportunities for professional growth.  Potential problems mentioned were difficulty in being accepted by the rural community, problems in convincing patients to follow medical advice, lack of exposure to rural life among the respondents, and cultural issues. Conclusions: About 40% of respondents would consider working in rural US/Canada. Conditions required to be fulfilled have been mentioned above. Graduates from Caribbean medical schools have a role in addressing rural physician shortage. Similar studies in other offshore Caribbean medical schools are required as Caribbean IMGs make an important contribution to the rural US and Canadian health workforce. PMID:25901275

Dental practitioner rural work movements: a systematic review.

PubMed

Godwin, Diana M; Hoang, Ha; Crocombe, Leonard A; Bell, Erica

2014-01-01

There is a globally observed unequal distribution of dental and other health practitioners between urban and rural areas in OECD countries. Dental practitioners provide important primary healthcare services to rural populations. Workforce shortages and stability issues in underserved areas can have negative effects on rural communities. Strategies used to fix the dental practitioner workforce maldistribution need to be investigated. The study had primary focus on Australia and included relevant international literature. Databases used were PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Informit, Web of Science, Scopus and Summon. Search terms included dental practitioner, rural, remote, retention, recruitment and strategies. Sixteen articles met the inclusion criteria. The articles described a total of eight different positive factors and 12 negative factors towards rural practice. The positive factors related to the nature of the type of clinical work being a 'challenge', close social and professional support networks, enjoyment of rural lifestyle and successful integration into the rural community. The negative factors mentioned included social and professional isolation, workload and type of clinical work, access to further education opportunities, access to facilities, education for children and job opportunities for a partner, and inability to integrate into the rural community. The articles that analysed recruitment incentives described three strategies currently used to influence recruitment, all of which were financial or contractual in nature. Articles mentioning retention factors described seven long-term retention motivators; of these, six of them were personal reasons. The most commonly mentioned motivational factor for recruitment and retention of the rural dental practitioner workforce was the effect of prior rural exposure for dental practitioners. The results of this review indicate that the most important influences on rural dental practitioner workforce recruitment and retention were a combination of financial reimbursement and personal reasons. There was also a large influence of rural medical workforce research on untested assumptions and drivers of the rural dental practitioner workforce. The high recruitment rate compared with the low retention rate indicates that current strategies were not effective in addressing rural dental practitioner workforce shortages in the long term.

Migrating husbands and changing cardiovascular risk factors in the wife: a cross sectional study in Asian Indian women.

PubMed

Gupta, Rajeev; Gupta, Rajiv; Agrawal, Aachu; Misra, Anoop; Guptha, Soneil; Pandey, Ravindra M; Misra, Puneet; Vikram, Naval K; Dey, Sanjit; Rao, Shobha; Menon, V Usha; Kamalamma, N; Revathi, K; Mathur, Beena; Sharma, Vinita

2012-10-01

The authors studied the influence of migration of husband on cardiovascular risk factors in Asian Indian women. Population-based studies in women aged 35-70 years were performed in four urban and five rural locations. 4608 (rural 2604 and urban 2004) of the targeted 8000 (57%) were enrolled. Demographic details, lifestyle factors, anthropometry, fasting glucose and cholesterol were measured. Multivariate logistic and quadratic regression was performed to compare influence of migration and its duration on prevalence of risk factors. Details of migration were available in 4573 women (rural 2267, rural-urban migrants 455, urban 1552 and urban-rural migrants 299). Majority were married, and illiteracy was high. Median (interquartile) duration of residence in urban locations among rural-urban migrants was 9 (4-18) years and in rural areas for urban-rural migrants 23 (18-30) years. In rural, rural-urban migrants, urban and urban-rural migrants, age-adjusted prevalence (%) of risk factors was tobacco use 41.9, 22.7, 18.8 and 38.1; sedentary lifestyle 69.7, 82.0, 79.9 and 74.6; high-fat diet 33.3, 54.2, 66.1 and 61.1; overweight 21.3, 42.7, 46.3 and 29.7; large waist 8.5, 38.5, 29.2 and 29.2; hypertension 30.4, 49.4, 47.7 and 38.4; hypercholesterolaemia 14.4, 31.3, 26.6 and 9.1 and diabetes 3.9, 15.8, 14.9 and 8.4, respectively (p<0.001). In rural-urban migrants, there was a significant correlation of duration of migration with waist size, waist-to-hip ratio and systolic blood pressure (quadratic regression, p<0.001). Association of risk factors with migration remained significant, though attenuated, after adjustment for socioeconomic, lifestyle and obesity variables (logistic regression, p<0.01). Compared with rural women, rural-urban migrants and urban have significantly greater cardiometabolic risk factors. Prevalence is lower in urban-rural migrants. There is significant correlation of duration of migration with obesity and blood pressure. Differences are attenuated after adjusting for social and lifestyle variables.

Rural rehabilitation practice: perspectives of occupational therapists and physical therapists in British Columbia, Canada.

PubMed

Roots, Robin K; Brown, Helen; Bainbridge, Lesley; Li, Linda C

2014-01-01

Providing rehabilitation services to address the health needs of rural residents requires overcoming the challenges of geography, limited referral options and a shortage of occupational therapists (OTs) and physical therapists (PTs). However, little is known about how rehabilitation professionals in rural areas enact their practice to meet and overcome these challenges. To address this gap and contribute to enhancing health for rural residents, this study was designed to explore rural rehabilitation practice from the perspectives of OTs and PTs in rural British Columbia (BC). A purposive sample of OTs and PTs in rural communities (population <15 000) in northern BC was recruited for this qualitative study. Potential participants received an invitation mailed to workplaces and were selected to ensure a variety of work experiences, roles and practice settings. In semi-structured interviews, participants were asked to describe the skills and knowledge they perceived as unique to rural practice and strategies they used to overcome challenges. Guided by interpretive description, transcripts were analysed inductively using broad-level coding, and findings were collapsed into interpretive categories. Interpretations and implications for education, practice and policy were reviewed with participants to ensure relevance to rural practice. From interviews with 6 OTs and 13 PTs, serving a total of 15 rural communities, rehabilitation practice and participants' definition of health were understood to be substantially shaped by rurality or the contextual features of geography, determinants of health and access to services. Participants considered general practice 'a specialty' requiring advanced skills in assessment. They described 'stretching their role' and 'participating in, and partnerships with, community' as ways to overcome resource shortages. Reflective practice, networking and collaboration were deemed essential to maintaining competence. Rural clinical placements, mentoring and improving access to continuing professional development were regarded as central to the recruitment and retention required to sustain optimal levels of service to residents. The research findings illustrate the unique influence that the rural context has on the practice of OTs and PTs in BC. They underscore the importance of facilitating learning about rural health within professional training programs and of providing accessible professional development resources to address health human resource shortages and meet the rehabilitation needs of rural residents.

A case study of the counterpart technical support policy to improve rural health services in Beijing.

PubMed

Jian, Weiyan; Chan, Kit Yee; Tang, Shunv; Reidpath, Daniel D

2012-12-29

There is, globally, an often observed inequality in the health services available in urban and rural areas. One strategy to overcome the inequality is to require urban doctors to spend time in rural hospitals. This approach was adopted by the Beijing Municipality (population of 20.19 million) to improve rural health services, but the approach has never been systematically evaluated. Drawing upon 1.6 million cases from 24 participating hospitals in Beijing (13 urban and 11 rural hospitals) from before and after the implementation of the policy, changes in the rural-urban hospital performance gap were examined. Hospital performance was assessed using changes in six indices over-time: Diagnosis Related Groups quantity, case-mix index (CMI), cost expenditure index (CEI), time expenditure index (TEI), and mortality rates of low- and high-risk diseases. Significant reductions in rural-urban gaps were observed in DRGs quantity and mortality rates for both high- and low-risk diseases. These results signify improvements of rural hospitals in terms of medical safety, and capacity to treat emergency cases and more diverse illnesses. No changes in the rural-urban gap in CMI were observed. Post-implementation, cost and time efficiencies worsened for the rural hospitals but improved for urban hospitals, leading to a widening rural-urban gap in hospital efficiency. The strategy for reducing urban-rural gaps in health services adopted, by the Beijing Municipality shows some promise. Gains were not consistent, however, across all performance indicators, and further improvements will need to be tried and evaluated.

Rural and Urban Differences in Sexual Behaviors Among Adolescents in Florida.

PubMed

Thompson, Erika L; Mahony, Helen; Noble, Charlotte; Wang, Wei; Ziemba, Robert; Malmi, Markku; Maness, Sarah B; Walsh-Buhi, Eric R; Daley, Ellen M

2018-04-01

The national teen birth rate is higher in rural compared to urban areas. While national data suggest rural areas may present higher risk for adverse sexual health outcomes among adolescents, it is unknown whether there are differences within the state of Florida. Overall, Florida has poorer sexual health indicators for adolescents compared to national rates. The purpose of this study was to assess differences in sexual behaviors among Florida adolescents by rural-urban community location. This study includes baseline data from a randomized controlled trial conducted in Florida high schools. Of the 6316 participants, 74% were urban and 26% were rural. Participants responded to questions on sexual behaviors, sexual behavior intentions, and demographics. We estimated the effect of rural-urban status on risk outcomes after controlling for demographic variables using generalized linear mixed models. More teens from rural areas reported ever having sex (24.0%) compared to urban teens (19.7%). No significant differences were observed for most of sexual behaviors assessed. Nonetheless, urban participants were less likely to intend to have sex without a condom in the next year compared to rural participants (aOR = 0.76, 95% CI 0.63-0.92). Overall, there were no major differences in sexual behaviors between rural and urban adolescents in Florida. However, sexual intentions differed between rural and urban adolescents; specifically, rural adolescents were more likely to intend to have sex without a condom in the next year compared to urban adolescents. Understanding the specific disparities can inform contraception and sexual health interventions among rural youth.

Rural pharmacy in Canada: pharmacist training, workforce capacity and research partnerships.

PubMed

Soon, Judith A; Levine, Marc

2011-09-01

To characterize rural health care and pharmacy recruitment and retention issues explored in Canadian pharmacy strategic guidelines and Canadian Faculties of Pharmacy curricula; compare the availability of pharmacy workforce across Canadian jurisdictions; and identify models for potential collaborations between universities and rural pharmacies in the North. Review of Canadian pharmacy strategic documents, Canadian Faculty of Pharmacy websites, Canadian pharmacy workforce data and relevant literature based on the search terms to identify university-rural community pharmacy initiatives. Three recent Canadian pharmacy strategic documents do not directly address issues related to rural and northern pharmacy practice, with recruitment and retention mentioned only in Canadian Pharmacists Association documents. Few Canadian Faculties of Pharmacy provide curricula on rural and northern health care issues or discuss rural recruitment and retention during training, with barriers to experiential rural practicums impeding placements. An innovative new partnership between the University of Waterloo School of Pharmacy and Gateway Rural Health Research Institute has the potential to enhance rural education, pharmacy services and community-based research. The number of pharmacists per 100,000 population in northern regions of British Columbia and the territories is low when compared with other Canadian provinces. In Australia, a model of university-rural pharmacy collaboration has been developed that may have the potential to inform future Canadian initiatives. Development of a coordinated, multifaceted approach involving universities, pharmacy professional associations and community-based research organizations in rural and northern regions of the country has the potential to enhance pharmacist education, practice recruitment, practice retention and community-based health outcomes research.

Analysis of Urban-Rural Land-Use Change during 1995-2006 and Its Policy Dimensional Driving Forces in Chongqing, China

PubMed Central

Long, Hualou; Wu, Xiuqin; Wang, Wenjie; Dong, Guihua

2008-01-01

This paper analyzes the urban-rural land-use change of Chongqing and its policy dimensional driving forces from 1995 to 2006, using high-resolution Landsat TM (Thematic Mapper) data of 1995, 2000 and 2006, and socio-economic data from both research institutes and government departments. The outcomes indicated that urban-rural land-use change in Chongqing can be characterized by two major trends: First, the non-agricultural land increased substantially from 1995 to 2006, thus causing agricultural land especially farmland to decrease continuously. Second, the aggregation index of urban settlements and rural settlements shows that local urban-rural development experienced a process of changing from aggregation (1995-2000) to decentralization (2000-2006). Chongqing is a special area getting immersed in many important policies, which include the establishment of the municipality directly under the Central Government, the building of Three Gorges Dam Project, the Western China Development Program and the Grain-for-Green Programme, and bring about tremendous influences on its land-use change. By analyzing Chongqing's land-use change and its policy driving forces, some implications for its new policy of ‘Urban-rural Integrated Reform’ are obtained. That is more attentions need to be paid to curbing excessive and idle rural housing and consolidating rural construction land, and to laying out a scientific land-use plan for its rural areas taking such rural land-use issues as farmland occupation and rural housing land management into accounts, so as to coordinate and balance the urban-rural development. PMID:27879729

The Changing Context of Rural America: A Call to Examine the Impact of Social Change on Mental Health and Mental Health Care.

PubMed

Carpenter-Song, Elizabeth; Snell-Rood, Claire

2017-05-01

Recent social changes and rising social inequality in the rural United States have affected the experience and meaning of mental illness and treatment seeking within rural communities. Rural Americans face serious mental health disparities, including higher rates of suicide and depression compared with residents of urban areas, and substance abuse rates in rural areas now equal those in urban areas. Despite these increased risks, people living in rural areas are less likely than their urban counterparts to seek or receive mental health services. This Open Forum calls for a research agenda supported by anthropological theory and methods to investigate the significance of this changed rural social context for mental health.

Health IT-enabled Care for Underserved Rural Populations: The Role of Nursing

PubMed Central

Effken, Judith A.; Abbott, Patricia

2009-01-01

This white paper explains the strong roles that nursing can play in using information technology (IT) to improve healthcare delivery in rural areas. The authors describe current challenges to providing care in rural areas, and how technology innovations can help rural communities to improve their health and health care. To maximize benefits, rural stakeholders (as individuals and groups) must collaborate to effect change. Because nonphysician providers deliver much of the health care in rural communities, this paper focuses on the critical roles of nurses on IT-enabled caremanagement teams. The authors propose changes in nursing practice, policy, and education to better prepare, encourage, and enable nurses to assume leadership roles in IT-enabled health care management in rural communities. PMID:19261937

Rural rustic roads improvement program

DOT National Transportation Integrated Search

2002-11-11

This program provides for the initial pavement of rural roads. Under the Rural Rustic Roads Program, the governing body of any county, in consultation with the Department, may designate a road or road segment as a Rural Rustic Road provided such road...

7 CFR 1955.51 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE... REGULATIONS (CONTINUED) PROPERTY MANAGEMENT Management of Property § 1955.51 Purpose. This subpart delegates authority and prescribes policies and procedures for the Rural Housing Service (RHS), Rural Business...

Change in Rural Schools.

ERIC Educational Resources Information Center

Edington, Everett D.

1981-01-01

Discusses nine major characteristics of rural schools which affected their willingness to accept change, as revealed in a study of the five-year Rural Experimental Schools Program. Available from: Rural Sociological Society, 325 Morgan Hall, University of Tennessee, Knoxville, TN 37916. (NEC)

Our science matters - and is recognized

USDA-ARS?s Scientific Manuscript database

The Presidential Task Force on Agriculture and Rural Prosperity listed five key indicators of rural prosperity: e-Connectivity for Rural America, Improving Quality of Life, Supporting a Rural Workforce, Harnessing Technological Innovation, and Economic Development (https://www.usda.gov/sites/default...

7 CFR 4284.513 - Evaluation criteria and weights.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 4284.513 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE GRANTS Rural Cooperative... Rural areas. (c) Economic development. The Agency will evaluate the applicant's demonstrated ability to...

7 CFR 4284.513 - Evaluation criteria and weights.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 4284.513 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE GRANTS Rural Cooperative... Rural areas. (c) Economic development. The Agency will evaluate the applicant's demonstrated ability to...

7 CFR 4284.513 - Evaluation criteria and weights.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 4284.513 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE GRANTS Rural Cooperative... Rural areas. (c) Economic development. The Agency will evaluate the applicant's demonstrated ability to...

7 CFR 4284.513 - Evaluation criteria and weights.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 4284.513 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE GRANTS Rural Cooperative... Rural areas. (c) Economic development. The Agency will evaluate the applicant's demonstrated ability to...

7 CFR 1942.304 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE... REGULATIONS (CONTINUED) ASSOCIATIONS Rural Business Enterprise Grants and Television Demonstration Grants § 1942.304 Definitions. Project. For rural business enterprise grants, the result of the use of program...

7 CFR 25.1 - Applicability and scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES General... applicable to rural empowerment zones and enterprise communities, authorized under the Omnibus Budget... area requirements, the nomination process for rural Empowerment Zones and rural Enterprise Communities...

47 CFR 22.705 - Rural radiotelephone system configuration.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Rural radiotelephone system configuration. 22.705 Section 22.705 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Rural Radiotelephone Service § 22.705 Rural radiotelephone system...