Search results for: rural surgery

Authors: Patti Kastanias, Wei Wang, Karyn Mackenzie, Sandra Robinson, Susan Wnuk

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Obesity is a worldwide epidemic and is recognized as a chronic disease. Pain in the obese individual is a multidimensional issue. An increase in BMI is positively correlated with pain incidence and severity, especially in central obesity where individuals are twice as likely to have chronic pain. Both obesity and chronic pain are also associated with mood disorders. Pain is worse among obese individuals with depression and anxiety. Bariatric surgery provides patients with an effective solution for long-term weight loss and associated health problems. However, not much is known about acute and chronic pain after bariatric surgery and its contributing factors, including mood disorders. Nurse practitioners (NPs) at one large multidisciplinary bariatric surgery centre led two studies to examine acute and chronic pain and pain management over time after bariatric surgery. The purpose of the initial study was to examine the incidence and severity of acute and chronic pain after bariatric surgery. The aim of the secondary study was to further examine chronic pain, specifically looking at psychological factors that influence severity or incidence of both neuropathic and somatic pain as well as changes in opioid use. The initial study was a prospective, longitudinal study where patients having bariatric surgery at one surgical center were followed up to 6 months postop. Data was collected at 7 time points using validated instruments for pain severity, pain interference, and patient satisfaction. In the second study, subjects were followed longitudinally starting preoperatively and then at 6 months and 1 year postoperatively to capture changes in chronic pain and influencing variables over time. Valid and reliable instruments were utilized for all major study outcomes. In the first study, there was a trend towards decreased acute post-operative pain over time. The incidence and severity of chronic pain was found to be significantly reduced at 6 months post bariatric surgery. Interestingly, interference of chronic pain in daily life such as normal work, mood, and walking ability was significantly improved at 6 months postop however; this was not the case with sleep. Preliminary results of the secondary study indicate that pain severity, pain interference, anxiety and depression are significantly improved at 6 months postoperatively. In addition, preoperative anxiety, depression and emotional regulation were predictive of pain interference, but not pain severity. The results of our regression analyses provide evidence for the impact of pre-existing psychological factors on pain, particularly anxiety in obese populations.

Keywords: bariatric surgery, mood disorders, obesity, pain

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Authors: Ziwei Qi

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This paper focuses on issues on Urbanization, Rural Migration and Neighborhood Collective Efficacy in urban China. The urbanization and migration trend and policies in China will be discussed and the various mechanisms through which social structures affect economic action and the consequent of social disequilibrium due to urbanization will be discussed. The positive and negative propositions on urbanization will also be highlighted. The primary methodologies applied in the paper will be the theoretical application and empirical implication on urbanization in developing countries. Western sociological theories, including theories in urban criminology /sociology including social disorganization, theories of social capital and collective efficacy will be applied and analyzed to test the market society in Chinese economic and cultural setting.

Keywords: collective efficacy, civic engagement, rural migration, urbanization

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Authors: Inemesit Akpan Umoren, Aniekan James Akpan

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Media practitioners and information managers have often erroneously operated on the premise that media messages are received as disseminated to the extent that audiences of whatever background assimilate the content uniformly. This does not subsist since media audiences are often segmented in terms of educational level, social category, place of residence, gender, among others. While those who are highly educated, live in urban areas and are of highest standing are more likely to have direct access to the media, those in the rural areas and of low education and standing, may not have direct or easy access. These, therefore, informed the study to establish the consumption patterns of mass media products by residents of rural communities in south-south, Nigeria. The study, which was anchored on the multi-step flow and social categories theories, adopted a survey research design and a sample of 383 using Mayer’s 1979 guide drawn from nine rural communities in the south-south, Nigeria states of Akwa Ibom, Rivers and Edo. Findings among others showed that while a negligible percentage is highly exposed to media messages of all types, a greater member depend on opinion leaders, social groups, drinking joints, among other such for filtered content. It was concluded that since rural or community media organizations are very vital in ensuring media content get to all audience without necessarily being passing through intermediaries. Among the recommendations was that information managers and media organizations should always have in mind the ruralites while packaging their contents even in the mainstream media.

Keywords: consumption, media, media product, pattern

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Authors: Evelyn Marie Richmond, Andrew McBride, Chris Johnston, John Marley

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Background: Good quality patient information resources for orthognathic treatment help to reinforce information delivered during the initial consultation and help patients make informed decisions about their care. The Consultant Orthodontists and a Dental Core Trainee noted limited patient engagement with the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources and that the existing BOS patient information leaflet (PIL) could be customised and developed to meet local requirements. Aim: The quality improvement project (QIP) aimed to improve patients' understanding of orthognathic treatment by ensuring at least 90% of patients had read the new in-house patient information leaflet (PIL) and a minimum of 50% of patients had accessed the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources before attending the joint orthognathic multidisciplinary clinic by June 2023. Methods: The QIP was undertaken in the orthodontic department of the School of Dentistry, Belfast. Data was collected prospectively during a 6-month period from January 2023 to June 2023 over 3 Plan, Do, Study, Act (PDSA) cycles. Suitable patients were identified at consultant orthodontic new patient clinics. Following initial consultation for orthognathic treatment, patients were contacted to complete a patient questionnaire. Design: The change ideas were a poster with a QR code directing patients to the BOS 'Your Jaw Surgery' website in consultation areas and a new in-house PIL with a QR code directing patients to the BOS 'Your Jaw Surgery' website. Results: In PDSA cycle 1, 86.7% of patients were verbally directed to the BOS 'Your Jaw Surgery' website, and 53.3% accessed the online resources after their initial consultation. Although 100% of patients reported reading the existing PIL, only 64.3% felt it discussed the risks of orthognathic treatment in sufficient detail. By PDSA cycle 3, 100% of patients reported being directed to the BOS 'Your Jaw Surgery' website, however, only 58.3% engaged with the website. 100% of patients who read the new PIL felt that it discussed the risks of orthognathic treatment in sufficient detail. Conclusion: The slight improvement in access to the BOS 'Your Jaw Surgery' website shows that patients do not necessarily choose to access information online despite its availability. The uptake of the new PIL was greater than reported patient engagement with the BOS 'Your Jaw Surgery' website, which indicates patients still value written information despite the availability of online resources.

Keywords: orthognathic surgery, patient information resources, quality improvement project, risks

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Authors: Munish Saroch, Amit Saini

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Introduction: Many children with congenital malformation of inner ear have undergone cochlear implant (CI) surgery. The results for cochlear implant surgery in these children are very encouraging and provide a ray of hope for these patients. Objective: The main objective of this presentation is to prove that even in Mondini’s deformity Minimal incision cochlear implantation improves cosmesis, reduces post-operative infection and earliest switch on of device. Methods: We report a case of two-year-old child suffering from Mondini’s deformity who underwent CI with minimal incision cochlear implantation (MICI). MICI has been developed with the aims of reducing the impact of surgery on the patient without any preoperative shaving of hairs. Results: Patient after surgery with MICI showed better looking postauricular scar, low post-operative morbidity in comparison to conventional wider access approach and hence earliest switch on of device (1st post operative day). Conclusion: We are of opinion that MICI is safe and successful in Mondini’s deformity.

Keywords: CI, Cochlear Implant, MICI, Minimal Incision Cochlear Implantation, HL, Hearing Loss, HRCT, High Resolution Computer Tomography, MRI, Magnetic resonance imaging, SCI, Standard cochlear implantation

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Authors: Murorunkwere Marie Claire

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Introduction: In Sub-Saharan Africa and specifically in Rwandan rural areas, mother-to-Child human immunodeficiency virus transmission remains a big challenge. This is mainly due to lack of awareness and ignorance among pregnant rural women, leading to neglect regular taking of prophylactic antiretroviral treatment and to persistently beliefs in traditional healers and home deliveries. This paper explores the factors associated with stagnant reduction in human immunodeficiency virus vertical transmission among pregnant rural women and provides solutions to tackle it. Methodology: The first phase of this research will be a qualitative survey was conducted to assess the knowledge, attitudes and practices towards vertical human immunodeficiency virus transmission among pregnant women in one rural district in Rwanda. The data generated from phase one of this research will be used to address the main factors revealed through community mobilization and motivation on attending required antenatal consultations and hospital deliveries, proper and regular antiretroviral treatment taking, and discouraging beliefs in traditional healers and home deliveries. Refresher training seminars will also be organized for healthcare providers qualified on conducting deliveries about current measures to maximize the reduction of chances that can lead to mother -child contamination (to avoid early rupture of membranes and to prevent any source of contamination). Results: This paper is expected to contribute in a significant reduction of the vertical human immunodeficiency virus transmission burden among pregnant rural women. Conclusion: Strong campaigns on prevention of mother- to-child human immunodeficiency virus transmission and community mobilization of pregnant rural women, and house to house education and continuous reminders as well as training seminars to health care personnel on updated measures is, key in addressing vertical human immunodeficiency virus transmission.

Keywords: attitudes transformation, community mobilisation, pregnant rural women, vertical HIV transmission

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Authors: Mimi Roy, Sriroop Chaudhuri

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Sustainable water supply is among the basic needs for human development, especially in the rural areas of the developing nations where safe water supply and basic sanitation infrastructure is direly needed. In light of the above, we propose a simple methodology to develop a composite water sustainability index (WSI) to assess the collective performance of the existing rural water supply services (RWSS) in India over time. The WSI will be computed by summarizing the details of all the different varieties of water supply schemes presently available in India comprising of 40 liters per capita per day (lpcd), 55 lpcd, and piped water supply (PWS) per household. The WSI will be computed annually, between 2010 and 2016, to elucidate changes in holistic RWSS performances. Results will be integrated within a robust geospatial framework to identify the ‘hotspots’ (states/districts) which have persistent issues over adequate RWSS coverage and warrant spatially-optimized policy reforms in future to address sustainable human development. Dataset will be obtained from the National Rural Drinking Water Program (NRDWP), operating under the aegis of the Ministry of Drinking Water and Sanitation (MoDWS), at state/district/block levels to offer the authorities a cross-sectional view of RWSS at different levels of administrative hierarchy. Due to simplistic design, complemented by spatio-temporal cartograms, similar approaches can also be adopted in other parts of the world where RWSS need a thorough appraisal.

Keywords: rural water supply services, piped water supply, sustainability, composite index, spatial, drinking water

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Authors: Tamunotonye Mayowa Braide, Isaac Oluwatayo

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This study investigates multidimensional poverty, and its correlates among rural households in Sekhukhune and Capricorn District municipalities (SDM & CDM) in Limpopo Province, South Africa. Primary data were collected from 407 rural households selected through purposive and simple random sampling techniques. Analytical techniques employed include descriptive statistics, principal component analysis (PCA), and the Alkire Foster (A-F) methodology. The results of the descriptive statistics showed there are more females (66%) than males (34%) in rural areas of Limpopo Province, with about 45% of them having secondary school education as the highest educational level attained and only about 3% do not have formal education. In the analysis of deprivation, eight dimensions of deprivation, constructed from 21 variables, were identified using the PCA. These dimensions include type and condition of dwelling water and sanitation, educational attainment and income, type of fuel for cooking and heating, access to clothing and cell phone, assets and fuel for light, health condition, crowding, and child health. In identifying the poor with poverty cut-off (0.13) of all indicators, about 75.9% of the rural households are deprived in 25% of the total dimensions, with the adjusted headcount ratio (M0) being 0.19. Multidimensional poverty estimates showed higher estimates of poor rural households with 71%, compared to 29%, which fall below the income poverty line. The study conducted poverty decomposition, using sub-groups within the area by examining regions and household characteristics. In SDM, there are more multidimensionally poor households than in CDM. The water and sanitation dimension is the largest contributor to the multidimensional poverty index (MPI) in rural areas of Limpopo Province. The findings can, therefore, assist in better design of welfare policy and target poverty alleviation programs and as well help in efficient resource allocation at the provincial and local municipality levels.

Keywords: Alkire-Foster methodology, Limpopo province, multidimensional poverty, principal component analysis, South Africa

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Authors: Dimitra V. Peristeri, Hussameldin M. Nour, Amiya Ahsan, Sameh Abogabal, Krishna K. Singh, Muhammad Shafique Sajid

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Introduction: The use of optimal skin antiseptic agents for the prevention of surgical site infection (SSI) is of critical importance, especially during abdominal surgical procedures. Alcohol-based chlorhexidine gluconate (CHG) and aqueous-based povidone-iodine (PVI) are the two most common skin antiseptics used nowadays. The objective of this article is to evaluate the effectiveness of alcohol-based CHG versus aqueous-based PVI used for skin preparation before abdominal surgery to reduce SSIs. Methods: Standard medical databases such as MEDLINE, Embase, Pubmed, and Cochrane Library were searched to find randomised, controlled trials (RCTs) comparing alcohol-based CHG skin preparation versus aqueous-based PVI in patients undergoing abdominal surgery. The combined outcomes of SSIs were calculated using an odds ratio (OR) with 95% confidence intervals (95% CI). All data were analysed using Review Manager (RevMan) Software 5.4, and the meta-analysis was performed with a random effect model analysis. Results: A total of 11 studies, all RCTs, were included (n= 12072 participants), recruiting adult patients undergoing abdominal surgery. In the random effect model analysis, the use of alcohol-based CHG in patients undergoing abdominal surgery was associated with a reduced risk of SSI compared to aqueous-based PVI (OR: 0.84; 95% CI [0.74, 0.96], z= 2.61, p= 0.009). Conclusion: Alcohol-based CHG may be more effective for preventing the risk of SSI compared to aqueous-based PVI agents in abdominal surgery. The conclusion of this meta-analysis may add a guiding value to reinforce current clinical practice guidelines.

Keywords: skin preparation, surgical site infection, chlorhexidine, skin antiseptics

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Authors: Shekoufeh Behdad, Amirhossein Yadegari, Leila Ghodrati, Saman Yadegari

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Context: Preoperative anxiety is a common psychological reaction experienced by all patients undergoing surgery. It can have negative effects on the patient's well-being and even impact surgical outcomes. Therefore, finding effective interventions to reduce preoperative anxiety is important in improving patient care. Research Aim: The aim of this study is to compare the effects of oral administration of zaleplon (5 mg) and alprazolam (0.5 mg) on preoperative anxiety levels in women undergoing gynecological abdominal surgery. Methodology: This study is a double-blind, randomized clinical trial conducted after receiving approval from the university's ethics committee and obtaining written informed consent from the patients. The night before the surgery, patients were randomly assigned to receive either 0.5 mg of alprazolam or 5 mg of zaleplon orally. Anxiety levels, measured using a 10-cm visual analog scale, and hemodynamic variables (blood pressure and heart rate) were assessed before drug administration and on the morning of the operation after the patient entered the pre-operation room. Findings: The study found that there were no significant differences in mean anxiety levels or hemodynamic variables before and after administration of either drug in both groups (P value > 0.05). This suggests that both 0.5 mg of alprazolam and 5 mg of zaleplon effectively reduce preoperative anxiety in women undergoing abdominal surgery without serious side effects. Theoretical Importance: This study contributes to the understanding of the effectiveness of alprazolam and zaleplon in reducing preoperative anxiety. It adds to the existing literature on pharmacological interventions for anxiety management, specifically in the context of gynecological abdominal surgery. Data Collection: Data for this study were collected through the assessment of anxiety levels using a visual analog scale and measuring hemodynamic variables, including systolic, diastolic, and mean arterial blood pressures, as well as heart rate. These measurements were taken before drug administration and on the morning of the surgery. Analysis Procedures: Statistical analysis was performed to compare the mean anxiety levels and hemodynamic variables before and after drug administration in the two groups. The significance of the differences was determined using appropriate statistical tests. Questions Addressed: This study aimed to answer the question of whether there are differences in the effects of alprazolam and zaleplon on preoperative anxiety levels in women undergoing gynecological abdominal surgery. Conclusion: The oral administration of both 0.5 mg of alprazolam and 5 mg of zaleplon the night before surgery effectively reduces preoperative anxiety in women undergoing abdominal surgery. These findings have important implications for the management of preoperative anxiety and can contribute to improving the overall surgical experience for patients.

Keywords: zaleplon, alprazolam, premedication, abdominal surgery

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Authors: Seema Dutt Bandhu, Yashi Bansal, Tania Moudgil, Barinder Kaur

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Introduction: Scleral perforation during the passage of suture needle is a known complication of strabismus surgery. The present study was conducted to evolve a safe and easy technique of passing the suture needle through the sclera. A scleral tunnel was created with a 26-guage needle through which the suture needle was passed. The rest of the steps of strabismus surgery were carried out as usual. Material and Methods: After taking clearance from the Institutional Ethics Committee, an interventional study was carried out on twenty patients. The scleral tunnel technique was performed on the patients of strabismus after taking written informed consent. Before passing the suture needle through the sclera during strabismus surgery, a tunnel through approximately half the thickness of the sclera was created with the help of a bent 26-gauge needle. The suture needle was then passed through this tunnel. Rest of the steps of the surgery were carried out in the conventional manner. In a control group of same number of patients, the surgery was performed in the conventional method. Both the groups were followed up for any complications. Ease of passing suture and surgeons’ satisfaction with the technique was noted on a 10-point Likert scale. Results: None of the patients in either group suffered from any complications. Four surgeons participated in the study. The average Likert scale score of the surgeons for satisfaction with the technique was 4.5 on a scale of 5. The score for ease of passage of suture needle was 5 on a score of 5. Discussion: Scleral perforation during passing the sutures through the sclera is a known complication of strabismus surgery. Incidence reported is 7.8% It occurs due to inappropriate engagement of the scleral tissue or passage of the suture needle along a wrong axis during the process of passing the suture needle. The needle track technique eases the passage of passing the suture needle through the sclera as the engagement of the scleral tissue can be done with greater control with a 26-guage needle. The surgeons have reported that they are highly satisfied with the technique and they have reported that the technique eased the passage of the suture needle through the sclera.

Keywords: suture, scleral tunnel, strabismus, scleral perforation

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Authors: Nuzhat Sultana

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Iron deficiency (IDA) is the commonest nutritional anemia present in Indian pregnant women. The overall development of a fetus is determined to a great extent by the type of nourishment mother receives right from its conception. To study the risk factors of iron deficiency anemia, two hundred rural pregnant women in the age of 15-35 years in the second trimester of pregnancy from the countryside of Beed district was selected. These samples were divided into groups 'A' (experimental samples) and 'C' (control samples). Experimental samples were received oral supplementation of iron and folic acid for ninety days, but control samples did not receive any supplementation. All the samples were observed anthropometrically, biochemically and clinically before and after supplementation. The study result shows that maximum numbers of i.e. 75% pregnant women had low levels of weight and hemoglobin as compared to standard weight and HB level. However, after supplementation only in experimental group weight and HB level was increased. It was observed that prevalence of risk factors associated with anemia was higher in rural pregnant women. Poverty, illiteracy, faulty food habits, and poor intake of iron during pregnancy are the main causative factors for iron deficiency anemia in rural pregnant women.

Keywords: iron deficiency, anemia, risk factors, pregnancy

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Authors: Castillo-Acevedo J, Mena-Rivero R, Silva-Poot H

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In Mexico, as largely of the developing countries, the rural housing is a study object, since the diversity of constructive idiosyncrasies for locality, involves various factors that make it vulnerable; an important aspect of study is the progressive deterioration that is seen in the rural housing. Various social programs, contribute financial resources in the field of housing to provide support for families living in rural areas, however, they do not provide a coordination with the self-construction that is usually the way in which is built in these areas. The present study, exposes the physical situation and an economic assessment that presents the rural self-constructed housing in three rural communities in the south of the state of Quintana Roo, Mexico, which were built with funding from federal social programs. The information compilation was carried out in a period of seven months in which there was used the intentional sampling of typical cases, where the object study was the housing constructed with supports of the program “Rural Housing” between the year 2009 and 2014. Instruments were used as the interview, ballot papers of observation, ballot papers of technical verification and various measuring equipment laboratory for the classification of pathologies; for the determination of some pathologies constructive Mexican standards were applied how NMX-C-192-ONNCCE, NMX-C-111-ONNCCE, NMX-C-404-ONNCCE and finally used the software of Opus CMS ® with the help of tables of the National Consumer Price Index (CPI) for update of costs and wages according to the line of being applied in Mexico, were used for an economic valuation. The results show 11 different constructive pathologies and exposes greater presence with the 22.50% to the segregation of the concrete; the economic assessment shows that 80% of self-constructed housing, exceed the cost of construction it would have compared to a similar dwelling built by a construction company; It is also exposed to the 46.10% of the universe of study represent economic losses in materials to the social activities by houses not built. The system of self-construction used by the social programs, affect to some extent the program objectives applied in underserved areas, as implicit and additional costs affect the economic capacity of beneficiaries who invest time and effort in an activity that are not specialists, which this research provides foundations for sustainable alternatives or possibly eliminate the practice of self-construction of implemented social programs in marginalized rural communities in the south of state of Quintana Roo, Mexico.

Keywords: economic valuation, pathologies constructive, rural housing, social programs

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Authors: Tahir Munir Butt, Gao Qijie, Babar Shahbaz, Muhammad Zakaria Yousaf Hassan, Zhnag Chuanhong

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The main objective of this paper is to identify the relationship between Information Communication Technology (ICTs) applications with Agricultural development in the process of communication at rural Punjab-Pakistan. The authors analyzed the relationship of ICTs applications with the most prominent factor for the Agricultural Information Services (AIS) in the Agricultural Extension Approaches (AEA). The data collection procedure was started from Jan. 2015 and completed in July 2015. It is the one of the part in PhD studies at China Agriculture, University Hadian-Beijng China. It was observed that on major constraint in the AIS disseminated was the limited number of farmers especially and unknown the farmers about new ICTs technology for Agriculture at rural areas. Majority of ICTs application e.g. Toll free number; Robo Calls; Text message was highly significances in the AIS approach. The recommendation is communication and capacity building one of the indispensable elements for sustainable and agricultural development and Agricultural extension should be provided training to farmer about new ICTs technologies to access and use of it for Sustainable Agriculture Development (SAD) and update the scenario of flow of information also with try to established ICTs hub at the village level.

Keywords: ICTs, AEA, AIS, SAD, rural farmers

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Authors: Mihail Nagea, Olivera Lupescu, Elena Taina Avramescu, Cristina Patru

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Classical education of orthopedic surgeons involves lectures, self study, workshops and cadaver dissections, and sometimes supervised practical training within surgery, which quite seldom gives the young surgeons the feeling of being unable to apply what they have learned especially in surgical practice. The purpose of this paper is to present a different approach from the classical one, which enhances the practical skills of the orthopedic trainees and prepare them for future practice. The paper presents the content of the research project 2015-1-RO01-KA202-015230, ERASMUS+ VET ‘Collaborative learning for enhancing practical skills for patient-focused interventions in gait rehabilitation after orthopedic surgery’ which, using e learning as a basic tool , delivers to the trainees not only courses, but especially practical information through videos and case scenarios including gait analysis in order to build patient focused therapeutic plans, adapted to the characteristics of each patient. The outcome of this project is to enhance the practical skills in orthopedic surgery and the results are evaluated following the answers to the questionnaires, but especially the reactions within the case scenarios. The participants will thus follow the idea that any mistake within solving the cases might represent a failure of treating a real patient. This modern approach, besides using interactivity to evaluate the theoretical and practical knowledge of the trainee, increases the sense of responsibility, as well as the ability to react properly in real cases.

Keywords: interdisciplinary approach, gait analysis, orthopedic surgery, vocational training

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Authors: Peeyush Verma, Anil Kumar, Anju Rawlley, Chanchal Mehra

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India's school-going population is largely served by an educational system that is, in most rural parts, stuck with methods that emphasize rote learning, endless examinations, and monotonous classroom activities. Rural government schools are generally seen as having poor infrastructure, poor support system and low motivation for teaching as well as learning. It was experienced during the survey of this project that there is lesser motivation of rural boys and girls to attend their schools and still less likely chances to study science, tabooed as “difficult”. An experiment was conducted with the help of Rural Knowledge Network Project through Department of Science and Technology, Govt of India in five remote villages of Sehore District in Madhya Pradesh (India) during 2012-2015. These schools are located about 50-70 Km away from Bhopal, the capital of Madhya Pradesh and can distinctively qualify as average rural schools. Three tier methodology was adapted to unfold the experiment. In first tier randomly selected boys and girls from these schools were taken to a daylong visit to the Regional Science Centre located in Bhopal. In second tier, randomly selected half of those who visited earlier were again taken to the Science Centre to make models of Science. And in third tier, all the boys and girls studying science were exposed to video lectures and study material through web. The results have shown an interesting face towards learning science among youths in rural schools through peer learning or incremental learning. The students who had little or no interest in learning science became good learners and queries started pouring in from the neighbourhood village as well as a few parents requested to take their wards in the project to learn science. The paper presented is a case study of the experiment conducted in five rural schools of Sehore District. It reflects upon the methodology of developing awareness and interest among students and finally engaging them in popularising science through peer-to-peer learning using incremental learning elements. The students, who had a poor perception about science initially, had changed their attitude towards learning science during the project period. The results of this case, however, cannot be generalised unless replicated in the same setting elsewhere.

Keywords: popularisation of science, science temper, incremental learning, peer-to-peer learning

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Authors: A. O. Arowolo, M. U. Agbonlahor, P. A. Okuneye, A. E. Obayelu

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Nigeria is rich with abundant resources with an immense contribution of the forest resource to her economic development and to the livelihood of the rural populace over the years. However, this important resource has continued to shrink because it is not sustainably used, managed or conserved. The loss of forest cover has far reaching consequences on regional, national and global economy as well as the environment. This paper reviewed the Nigeria forest management policies, the challenges and willingness to pay (WTP) for management of the community forests in Ogun State, Nigeria. Data for the empirical investigation were obtained using a cross-section survey of 160 rural households by multistage sampling technique. The WTP was assessed by the Dichotomous Choice Contingent Valuation. One major findings is that, the Nigerian forest reserves is established in order to conserve and manage forest resources but has since been neglected while the management plans are either non-existent or abandoned. Also, the free areas termed the community forests where people have unrestricted access to exploit are fast diminishing in both contents and scale. The mean WTP for sustainable management of community forests in the study area was positive with a value of ₦389.04/month. The study recommends policy measures aimed at participatory forest management plan which will include the rural communities in the management of community forests. This will help ensure sustainable management of forest resources as well as improve the welfare of the rural households.

Keywords: forests, management, WTP, Nigeria

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Authors: Salam Abukhadrah

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This research advocates for the use of feminist evaluation (FE) as a tool of great potential in policy and program assessment in relation to women’s empowerment. This research explores the journey of women’s place into the evaluation and international development. Moreover, this research presents a case example of the use of FE on the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), in Ganaparthi village in rural India, in Andhra Pradesh state (AP). This evaluation is formed on the basis of women’s empowerment framework that seeks to examine empowerment as a process and an end in itself rather than as just simplified quantifiable outcomes. This framework is used to conduct in-depth semi-structured interviews that are later cross-validated by a focus group discussion. In addition, this evaluation draws on secondary data from the MGNREGA website and on extracted data from the National Family Health Survey of AP.

Keywords: feminist evaluation, MGNREGA, women’s empowerment, case example, India

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Authors: Laila Al-Balushi, Suad Al-Kharosui

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Due to the increasing number of breast cancer cases in Oman and the impact of the novel coronavirus disease 2019 (COVID-19 on bed situation in the hospital, a policy of early discharge (ED) with drain after breast cancer surgery was initiated at one of the tertiary hospitals in Oman. The uniqueness of this policy is no home visit follow-up, conducted after discharge and the main mode of communication was Instagram media. This policy then was evaluated by conducting a quasi-experimental study using a questionnaire with ten open and closed-ended questions, five questions to explore patient experience using a five-point Likert scale. A total of 41 female patients responded to the questionnaire. Almost 96% of the participants stated being well informed about drain care pre- and post-surgery at home. 9% of the participants developed early sign of infection and was managed at out-patient clinics. Participants with bilateral drains expressed more pain than those with single drain. 90% stated satisfied being discharged with breast drain whereas 10% preferred to stay in the hospital until the drains were removed. This study found that the policy of ED with a drain after BC surgery is practical and well-accepted by most patients. The role of breast nurse and presence of family and institutional support enhanced the success of the policy implementation. To optimize patient care, conducting a training program by breast nurse for nurses at local health centres about care management of patients with drain could improve care and enhance patient satisfaction.

Keywords: breast cancer, surgery, early discharge, surgical drain

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Authors: Shishir Kumar, Chhaya Gangwal, Seema Raj

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Public health informatics (PHI) which has seen successful implementation in the developed world, become the buzzword in the developing countries in providing improved healthcare with enhanced access. In rural areas especially, where a huge gap exists between demand and supply of healthcare facilities, PHI is being seen as a major solution. There are factors such as growing network infrastructure and the technological adoption by the health fraternity which provide support to these claims. Public health informatics has opportunities in healthcare by providing opportunities to diagnose patients, provide intra-operative assistance and consultation from a remote site. It also has certain barriers in the awareness, adaptation, network infrastructure, funding and policy related areas. There are certain medico-legal aspects involving all the stakeholders which need to be standardized to enable a working system. This paper aims to analyze the potential and challenges of public health informatics services in rural communities.

Keywords: PHI, e-health, public health, health informatics

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Authors: Smita Lakhotia, C. Kew, S. H. M. Siraj, B. Chern

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Up to 50% of those with endometriosis may suffer from infertility due to either distorted pelvic anatomy/impaired oocyte release or inhibit ovum pickup and transport, altered peritoneal function, endocrine and anovulatory disorders, including LUF, impaired implantation, progesterone resistance or decreased levels of cellular immunity. The dilemma continues as to whether the surgery or IVF is the optimal management for such recurrent endometriomas. The core question is whether surgery adds anything of value for infertile women with recurrent endometriosis or not. Complete and detailed information on risks and benefits of treatment alternatives must be offered to patients, giving a realistic estimate of chances of success of repetitive surgery and of multiple IVF cycles in order to allow unbiased choices between different possible optionsAn individualized treatment plan should be developed taking into account patient age, duration of infertility, previous pregnancies and specific clinical conditions and wish.

Keywords: recurrent endometriosis, infertility, oocyte release, pregnancy

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Authors: Lingfei Sun

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Based on the significant value of ecology, the strategic planning for ecological civilization construction was mentioned in the 17th and 18th National Congress of the Communist Party of China. How to generate economic value based on the environmental capacity is not only an economic decision but also a political decision to make. Boshan took the full use of “Ecology” and transformed it as an inexhaustible green resource to benefit people, reflecting the sustainable value of new agriculture development mode. The Strawberry Harvest Festival and Blueberry Harvest Festival hosted approximately 96,000 and 54,000 leisure tourists respectively in 2014. For the Kiwi Harvest Festival in August 2014, in average, it attracted about 4600 tourists per day, which generated daily kiwi sales of 50,000 lbs and 3 million RMB (About 476,000 USD) of daily revenue. The purpose of this study is to elaborate the modes of agritourism development, by analyzing the cases in rural area of Boshan, China. Interviews with the local government officers were applied to discover operation mode of agritourism operation. The financial data was used to demonstrate the strength of government policy and improvement of the income of rural people. The result indicated that there are mainly three types of modes: the Intensive Mode, the Model Mode and the Mixed Mode, supported by case study respectively. With the boom of tourism, the development of agritourism in Boshan relies on the agriculture encouraging policy of China and the effort of local government; meanwhile, large scale of cultivation and the product differentiation are the crucial elements for the success of rural agritourism projects.

Keywords: agriculture, agritourism, economy, rural area development

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Authors: Pianpian Zhang, Qingping Luo

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Currently, there is a great tendency that more and more villages in China are trying to increase income by development of tourism. Especially in Zhejiang Province, 'Beautiful Rural Construction' provides an excellent opportunity for the development of tourism. In this context, development orientation, transportation routes and tourism service facilities are analyzed under the perspective of water resources protection and regional integration based on the development tourism industry of the six villages in Pujiang County, Zhejiang Province as a research object. In the program, the biggest issue is the contradiction between the ecological protection of the water and the development of economy. How to deal with the relationship between protection and development is the key to the design of this case. Furthermore, the six villages are regarded as a whole, connecting to each other by the system of five-path and the landscape along the lake. Every village has its own features, but cannot develop without one another. The article is actively exploring for suggestions and countermeasures to promote the development premised on protection and based on a regional view.

Keywords: development, integration, protection, rural tourism

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Authors: Mohamed Majrashi, Patricia Connolly, Terry Gourlay

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Cardiopulmonary bypass is known to cause inflammatory response during open heart surgery. It includes the initiation of different cascades such as coagulation, complement system and cytokines. Although the immune system is body’s key defense mechanism against external assault, when overexpressed, it can be injurious to the patient, particularly in a cohort of patients in which there is a heightened and uncontrolled response. The inflammatory response develops in these patients to an exaggerated level resulting in an autoimmune injury and may lead to poor postoperative outcomes (systemic inflammatory response syndrome and multi-organs failure). Previous studies by this group have suggested a correlation between the level of IL6 measured in patient’s blood before surgery and after polymeric activation and the observed inflammatory response during surgery. Based upon these findings, the present work is aimed at using this response to develop a test which can be used prior to the open heart surgery to identify the high-risk patients before their operation. The work will be accomplished via three main clinical phases including some pilot in-vitro studies, device development and clinical investigation. Current findings from studies using animal blood, employing DEHP and DEHP plasticized PVC materials as the activator, support the earlier results in patient samples. Having established this relationship, ongoing work will focus on developing an activated lateral flow strip technology as a screening device for heightened inflammatory propensity.

Keywords: cardiopulmonary bypass, cytokines, inflammatory response, overexpression

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Authors: Mohamed Ahmed Madkour, Haitham Magdy Hamad

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This research aims to study of the surgery science and imaging in ancient Egypt, and how to diagnose the surgical cases, whether due to injuries or disease that requires surgical intervention, Medical diagnosis and how to treat it. The ancient Egyptian physician tried to change over from magic and theological thinking to become a stand-alone experimental science, they were able to distinguish between diseases and they divide them into internal and external diseases even this division exists to date in modern medicine. There is no evidence to recognize the amount of human knowledge in the prehistoric knowledge of medicine and surgery except skeleton. It is not far from the human being in those times familiar with some means of treatment, Surgery in the Stone age was rudimentary, Flint stone was used after trimming in a certain way as a lancet to slit and open the skin. Wooden tree branches were used to make splints to treat bone fractures. Surgery developed further when copper was discovered, it led to the advancement of Egyptian civilization, then modern and advanced tools appeared in the operating theater like a knife or a scalpel. The climate and environmental conditions have preserved medical papyri and human remains that have confirmed their knowledge of surgical methods including sedation. The ancient Egyptians reached a great importance in surgery, evidenced by the scenes that depict the pathological image and the surgical process, but the image alone is not sufficient to prove the pathology, its presence in ancient Egypt and its treatment method. As there are a number of medical papyri, especially Edwin Smith and Ebris, which prove the ancient Egyptian surgeon's knowledge of the pathological condition that It requires a surgical intervention, otherwise its diagnosis and the method of treatment will not be described with such accuracy through these texts. Some surgeries are described in the department of surgery at Ebris papyrus. The level of surgery in ancient Egypt was high, and they performed surgery such as hernias and Aneurysm, however we have not received a lengthy explanation of the various surgeries and the surgeon has usually only said “treated surgically”. It is evident in the Ebris papyrus that they used sharp surgical tools and cautery in operations where bleeding is expected, such as hernias, arterial sacs and tumors.

Keywords: ancient Egypt, archaeology, Egyptian history, ancient asurgical imaging, Egyptian civilization, civilization

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Authors: Dare Ebenezer Fatumo, Olusesan Emmanuel Adelabu

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Online learning has taken another dimension through the introduction of Massive Open Online Courses (MOOCs), it has also become an important resource base for teaching and learning. This research aimed at investigating the use of Massive Open Online Course in a rural marginalized area. The survey research design of descriptive nature was adopted to evaluate the awareness and usage of Massive Open Online Course (MOOCs) in Alice community, Eastern Cape, South Africa. This study also employed quantitative approach by using self-structured questionnaire to evoke information from the respondents. The data collected were analyzed by Statistical Package for Social Sciences (SPSS). The findings revealed amongst others the efficacy of Massive Open Online Course (MOOCs) in fostering teaching and learning in rural marginalized areas. This study concludes that MOOCs is a veritable medium for busy or less privileged individual to acquire a degree or certification. Therefore, the study recommends MOOCs platform to be fully embraced by people in rural marginalized areas, awareness programs about its usefulness should be propagated across the municipalities nationwide.

Keywords: distance learning, information and communication technology, massive open online course, online learning, teaching and learning

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Authors: Sushma Ghildyal, Sanjay Kumar Singh

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The present study was undertaken with the purpose to understand the relationship of lifestyle and Socio-Economic status with child obesity among 1000 boys aged from 16 to 18 years of Varanasi District of Uttar Pradesh State in India. The study was conducted in both urban and rural area of the District. Ten schools i.e. five from urban area and five from rural area were selected by using purposive sampling. Healthy boys of class 10th, 11th and 12th were taken as subjects for the study. Prior consent was obtained from school authority. Anthropometric measurements were taken from each subject. Anthropometric measurements were Standing Height, Weight, Biceps skin folds, Triceps skin folds, Sub-scapular skin folds and Supra-iliac skin folds taken by Lange’s skin fold caliper. Lifestyle and Socio-Economic Status were obtained by questionnaires. In order to assess the BMI, Body fat %, Lifestyle and Socio-Economic Status; descriptive analyses were done. To find out the significant association of obesity with lifestyle and Socio-Economic Status Chi-square test was used. To find out significant difference between obesity of Urban and Rural children t-test was applied. Level of significance was set at 0.05 level. The conclusions drawn were: (1) The result showed that in urban area Varanasi District of Uttar Pradesh 0.6% children were in very high level adaptive lifestyle, 6.2% were in high level adaptive lifestyle, 25.4% above average level adaptive lifestyle, 47.8% moderately adaptive lifestyle, 3.6% and 0.4% low and very low level adaptive lifestyle. (2) In rural area Varanasi District of Uttar Pradesh 0.00% children were in very high level adaptive lifestyle, 9.4% were in high level adaptive lifestyle, 24.8% average level adaptive lifestyle, 47.0% moderately adaptive lifestyle, 15.2% below average and 3.0% very low level adaptive lifestyle.(3) In urban area 12.8% were in upper class Socio-Economic Status, 56.6% in upper middle class Socio-Economic Status, 30.2% in middle class Socio-Economic Status and 0.2% in lower middle class Socio-Economic Status. (4) In rural area 1.4% were in upper class Socio-Economic Status, 15.2% in upper middle class Socio-Economic Status, 51.6% in middle class Socio-Economic Status and 0.8% in lower middle class Socio-Economic Status. (5) In urban area 21.2% children of 16-18 years were obese. (6) In rural area 0.2% children of 16-18 years were obese. (7) In overall Varanasi District of Uttar Pradesh 10.7% children of 16-18 years were obese. (8) There was no significant relationship of obesity with Lifestyle of urban area children of 16-18 years. (9) There was significant relationship of obesity with Socio-Economic Status of urban area children of 16-18 years (10) There was no significant relationship of obesity with Lifestyle of rural area children of 16-18 years of Varanasi District Uttar Pradesh. (11) There was significant relationship of obesity with Socio-Economic Status of rural area children of 16-18 years. (12) Results showed significant difference between urban and rural area children of 16-18 years in respect to obesity of Varanasi District of Uttar Pradesh.

Keywords: lifestyle, obesity, rural area, socio-economic status, urban area

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Authors: K. R. Mukuna

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Teachers are faced many challenges in the South African rural schools such as stress, depression, lack of resources, poor working relationships, inflexible curriculum etc. These could affect their wellbeing and effectiveness at the workplace. As a result, the study had a significance in the teacher’s lives, and community due teachers worked under conditions that are unfavourable to perform their jobs effectively. Despite these conditions, they still managed to do their jobs and the community is uplifted. However, this study aimed to explore factors that enable teachers to cope with workplace adversities at a rural school district in the Free State Province. It adopted a qualitative case study as a research design. Semi-structured interviews and colleges had employed as tools to collect data. Ten participants (n=10; 5 males and 5 females) were selected through purposive and convenience sampling. All participants selected from a South African rural school. Sesotho culture was their home language, and most of them had 5 years of teaching experiences. The thematic findings revealed that they developed abilities to cope with and adjust to the social and cultural environment. These included self-efficacy, developing problem-solving skills, awareness of strengths and asserts, self-managing of emotions, and self-confidence. This study concluded that these psychosocial factors contributed to coping with teacher’s diversities, and effectively stabilized their wellbeing in the schools.

Keywords: psychosocial factors, teachers counselling, teacher stress, workplace adversity, rural school, teachers’ wellbeing, teachers’ resilience, teachers’ self-efficacy, social interaction

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Authors: Adelaide Rethabile Motshabi Pitso-Mbili

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The disparity between universities in rural and urban areas of South Africa is still an ongoing issue. There are a lot of variations in these universities, such as the performance of the students and the lecturers, which is viewed as a worrying discrepancy related to knowledge gaps or educational inequality. According to research, rural students routinely perform worse than urban students in sub-Saharan Africa, and the disparity is wide when compared to the global average. This may be a result of the various challenges that universities in rural and urban areas face. Hence, the aim of this study was to compare the challenges faced by rural and urban universities, especially in hospitality and tourism programs, and recommend possible solutions. This study used a qualitative methodology and included focus groups and in-depth interviews. Eight focus groups of final-year students in hospitality and tourism programs from four institutions and four department heads of those programs participated in in-depth interviews. Additionally, the study was motivated by the teacher collaboration theory, which proposes that colleagues can help one another for the benefit of students and the institution. It was revealed that rural universities face more challenges than urban universities when it comes to hospitality and tourism education. The results of the interviews showed that universities in rural areas have a high staff turnover rate and offer fewer courses due to a lack of resources, such as the infrastructure, staff, equipment, and materials needed to give students hands-on training on the campus and in various hospitality and tourism programs. Urban universities, on the other hand, provide a variety of courses in the hospitality and tourism areas, and while resources are seldom an issue, they must deal with classes that have large enrolments and insufficient funding to support them all. Additionally, students in remote locations noted that having a lack of water and electricity makes it difficult for them to perform practical lessons. It is recommended that universities work together to collaborate or develop partnerships to help one another overcome obstacles and that universities in rural areas visit those in urban areas to observe how things are done there and to determine where they can improve themselves. The significance of the study is that it will truly bring rural and urban educational processes and practices into greater alignment of standards, benefits, and achievements; this will also help retain staff members within the rural area universities. The present study contributes to the literature by increasing the accumulation of knowledge on research topics, challenges, trends and innovation in hospitality and tourism education and setting forth an agenda for future research. The current study adds to the body of literature by expanding the accumulation of knowledge on research topics that contribute to trends and innovations in hospitality and tourism education and by laying out a plan for future research.

Keywords: hospitality and tourism education, rural and urban universities, collaboration, teacher and student performance, educational inequality

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Authors: Anne Allmrodt

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Regions of South-East Europe are characterised by high out-migration for decades. The reasons for leaving range from the hope of a better work situation to a better health care system and beyond. In Serbia, this high out-migration hits the rural areas in particular so that the population number is in the red repeatedly. It might not be hard to guess that this negative population growth has the potential to create different challenges for those who stay in rural areas. So how are they coping with the – statistically proven – high out-migration? Having this in mind, the study is investigating the people‘s individual awareness of the social phenomenon high out-migration and their daily life strategies in rural areas. Furthermore, the study seeks to find out the people’s resilient skills in that context. Is the condition of high out-migration conducive for resilience? The methodology combines a quantitative and a qualitative approach (mixed methods). For the quantitative part, a standardised questionnaire has been developed, including a multiple choice section and a choice experiment. The questionnaire was handed out to people living in rural areas of Serbia only (n = 100). The sheet included questions about people’s awareness of high out-migration, their own daily life strategies or challenges and their social network situation (data about the social network was necessary here since it is supposed to be an influencing variable for resilience). Furthermore, test persons were asked to make different choices of coping with high out-migration in a self-designed choice experiment. Additionally, the study included qualitative interviews asking citizens from rural areas of Serbia. The topics asked during the interview focused on their awareness of high out-migration, their daily life strategies, and challenges as well as their social network situation. Results have shown the following major findings. The awareness of high out-migration is not the same with all test persons. Some declare it as something positive for their own life, others as negative or not effecting at all. The way of coping generally depended – maybe not surprising – on the people’s social network. However – and this might be the most important finding - not everybody with a certain number of contacts had better coping strategies and was, therefore, more resilient. Here the results show that especially people with high affiliation and proximity inside their network were able to cope better and shew higher resilience skills. The study took one step forward in terms of knowledge about societal resilience as well as coping strategies of societies in rural areas. It has shown part of the other side of nowadays migration‘s coin and gives a hint for a more sustainable rural development and community empowerment.

Keywords: coping, out-migration, resilience, rural development, social networks, south-east Europe

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