Search results for: rural surgery

Authors: Neda Najafi, Mehran Allalhesabi

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At present, the natural, geographical, physical contexts of the rural textures, which play a crucial role in making the concept behind their body, are not considered in the new designs. Despite the fundamental differences in contexts, this issue has caused that, the new rural textures in our country become similar to each other and the cohesive structure of many villages in the development of rural areas are exposed to deterioration. The villages of northern Iran are not immune from this situation and nothing have remained from their physical characteristic, and the new sections of rural areas are designed heterogeneously and regardless to the concepts behind the region's architecture, which destroys the originality of the environment. The purpose of this study is to extract the concepts and criteria that differentiate the body of the village and reveal its similarity with the same structures. In this way, understanding the underlying values is extremely useful and is considered very important to approach the new model. In the first part, the subject matters of the research (context, village and rural architecture) are defined and then the characteristics of context-oriented rural architecture and criteria that can be examined from the perspective of contextualism approach are presented. In the second part, by selecting 3 samples from the houses of Baliran village, these concepts and criteria have been evaluated in the houses of the village. The results of this study show that the characteristics of contextual rural architecture have the ability to adapt to the body of the village and can be the best model to achieve contextual architecture in this area. Therefore, by using these concepts and criteria, it is possible to achieve a type of architecture that is located along with the past architecture and, with the help of the modern facilities and environmental potentials, creates a logical and correct flow in the physical development of the rural textures.

Keywords: context, village, rural architecture, concepts and criteria of physical contextualism

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Authors: R. Litt, A. Kana, K. House

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The primary aim of this patient-related experience questionnaire was to gain a better understanding of our patients' experience as inpatients when they undergo orthognathic surgery. The secondary aim of this study was to identify ways in which we can improve the orthognathic inpatient experience and to share this with other units. All patients who received orthognathic surgery at an NHS hospital - Bristol Royal Infirmary, England, over the course of 6 months were asked to complete a questionnaire regarding their care. This data was then analysed and compared to the same questionnaire given to patients treated in a private hospital where orthognathic surgery was completed. All treatment was completed by the same surgeon. The design of the questions took into account NICE (National Institute for Health and Care Excellence) guidance on improving the experience of patient care. Particularly taking into account patients' essential requirements of care, for example, assessing and managing pain, ensuring adequate and appropriate nutrition, and ensuring the patients' personal needs are regularly reviewed and addressed. Overall the patient-related experience after orthognathic surgery was comparable in both the NHS and private hospitals. However, the questionnaire highlighted aspects of inpatient care after orthognathic surgery that can easily be improved in order to provide our patients with the best possible care.

Keywords: orthognathic surgery, patient feedback, jaw surgery, inpatient experience

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Authors: Daisy Owomugasho Ndikuno

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The paper explores the extent to which mindset change has been critical in the community rural development in Uganda. It is descriptive research with The Parish Development Model as a case study. The results show that rural community development is possible and its success largely depends on harnessing local resources and knowledge; leveraging education, empowerment and awareness; creating sustainable livelihoods and encouraging entrepreneurship and innovation; access to financial resources; and building collaborative networks and partnerships. In all these, the role of mindset change is critical. By instilling a positive, collaborative and innovative mindset, rural communities can overcome challenges and chat a path towards sustainable development.

Keywords: community, development, mindset, change

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Authors: Happy Zulu

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Neuropsychological examination is an important way of formally assessing brain function. While there is so much documentation about the influence that some factors, such as age and education, have on neuropsychological tests (NP), not so much has been done to assess the influence that residency (rural/urban) may have. The specific objectives of this study were to establish if there is a significant difference in mean test scores on NP tests between rural and urban participants and to assess which tests on the Zambia Neurobehavioural Test Battery (ZNTB) are more affected by the participants‘ residency (rural/urban) and to determine the extent to which education, gender, and age predict test performance on NP tests for rural and urban participants. The participants (324) were drawn from both urban and rural areas of Zambia (Rural = 152 and Urban = 172). However, only 234 participants (Rural = 152 and Urban 82) were used for all the analyses in this particular study. The 234 participants were used as the actual proportion of the rural vs urban population in Zambia was 65% : 35%, respectively (CSO, 2003). The rural-urban ratio for the participants that were captured during the data collection process was 152 : 172, respectively. Thus, all the rural participants (152) were included and 90 of the 172 urban participants were randomly excluded so that the rural/urban ratio reached the desired 65% : 35 % which was the required ideal statistic for appropriate representation of the actual population in Zambia. Data on NP tests were analyzed from 234 participants, rural (N=152) reflecting 65% and urban (N=82) reflecting 35%. T-tests indicated that urban participants had superior performances in all the seven NP test domains, and all the mean differences in all these domains were found to be statistically significant. Residency had a large or moderate effect in five domains, while its effect size was small only in two of the domains. A standard multiple regression revealed that education, age and residency as predictor variables made a significant contribution to variance in performance on various domains of the ZNTB. However, the gender of participants was not a major factor in determining one‘s performance on neuropsychological tests. This particular report is part of an ongoing, larger, cutting-edge study aimed at formulating the normative data for Zambia with regard to performance on neuropsychological tests. This is necessary for appropriate, effective, and efficient assessment or diagnosis of various neurocognitive and neurobehavioural deficits that a number of people may currently be suffering from. It has been shown in this study that it is vital to make careful analyses of the variables that may be associated with one‘s performance on neuropsychological tests.

Keywords: neuropsychology, neurobehavioural, residency, Zambia

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Authors: Sangram A. Sathe, Neha A. Madgulkar, Shruti S. Raut, S. P. Wadkar

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Transforaminal lumbar interbody fusion (TLIF) surgeries have nowadays became popular for treatment of degenerated spinal disorders. The interbody fusion technique like TLIF maintains load bearing capacity of the spine and a suitable disc height. Currently many techniques have been introduced to cure Spondylolisthesis. This surgery provides greater rehabilitation of degenerative spines. While performing this TLIF surgery existing methods use guideway, which is a troublesome surgery technique as the use of two separate instruments is required to perform this surgery. This paper presents a concept which eliminates the use of guideway. This concept also eliminates problems that occur like reverting the cage. The concept discussed in this paper also gives high accuracy while performing surgery.

Keywords: TLIF, spondylolisthesis, spine, instruments

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Authors: Tolu Lawal

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The genuine development of the grassroots particularly in the developing societies depends largely on the participation of the rural populace in policy conception and implementation, especially in the area of development policies, fundamentally, the rural people play a vital and significance role in economic and political development of the nation. This is because the bulk of the economic produce as well as votes come from these areas. However, the much needed development has continued to elude the rural communities inspire of the various development policies carried out by successive governments in the state. The exclusion of rural communities from planning and implementation of facilities meant to benefit them, and the international debate on sustainable rural development led Ondo State government to re-think its rural development policy with a view to establishing more effective strategies for rural development. The 31s initiatives introduced in 2009 emphasizes the important role of communities in their own development. The paper therefore critically assessed the 31s initiative of the present government in Ondo State with a view to knowing its impact on rural people. The study adopted both primary and secondary data to source its information. Interviews were conducted with the key informants, and field survey (visit) was also part of method of collecting data. Documents, reports and records on 31s initiatives in the selected villages and from outside were also consulted. The paper submitted that 31s initiative has not impacted positively on the lives of rural dwellers in Ondo-State, most especially in the areas of infrastructure and integrated development. The findings also suggested that 31s initiatives is not hopeless, but needs a different kind of investment, for example introducing measures of accountability, addressing the politicization of the initiative and exploiting key principles of development and service delivery.

Keywords: development, infrastructure, rural development, participation

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Authors: Shalaka Sharad Dixit

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Rural Development in India is an important part of the rural economy & empowerment. Almost 70 percent of the Indian population lives in villages, hence rural development is important to become self-sustainable. Hence, the process to aiming the self-reliance of people living in rural areas. Maharashtra is one of the leading states in rural development. Hence, further study of the different villages in the five regions of Maharashtra i.e. Kokan, Pashchim, Marathwada, Khandesh, and Vidharbh. The study shows that major amenities lacking in the village. Annapur village case study has been done. The result has shown that the villagers face major problems like Unemployment, Load shedding, missing education facilities, unavailability of Bank and ATM, etc. They are facing lots of problems because scarce of required amenities. Therefore, the aim is to provide the amenities lacking in the Annapur village through a different government scheme. Government plans are devoted to development that includes the PMGSY, MGNREG, and GRAM UJALA. The study concluded that to provide and fulfill the amenities lacking in the Annapur village with the help of this government initiative.

Keywords: self sustainable rural development, government policies, Annapurna village, amenities, smart village

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Authors: Marwa H. Salah

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Modern consumption culture represents a widespread phenomenon that affects young people, as it affects all age groups in both urban and rural societies. It has been helped by globalization, specifically cultural globalization, also internal and external migration, and the immense development in information technology as well, these factors have led to the appearance of the conspicuous consumption pattern among young people. This research firstly interested in identifying the nature of this pattern of consumption among young people in the countryside, which represents a society with a special nature, was characterized by the pattern of traditional consumption. Secondly to find out whether the rural character has an impact on the conspicuous consumption of youth. Finally to identify the reasons for the rural youth's tendency to such type of consumption and if it contributes in satisfying certain social needs. The research used the anthropological method. Observation and open-ended interviews were used as tools to collect data and an interview guide was applied on a selective youth sample (40:20 male and 20 female) aged between 17to 34 in an Egyptian village located in Dakahlia governorate. The research showed that rural youth has impacted with the modern consumption culture and not isolated from it despite the lack of financial abilities. The conspicuous consumption is a dominant pattern of consumption among the Egyptian rural youth and it has been practicing by rural youth regardless of their educational & financial levels. Also, the wish to show the social and economic status, bragging and show off is the main reason for the rural youth to adopt the conspicuous consumption, moreover to face the inferior view from their counterparts’ urban youth.

Keywords: consumption culture, youth, conspicuous consumption, rural society

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Authors: Rosemarie Basile, Maria Loizos, John Pallarino, Karen Gibbs

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Given that complications can be significant following bariatric surgery and with rates of long-term success measured in excess weight loss varying as low as 33% after five years, an understanding of the psychological factors that may mitigate findings and increase success and result in better screening and supports prior to surgery are critical. An internally oriented locus of control (LOC) has been identified as a predictor for success in obesity therapy, but has not been investigated within the context of bariatric surgery. It is hypothesized that making behavioral changes prior to surgery which mirror those that are required post-surgery may ultimately predict long-term success. 122 subjects participated in a clinical interview and completed self-report measures including the Multidimensional Health Locus of Control Scale, Overeating Questionnaire (OQ), and Lifestyle Questionnaire (LQ). Pearson correlations were computed between locus of control orientation and likelihood to make behavior changes prior to surgery. Pearson correlations revealed a positive correlation between locus of control and likelihood to make behavior changes r = 0.23, p < .05. As hypothesized, there was a significant correlation between internal locus of control and likelihood to make behavior changes. Participants with a higher LOC believe that they are able to make decisions about their own health. Future research will focus on whether this positive correlation is a predictor for future bariatric surgery success.

Keywords: bariatric surgery, behavior modification, health locus of control, overeating questionnaire

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Authors: Afrah Saad Mohsen Al-Mahfadi

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In rural areas of developing countries, participation of all stakeholders in water supply projects is an important step towards further development. As most of the beneficiaries are women, it is important that they should be involved to achieve successful and sustainable water supply projects. Women are responsible for the management of water both inside and outside home, and often spend more than six-hours a day fetching drinking water from distant water sources. The problem is that rural women play a role of little importance in the water supply projects’ phases in rural Yemen. Therefore, this research aimed at analyzing the different reasons of their lack of participation in projects and in what way a full participation -if achieved- could contribute to sustainable water supply projects in the rural mountainous areas in Yemen. Four water supply projects were selected as a case study in Al-Della'a Alaala sub-district in the Al-Mahweet governorate, two of them were implemented by the Social Fund and Development (SFD), while others were implemented by the General Authority for Rural Water Supply Projects (GARWSSP). Furthermore, the successful Al-Galba project, which is located in Badan district in Ibb governorate, was selected for comparison. The rural women's active participation in water projects have potential consequences including continuity and maintenance improvement, equipment security, and improvement in the overall health and education status of these areas. The majority of respondents taking part in GARWSSP projects estimated that there is no reason to involve women in the project activities. In the comparison project - in which a woman worked as a supervisor and implemented the project – all respondents indicated that the participation of women is vital for sustainability. Therefore, the results of this research are intended to stimulate rural women's participation in the mountainous areas of Yemen.

Keywords: assessment, rural woman, sustainability, water management

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Authors: Ondiba Hesborn Andole, Kenichi Matsui

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Women entrepreneurs in the rural areas of Kenya have continually been affected by culturally engraved gendered bias customs. This research investigates challenges and prospects of rural women entrepreneurship in Kakamega County, Kenya. We conducted the questionnaire survey and interviews among 153 women entrepreneurs in the County to better understand how traditional norms influence them in conducting or seeking small businesses. We found that Luhya customs significantly affect growth and performance of rural women enterprises. Traditional Luhya society does not recognize women’s rights to land and higher education. The Luhya traditional roles of women are limited so that, without competing with men, they need to find gender biased works through networking activities. Also, without higher education degrees, their business prospects are limited. Among the respondents, 31% had primary education and about 5% had no formal education at all. We discuss how these women may succeed in businesses under these conditions.

Keywords: chama, culture, entrepreneurs, rural women

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Authors: Emad Matar Alotaibi

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In line with other Arabic countries, Saudi Arabia is currently undergoing large scale school reform in response to key factors brought about by globalization. While there is a growing body of research exploring these systemic changes in urban environments, there is very little published research regarding rural schools. In fact, rural schools are still under-examined globally comparing to their urban and suburban counterparts over a range of reform dimensions. In Saudi Arabia, there are around 1128 rural areas that contain about 3200 schools. Several challenges face rural schools, especially in relation to recruitment, retention, and professional development opportunities for teachers and school leaders. However, there is very little in depth research which explores these issues “on the ground”. The aim of this research is fill this knowledge gap and explore teachers’ and leaders’ perceptions and experiences of working in rural schools in KSA. In Saudi Arabia, there is a growing body of research into school leadership. However, there is very little published research specifically exploring rural schools. By using an in-depth case study approach and adopting an analytical framework based on the interlinking concepts of leadership practices, culture, and CPD, this study offers and significant and original contribution to knowledge in this area. This study also will adopt a qualitative multiple case studies, which is going to employ semi-structured interviews, focus groups, and documentary analysis.

Keywords: leadership practice, school culture, continuing professional development, rural school

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Authors: Lauren Zammerilla Westcott, Ronald C. Jones, James W. Fleshman

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The surgical treatment of breast cancer has rapidly evolved over the past 50 years, progressing from Halsted’s radical mastectomy to a public campaign of surgical options, aesthetic reconstruction, and patient empowerment. This article examines the happenings that led to the transition of breast surgery as a subset of general surgery to its own specialized field. Sparked by the research of Dr. Bernard Fisher and the first National Surgical Adjuvant Breast and Bowel Project trial in 1971, the field of breast surgery underwent significant growth over the next several decades, enabling general surgeons to limit their practices to the breast. High surgical volumes eventually led to the development of the first formal breast surgical oncology fellowship in a large community-based hospital at Baylor University Medical Center in 1982. The establishment of the American Society of Breast Surgeons, as well several landmark clinical trials and public campaign efforts, further contributed to the advancement of breast surgery, making it the specialized field of the current era.

Keywords: breast cancer, breast fellowship, breast surgery, surgical history

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Authors: Yifan Dong, Xincheng Pu

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Rural settlements originate from the accumulation of residential building elements, and their agglomeration forms the settlement pattern and defines the relationship between the settlement and the inside and outside. The settlement boundary is an important part of the settlement pattern. Compared with the simplification of the urban settlement boundary, the settlement of the country is more complex, fuzzy and uncertain, and then presents a rich and diverse boundary morphological phenomenon. In this paper, China traditional rural settlements plane boundary as the research object, using fractal theory and fractal dimension method, quantitative analysis of planar shape boundary settlement, and expounds the research for the architectural design, ancient architecture protection and renewal and development and the significance of the protection of settlements.

Keywords: rural settlement, border, fractal, quantification

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Authors: Rahmi Yetri Kasri, Paulus Wirutomo

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Citizen engagement approach has become increasingly important in the rural water sector. However, the question remains as to what exactly is meant by citizen engagement and how this approach can lead to sustainable service delivery. To understand citizen engagement, this paper argues that we need to understand basic elements of social life that consist of social structure, process, and culture within the realm of community’s living environment. Extracting from empirical data from Pamsimas villages in rural West Java, Indonesia, this paper will identify basic elements of social life and environment that influence and form the engagement of citizen and government in delivering and sustaining rural water supply services in Indonesia. Pamsimas or the Water Supply and Sanitation for Low Income Communities project is the biggest rural water program in Indonesia, implemented since 1993 in more than 27,000 villages. The sustainability of this sector is explored through a rural water supply service delivery life-cycle, starts with capital investment, operational and maintenance, asset expansion or renewal, strategic planning for future services and matching cost with financing. Using mixed-method data collection in case study research, this paper argues that increased citizen engagement contributes to a more sustainable rural water service delivery.

Keywords: citizen engagement, rural water supply, sustainability, Indonesia

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Authors: Xiaoxin Zhao

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Because of the long-time dual structure development in urban and rural areas, the rapid urbanization in China devours the rural resources and causes the unbalanced development of cities and the countryside. On one side, the urban sprawl is swallowing the villages in the peripheral area of cities and forms the ‘urban village’. On the other side, people from traditional and vernacular villages immigrate to the metropolis that their homeland becomes the ‘hollowed village’. In 2005, the national state council noticed the significance of rural development and promoted the ‘beautiful countryside’ project when Minsu was rising. In the 19th National Congress of the Communist Party of China (2017), president Xi Jinping announces the importance of ‘rural revitalization’ and states that the relationship between urban and rural areas should be an integrated development model. However, most Minsu projects in China was invested and managed by individual or group investors and focused on the profits but not the vernacular culture and rural development, and enhanced the urban-rural distinction. This paper introduces two Minsu projects in China designed by star-architects and advertised by social network media as case studies through photos and public comments collections. Architects as the servant to the investors, designed fancy houses, brings the urban life mode but expelled the real vernacular lifestyle as a cultural experience in rural areas. Moreover, to advertise the Minsu hotel, the social media propagates a distorted value that ‘luxury is good taste’ and motivates the vanity of people. Lastly, to maximize the profits, the investors set a high price that caused another unbalanced development in rural area since the price for one night in the Minsu hotel may exceed the monthly income of a local inhabitant. With these material, the author discusses the problems in Chinese Minsu industry and argues that the media, architects and investors play the negative role in the separation between Minsu cultural tourism and rural population. As a result, the author points out the significance of rural population participation that sharing the profits with them if we take Minsu industry as a method for rural revitalization in China.

Keywords: Minsu, vernacular, rural development, rural population participation

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Authors: Ahuja Ashish, Nain Prabhdeep Singh

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Introduction: Polycystic ovarian syndrome(PCOS) is the most common endocrine disorder among women of reproductive age.Pcos encompasses a broad spectrum of signs&symptoms of ovary dysfunction,obesity,blood pressure,insulin resistance & infertility. Bariatric Surgery can be an effective means of weight loss in Pcos & curing infertility. Materials and Methods: 15 female patients were enrolled in the study from 2012-2014.66%(n=10) were in age group of 20-25 years,33%(n=5) were in age group of 25-33 years who underwent. Bariatric surgery in form of Laproscopic sleeve Gastrectomy(LSG)& Roux-en-Y gastric bypass. LSG 73%(n=11), RYGB26% (n=4). Results: There was a significant improvement in obesity (60% excess weight loss)over 1 year after bariatric surgery, in 12 patients there was gross improvement in restoration of menstrual cycle who had irregular menstrual cycle. In 80% patients the serum insulin level showed normal value. Over two years 8 patients become pregnant. Conclusions: 1)Obese women with Pcos maybe able to conceive after Bariatric Surgery. 2) Women with Pcos should only consider bariatric surgery if they were already considering it for other reasons to treat obesity, blood pressure & other co-morbid conditions.

Keywords: obesity, bariatric surgery, polycystic ovarian syndrome, infertility

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Authors: Muhammad Kamran Hanif Khan, Fahad Mushtaq

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Background: In both developed and underdeveloped countries, coronary artery disease (CAD) is a serious cause of death and disability. Cardiovascular disease (CVD) is becoming more prevalent in emerging countries like Pakistan due to the spread and acceptance of Western lifestyles. Material and Methods: An observational cross-sectional investigation was conducted, and data collection relied on a random cluster sampling method. The sample size for this cross-sectional study was calculated using the following factors: estimated true proportion of 17.5%, desired precision of 2%, and confidence interval of 95%. The data for this study was collected from a sample of 1387 adults. Results: The average age of those living in rural areas is 55.24 years, compared to 52.60 years for those living in urban areas. The mean fasting blood glucose of the urban participants is 105.28 mg/dL, which is higher than the mean fasting blood glucose of the rural participants, which is 102.06 mg/dL. The mean total cholesterol of the urban participants is 192.20 mg/dL, which is slightly higher than the mean total cholesterol of the rural participants, which is 191.97 mg/dL. CAD prevalence is greater in urban areas than in rural areas. ECG abnormalities prevalence is 16.1% in females compared to 12.5% in men. Conclusion: The prevalence of CAD is more common in urban areas than in rural ones for all of the measures of CAD used in the study.

Keywords: CVD prevalence, CVD risk factors, rural area, urban area

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Authors: Yakubu Abdulai, Kenichi Matsui

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The agricultural industry has faced a variety of challenges in meeting the expanding income demand of the rural population. As a result, rural households must diversify their income sources to meet their income demand. Although income diversification strategies help rural households, it contributes to total household income, and the socio-demographic determinants are not known in the Upper East Region of Ghana. For these reasons, the purpose of this study was to determine the contribution of income diversification strategies to household income and the socio-demographic factors influencing it. We conducted a questionnaire survey among 360 rural households in the Upper East Region of Ghana. We asked about their socio-demographic information, their choice of income diversification strategies, and their remittances through rural-city migration. The questionnaire survey findings demonstrate that the main livelihood income source contributes 22%, and on-farm income diversification contributes the most to household total income (47%), followed by non-farm diversification income (16%) and off-farm diversification income (15%). Calculations from the income diversity index showed that the average income diversification strategy was 0.5 out of 1. The calculation of the income dependence index also showed that the average dependent on a particular source of income was 0.2 out of 1. All the respondents said household members temporarily migrate to contribute to household income through remittances. The results further reveal that their choice of income diversification is influenced by their age, educational background, experience, and farm size. The paper recommends the promotion of rural development policies that increase income-generating activities and educate rural households on how to increase returns from their investment.

Keywords: income diversification, poverty alleviation, rural households, upper east region

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Authors: Amirmohsen Behjat, Aleck Ostry, Christina Miewald, Bernie Pauly

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Farmers’ Markets have become one of the important healthy food suppliers in both rural communities and urban settings. Farmers’ markets are evolving and their number has rapidly increased in the past decade. Despite this drastic increase, the distribution of the farmers’ markets is not even across different areas. The main goal of this study is to explore the socioeconomic, geographic, and demographic variables which affect the establishment of farmers’ market in rural communities in British Columbia (BC). Thus, the data on available farmers’ markets in rural areas were collected from BC Association of Farmers’ Markets and spatially joined to BC map at Dissemination Area (DA) level using ArcGIS software to link the farmers’ market to the respective communities that they serve. Then, in order to investigate this issue and understand which rural communities farmer’ markets tend to operate, a binary logistic regression analysis was performed with the availability of farmer’ markets at DA-level as dependent variable and Deprivation Index (DI), Metro Influence Zone (MIZ) and population as independent variables. The results indicated that DI and MIZ variables are not statistically significant whereas the population is the only which had a significant contribution in predicting the availability of farmers’ markets in rural BC. Moreover, this study found that farmers’ markets usually do not operate in rural food deserts where other healthy food providers such as supermarkets and grocery stores are non-existent. In conclusion, the presence of farmers markets is not associated with socioeconomic and geographic characteristics of rural communities in BC, but farmers’ markets tend to operate in more populated rural communities in BC.

Keywords: farmers’ markets, socioeconomic and demographic variables, metro influence zone, logistic regression, ArcGIS

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Authors: Cecilia Kunseh Betek

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Managing rural water supply systems effectively and efficiently is a challenge in the O R Tambo District Municipality due to the long distances between consumers and municipal centres. This is a couple with the low income of most residents and the government's policy of free basic water which is making rural water provision very difficult. With regard to cartage, the results reveal that the majority (84.4%) of the population covers distances of about 1kilometre to fetch water, and 15.6% travel up kilometer to access water facilities. This means that the water sources are located very far from households, outside the officially legislated array of 200metres. These are many reasons to account for this situation. Firstly, this implies that there are inadequate stand pipes to cater for all the homesteads scattered across the rugged terrain of OR Tambo District municipality. Secondly, and following from the first explanation, it would be seen that funding that is made available is not adequate, or is not efficiently spent on the targeted projects. The situation in the rural areas of South Africa is fraught with cumbersome complexity when it comes to service delivery.

Keywords: water, management, government, rural

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Authors: Ramesh K. Adsul, V. R. Shinde, S. S. Jadhav

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The main aim of the present study was to explore the effect of various levels of parental acceptance – avoidance attitude on various areas of adjustment of urban and rural junior college students. It was hypothesized that 1. There exists no significant effect of various levels of parental acceptance attitude on adjustment of urban and rural junior college students. 2. There exists no significant effect of various levels of parental avoidance attitude on adjustment of urban and rural junior college students. 3. There would be no significant difference between urban and rural Junior College students on various areas of (home, health, social, and emotional) adjustment. The 847 students (427 boys and 420 girls) studying in 11th class of various Junior colleges in Sangli ,Satara and Kolhapur districts of Maharashtra State, India were selected by random sampling method. Study was conducted by using two psychological tests namely 1. Family Relationship Inventory. 2.Bell’s Adjustment Inventory. One way ANOVA was employed to find out the effect of parental acceptance – avoidance attitude and adjustment in various areas of urban and rural junior college students. ‘t’ test was used to find out the difference between urban and rural students on various areas of adjustment. The results of the study indicate that (1) It is observed that three groups of parental acceptance attitude (PA) are significantly varied on home and social adjustment. It means that PA affects home and social adjustment of adolescents. High PA creates excellent adjustment and low PA creates poor adjustment in adolescents. (2) Study revealed that PV significantly affects adjustment of adolescents. High PV significantly creates poor adjustment in adolescents than average and low PV. (3) There is significant difference between urban and rural adolescents on adjustment. Urban adolescents have better adjustment than rural adolescents.

Keywords: parental acceptance, avoidance attitude, adjustment, urban-rural student

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Authors: S. P. Koko, K. Kusakana, H. J. Vermaak

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Standalone micro-hydrokinetic river (MHR) system is one of the promising technologies to be used for remote rural electrification. It simply requires the flow of water instead of elevation or head, leading to expensive civil works. This paper demonstrates an economic benefit offered by a standalone MHR system when compared to the commonly used standalone systems such as solar, wind and diesel generator (DG) at the selected study site in Kwazulu Natal. Wind speed and solar radiation data of the selected rural site have been taken from national aeronautics and space administration (NASA) surface meteorology database. The hybrid optimization model for electric renewable (HOMER) software was used to determine the most feasible solution when using MHR, solar, wind or DG system to supply 5 rural houses. MHR system proved to be the best cost-effective option to consider at the study site due to its low cost of energy (COE) and low net present cost (NPC).

Keywords: economic analysis, micro-hydrokinetic, rural-electrification, cost of energy (COE), net present cost (NPC)

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Authors: Festus Adedoyin, Nana Mbeah Otoo, Sofia Meacham

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Hypertension is one of the main health issues in Ghana, where prevalence is higher in rural than in urban areas. This is due to the challenges rural areas have in accessing technology and healthcare services for hypertension control. This study's goal is to create a digital healthcare solution to alleviate this inequality. Through an analysis of current technology and problems, using the ring onion methodology, the study determined the needs for the intervention and evaluated healthcare disparities. An online application with teleconsultation capabilities, reminder mechanisms, and clinical decision support is part of the suggested solution. In outlying areas, mobile clinics in containers with the required equipment will be established. Heuristic evaluation and think-aloud sessions were used to assess the prototype's usability and navigational problems. This study highlights the need to develop digital health interventions to help manage hypertension in rural locations and decrease healthcare disparities. To develop and improve digital healthcare solutions for rural areas worldwide and in Ghana, this study might be used as a tool for future research.

Keywords: digital health, health inequalities, hypertension management, rural areas

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Authors: Azadeh Mottaghi, Reyhaneh Yousefi, Saeed Safari

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Background: Bariatric surgery is widely proposed as the most effective approach to mitigate the growing pace of morbid obesity. As bariatric surgery candidates suffer from pre-existing nutritional deficiencies, it is of great importance to assess nutritional status of candidates before surgery in order to establish appropriate nutritional interventions. Objectives: The present study assessed and represented baseline data according to the nutritional status among candidates for bariatric surgery. Methods: A cross-sectional analysis of pre-surgery data was collected on 170 morbidly obese patients undergoing bariatric surgery between October 2017 and February 2018. Dietary intake data (evaluated through 147-item food frequency questionnaire), anthropometric measures and biochemical parameters were assessed. Results: Participants included 145 females (25 males) with average age of 37.3 ± 10.2 years, BMI of 45.7 ± 6.4 kg/m² and reported to have a total of 72.3 ± 22.2 kg excess body weight. The most common nutritional deficiencies referred to iron, ferritin, transferrin, albumin, vitamin B12, and vitamin D, the prevalence of which in the study population were as followed; 6.5, 6.5, 3, 2, 17.6 and 66%, respectively. Mean energy, protein, fat, and carbohydrate intake were 3887.3 ± 1748.32 kcal/day, 121.6 ± 57.1, 144.1 ± 83.05, and 552.4 ± 240.5 gr/day, respectively. The study population consumed lower levels of iron, calcium, folic acid, and vitamin B12 compared to the Dietary Reference Intake (DRI) recommendations (2, 26, 2.5, and 13%, respectively). Conclusion: According to the poor dietary quality of bariatric surgery candidates, leading to nutritional deficiencies pre-operatively, close monitoring and tailored supplementation pre- and post-bariatric surgery are required.

Keywords: bariatric surgery, food frequency questionnaire, obesity, nutritional status

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Authors: S. O. Odebode, O. E. Adelakun

Abstract:

The study assessed the perception of rural dwellers on the nutritional and social values of mushroom in Oyo state, Nigeria. One hundred and forty respondents were sampled and interviewed. Results showed that majority (84.9%) had below secondary education and 81.4 % were married, with fairly large (71.4%) household size (5–8). Also, 52.1% had favourable perception toward the nutritional values and 57.1% toward the social values of mushrooms in the study area. There was significant relationship between sex (X² = 4.673), educational level (X² = 11.969) and perception on the values of mushroom. The knowledge level of respondents on mushroom utilization and production is low in the study area. Farmers’ research field should be established to educate rural dwellers on mushroom farm practices and utilization.

Keywords: mushroom, nutritional value, rural dwellers, social value

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Authors: Gunjan Saxena

Abstract:

This paper presents case insights from India and Mexico to illustrate how tourism can work as a tool for bringing about peace and prosperity in disadvantaged communities living in peripheral rural localities. A reordering of rural space, given the slow but definite shift from production-oriented activities towards more complex and contested blends of production, consumption and protection indicates clearly that rurality is in flux. Whilst on one hand, there is a predominance of urban interests in the countryside, on the other rurality is boxed and presented for consumption in urban localities. Qualitative data, collected using semi-structured interviews and participant observation, is used in illustrating how creative enterprise is bringing about innovative use of rural ethos and space in response to consumer demands. Overall, this work seeks to contribute to debates on how rurality no longer represents a fixed space of tradition, but is packaged and promoted in a multi-faceted manner to creatively perform for and access tourism markets.

Keywords: rural tourism, creative enterprise, India, Mexico

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Authors: Giuliana Murfet, Heidi Behrens

Abstract:

Chronic disease is Australia’s biggest health concern and obesity the leading risk factor for many. Obesity and chronic disease have a higher representation in rural Tasmania, where levels of socio-disadvantage are also higher. People living outside major cities have less access to health services and poorer health outcomes. To help primary healthcare professionals manage obesity, the Australian NHMRC evidence-based clinical practice guidelines for management of overweight and obesity in adults were developed. They include recommendations for practice and models for obesity management. To our knowledge there has been no research conducted that investigates translation of these guidelines into practice in rural-regional areas; where implementation can be complicated by limited financial and staffing resources. Also, the systematic review that informed the guidelines revealed a lack of evidence for chronic disease models of obesity care. The aim was to establish and evaluate a multidisciplinary model for obesity management in a group of adult people with type 2 diabetes in a dispersed rural population in Australia. Extensive stakeholder engagement was undertaken to both garner support for an obesity clinic and develop a sustainable model of care. A comprehensive nurse practitioner-led outpatient model for obesity care was designed. Multidisciplinary obesity clinics for adults with type 2 diabetes including a dietitian, psychologist, physiotherapist and nurse practitioner were set up in the north-west of Tasmania at two geographically-rural towns. Implementation was underpinned by the NHMRC guidelines and recommendations focused on: assessment approaches; promotion of health benefits of weight loss; identification of relevant programs for individualising care; medication and bariatric surgery options for obesity management; and, the importance of long-term weight management. A clinical pathway for adult weight management is delivered by the multidisciplinary team with recognition of the impact of and adjustments needed for other comorbidities. The model allowed for intensification of intervention such as bariatric surgery according to recommendations, patient desires and suitability. A randomised controlled trial is ongoing, with the aim to evaluate standard care (diabetes-focused management) compared with an obesity-related approach with additional dietetic, physiotherapy, psychology and lifestyle advice. Key barriers and enablers to guideline implementation were identified that fall under the following themes: 1) health care delivery changes and the project framework development; 2) capacity and team-building; 3) stakeholder engagement; and, 4) the research project and partnerships. Engagement of not only local hospital but also state-wide health executives and surgical services committee were paramount to the success of the project. Staff training and collective development of the framework allowed for shared understanding. Staff capacity was increased with most taking on other activities (e.g., surgery coordination). Barriers were often related to differences of opinions in focus of the project; a desire to remain evidenced based (e.g., exercise prescription) without adjusting the model to allow for consideration of comorbidities. While barriers did exist and challenges overcome; the development of critical partnerships did enable the capacity for a potential model of obesity care for rural regional areas. Importantly, the findings contribute to the evidence base for models of diabetes and obesity care that coordinate limited resources.

Keywords: diabetes, interdisciplinary, model of care, obesity, rural regional

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Authors: Neha Bhushan

Abstract:

For the purpose of this study a village of district Azamgarh has been selected which is a part of the most populous and backward state of the country, Uttar Pradesh. In the age of information, everyone has the right to acquire information and it becomes important to assess the acceptance and non-acceptance of social media among rural population. Rural women of the state are showing positive trends in the form of increased social media and mobile usage. This study is an effort to know the purpose of rural women for using social media. The study design is exploratory and qualitative in nature. Data collection primarily consisted of 25 semi-structured individual interviews having 10 open-ended specific questions in one of the villages of Azamgarh district of Eastern Uttar Pradesh. Sampling approach is flexible and situational. Data reveals that rural women have become active on social media since last six months to one year. Most of them are using Facebook, Whatsapp, and YouTube for the purpose of interaction, learning new skills, checking out recipes and latest fashion. This pilot study gives a bird eye view of the problem and opens door for exploring this least explored area.

Keywords: exploratory research, mobile usage, rural women, social media

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Authors: Sharon Baoas, Toni Beninato, Michael Zenilman, Gokhan Ozuner

Abstract:

Background An enhanced recovery after surgery (ERAS) protocol was implemented to improve quality and cost effectiveness of surgical care in elective colorectal procedures. Results A total of 109 patients, 55 (pre-ERAS) and 54 (post-ERAS) are included in the final analysis. There were no differences in complications were recorded (p = 0.37) and 30-day readmissions (p = 0.785). The mean hospital stay was 5.89 ± 2.62 days in pre-ERAS and 4.94 ± 2.27 days in post-ERAS group which was statistically significant (p = 0.047). Conclusions An ERAS protocol for colorectal surgery harmonised perioperative care and decreased length of stay.

Keywords: 30-day readmission, lenght of stay, Enhanced Recovery after surgery, Surgical site infection

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