Search results for: rural surgery

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: Bouhouf Atef, Beloulou Mohamed Lamine

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Introduction: Outpatient surgery is continually developing compared to conventional inpatient surgery; its rate is constantly increasing every year due to global socio-economic pressure. Most hospitals continue to perform proctologic surgery in conventional hospitalization. Purpose: As part of a monocentric prospective descriptive study, we examined the feasibility of proctologic surgery under saddle block on an outpatient basis with the same safety conditions as in traditional hospitalization. Material and methods: This is a monocentric prospective descriptive study spread over a period of 24 months, from December 2018 to December 2020 including 150 patients meeting the medico-surgical and socio-environmental criteria of eligibility for outpatient surgery, operated for proctological pathologies under saddle block in outpatient mode, in the surgery department of the regional military hospital of Constantine Algeria. The data were collected and analyzed by the biomedical statistics software Epi-info and Microsoft Excel, then compared with other related studies. Results: This study involved over a period of two years, 150 male patients with an average age of 32 years (20-64). Most patients (95,33%) were ASA I class, and 4,67% ASA II class. All patients received saddle blocks. The average length of stay of patients was six hours. The quality indicators in outpatient surgery in our study were: zero (0)% of deprogrammings, three (3)% of conversions to full hospitalization, 0,7% of readmissions, an average waiting time before access to the operating room of 83 minutes without delay of discharge, a satisfaction rate of 90,8% and a reduction in the cost compared to conventional inpatient surgery in proportions ranging from – 32,6% and – 48,75%. Conclusions: The outpatient management of proctological surgery under saddle block is very beneficial in terms of safety, efficiency, simplicity, and economy. Our results are in line with those of the literature and our work deserves to be continued to include many patients.

Keywords: outpatient surgery, proctological surgery, saddle block, satisfaction, cost

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

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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

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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: Neha Bhushan

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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: Vishal Bhatnagar

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The objective of this study is to compare the efficacy of epidural analgesia of two amide local anesthetics, ropivacaine and levobupivacaine, with fentanyl for postoperative analgesia in major abdominal surgery CRS+HIPEC. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) are done for primary peritoneal malignancies or peritoneal spread of malignant neoplasm. CRS and HIPEC are considered one of the most painful surgery among all major abdominal surgeries. Poorly managed postoperative pain elevates stress, increases anxiety, causes prolonged Hospital stay, increases opioid requirement and side effects, increases the cost of treatment and psychological effects on patient and family. It affects the quality of life of patients. The epidural technique provides better postoperative analgesia, earlier recovery of bowel function, fewer side effects, higher patient satisfaction, and an improvement in life quality in the postoperative days after abdominal surgery than other analgesic techniques.

Keywords: HIPEC, postoperative analgesia, cytoreductive surgery, VAS score, rescue analgesia

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Authors: Henriette van Rensburg, Betty Adcock

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Concern about the lack of knowledge of quality teaching and teacher retention in rural and remote areas of Australia, has caused academics to improve pre-service teachers’ understanding of this problem. The participants in this study were forty students enrolled in an undergraduate educational course (EDO3341 Teaching in rural and remote communities) at the University of Southern Queensland in Toowoomba in 2012. This study involved an innovative case-based teaching approach in order to broaden their generally under-informed understanding of teaching in a rural and remote area. Three themes have been identified through analysing students’ critical reflections: learning expertise, case-based learning support and authentic learning. The outcomes identified the changes in pre-service teachers’ understanding after they have deepened their knowledge of the realities of teaching in rural and remote areas.

Keywords: rural and remote education, case based teaching, innovative education approach, higher education

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Authors: Sukhee Park, Gaab Soo Kim

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Purpose: We aimed to evaluate the adequacy of second-generation laryngeal mask airway use during prolonged abdominal surgery in respect of ventilation, oxygenation, postoperative pulmonary complications (PPC), and postoperative non-pulmonary complications on living donor kidney transplant (LDKT) surgery. Methods: In total, 257 recipients who underwent LDKT using either laryngeal mask airway-ProSeal (LMA-P) or endotracheal tube (ETT) were retrospectively analyzed. Arterial partial pressure of carbon dioxide (PaCO2 and ratio of arterial partial pressure of oxygen to fractional inspired oxygen (PFR) during surgery were compared between two groups. In addition, PPC including pulmonary aspiration and postoperative non-pulmonary complications including nausea, vomiting, hoarseness, vocal cord palsy, delirium, and atrial fibrillation were also compared. Results: PaCO2 and PFR during surgery were not significantly different between the two groups. PPC was also not significantly different between the two groups. Interestingly, the incidence of delirium was significantly lower in the LMA-P group than the ETT group (3.0% vs. 10.3%, P = 0.029). Conclusions: During prolonged abdominal surgery such as LDKT, second-generation laryngeal mask airway offers adequate ventilation and oxygenation and can be considered a suitable alternative to ETT.

Keywords: laryngeal mask airway, prolonged abdominal surgery, kidney transplantation, postoperative pulmonary complication

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Authors: Jahanzaib

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The rural economy can be uplifted through agricultural extension education for female as the majority is uneducated. The present study was carried out in five districts (Bahawalpur, Lodhran, Raheem Yar Khan, Bahawalnagr, and Vehari) of southern Punjab, Pakistan. The ten females were selected from each district, poor economic background for agricultural training. The training was provided free of cost, through Punjab skills development program. After six month training, the trainees were awarded with certificates and a tool kit. After completion of training data was recorded and analyzed, the results indicate that, female trainees were in a better economic position than the females of nearby districts without training. From this study, we can conclude that agricultural education for female can not only improve the economy of the individual family but also improve the agriculture of Pakistan on the sustainable basis as the majority of workers are female in rural areas of Pakistan.

Keywords: agricultural extension education, sustainable rural development, agriculture, rural development in Pakistan

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Authors: Prachi Abhishek Dave, Manisha Singh

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Purpose: The purpose is to study the microbiological profile, prognostic factors, and outcomes of surgery for microbial keratitis (MK) associated endophthalmitis. Methods: It is a retrospective analysis of 39 MK associated endophthalmitis cases which underwent combined PKP with VR surgery. Results: The majority (84.6%) of patients had a history of previous ocular surgery, cataract surgery being the most common (51.2%). Six patients had a history of trauma and 8 patients had corneal graft infection. The culture positivity rate was 92.3%. Organisms isolated were Streptococcal sp (20.5%), Pseudomonas (15.3%), Staphylococcal sp (12.8%) and Fungus (35.8%). Final visual acuities ranged from NPL to 20/120. Poor anatomic success was seen in 15(38.46%) eyes (9-phthisis, 6-eviscerated). Fungal cases had a poor success rate (P-0.02). Conclusion: MK associated endophthalmitis is a sight threatening ocular condition. Fungal etiology carries a poorer prognosis. Timely surgical intervention can achieve favourable anatomical and functional results.

Keywords: endophthalmitis, microbial keratitis, penetrating keratoplasty, vitreo retinal surgery

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Authors: Innocent Pangapanga-Phiri, Eric Dada Mungatana

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This study estimates the effect of climate-induced rural-urban migrants (RUM) on maize productivity. It uses panel data gathered by the National Statistics Office and the World Bank to understand the effect of RUM on the technical efficiency of maize production in rural Malawi. The study runs the two-stage Tobit regression to isolate the real effect of rural-urban migration on the technical efficiency of maize production. The results show that RUM significantly reduces the technical efficiency of maize production. However, the interaction of RUM and climate-smart agriculture has a positive and significant influence on the technical efficiency of maize production, suggesting the need for re-investing migrants’ remittances in agricultural activities.

Keywords: climate-smart agriculture, farm productivity, rural-urban migration, panel stochastic frontier models, two-stage Tobit regression

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Authors: Jake Hindmarch, Edward Farley, Norman Eizenberg, Mark Midwinter

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There is a need to bring the anatomical knowledge of medical students up to the standards required by surgical specialties. Contention exists amongst anatomists, clinicians, and surgeons about the standard of anatomical knowledge medical students need. The aim of this study was to explore the standards which the Royal Australasian College of Surgeons are applying knowledge of anatomy. Furthermore, to align medical school teaching to what the surgical profession requires from graduates.: The 2018 volume of the ANZ Journal of Surgery was narrowed down to 254 articles by applying the search term “Anatomy”. The main topic was then extracted from each paper. The content of the paper was assessed for ‘novel description’ or ‘application’ of anatomical knowledge’ and classified accordingly. The majority of papers with an anatomical focus was from the general surgery specialty, which focused on surgical techniques, outcomes and management. Vascular surgery had the highest percentage of papers with a novel description and application of anatomy. Cardiothoracic and paediatric surgery had no papers with a novel description of anatomy. Finally, a novel application of anatomy was the main focus of each speciality. Firstly, a high proportion of novel applications and descriptions of anatomy are in general surgery. Secondly, vascular surgery had the largest proportion of novel application and description of anatomy, namely due to the rise of therapeutic imaging and endovascular techniques. Finally, all disciplines demonstrated a trend towards having a higher proportion of novel application of anatomical knowledge

Keywords: anatomical knowledge, anatomy, surgery, novel anatomy

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Authors: Vedat Acar, Osman Eralp Çolakoğlu

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In this research, with reference to specialization of travel agencies being an important part of tourism industry, a project has been presented about a small-scale enterprise, called as Zeytinseli, contributing actively from the beginning to the end of the production process of olive and olive oil within the context of rural tourism. For this purpose in the research done, firstly, conceptual framework has been formed about travel agency, tour operatorship, specialized travel agency and rural tourism and the necessity of specialization on tourism has been emphasized in today's world. Afterwards, "olive", having an important role in both mythology and divine religions, has been handled within the scope of rural tourism. The cost of accommodation units about Zeytinseli operating in Didim, being a district of Aydın, has been calculated within the context of the project and a fifteen-day's tour to this enterprise has been presented at the end of this project. The research may be said to be an original research on account of embodying not only ecotourism, agro tourism but also cultural tourism and special interest tourism.

Keywords: agro tourism, rural tourism, specialization of travel agency, special interest tourism

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Authors: Martin Dupuy, Solange Grunenwald, Pierre-Louis Colombo, Laurence Mahieu, Pomone Richard, Philippe Bartoli

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Endonasal endoscopic trans-sphenoidal surgery for pituitary tumours has become a mainstay of treatment over the last two decades. Although it is generally accepted that there is no significant difference between endoscopic versus microscopic approach for surgical outcomes (endocrine and ophthalmologic status), nasal morbidity seems to the benefit of endoscopic procedures. Minimally invasive endoscopic surgery needs an operative learning curve to achieve surgeon’s efficiency. This learning curve is now well known for surgical outcomes and complications rate, however, few data are available for nasal morbidity. The aim of our series is to document operative experience and nasal quality of life after (NQOL) endoscopic trans-sphenoidal surgery. The prospective pituitary surgical cohort consisted of 525 consecutives patients referred to our Skull Base Diseases Department. Endoscopic procedures were performed by a single neurosurgeon using an uninostril approach. NQOL was evaluated using the Sino-Nasal Test (SNOT-22), the Anterior Base Nasal Inventory (ASBNI) and the Skull Base Inventory Score (SBIS). Data were collected before surgery during hospital stay and 3 months after the surgery. The seventy first patients were compared to the latest 70 patients. There was no significant difference between comparison score before versus after surgery for SNOT-22, ASBNI and SBIS during the single surgeon’s learning curve. Our series demonstrates that in our institution there is no statistically significant learning curve for NQOL after uninostril endoscopic pituitary surgery. A careful progression through sinonasal structures with very limited mucosal incision is associated with minimal morbidity and preserves nasal function. Conservative and minimal invasive approach could be achieved early during learning curve.

Keywords: pituitary surgery, quality of life, minimal invasive surgery, learning curve, pituitary tumours, skull base surgery, endoscopic surgery

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Authors: Miguel A. Borrella, Ana P. Fanjul, Suca Munoz, Liliana Herrera

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This paper evaluates the impact of LEADER, a remarkable Community-Led Local Development (CLLD) approach of the European Program for Rural Development applied to rural municipalities of Spain in 2018 and 2019. Using a difference-in-difference estimation strategy and a newly-constructed database, results show that aided municipalities have significantly lower unemployment levels than non-aided municipalities. Results are significant for the decrease in unemployment for both women and people younger than 25 years old, two of the target groups of the policy. Nevertheless, they are larger for male and older workers. Therefore, findings suggest that LEADER 2017-2018 was successful in reducing unemployment in rural areas.

Keywords: community-led local development, ex-post evaluation, LEADER, rural development

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Authors: Abhishek Dave, Manisha Singh

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Purpose: The study aims to evaluate the outcomes of combined Penetrating keratoplasty (PKP) and Vitreo-Retinal (VR) surgery in patients having endophthalmitis with poor corneal clarity. Methods: PKP with VR Surgery was performed in 43 eyes. This is a retrospective analysis of their preoperative, intraoperative and microbiological characteristics and anatomical and functional outcomes. Results: Corneal opacification was due to corneal ulcer in 30 (69.7%), graft infection in 8 (18.6%), bullous keratopathy in 4 and corneal scar in 1 eye. Postoperative visual acuity improved in 20 (46.5%), not changed in 14 (32.5%) and deteriorated in 9 eyes (20.9%). Poor anatomic success was seen in 15 (34.88%) eyes (9-phthisis bulbi, 6-eviscerated). Graft remained clear in 24 eyes (1 year). Microbiology revealed bacteria in 26, fungus in 14 and no growth in 3 eyes. Six out of 11 patients having poor vision in the fellow eye, too, achieved functional success. Conclusion: PKP with VR surgery is a complex but globe-salvaging procedure for poor prognosis eyes, which otherwise would need evisceration.

Keywords: penetrating keratoplasty, VR surgery, endophthalmitis, corneal ulcer

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Authors: Asmaa Ahmed Nasr El-Din

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The Egyptian countryside faces many environmental problems in the field of environmental pollution in a wide range due to the current bad behavior patterns towards the environment, where the rural people continued to follow unconscious environmental practices in addition to the lack of environmental awareness among the rural people in terms of legislation, and the damages resulting from those practices. Rural women play an important and vital role that cannot be neglected in the field of reducing environmental pollution and rationalizing environmental resources, and it is their responsibility to maintain the safety of environmental elements such as water, air, food, and soil from pollution, either through limiting their personal practice that leads to the pollution of these elements or from During the upbringing of her children on the right behaviors towards these elements to protect them from pollution and thus avoid the infection of family members with diseases arising from environmental pollution that may affect their health and production capacity. Therefore, the research aimed to identify the level of rural women’s implementation of environmental practices (land, water, air, public health, and food waste), as well as determining the nature of the relationship between the studied independent variables (demographic, social and economic characteristics) and the level of rural women’s implementation of their role in preserving the environment and identifying some women’s information sources rural environment to preserve the environment. The research was conducted in the villages of Tarout and Qam al-Arous in the governorates of Sharkia and BeniSuef, respectively, and a random sample of 333 rural women was selected using the Yamani equation. Statistical ratio analysis, arithmetic mean, Pearson simple correlation coefficient value, and T-test.

Keywords: environment, rural women, EL-sharkia, banuef

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Authors: Ramon Sancibrian, Carlos Redondo-Figuero, Maria C. Gutierrez-Diez, Esther G. Sarabia, Maria A. Benito-Gonzalez, Jose C. Manuel-Palazuelos

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In this paper, the design and evaluation of a handle for laparoscopic surgery is presented. The design of the handle is based on ergonomic principles and tries to avoid awkward postures for surgeons. The handle combines the so-called power-grip and accurate-grip in order to provide strength and accuracy in the performance of surgery. The handle is tested using both objective and subjective approaches. The objective approach uses motion capture techniques to obtain the angles of forearm, arm, wrist and hand. The muscular effort is obtained with electromyography electrodes. On the other hand, a subjective survey has been carried out using questionnaires. Results confirm that the handle is preferred by the majority of the surgeons.

Keywords: laparoscopic surgery, ergonomics, mechanical design, biomechanics

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Authors: Danhua Xu, Zhenlan Qian, Zhu Wang, Jiayan Fu, Ling Wang

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A new business mode called rural complex is proposed by the China’s government to promote the development the economy in the rural area. However, for the sake of current national conditions including the great number of labor farmers owning the small scale farmlands and the uncertain enthusiasm from the enterprises, it is challenging to develop the big scale rural complex. To react to the dilemmas, this paper puts forward the micro-rural complex to boost the small scale farms by co-participation from a bottom-up mode. By analyzing the potential opportunities to find the suitable mode, exploring the interdisciplinary and interdepartmental co-participation way beyond architecture design and spatial planning between different actors, the paper tries to find a complete process towards the sustainable micro-rural complex and conducts an ongoing practice to optimize it, to bring new insights and reference to the rural development. According to the transformation of the economy, the micro-rural complex will develop into two phases, both of which can be discussed in three parts, the economic mode, the spatial support, and the Cooperating mechanism. The first stage is the agriculture co-participation based on the rise of Community supported agriculture (CSA) in which the consumers buy the products planted in an organic way from the farmers directly with a higher price to support the small-scale agriculture and overcome the food safety issues. The following stage sets up the agritourism catering the citizens with the restaurants, inns and other tourist service facilities to be planned and designed. In the whole process, the interdisciplinary co-participation will play an important role to provide the guidelines and consultation from the agronomists, architects and rural planners to the farmers. This mode has been applied to an on-going farm project, from which to explore the mode in a more practical way. In conclusion, the micro-rural complex aims at creating a balanced urban-rural relationship by co-participation taking advantage of the different actors. The spatial development is considered from the economic mode and social organization. The integration of the mode based on the small-scale agriculture will contribute to a sustainable growth and realize the long run development in the rural area.

Keywords: micro-rural complex, co-participation, sustainable development, China

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Authors: Amichai Ben ari, Daniella Margalit

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Medical procedures, such as surgery, may have traumatic significance for some children. This study examines the relationship between maltreatment in children and the development Pediatric Medical Traumatic Stress (PMTS). To this end, differences in the level of distress of children after surgery were examined between two groups: children who were maltreated ("children at risk") and children from the control group ("children who are not at risk"). The study involved 230 parents of children who came to the hospital to undergo surgery. Parents filled out demographic questionnaires to measure socioeconomic variables and psychological questionnaires to measure the distress of the child and parent before surgery. After 6 months from the time of surgery, the parents again filled in the questionnaire measuring the child's distress. The results of the study showed that the level of distress experienced by children at risk after surgery was significantly higher relative to children who are not at risk. It was also found that the level of distress experienced by parents of children at risk in relation to their child’s surgery is significantly higher compared to parents of children who are not at risk. Finally, it was found that the variables: (1) pre-morbid psychological functioning of the child. (2) Parental and family functioning in daily life. (3) Exposure of the child to traumatic events. (4) Support factors for the family. Are variables that predict the development of PMTS in children after surgery, but only for children at risk and not for children who are not at risk. The significance of the findings in relation to the need to identify at-risk populations in the hospitals and the policies derived from them were discussed, and several directions were raised for further research.

Keywords: children at risk, pediatric medical traumatic stress (PMTS), PTSD, medical procedures

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Authors: Fiona Lourenco, William Allen

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Dentofacial deformities are primarily surgically treated via orthognathic surgery. Health-related quality of life is concerned with aspects of quality of life that relate specifically to an individual’s health. Design and Setting: Retrospective analysis of patients who had orthognathic surgery from January 2018 - December 2022 at the trust using the previously validated Orthognathic Quality of Life questionnaire (OQoL). Materials and Methods: 32 Patient questionnaires (which included pre-operative and post-operative separate sections) were obtained via telephone survey. The data was analysed using the two-tailed paired t-test and Wilcoxon signed-rank test. Results: The change in perception post-surgery was highly significant (both tests resulted in p<0.001 for overall analysis as well as for each domain). Overall, a 74% improvement in QoL was seen following orthognathic surgery. Reports of improvement in each domain were as follows: 71% in the social aspect of the deformity domain, 76% in facial aesthetics, 60% in function, and 57% improvement in awareness of facial deformity. Conclusion: The assessment of QoL is becoming progressively imperative in clinical research. The above data shows that orthognathic surgery has a significant improvement in the QoL of patients post-operatively. The results demonstrate improvement in all domains, with perceptions in facial aesthetics seeing the highest change post-operatively.

Keywords: dentofacial, oral, facial asymmetry, orthognathic surgery, quality of life

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Authors: Jerry D. Johnson, Jason A. LaFrance, Matthew A. Ohlson, Shane C. Shope

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The public school system is the largest employer and most impactful factor in the local economy for many rural communities in the United States. The relationship between the school system and the community is symbiotic—they thrive together or decline together. Understanding the perceptions of rural school superintendents (the titular head of the local school district) with regard to rural development is foundational to understanding how the school and community interact and collaborate in key areas like economic development, community development, and workforce development. To investigate those perceptions as they manifest among superintendents in thriving rural communities, a collective case study was designed and conducted to disclose and characterize superintendent perceptions about rural development in three diverse rural settings in the U.S.: Florida, Kansas, and Ohio. Appreciative Inquiry (AI) served as the conceptual framework and supported a focus on identifying and describing assets and strategies/activities that helped explain the positive results in the communities of interest. Implementation of a criterion-based purposive sampling process (using extant data and a nomination process to identify rural superintendents in communities with vibrant economies and recognized the contribution by the schools in rural development) resulted in two superintendents from each of these state settings who participated in semi-structured interviews. Interview transcripts and relevant extant documents were coded and analyzed to produce individual cases with representative themes, after which a cross-case analysis was conducted to generate overarching themes. The overarching themes were then scrutinized and tested through the application of appropriate credibility techniques to promote the trustworthiness of the results. Findings include the importance of building and maintaining relationships that extend beyond the immediate collaboration activity, the importance of collaboration skills, intentionality of practice, and organizational systems/structures as facilitators/affordances. The results offer potential guidance for leveraging the potential for public schools to contribute to their rural development in the communities they serve.

Keywords: collaboration, leadership, rural development, rural schools

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Authors: Reetika Sharma, Lalit Tejwani, Himanshu Shekhar, Arun Singhvi

Abstract:

Purpose: Advanced Glaucoma with Failed trab is not an uncommon sight in glaucoma clinic, and such cases usually tend to present with high intraocular pressure (IOP) and advanced cupping, or even glaucomatous atrophy stage. Re-surgery is needed for such cases, and wound modulation poses a major challenge in these cases. We share our experience in this case series with the use of Ologen (collagen matrix implant) along with MMC 0.04% used in surgery. The purpose of the study was to evaluate the efficacy and outcome of collagen matrix implant in re-trabeculectomy in advanced glaucoma cases. Methodology: Eleven eyes of 11 patients (one eye of one patient) underwent re-trabeculectomy surgery with MMC and Ologen. Ologen implant was used in sub scleral and subconjunctival space, as a spacer and wound modulator. In five cases, triple modulation with implant soaked in anti-VEGF was used. Results: All patients had cupping more than 0.9, and one case was GOA. All cases were on maximal medication at presentation and majority were on systemic anti-glaucoma therapy also. Post-surgery, follow-up ranged from 13 – 34 months, and all cases had a follow longer than the gap between previous surgery (which was failed) and re-trab. One case needed AC reformation and one needling was done. Phaco was done at same sitting in four cases. All cases had their IOP lowered post surgery, and vision was maintained in all, however one case was considered as failed re-surgery case. Topical medication was needed in seven cases post-surgery also. Conclusion: Ologen as adjuvant should be considered in all re-trab cases and all high risk and advanced cases, and triple modulation can be next step in these cases. Aggressive IOP control and non- reluctance to continue topical medications post second surgery should be considered in such cases, to give them best possible vision.

Keywords: failed trabeculectomy, ologen, trabeculectomy, advanced glaucoma

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Authors: K. Bensafia, A. Mansour, G. Le Maillot, B. Clement, O. Reynet, P. Ariès, S. Haddab

Abstract:

This paper presents a system designed for wireless acquisition, the recording of electrocardiogram (ECG) signals and the monitoring of the heart’s health during surgery. This wireless recording system allows us to visualize and monitor the state of the heart’s health during a surgery, even if the patient is moved from the operating theater to post anesthesia care unit. The acquired signal is transmitted via a Bluetooth unit to a PC where the data are displayed, stored and processed. To test the reliability of our system, a comparison between ECG signals processed by a conventional ECG monitoring system (Datex-Ohmeda) and by our wireless system is made. The comparison is based on the shape of the ECG signal, the duration of the QRS complex, the P and T waves, as well as the position of the ST segments with respect to the isoelectric line. The proposed system is presented and discussed. The results have confirmed that the use of Bluetooth during surgery does not affect the devices used and vice versa. Pre- and post-processing steps are briefly discussed. Experimental results are also provided.

Keywords: electrocardiography, monitoring, surgery, wireless system

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Authors: Lim Lie Pin, Lin Hui Wen

Abstract:

Rural tourism has become popular in Taiwan, the villages based on agriculture including fishery have to follow the trend to develop the local economy and achieve the sustainable development of the rural areas. Through cultural festivals, the tourist could experience the benefit while promoting and stimulating the local development of rural tourism. Cigu is famous for salt history and abundant natural resources, such as lagoon, black-faced spoonbills and other fishery products. Digging clam has become the most special parent-child activities in Tainan and increasing awareness since it was initiated. Therefore, festival organizers and regional destination marketers need to identify visitors’ experiences attributes which lead to opportunities for industry professionals, community involvement to plan and organize regional festivals and their programmes for effective destination branding finding out more potential rural resources encouraging the local industry growth and sustainable development.

Keywords: rural tourism, cultural festival, destination branding, tourist experience, sustainable development

Procedia PDF Downloads 304

Authors: Farhad Fakoursevom

Abstract:

Heart disease is one of the diseases which is found in abundance today. Various types of surgeries, such as bypasses, angiography, angioplasty, etc., are used to treat patients. People may receive such surgeries, some of which are invasive and some non-invasive, throughout their lives. People might cope with pre-surgery anxiety and stress, which can disrupt their normal life and even reduce the effects of the surgery, so the desired result can not be achieved in surgery. Considering this issue, the present study aimed to do a comparative assessment of people who received sedatives before surgery and people who did not receive sedatives. In terms of the purpose, this is an applied research and descriptive survey in terms of method. The statistical population included patients who underwent surgeries in the specialist heart hospitals of Mashhad, Iran; 60 people were considered as a statistical population, 30 of them received sedatives before surgery, and 30 others had not received sedatives before surgery. Valid and up-to-date articles were systematically used to collect theoretical bases, and a researcher-made questionnaire was used to examine the level of stress and anxiety of people. The questionnaire content validity was assessed by a panel of experts in psychology and medicine. The construct validity was tested using the software. Cronbach's alpha and composite reliability were used for reliability, which shows the appropriate reliability of the questionnaire. SPSS software was used to compare the research results between two groups, and the research findings showed that there is no significant association between the people who received sedatives and those who did not receive sedatives in terms of the amount of stress and anxiety. The longer the time of taking the drugs before the surgery, the more the mental peace of the patients will be. According to the results, it can be said that if we don't need to have an emergency operation and need more time, we have to use sedative drugs with different doses compared to the severity of the surgery, and also in case of a medical emergency such as heart surgery due to a stroke, we have to take advantage of psychological services during and before the operation and sedative drugs so that the patients can control their stress and anxiety and achieve better outcomes.

Keywords: sedative drugs, stress, anxiety, surgery

Procedia PDF Downloads 99