Search results for: rural hospitals

Authors: Jiazhi Zeng, Leiyu Shi, Xia Zou, Wen Chen, Li Ling

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Background: China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Due to the household registration system, migrants are in a vulnerable state when they attempt to access to primary care services. A strong primary care system can reduce health inequities and mitigate socioeconomic disparities in healthcare utilization. Literature indicated that migrants were more reliant on the primary care system than local residents. Although the Chinese government has attached great importance to creating an efficient health system, primary care services are still underutilized. The referral system between primary care institutions and hospitals has not yet been completely established in China. The general populations often go directly to hospitals instead of primary care institutions for their primary care. Primary care institutions generally consist of community health centers (CHCs) and community health stations (CHSs) in urban areas, and township health centers (THCs) and rural health stations (THSs) in rural areas. In addition, primary care services are also provided by the outpatient department of municipal hospitals and tertiary hospitals. A better understanding of migrants’ experiences with primary care in the above-mentioned medical institutions is critical for improving the performance of primary care institutions and providing indications of the attributes that require further attention. The purpose of this pioneering study is to explore rural-to-urban migrants’ experiences in primary care, compare their primary care experiences in four types of medical institutions in Guangzhou, China, and suggest implications for targeted interventions to improve primary care for the migrants. Methods: This was a cross-sectional study conducted with 736 rural-to-urban migrants in Guangzhou, China, in 2014. A multistage sampling method was employed. A validated Chinese version of Primary Care Assessment Tool - Adult Short Version (PCAT-AS) was used to collect information on migrants’ primary care experiences. The PCAT-AS consists of 10 domains. Analysis of covariance was conducted for comparison on PCAT domain scores and total scores among migrants accessing four types of medical institutions. Multiple linear regression models were used to explore factors associated with PCAT total scores. Results: After controlling for socio-demographic characteristics, migrant characteristics, health status and health insurance status, migrants accessing primary care in tertiary hospitals had the highest PCAT total scores when compared with those accessing primary care THCs/ RHSs (25.49 vs. 24.18, P=0.007) and CHCs/ CHSs(25.49 vs. 24.24, P=0.006). There was no statistical significant difference for PCAT total scores between migrants accessing primary care in CHCs/CHSs and those in municipal hospitals (24.24 vs. 25.02, P=0.436). Factors positively associated with higher PCAT total scores also included insurance covering parts of healthcare payment (P < 0.001). Conclusions: This study highlights the need for improvement in primary care provided by primary care institutions for rural-to-urban migrants. Migrants receiving primary care from THCs, RHSs, CHSs and CHSs reported worse primary care experiences than those receiving primary care from tertiary hospitals. Relevant policies related to medical insurance should be implemented for providing affordable healthcare services for migrants accessing primary care. Further research exploring the specific reasons for poorer PCAT scores of primary care institutions users will be needed.

Keywords: China, PCAT, primary care, rural-to-urban migrants

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Authors: Wei Fang, Jian Jun Gu, Di Xue

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Objective: To analyze the employee compensation status of secondary public hospitals of Pudong New Area in Shanghai in order to provide information for compensation reform of public hospitals in Shanghai and as well as in China. Methods: We surveyed all 15 secondary public hospitals of Pudong New Area in Shanghai to collect hospital annual compensation data for their employees and to investigate their suggestions for compensation reform in public hospitals in China. We also collected related annual compensation data of employees in Shanghai and of physicians in the USA from Shanghai statistical Yearbook 2013 and from Bureau of Labor Statistics, U.S. Department of Labor. Results: The average annual compensation for the employees in secondary public hospitals of Pudong New Area in Shanghai in 2012 was 2.65 times of that for overall employees in Shanghai. The physician’s compensation in these public hospitals was relatively lower than that in the USA. Conclusion: The physicians’ compensation in the secondary public hospitals of Pudong New Area in Shanghai should be increased rationally and new compensation reform in public hospitals in Shanghai should be carefully designed.

Keywords: human resource, compensation, public hospital, Shanghai

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Authors: Mohammad Safaeipour, Yousef Amer

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This study directs its focus on developing a conceptual model to offer a systematic and integrated method to weigh the related measures and evaluate a competence of hospitals and rank of the selected hospitals that involve and consider the stakeholders’ key performance indicators (KPI’s). The Analytical Hierarchy Process (AHP) approach will use to weigh the dimensions and related sub- components. The weights and performance scores will combine by using the Technique for Order Performance by Similarity to Ideal Solution (TOPSIS) and rank the selected hospitals. The results of this study provide interesting insight into the necessity of process improvement implementation in which hospital that received the lowest ranking score.

Keywords: performance measurement system, PMS, hospitals, AHP, TOPSIS

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Authors: B. Alajmi, L. Marouf, A. S. Chaudhry

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In recent years, increasing emphasis has been placed upon issues concerning the evaluation of health care. In this regard, knowledge management has also been considered an important component of the evaluation process. KM facilitates the transfer of existing knowledge or the development of new knowledge among healthcare staff and patients. This research aimed to examine how hospitals in Kuwait employ knowledge management practices, including capturing, sharing, and generating, and the perceived impact of KM practices on performance of hospitals in Kuwait. Through adopting a quantitative survey method with 277 sample of doctors, the study found that in terms of the three major knowledge management practices – knowledge capturing, sharing, and generating – the adoption of KM practices were rated very low in the sampled hospitals in Kuwait. Hospitals paid little attention to the main activities that support the transfer of expertise among doctors in hospitals. However, as predicted by previous studies, knowledge management practices were perceived to have an impact on hospitals’ performance. Through knowledge capturing, sharing, and generating, hospitals could improve the services they provide through documenting best practices, transforming their hospitals into learning organizations in which lessons learned are captured, stored, and made available for others to learn from.

Keywords: knowledge management, hospitals, knowledge management practices, knowledge management tools, performance

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Authors: P. Chandhra Sekhar, R. A. Deshpande, T. Raghunatha

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The government of India has given special attention on rural electrification under Rajiv Gandhi Grameena Vidyuthikarana Yojana (RGGVY) during 10th plan and 11th plan. Government of India electrified about 107523 villages and 21164003 BPL Households. This paper briefs about various rural electrification programs initiated by government of India and status of RGGVY in India. The paper mainly describes about challenges in the rural electrification, new ideas recently implemented and suggestions for improvement in the rural electrification.

Keywords: rural electrification, RGGVY, NJY, BPL

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Authors: Catherine Bernard

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The maldistribution of clinicians within countries is well documented. It is a common theme throughout the world that rural areas often struggle to recruit and retain health workers resulting in inadequate healthcare for many. This paper will concentrate on the responsibilities that medical schools may have in addressing this shortage of rural health workers. Recommendations are made with regards to targeted rural student admissions, rurally-based medical schools, rural clinical rotations and a curriculum orientated towards rural health issues. The evidence gathered suggests that individual factors are positive in encouraging health workers to practice in rural locations. However, there is strength in numbers, and combining all the recommendations will likely result in a synergistic effect, thereby increasing numbers of rural health workers and achieving accessible healthcare for those living in rural populations.

Keywords: medical education, medical education design, public health, rural health

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Authors: Jiawei Liang

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Against the backdrop of China's burgeoning migration from rural to urban areas, a demographic group has emerged in China, which is called left-behind children. Due to many reasons, including the issue of the rural-urban education gap, the education of left-behind children has been below the national education average. In this situation, the issue has attracted the attention of researchers and policymakers. In order to gain a comprehensive understanding of this issue, this paper adopts an analytical approach to studying the rural-urban education gap and left-behind children in rural China. The paper first introduces the current situation of migration, the education gap, and left-behind children within China. Then, it further explores the causes of these two questions and barriers as well as the consequences for left-behind children. Finally, the study offers some suggestions to alleviate the urban-rural gap and the current situation of education for left-behind children in rural areas, which will hopefully shed light on the issue of left-behind children in China and the urban-rural education gap.

Keywords: left-behind children, rural China, education improvement, Hukou policy, rural-urban education gap

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Authors: Zheng Junchao, Wang Zhu

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With the advancement of China's urbanization process, the Chinese government has put forward the strategy of rural revitalization which is aiming at realizing the comprehensive integration of urban and rural areas and the comprehensive revitalization of rural areas. The path of rural revitalization in Zhejiang province put forward a typical model from four dimensions: suburban area, plain, island and mountain area. Research methods include on-the-spot investigation, visiting a number of successful demonstration villages in Zhejiang and interviewing village officials. Based on the location conditions, resource endowments, industrial forms and development foundations of Zhejiang Province, this paper introduces in detail the model of rural revitalization in Zhejiang Province and the challenges it encounters, as well as the role of building construction. The rural development model of Zhejiang province makes the rural culture flourish. Taking the construction of rural scenic spots as the carrier, the rural culture, and natural landscape are constantly improved. It provides a model and template for the country's rural revitalization. The promotion of Zhejiang rural revitalization model will improve the current rural landscape, living standard and industrial structure, which will narrow the urban-rural gap greatly.

Keywords: comprehensive rural revitalization, Zhejiang model, reproducible, comprehensive integration

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Authors: Han Song, Tingting Wei, Dong Chen

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The combination of capital and rural areas in China has shown its great significance in promoting urban-rural integration and new-style urbanization, enhancing regional capacity for sustainable rural development and optimizing human settlement environment. The purpose of this study is to find capital operation mechanism in rural area and rural planning guidance in China. Based on case studies in Chinese rural areas, two types of capital operation mechanism in rural areas are summed up: intervention in the field of agriculture promoting the upgrading and innovation of agricultural industry chain, intervention in rural life and leisure areas updating rural connotation and form. In the light of experiences in Japan and Taiwan, it is proposed that government's norms and guidance, rural investment intensity and rural self-organization are three important factors for capital to drive rural development. It is also found that the unique land tenure and rural governance tradition are two important factors effecting the combination of capital and rural regions in China, which requires full attention in rational policy-making and rural planning. It comes to a conclusion as four directions of the overall reform of the rural planning: targeting at enhancing the viability of rural and sustainable capacity, encouraging differences in investment incentives and planning policies, providing land usage in the rural areas with planning support and reforming the village system. Directional guidance is also made for different types of capital investments, suggesting that capital should be rooted in agriculture and rural land to benefit farmers and update human settlements.

Keywords: capital, rural areas, rural planning, rural governance

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Authors: Tzu-Jung Tseng, Pei-Hsuen Han, Tsung-Hsueh Lu

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Background: Ensuring patients with ST-elevation myocardial infarction (STEMI) access to hospitals that could perform percutaneous coronary intervention (PCI) in time is an important concern of healthcare managers. One commonly used the method to assess the coverage of population access to PCI hospital is the use GIS-estimated linear distance (crow's fly distance) between the district centroid and the nearest PCI hospital. If the distance is within a given distance (such as 20 km), the entire population of that district is considered to have appropriate access to PCI. The premise of using district centroid to estimate the coverage of population resident in that district is that the people live in the district are evenly distributed. In reality, the population density is not evenly distributed within the administrative district, especially in rural districts. Fortunately, the Taiwan government released basic statistical area (on average 450 population within the area) recently, which provide us an opportunity to estimate the coverage of population access to PCI services more accurate. Objectives: We aimed in this study to compare the population covered by a give PCI hospital according to traditional administrative district versus basic statistical area. We further examined if the differences between two geographic units used would be larger in a rural area than in urban area. Method: We selected two hospitals in Tainan City for this analysis. Hospital A is in urban area, hospital B is in rural area. The population in each traditional administrative district and basic statistical area are obtained from Taiwan National Geographic Information System, Ministry of Internal Affairs. Results: Estimated population live within 20 km of hospital A and B was 1,515,846 and 323,472 according to traditional administrative district and was 1,506,325 and 428,556 according to basic statistical area. Conclusion: In urban area, the estimated access population to PCI services was similar between two geographic units. However, in rural areas, the access population would be overestimated.

Keywords: accessibility, basic statistical area, modifiable areal unit problem (MAUP), percutaneous coronary intervention (PCI)

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Authors: Takalani Tshitangano

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Background: In Limpopo province the rate of new tuberculosis (TB) cases increase daily. The Infection Control (IC) plan is one of the essential actions for TB IC. This study aimed to establish the availability of these plans at health care facilities. Objectives: The objectives were to explore and describe the awareness and knowledge of health care workers (HCWs) of the availability and content of TB IC plan; and to identity the role of infection control committees from the perspective of HCWs. Method: A qualitative approach using a cross-sectional descriptive design was adopted. The target population was all HCWs from the seven hospitals of Vhembe district. A purposive sampling approach was used to select 57 participants. The approval to conduct this study was obtained from the relevant authorities and participants. Data were collected through seven focus group discussions comprising five to 10 members. An unstructured discussion guide was used to collect data, and an open-coding method was used to analyse the data. Lincoln and Guba’s criteria ensured trustworthiness of the study findings. Results: Findings revealed that HCWs were not aware of the availability and the information contained in the TB IC plans. No person was designated as TB IC officer at hospital level. There was lack of a TB IC Committee and teams as well as ineffective utilisation of those that did exist. Conclusions: It was concluded that if the TB IC plans are not available at health care facilities, then the TB IC practices implemented by HCWs vary, resulting in TB nosocomial infection transmission. It was recommended that the World Health Organisation’s TB IC plans be adopted and implemented in Vhembe district.

Keywords: health care workers' awareness, health care workers' knowledge, availability of TB infection control plans, rural hospitals

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Authors: H. Nur Görkemli, Mehmet Fidan

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After the first acquaintance with internet in April 1993, number of internet users increased rapidly in Turkey. According to Turkish Statistical Institute’s 2013 data, internet usage in Turkey between 16-74 age group is 48,9%. Hospitals are one of the areas where internet is being intensively used like many other businesses. As a part of public relations application, websites are important tools for hospitals to reach a wide range of target audience within and outside the organization. With their websites, hospitals have opportunities to give information about their organization, strengthen their image, compete with their rivals, interact with shareholders, reflect their transparency and meet with new audiences. This study examines web sites of totally 31 hospitals which are located in Konya. Institutions are categorized as public and private hospitals and then three main research categories are determined: content, visual and technical. Main and sub categories are examined by using content analysis method. Results are interpreted in terms of public and private institutions.

Keywords: websites, hospital, health communication, internet, webpages

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Authors: Manar Aslan, Ayse Yildiz

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The study was conducted descriptively to assess their hospital institutionalization of upper and mid-level managers of 18 hospitals affiliated to Public Hospitals Association. In its simplest form institutionalization is whatever the subject matter, is dominated by the rules of articulated and determined behavior in all kinds of business, interaction, and communication. Hospital service is a type of service carried out chained together. It should not be forgotten that this kind of services is carried out without barrier, and who and what to do with definite lines, hospital management is a process, and this process can be achieved through institutionalization. With the establishment of the Public Hospitals Unions in Turkey, all the state hospitals in the provinces have been gathered under this roof. One of the goals is to establish control mechanisms to ensure that hospitals reach pre-determined financial, medical, and administrative standards. In this way, the preparations for the institutionalization of units and hospital enterprises will be completed. The data of the study were collected by institutionalization management attitude scale (cronbach alpha: 0.98) of composed of 5 sub-dimensions and 52 questions in 18 hospitals’ managers (N=310) in the largest province in Turkey. The results of the study revealed that the total score taken by managers at the institutionalization scale was 200.80, and this was close to the maximum score. In addition, it was determined that the difference between the mean score of the scale and its sub-dimensions with the gender, the hospitals, and the management position.

Keywords: institutionalization, hospital, manager, evaluation

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Authors: N. P. Tsephe, S. D. Eyono Obono

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Rural tourism is usually associated with rural development because it has strong linkages to rural resources; but it remains underdeveloped compared to urban tourism. This underdevelopment of rural tourism serves as a motivation for this study whose aim is to examine the factors affecting the perceived satisfaction of rural tourists. The objectives of this study are: to identify and design theories and models on rural tourism satisfaction, and to empirically validate these models and theories through a survey of tourists from the Malealea Lodge which is located in the Mafeteng District, in the Mountain Kingdom of Lesotho. Data generated by the collection of questionnaires used by this survey was analyzed quantitatively using descriptive statistics and correlations in SPSS after checking the validity and the reliability of the questionnaire. The main hypothesis behind this study is the relationship between the demographics of rural tourists, the motivation, and their satisfaction of tourists, as supported by existing literature; except that motivation is measured in this study according to three dimensions: push factors, pull factors, and perceived usefulness of ICT's in the rural tourism experience. Findings from this study indicate that among the demographics factors, continent of origin and marital status influence the satisfaction of rural tourists; and their occupation affects their perceptions on the use of ICT's in rural tourism. Moreover, only pull factors were found to influence the satisfaction of rural tourists.

Keywords: digital world, motivation, rural tourism, satisfaction

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Authors: Peiyin Hung, Katy Kozhimannil, Michelle Casey, Ira Moscovice

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Background/Objective: The loss of obstetric services has been a pressing concern in urban and rural areas nationwide. This study aims to determine factors that contribute to the loss of obstetric care through closures of a hospital or obstetric unit. Methods: Data from 2002-2013 American Hospital Association annual surveys were used to identify hospitals providing obstetric services. We linked these data to Medicare Healthcare Cost Report Information for hospital financial indicators, the US Census Bureau’s American Community Survey for zip-code level characteristics, and Area Health Resource files for county- level clinician supply measures. A discrete-time multinomial logit model was used to determine contributing factors to obstetric unit or hospital closures. Results: Of 3,551 hospitals providing obstetrics services during 2002-2013, 82% kept units open, 12% stopped providing obstetrics services, and 6% closed down completely. State-level variations existed. Factors that significantly increased hospitals’ probability of obstetric unit closures included lower than 250 annual birth volume (adjusted marginal effects [95% confidence interval]=34.1% [28%, 40%]), closer proximity to another hospital with obstetric services (per 10 miles: -1.5% [-2.4, -0.5%]), being in a county with lower family physician supply (-7.8% [-15.0%, -0.6%), being in a zip code with higher percentage of non-white females (per 10%: 10.2% [2.1%, 18.3%]), and with lower income (per $1,000 income: -0.14% [-0.28%, -0.01%]). Conclusions: Over the past 12 years, loss of obstetric services has disproportionately affected areas served by low-volume urban and rural hospitals, non-white and low-income communities, and counties with fewer family physicians, signaling a need to address maternity care access in these communities.

Keywords: access to care, obstetric care, service line discontinuation, hospital, obstetric unit closures

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Authors: Nahid Tavakoli, Asghar Ehteshami, Akbar Hassanzadeh, Fatemeh Amini

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Introduction: The Information security incident management guidelines was been developed to help hospitals to meet their information security event and incident management requirements. The purpose of this Study was to investigate on Information Security Incident Management in Isfahan’s educational hospitals in accordance to ISO/IEC 27002 standards. Methods: This was a cross-sectional study to investigate on Information Security Incident Management of educational hospitals in 2014. Based on ISO/IEC 27002 standards, two checklists were applied to check the compliance with standards on Reporting Information Security Events and Weakness and Management of Information Security Incidents and Improvements. One inspector was trained to carry out the assessments in the hospitals. The data was analyzed by SPSS. Findings: In general the score of compliance Information Security Incident Management requirements in two steps; Reporting Information Security Events and Weakness and Management of Information Security Incidents and Improvements was %60. There was the significant difference in various compliance levels among the hospitals (p-valueKeywords: information security incident management, information security management, standards, hospitals

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Authors: Ifeanyi Charles Otuokere, Victoria Nneoma Nnochiri

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Entrepreneurship generally and specifically within the rural communities in Nigeria is a fast means of bringing development within the communities. This is made possible by utmost maximization and management of available local resources to develop rural areas through good management of these local resources. This study anchors on the rural development paradigm and the integrated rural development theories to understudy the knowledge of rural entrepreneurs on rural economic development. The research study made use of surveys and descriptive analysis. The assessable population for the study, which was randomly selected, is 100 rural entrepreneurs from ten rural communities within the Ikwuano Local Government Area of Abia State. The study made use of both primary and secondary as a source of data collection with much emphasis on a primary source, although secondary data such as journals, textbooks electronic sources were also utilised. A carefully structured questionnaire drafted to extract raw data was administered to selected entrepreneurs. The findings of the study showed that developments within rural communities can only be achieved through rural entrepreneurship. This is evidenced in increased output, job creation, and most importantly, reduction of rural to urban migration, among other things. Recommendations were also made based on these findings; the researchers recommended that infrastructural developments should be made available in the rural communities and government policies should create enabling environments along with other assistance to help these rural entrepreneurs achieve their sole aim.

Keywords: economic developments, rural communities, rural development, rural entrepreneurship

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Authors: Kherbache Radhwane

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This study is concerned with the nature of the strategy of agricultural and rural development, through the fiscal policy adopted by the government throughout programs included in the general budget of the state represented in the national program of agricultural and rural development. This study concluded that the general balance play an important role in the design of the strategy of agricultural and rural development despite the numerous problems clear in the result of the precedent plans of agricultural and rural development. Based on that we suggest that more importance should be accorded to the agricultural and rural field and that it should be one among economic alternatives to the collection of petroleum, as the countryside is the future.

Keywords: general balance, political economy, strategy of agricultural and rural development, economic alternatives, collection of petroleum

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Authors: C. M. Sapkota, B. P. Sapkota

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Background: Continuous developments in science and technology are increasing the availability of thousands of medical devices – all of which should be of good quality and used appropriately to address global health challenges. It is obvious that bio medical devices are becoming ever more indispensable in health service delivery and among the key workforce responsible for their design, development, regulation, evaluation and training in their use: biomedical technician (BMET) is the crucial. As a pivotal member of health workforce, biomedical technicians are an essential component of the quality health service delivery mechanism supporting the attainment of the Sustainable Development Goals. Methods: The study was based on cross sectional descriptive design. Indicators measuring the quality of health services were assessed in Mechi Zonal Hospital (MZH) and Sagarmatha Zonal Hospital (SZH). Indicators were calculated based on the data about hospital utilization and performance of 2018 available in Medical record section of both hospitals. MZH had employed the BMET during 2018 but SZH had no BMET in 2018.Focus Group Discussion with health workers in both hospitals was conducted to validate the hospital records. Client exit interview was conducted to assess the level of client satisfaction in both the hospitals. Results: In MZH there was round the clock availability and utilization of Radio diagnostics equipment, Laboratory equipment. Operation Theater was functional throughout the year. Bed Occupancy rate in MZH was 97% but in SZH it was only 63%.In SZH, OT was functional only 54% of the days in 2018. CT scan machine was just installed but not functional. Computerized X-Ray in SZH was functional only in 72% of the days. Level of client satisfaction was 87% in MZH but was just 43% in SZH. MZH performed all (256) the Caesarean Sections but SZH performed only 36% of 210 Caesarean Sections in 2018. In annual performance ranking of Government Hospitals, MZH was placed in 1st rank while as SZH was placed in 19th rank out of 32 referral hospitals nationwide in 2018. Conclusion: Biomedical technicians are the crucial member of the human resource for health team with the pivotal role. Trained and qualified BMET professionals are required within health-care systems in order to design, evaluate, regulate, acquire, maintain, manage and train on safe medical technologies. Applying knowledge of engineering and technology to health-care systems to ensure availability, affordability, accessibility, acceptability and utilization of the safer, higher quality, effective, appropriate and socially acceptable bio medical technology to populations for preventive, promotive, curative, rehabilitative and palliative care across all levels of the health service delivery.

Keywords: biomedical equipment technicians, BMET, human resources for health, HRH, quality health service, rural hospitals

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Authors: Maher El-Masri, Jamie Crawley, Judy Bornais, Abeer Omar

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Background: Misuse of Emergency Department (ED) for non-urgent healthcare results in unnecessary crowdedness that can result in long ED waits and delays in treatment, diversion of ambulances to other hospitals, poor health outcomes for patients, and increased risk of death Objectives: The main purpose of this study was to explore the independent predictors of non-urgent ED visits in Erie St. Clair LHIN. Secondary purposes of the study include comparison of the rates of non-urgent ED visits between urban and rural hospitals Design: A secondary analysis of archived population-based data on 597,373 ED visits in southwestern Ontario Results The results suggest that older (OR = .992; 95% CI .992 – .993) and female patients (OR = .940; 95% CI .929 - .950) were less likely to visit ED for non-urgent causes. Non-urgent ED visits during the winter, spring, and fall were 13%, 5.8%, and 7.5%, respectively, lesser than they were during the summer time. The data further suggest that non-urgent visits were 19.6% and 21.3% less likely to occur in evening and overnight shifts compared to the day shift. Non-urgent visits were 2.76 times more likely to present to small community hospitals than large community hospitals. Health care providers were 1.92 times more likely to refer patients with non-urgent health problem to the ED than the decision taken by patients, family member or caretakers. Conclusion: In conclusion, our study highlights a number of important factors that are associated with inappropriate use of ED visits for non-urgent health problems. Knowledge of these factors could be used to address the issue of unnecessary ED crowdedness.

Keywords: emergency department, non-urgent visits, predictors, logistic regression

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Authors: Jin Chuhao, Chen Xiang

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In recent years, due to the rapid development of Chinese urbanization, a great deal of rural population surge into urban to make a living. This fact causes the vicious circulation of rural development including sharp decrease of agricultural labor force in rural area, the obvious increase of rural land price, the shrinking of traditional agriculture and the bigger gap between Chinese urban and rural areas. With the improvement of living condition and ideological level of the Chinese people, the use and renewal of the traditional villages are gaining more and more attention, thus agricultural cultural and creative industries appears. Basing on the investigation of practical projects, this paper discusses how the agricultural cultural and creative industries promote the sustainable development of Chinese rural areas.

Keywords: sustainable design, Chinese rural areas, renewal, agricultural cultural and creative industries

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Authors: Baluku Nathan

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Transferring critically ill patients from one health facility to another poses a major risk to the patient because of increased oxygen demands. transferring patients with critical COVID-19 from a rural health canter in a rural district to a national referral hospital over 350 km in 7 hours would require three size H oxygen cylinders for successful transfer. It was always difficult to arrange the three size cylinders in the ambulance as workspace was greatly compromised for the ambulance assistant. Purpose: The purpose of this study was to investigate the impact and effectiveness of transport ventilators on the transportation of the critically ill patients from rural health canters to national referral hospitals in Uganda. Methodology: This was a descriptive cross-sectional study conducted in sept 2022 among critical care nurses and ambulance assistants who had used both methods of transportation (ventilators and cylinders). A semi structured questionnaire was used to collect quantitative data after informed consent. Results: From the findings, distribution of transport ventilators to the regional referral hospitals by the Ministry of Health has gradually improved patient transfer as the team requires less than one size oxygen cylinder to successfully transfer a patient. We use two ambulance assistants (a critical care nurse and another nurse who has been trained on use of the ventilator) when transferring patients with critical COVID-19 as the teams have to interchange over the long distance. Conclusions: Transport ventilators are effective and efficient in transferring critically ill patients, therefore should be rolled out to lower levels coupled with user training to improve outcomes of patients transferred in ambulances in lower income countries.

Keywords: emergency medical technician, critically ill, COVID-19, transport ventilator

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Authors: J. Niyitegeka, G. Nshimirimana, A. Silverstein, J. Odhiambo, Y. Lin, T. Nkurunziza, R. Riviello, S. Rulisa, P. Banguti, H. Magge, M. Macharia, J. P. Dushime, R. Habimana, B. Hedt-Gauthier

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In low-resource settings, women needing an emergency cesarean section experiences various delays in both reaching and receiving care that is often linked to poor neonatal outcomes. In this study, we quantified different measures of delays and assessed the association between these delays and neonatal outcomes at three rural district hospitals in Rwanda. This retrospective study included 441 neonates and their mothers who underwent emergency cesarean sections in 2015 at Butaro, Kirehe and Rwinkwavu District Hospitals. Four possible delays were measured: Time from start of labor to district hospital admission, travel time from a health center to the district hospital, time from admission to surgical incision, and time from the decision for the emergency cesarean section to surgical incision. Neonatal outcomes were categorized as unfavorable (APGAR < 7 or death) and favorable (APGAR ≥ 7). We assessed the relationship between each type of delay and neonatal outcomes using multivariate logistic regression. In our study, 38.7% (108 out of 279) of neonates’ mothers labored for 12 to 24 hours before hospital admission and 44.7% (159 of 356) of mothers were transferred from health centers that required 30 to 60 minutes of travel time to reach the district hospital. 48.1% (178 of 370) of caesarean sections started within five hours after admission and 85.2% (288 of 338) started more than thirty minutes after the decision for the emergency cesarean section was made. Neonatal outcomes were significantly worse among mothers with more than 90 minutes of travel time from the health center to the district hospital compared to health centers attached to the hospital (OR = 5.12, p = 0.02). Neonatal outcomes were also significantly different depending on decision to incision intervals; neonates with cesarean deliveries starting more than thirty minutes after decision had better outcomes than those started immediately (OR = 0.32, p = 0.04). Interventions that decrease barriers to access to maternal health care services can improve neonatal outcome after emergency cesarean section. Triaging could explain the inverse relationship between time from decision to incision and neonatal outcome; this must be studied more in the future.

Keywords: Africa, emergency obstetric care, rural health delivery, maternal and child health

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Authors: Arun Kumar

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For the present study a total of 219 women, from urban and rural areas of Sagar district of central India were selected. The mean age at menarche of rural women was found 13.89±1.17 years and for urban women, it was 13.78±1.12 years. The difference between the mean age at menarche of urban and rural women was statistically insignificant (t=0.580, p≤0.05). Mean age at menopause among rural women was (47.4±4.92). The difference between the mean of urban and rural women was statistically insignificant (t=0.739 and p≤0.05). These findings indicate that rural women experience menopause at a later age as compared to their urban counterparts.

Keywords: menarche, menopause, urban, rural, Bidi workers

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Authors: Liuhui Zhu, Peng Zeng

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The rural revitalization strategy means to take the country and the city on the same level, and achieve urban-rural integration and comprehensive development of rural areas. Beijing-Tianjin-Hebei rural areas have always been the weak links in the region, with prominently uneven development between urban and rural areas. The rural areas need to join the overall regional synergy. Based on the analysis of the characteristics and problems of rural development in the region from the perspective of production-living-ecology space, the paper proposes the township as the basic unit for rural revitalization according to the overall requirements of the rural revitalization strategy. The basic unit helps to realize resource arrangement, functional organization, and collaborative governance organized by the production-living-ecology spatial network. The paper summarizes the planning strategies for the basic unit. Through spatial cognition and spatial reconstruction, the three space is networked through the base, nodes, and connections to improve the comprehensive value of rural areas and achieve the multiple goals of rural revitalization.

Keywords: rural revitalization, Beijing-Tianjin-Hebei region, township level, production-living-ecology spatial network

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Authors: Suphap Sikkhaphan, Muwanga Zake, Johnnie Wycliffe Frank

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The purposes of the study included a) investigating the authentic and transformational leadership model of the directors of tambon health promoting hospitals b) evaluating the relation between the authentic and transformation leadership of the directors of tambon health promoting hospitals and the effectiveness of their hospitals and c) assessing the invariance test of the authentic and transformation leadership of the directors of tambon health promoting hospitals. All 400 southern tambon health promoting hospital directors were enrolled into the study. Half were males (200), and another half were females (200). They were sampled via a stratified method. A research tool was a questionnaire paper containing 4 different sections. The Alpha-Cronbach’s Coefficient was equally to .98. Descriptive analysis was used for demographic data, and inferential statistics was used for the relation and invariance tests of authentic and transformational leadership of the directors of tambon health promoting hospitals. The findings revealed overall the authentic and transformation leadership model of the directors of tambon health promoting hospitals has the relation to the effectiveness of the hospitals. Only the factor of “strong community support” was statistically significantly related to the authentic leadership (p < .05). However, there were four latent variables statistically related to the transformational leadership including, competency and work climate, management system, network cooperation, and strong community support (p = .01). Regarding the relation between the authentic and transformation leadership of the directors of tambon health promoting hospitals and the effectiveness of their hospitals, four casual variables of authentic leadership were not related to those latent variables. In contrast, all four latent variables of transformational leadership has statistically significantly related to the effectiveness of tambon health promoting hospitals (p = .001). Furthermore, only management system variable was significantly related to those casual variables of the authentic leadership (p < .05). Regarding the invariance test, the result found no statistical significance of the authentic and transformational leadership model of the directors of tambon health promoting hospitals, especially between male and female genders (p > .05).

Keywords: authentic leadership, transformational leadership, tambon health promoting hospital

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Authors: Ashish Shrivastava, C. Pandu Rangan

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In this paper, we consider The Hospitals Residents problem with Social Stability (HRSS), where hospitals and residents can communicate only through the underlying social network. Those residents and hospitals which don not have any social connection between them can not communicate and hence they cannot be a social blocking pair with respect to a socially stable matching in an instance of hospitals residents problem with social stability. In large scale matching like NRMP or Scottish medical matching scheme etc. where set of agents, as well as length of preference lists, are very large, social stability is a useful notion in which members of a blocking pair could block a matching if and only if they know the existence of each other. Thus the notion of social stability in hospitals residents problem allows us to increase the cardinality of the matching without taking care of those blocking pairs which are not socially connected to each other. We know that finding a maximum cardinality socially stable matching, in an instance, of HRSS is NP-hard. This motivates us to solve this problem with bounded length preference lists on one side. In this paper, we have presented a polynomial time algorithm to compute maximum cardinality socially stable matching in a HRSS instance where residents can give at most two length and hospitals can give unbounded length preference list. Preference lists of residents and hospitals will be strict in nature.

Keywords: matching under preference, socially stable matching, the hospital residents problem, the stable marriage problem

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Authors: Lei Liu

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This paper concerns on a special phenomenon of rocketing of bride’s price in rural China after the rural-urban labor migration nowadays. It provides a brief overview of three major prospective on marriage exchange, especially impose the local marriage market due to the post-migration economic environments. Then the author highlights on several factors that influence the rocketing raise of rural marriage gifts using both the primary data from census 2010 and the interviews from the field study, such as one-child policy and the unbalanced sex ratio with the familiar context parents used different strategies in raising their sons and daughters so as to best hold their own interests, causing inequality between females and males. Then this was broken by the independence of rural women and the phenomenon of cross-regional marriage after the free mobility of labor resource between rural areas and urban areas which gives women equal rights to choose their spouses together with some publicly policies that accelerate the decline of patriarchy. In the end, the author spells out a framework of migration influence on rural marriage for some theoretical and policy implications of the findings.

Keywords: rural-urban migration, gender stratification, rural China, bride price, marriage

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Authors: Morar (Bumbu) Nicoleta Ileana

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Located in the northeastern part of Romania in a cross-border area, Bucovina region, due to historical events that took place here, is characterized by the cohabitation in the same area of a significant number of ethnic communities, represented in 54% by rural population. In addition to providing the natural, economic history and decision makers, the demographic component is responsible for the region's development trajectory to which it belongs. The influence that people exert on rural development is shown by the values of the different demographic indicator. This study will analyze the demographic indicators obtained against a strong database, emphasizing the indicators that favor the rural development of the region and those that prevent it. The study is useful in defining the rightful directions that rural economic development can focus on, also representing an important tool in developing strategies for the development of rural settlements of Bucovina region.

Keywords: Bucovina, development directions, demographic indicators, rural development

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Authors: N. R. Ramkumar

Abstract:

The foremost aim of physical education has been to inculcate a healthy mind in a healthy body. The aim of this study was to find out the differences in nutritional awareness among urban, semi urban and rural girls of South India. The investigator administered a nutritional awareness questionnaire consisting of 25 statements among 100 rural; 100 semi urban and 100 urban girls studying in different schools in South India. The filled up questionnaire were scored and the total scores for all the twenty five statements were considered as the nutritional awareness level of the subjects. The differences on nutritional awareness among urban, semi urban and rural girls were tested for statistical significance using ANOVA. In all cases 0.05 level was fixed to test the significance. The results proved that there were significant differences on nutritional awareness among urban, semi urban and rural girls (P<0.05). The paired mean comparisons proved that urban girls were having highest nutritional awareness (M: 86.86), followed by semi urban girls (M: 81.86) and then by rural girls (M: 79.48). The differences between urban and semi urban girls and urban and rural girls were significant and there was no significant differences between semi urban and rural girls. The findings of this study proved that rural girls were significantly having lesser nutritional awareness and hence the study recommends the strong need of nutritional education for rural girls in South India.

Keywords: nutrition, awareness, urban, semi urban, rural girls

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