Knowledge and attitudes of rural healthcare providers regarding domestic violence against women: a systematic review

ABSTRACT BACKGROUND: Specific types of violence such as intimate partner sexual violence and intimate partner homicide occur more frequently in rural areas. OBJECTIVE: This study aimed to systematically review the literature on the knowledge and attitudes of rural healthcare providers regarding cases of domestic violence against women. DESIGN AND SETTING: Systematic review developed at Universidade Federal de Uberlândia. METHODS: We conducted an electronic search of six databases, which only included observational studies, regardless of the year, language, or country of publication, except for studies that used secondary data and were exclusively qualitative. Two reviewers performed the selection, data extraction, and risk of bias assessment using a specific Joanna Briggs Institute tool. RESULTS: Six studies met the inclusion criteria. All the studies had a low risk of bias. Approximately 38% of these professionals identified injuries caused by violence in patients. When asked about knowing the correct attitude to take in cases of confirmed violence, between 12% and 64% of rural healthcare providers answered positively; most of them would refer to specialized institutions and promote victim empowerment and counseling. The number of professionals with an educational background in the field ranged from 16% to 98%. CONCLUSIONS: The evident disparity across studies shows that some professionals have suboptimal knowledge and require training to adopt the correct attitude when identifying female victims of domestic violence in clinical practice. SYSTEMATIC REVIEW REGISTRATION: This systematic review was registered in the Open Science Framework Database under the registration http://doi.org/10.17605/OSF.IO/B7Q6S.

Developmental characteristics of younger school-aged boys in relation to the socio-economic environment / Características del desarrollo de niños menores en edad escolar en relación con el entorno socioeconómico

SUMMARY: The main goal of this research was to determine whether there is a statistically significant difference in the anthropometric characteristics of fourth grade elementary school students, who live in different demographic environments in Montenegro. The research was conducted on a sample of 120 students, fourth grade elementary school, male (60 students from urban areas and 60 students from rural areas). To measure anthropometric characteristics, 12 measures were applied (Body height, arm length, leg length, shoulder width, elbow diameter, knee diameter, body weight, upper arm circumference, lower leg circumference, skin fold of the back, skin fold of the upper arm, skin fold of the abdomen). After conducting research with the application of appropriate statistical procedures: descriptive analysis, multivariate analysis of variance (MANOVA) and analysis of variance (ANOVA), it was noticed that there is a statistically significant difference in the treated space of anthropometric characteristics. Boys from rural areas are more dominant than boys from urban areas in the longitudinal and transverse dimensionality of the skeleton and in volume on certain body segments, and boys from urban areas are more dominant than boys from rural areas in body weight and subcutaneous fat, which puts them at risk for obesity.

El objetivo principal de esta investigación fue determinar si existe una diferencia estadísticamente significativa en las características antropométricas de los estudiantes de cuarto grado de primaria, que viven en diferentes entornos demográficos en Montenegro. La investigación se realizó sobre una muestra de 120 estudiantes, cuarto grado de primaria, sexo masculino (60 estudiantes de zona urbana y 60 estudiantes de zona rural). Para medir las características antropométricas se aplicaron 12 medidas (Altura del cuerpo, longitud del brazo, longitud de la pierna, ancho del hombro, diámetro del codo, diámetro de la rodilla, peso corporal, circunferencia del brazo, circunferencia de la pierna, pliegue de la piel de la espalda, pliegue de la piel de la parte superior brazo, pliegue cutáneo del abdomen). Después de realizar la investigación con la aplicación de los procedimientos estadísticos apropiados: análisis descriptivo, análisis de varianza multivariante (MANOVA) y análisis de varianza (ANOVA), se observó que existe una diferencia estadísticamente significativa en el espacio tratado de características antropométricas. Los niños de áreas rurales son más dominantes que los niños de áreas urbanas en la dimensionalidad longitudinal y transversal del esqueleto y en volumen en ciertos segmentos del cuerpo, y los niños de áreas urbanas son más dominantes que los niños de áreas rurales en peso corporal y grasa subcutánea, lo que los pone en riesgo de obesidad.

Madurez neuropsicológica en niños bilingües y monolingües de zonas urbanas y rurales de la región Arequipa

Introducción: Diversos estudios han planteado que el bilingüismo favorece el desarrollo de las funciones neuropsicológicas, mientras que también se ha demostrado que, en los países de América Latina, los niños que viven en zonas urbanas presentan mayor nivel de desarrollo neuropsicológico que sus pares de zonas rurales. Objetivo: Comparar la madurez neuropsicológica en niños y niñas que viven en zonas rurales y urbanas de Arequipa (Perú), en función del sexo, la zona de residencia y el bilingüismo. Sujetos y métodos: Se evaluó a 140 niños (52.8% varones y 47.2% mujeres) con una edad promedio de 76 meses, 50% monolingües y 50% bilingües, 50% viven en zonas urbanas y 50% en zonas rurales. Se aplicó el Cuestionario de Madurez Neuropsicológica Infantil (CUMANIN) de Portellano et al. (2000). Resultados: El cociente de madurez neuropsicológica se ubica en un nivel medio alto en la muestra general. Las niñas presentan mayor nivel de estructuración espacial y madurez neuropsicológica que los niños. Los niños bilingües tuvieron un mejor rendimiento en lenguaje expresivo en comparación con los monolingües con un tamaño de efecto moderado, y los niños que residen en zonas urbanas tienen puntuaciones mayores en fluidez verbal, lectura y escritura que los de zonas rurales, con diferencias significativas y tamaños del efecto grandes. Conclusiones: La zona de residencia es determinante en el desarrollo neuropsicológico de niños bilingües y monolingües, a favor de los que provienen de zonas urbanas en funciones tales como fluidez verbal, lectura y escritura.

Introduction: Several studies have suggested that bilingualism favors development of neuropsychological functions. In addition, it has also been shown, in Latin American countries, children living in urban areas have a higher level of neuropsychological development than their peers who live in rural areas. Objective: To compare the neuropsychological maturity in boys and girls who live in rural and urban areas of Arequipa (Peru), according to sex, area of residence, and bilingualism. Subjects and methods: 140 children were evaluated (52.8% male and 47.2% female) with an average age of 76 months, 50% monolingual and 50% bilingual, 50% living in urban areas and 50% in rural areas. The Childhood Neuropsychological Maturity Questionnaire (CUMANIN) of Portellano et al. (2000) was used. Results: The neuropsychological maturity quotient is located at a high average level in the general sample. Girls presented a higher level of spatial structuring and neuropsychological maturity than boys. Bilingual children had a better performance in expressive language compared to monolinguals with a moderate effect size. Moreover, children residing in urban areas have higher scores in verbal fluency, reading and writing than those in rural areas, with significant differences and sizes of the big effect. Conclusions: The area of residence is determinant in the neuropsychological development of bilingual and monolingual children, in favor of those who come from urban areas in functions such as verbal fluency, reading and writing.

70 years of progress in environmental health in Shanghai / 上海预防医学

Shanghai is one of the cities with the highest economic level in China. Environmental health in Shanghai has always been a national pilot and at the forefront of the country. After 70 years of development, Shanghai has established a public health monitoring network for major environmental health issues. The main line of research work has turned to be on health risk assessment, exposure-health effect, and the relationship between environment and population health. This article reviews the achievements and problems of in various aspects of environmental health in the past 70 years, including drinking water, the atmosphere, public places, rural environments, emergency handling and featured researches. It provides reference for the development of environmental health in the future.

Ideação suicida em assentamentos rurais no Piauí / Suicidal ideation in rural settlements in Piauí

Objetiva investigar possíveis casos de ideação suicida em áreas de assentamentos rurais no Piauí. Para isso, realizou-se estudo de corte transversal em dois assentamentos rurais. Por meio de questionário sócio demográfico e o instrumento Self-Reporting Questionnaire (SRQ-??), identificou-se casos de transtorno mental comum na população investigada, com destaque para indivíduos que pontuaram o item do questionário que trata da presença de pensamentos suicidas. Para análise dos dados utilizou-se o pacote estatístico SPSS. Os resultados evidenciaram relação do indicativo de pensamentos com pessoas do sexo feminino, número de filhos, ocupação dona de casa e presença de transtorno mental comum. Tais variáveis por si só não são preditoras ao suicídio, mas evidenciam uma grande vulnerabilidade de mulheres ao comportamento suicida.

The study aimed to investigate possible cases of suicidal ideation in rural settlement areas in Piauí. Therefore, a cross-sectional study was conducted in two rural settlements. A demographic questionnaire and the Self-Reporting Questionnaire (SRQ-20) were used and we looked at cases of common mental disorder in the population investigated, with special note to individuals who scored higher in the item about suicidal thoughts. SPSS was used for data analysis. Results showed that suicidal thoughts were more strongly associated with women, the number of children, being a house wife and having a common mental disorder. These variables, by themselves, are not predictors of suicide, but they evidence the vulnerability of women to suicidal behaviour.

Analysis of Medical Treatment Interest Trend in Rural Environment by Big Data / 의료커뮤니케이션

BACKGROUND: In the rural environment, medicine treatment has analyzed the health behavior of some rural areas, but it is necessary to study and generalize trends of interest in the whole country. Therefore, The objective of this study is to analyze interest trends of rural health care services of rural residents in rural areas by Big Data.METHODS: Big medical data collection related to rural environment medicine treatment used portal site data of social networks. The Big Data was analyzed utilizing a Textom and Ucinet6 analysis tools.RESULTS: Among the major keywords of Big Data are ‘hospital’, ‘university’, ‘management’, ‘seat’, ‘improvement’, ‘residents’, ‘information’, ‘exercise’, ‘development’, ‘problem’, ‘Pain’, ‘Possibility’, ‘Post’, ‘Work’, ‘Relationship’ etc occupy a high rank in all analyzes such as frequency ranking, total network analysis, 4 centrality and CONCOR analysis. In rural environment medicine, the individual diseases of interest were skin, scars, atopy, acne, eyes, hyperlipidemia, stress and so on. It is also possible to find out whether the program, the longevity person, the cultivation, the village, the farm, the activity, the program, the education, the experience, etc.CONCLUSION: In the rural areas, they are interested in the folk medicine that can be used in the rural areas for the treatment of the diseases related to the rural areas.The lack of treatment for children and women indicated that professional information was needed, and they also expressed interest in food, life, and spatial location for long-lived villages. Specially, “atopy” and “earnestness” were included in the main words. The word ‘health center’, which is the subject of various health promotion projects, was not included in the 170 main words.

Aportes a la seguridad alimentaria a través de la lactancia materna en comunidades rurales / Contributions to food security through breastfeeding in rural communities

Desde el 2008 Colombia aprueba la Política Nacional de Seguridad Alimentaria y Nutricional, esta recomienda la lactancia materna (LM) por los beneficios en el bienestar de la familia y el niño, al prevenir infecciones respiratorias, digestivas, neurológicas y por sus características nutricionales que contribuyen a un adecuado desarrollo neurológico, ganancia de talla y peso, este estudio evaluó esta práctica en población rural. Métodos Mediante grupos focales, 25 personas convocadas por escuelas campesinas de agroecología intercambiaron prácticas y saberes sobre LM, las entrevistadas corresponden a la generación actual y la anterior que tuvieron experiencias de LM. Resultados La generación más joven con paridad entre 1 y 5, lactó en promedio 14.9 meses y las abuelas con paridad entre 1 y 12, lactó en promedio 22 meses. La leche entera de vaca se aprecia tanto como la leche humana, esta es valorada por sus efectos en el desarrollo y bienestar de los hijos, siendo más alegres y activos, más no reconocen sus beneficios económicos. Consideran que genera alteraciones físicas en las madres y en la sexualidad de los varoncitos. Conclusiones Disminuyó en 7 meses el promedio de duración de la LM entre las dos generaciones de madres. El desarrollo motor precoz y las expresiones de sexualidad observadas en los hijos, durante el acto de amamantamiento, motivaron a algunas madres a suspenderla antes de los 2 años de edad, igualmente los cambios anatómicos que afectan sicológica y estéticamente a las madres. Los participantes no valoran económica ni socialmente la LM.

Since 2008, Colombia has approved the National Food and Nutrition Security Policy, which recommends breastfeeding for welfare benefits of the family and child, and preventing respiratory, digestive, neurological infections and their contributing nutritional characteristics-Methods Through focus groups, 25 people convened by schools of agroecology exchanged practices and knowledge about breastfeeding, the interviewees correspond to the current and previous generations who practiced breastfeeding. Results The youngest generation with parity between 1 and 5, had breastfeeding mean 14.9 months and grandmothers had parity between 1 and 12, lactated on average 22 months. All them were thinking Whole cow’s milk is good as human milk. Breastfeeding was valued for its effects on the development and well-being of children, their children being more cheerful and active, but they do not recognize their economic benefits in breastfeeding vs cow’s milk. The mothers consider that breastfeeding generates physical alterations in the mothers and in the sexuality of the children Conclusions Breastfeeding decreased in seven months between the two generations. The early motor development and the expressions of sexuality observed in the children, during breastfeeding, motivated some mothers to suspend before the 2 years of age, also the anatomical changes perceiving for mothers was defined cause for interrupt breastfeeding .

Habilidades cognitivas, contexto rural y urbano: comparación de perfiles WAIS-IV en jóvenes / Cognitive skills, rural and urban context: comparison of WAIS-IV profiles in youth

La reciente estandarización en Chile de la Escala Wechsler de Inteligencia para Adultos (WAIS), en su cuarta versión, obliga a investigar el impacto que condiciones culturales y ambientales pueden tener sobre el rendimiento intelectual de las personas. El presente estudio comparó el desempeño de jóvenes provenientes de sectores rurales y urbanos de la región del Biobío, segmentados según nivel educativo de los padres como variable de aproximación al nivel socioeconómico. Los resultados muestran un efecto de interacción entre el nivel socioeconómico y el lugar de residencia. Comprensión verbal y memoria de trabajo son los constructos que reciben un mayor impacto del nivel socioeconómico. Se espera que futuros estudios contribuyan a la investigación de habilidades cognitivas en sectores rurales y socialmente deprivados de Chile.

The recent standardization of Wechsler Adult Intelligence Scale (WAIS) in its fourth version in Chile forces to test the impact that cultural and environmental conditions can have on people's intellectual performance. The present study compared the performance of young people from rural and urban areas of the Biobío region, segmented by parental education level as proxy variable to socioeconomic status. Results showed an interaction effect between socioeconomic status and place of residence. Verbal Comprehension and Working Memory are the constructs that received a higher impact of the socioeconomic status. Future studies are expected to contribute to research on cognitive abilities in rural and socially deprived sectors in Chile.

A fragilidade/resistência da vida humana em comunidades rurais do Pantanal Mato-Grossense (MT, Brasil) / The human life fragility/resistance in rurals communities of Pantanal (MT, Brazil)

A fragilidade/resistência da vida humana tomada no sentido ambíguo/complexo sugere o olhar para a dinâmica da vida de grupos populacionais específicos. O estudo de uma comunidade no entorno da Reserva Particular do Patrimônio Natural do Serviço Social do Comércio (RPPN Sesc) Pantanal, Distrito Rural de Joselândia, município de Barão de Melgaço (MT), no período de 2003 a 2005, buscou apreender o modo de vida dessa população, articulando a explicação do processo saúde doença com os aspectos históricos, econômicos e sociais da comunidade em questão e a singularidade das práticas de cura ocorridas no local. Utilizou-se de registros documentais históricos, depoimentos de moradores, inquérito populacional, entrevistas e observações. Verificou-se que houve mudanças nos laços de solidariedade entre os moradores no trabalho e na produção de alimentos. As práticas de cura populares são alternativas utilizadas para abrandar os sintomas e doenças. A fragilidade/resistência desse grupo específico se configura como resistência baseada nas relações de solidariedade e familiares e a fragilidade na dificuldade do acesso ao trabalho, serviços de saúde e equipamentos públicos.

The human life fragility/resistance taken in the ambiguous/complexity sense suggests an eye to the dynamics of life of specific groups. The study of the community around the Private Reserve of Natural Patrimony of the Social Service Commerce (RPPN Sesc) Pantanal, situated in Joselândia rural district, municipality of Barão de Melgaço - Mato Grosso state - Brasil, 2003 at 2005, used qualitative methods to apprehend the lifestyle of this population, articulating the explanation of the health-ill process with historical, economic and social aspects of the respective community and the singularity of the cure practices that happened on site. It was used historical records, testimonials of residents, population survey, interviews and observations. The results indicate changes in the solidarity bonds among residents at work and at food production. Popular cure practices are frequently used to reduce symptoms and diseases. The fragility/resistance of this specific group is observed while resistance based in solidarity and familiar relations and the fragility in the difficulty of access of work, health services and public equipments.

PROCESOS Y DINÁMICAS RURALES: Una lectura desde el enfoque de género / RURAL PROCESSES AND DYNAMICS: A reading from the gender approach

Este documento aporta elementos teóricos y empíricos para enriquecer la reflexión sobre los procesos y dinámicas que tejen la vida cotidiana de los hombres y de las mujeres rurales. En la primera parte se hacen explícitas algunas consideraciones a) sobre el medio rural, resaltando las características principales de lo que se ha denominado Nueva Ruralidad y b) sobre el enfoque de género, haciendo énfasis en la situación de las mujeres rurales. Después de una rápida ubicación contextual del estudio empírico, en términos geofísicos y demográficos, se plantean algunas consideraciones en torno a las condiciones existenciales de los hombres y de las mujeres que habitan la Vereda San Peregrino, zona rural del Municipio de Manizales, Caldas, Colombia.

This document gives theoretical and empirical elements in order to enrich the reflection on processes and dynamics which are involved in the day-to-day life of rural men and women. The first part explicitly describes some considerations on: a) the rural environment, highlighting the main characteristics of what has been called New Rurality, and b) the gender approach, focusing on the circumstances of rural women. After a quick contextualization of this empirical study, in geophysical and demographical terms, some considerations about the life conditions of the men and women who live in the municipal rural settlement of San Peregrino, in Manizales, Caldas, Colombia.

A fragilidade/resistência da vida humana em comunidades rurais do Pantanal Mato-grossense, MT, Brasil / The fragility/strength of human life in rural communities of the Pantanal wetlands, Mato Grosso State, Brazil

A fragilidade/resistência da vida humana tomada no sentido ambíguo/complexo sugere o olhar para a dinâmica da vida de grupos populacionais específicos. O estudo de uma comunidade no entorno da Reserva Particular do Patrimônio Natural do Serviço Social do Comércio - RPPN SESC Pantanal, Distrito Rural de Joselândia, município de Barão de Melgaço (MT), no período de 2003-2005, buscou aprender o modo de vida dessa população, articulando a explicação do processo saúde-doença com os aspectos históricos, econômicos e sociais da comunidade em questão e a singularidade das práticas de cura ocorridas no local. Utilizou-se de registros documentais históricos, depoimentos de moradores, inquérito populacional, entrevistas e observações. Verificou-se que houve mudanças nos laços de solidariedade entre os moradores no trabalho e na produção de alimentos. As práticas de cura populares são alternativas utilizadas para abrandar os sintomas e doenças. A fragilidade/resistência deste grupo específico se configura enquanto resistência baseada nas relações de solidariedade e familiares e a fragilidade na dificuldade do acesso ao trabalho, serviços de saúde e equipamentos públicos.

From an ambiguous/complex standpoint, the fragility/strength of human life suggests an approach based on observations of the life-style dynamics of specific population groups. Conducted between 2003 and 2005, this study of a community living alongside the Pantanal Wetlands Private Natural Heritage Reserve established by the Social Enterprise Support Centre (RPPN/ SESC) in the Joselândia Rural District, Barão de Melgaço Municipality, Mato Grosso State, Brazil, explores its life-style, linking explanations of the health/disease process to historical, economic and social aspects of this community and the singularity of local healing practices, using historical documentary records, statements from local residents, a population poll, interviews and observations. Changes were noted in the links of solidarity among community members at work and for growing food. Healing practices based on folk-medicine are alternatives used to relieve symptoms and diseases. The fragility/strength of this specific community is established through strength based on solidarity and family ties, while its fragility is due to difficulties in accessing work, healthcare services and public facilities.

Um estudo do nicho de desenvolvimento de um grupo de crianças em uma comunidade rural / A study of developmental niche of a group of children in a rural community

Este trabalho adota uma perspectiva de desenvolvimento situado no contexto, empregando a noção de nicho de desenvolvimento, definido a partir de três subsistemas: ambiente físico e social, práticas de cuidado e psicologia dos cuidadores. Seu objetivo foi investigar as idéias e práticas de um grupo de mães e o ambiente físico e social que elas propiciam a seus filhos, em uma comunidade rural do Estado do Rio de Janeiro. Seis mães foram observadas com seus bebês em suas casas, e preencheram um inventário específico. A idade das mães variou de 19 a 32 anos e seu nível educacional de fundamental a médio. Os bebês tinham entre 1 e 21 meses. Em geral, os resultados sugerem, como previsto pelo modelo, uma interação entre os componentes do nicho. Explicitam, também, concepções de maternidade e desenvolvimento reveladas pelos membros dessa comunidade, e permitem considerações sobre o nicho de desenvolvimento das crianças estudadas.

This study adopts a perspective of development as contextually situated, employing the notion of developmental niche that is composed of three sub-systems: social and physical environment, care practices, and the psychology of the caregivers. The aim of the study was to investigate the ideas and practices of the mothers, and the physical and social environment they offer to their children in a rural community of the State of Rio de Janeiro. Six mothers were observed at home with their children and filled a specific inventory. Mothers age varied from 19 to 32 years, and their educational level ranged from elementary to high school. Babies had from 1 month to 21 months. In general, the results suggest, as predicted by the model, an interaction between those components. They also indicate conceptions of maternity and development shared by members of this community, and allow considerations about the developmental niche of the children studied.

Este trabajo adopta una perspectiva del desarrollo situado en el contexto, empleando la noción del lugar de desarrollo que se compone a partir de tres subsistemas: ambiente social y físico, prácticas de cuidado, y la psicología de los cuidadores. El objetivo fue el de investigar las ideas y las prácticas de un grupo de madres, y el ambiente físico y social que ofrecen a sus niños en una comunidad rural del estado de Río de Janeiro. Seis madres fueron observadas con sus bebés en sus casas y llenaron un inventario específico. La edad de las madres variaba de 19 a 32 años, y su nivel educacional de la primaria a la secundaria. Los bebés tenían entre 1 y 21 meses. Por lo general los resultados sugieren, según lo previsto por el modelo, una interacción entre esos componentes. También indican conceptos de maternidad y desarrollo revelados por los miembros de esa comunidad y permiten consideraciones sobre el lugar de desarrollo de los niños estudiados.