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Housing quality and affordability are well established as social determinants of health through direct and indirect mechanisms. Respiratory illnesses related to housing are nearly all the result of housing disrepair that allows intrusion into the home of environmental agents that are directly or indirectly associated with disease. Structural deficiencies such as leaks, cracks in the foundation or holes in the home's exterior can facilitate the presence of mould, which is causally linked to the development of asthma and is associated with exacerbation of asthma symptoms in children and adults. Indoor cleanliness can also contribute to the presence of mice and cockroaches. Proper ventilation can improve air quality, reducing exposure to PM, VOCs and infectious respiratory agents. Disparities in exposure to the housing conditions associated with respiratory disease are readily apparent across socioeconomic lines. Low-income families are less likely to be able to afford the costs of maintaining a home, which prevents them from making repairs that could improve respiratory health.Copyright © ERS 2023.
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An introduction to journal is presented in which the author discusses articles within the issue on topics including differences in the receipt and delivery of extended school year services in the U.S., ways to sustain work experiences in rural communities and improve for youth with disabilities, and professional development model for secondary mathematics co-teaching.
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Background: The coronavirus disease (COVID-19) was a pandemic which spread to various countries and originated in Wuhan, China. For appropriate response, planning, and allocation of resources demographic data play an important role in understanding the impact of COVID-19 across the country. Aim(s): To estimate epidemiological and demographic parameters like age, sex, area, sample type etc. of samples reported in COVID-19 diagnostic laboratory of RUHS College of Medical Sciences, Jaipur, Rajasthan. Material(s) and Method(s): The study was conducted retrospectively in a tertiary care hospital at Jaipur. Data like age, gender, urban or rural, IPD/ICU or OPD etc. were collected between January 1, 2021 to June 30, 2021. The collected data were expressed in number, counts and percentage. The data of six months were analysed using Microsoft Excel. Result(s): From January to June 2021, April and May 2021 showed highest positivity 13084 (27.42%) and 10968 (23.06%) respectively. February 2021 and June 2021 showed least positivity 156 (2.39%) and 163 (0.8%) respectively. Total COVID-19 positive cases during 6 months were 25134 and deaths were 357 with highest deaths were during May 2021 (n=270). Males (64.28% to 72.20%) were affected most. In April and May 2021 positivity in urban area was 6053 (46.26%) and 5712 (52.07%) respectively, while in rural area 7031 (53.74%) and 5256 (47.93%) respectively. The positivity in OPD patient during April and May was 93.58% (12245) and 95.26 % (10449) respectively. Nineteen to forty years was most affected age group. Conclusion(s): During second wave both urban and rural population was affected. Males and working age group were affected more. Among COVID-19 suspects' positivity rate was low in IPD patients as compared to OPD patients. Critical factors for an effective public health response are surveillance and contact tracing.Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.
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This work describes food experiences during the Covid-19 pandemic, according to the urban or rural ecological configuration and the socioeconomic level (SES) in households in the province of Tucumán (Argentina). A digital field work was carried out in 1342 households classified as urban (942) or rural (400) according to the criteria of the Instituto Nacional de Estadísticas y Censos. Food experiences were assessed through primary data analysis applying the Latin American and Caribbean Scale for the measurement of Food Security and SES through the Family Affluence Scale. Likewise, secondary information sources were used to characterize the structural living conditions of the urban and rural population. The results showed a higher affectation in the experiences of the home in general, compared to the experiences of adults and children and adolescents, in particular. Rural households were the most affected, as were those with low SES. However, the experiences and practices in both environments had in common the care of feeding children and adolescents. © Editado por D. Demarchi
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Purpose of Study Lewis County is in southwest Washington state. With a population per square mile of 31.4, Lewis County is more rural than the rest of the state (101.2 per square mile). Citizens of the county, as well as health care workers at Chehalis Family Medicine (located in Lewis County), report concerns over rates of opioid use disorder. While Lewis County's age adjusted rate per 100,000 of deaths due to opioid overdose from 2014-2017 was lower than that of Washington state (7.6 vs 9.3), its rate of opioid related hospitalizations was significantly higher (110.7 vs 81.5). Methods Used An asset-based approach was used to learn how Lewis County has been addressing opioid use disorder amongst its citizens. Interviews with health care providers, patients at Chehalis Family Medicine, and the pastor of a local church were performed. These conversations revealed a lack of access to public transportation creates a major barrier to receiving opioid use disorder treatment. A literature review of interventions implemented in rural areas to deliver medically assisted opioid use disorder treatment was performed. Summary of Results The recent use of telemedicine to deliver suboxone treatment at Chehalis Family Medicine has increased access to medically assisted treatment of opioid use disorder. Telemedicine has become more prevalent with some loosening of governmental regulations due to the COVID-19 pandemic. Based upon articles by Guille et al and Weintraub et al, administration of medically assisted opioid use disorder treatment via telehealth offers a means to expand access to care in rural communities. They demonstrated no significant differences in patient outcomes. Implementation of telemedicine at other suboxone clinics in Lewis County would improve access to suboxone treatment. Conclusions A strength-based framework allows the existing assets in Lewis County to be appraised so future work can build upon what has already proved effective for the community. Regarding opioid use disorder treatment, Lewis county has several low barrier suboxone clinics which could increase access for rural patients through implementation of telemedicine. Chehalis Family Medicine's recent success with telemedicine in suboxone treatment could serve as a template for how to do so effectively.
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Certain populations have been excluded from the benefits of telehealth and the recent advances and widespread use of technology in health promotion due to limited technology access. Although research has identified these specific groups, none has explored these issues using the social determinants of health (SDH) framework. This exploratory study aimed 1) to investigate technology access and 2) to identify associated SDHs. A cross-sectional research design was implemented, and participants were recruited from rural Alabama (N=185). Binary logistic regressions were conducted. Only 60% of participants had technology access. People with food insecurity and health illiteracy were less likely to have internet and PC/tablet access. In addition, older age was associated with a lower likelihood of access to a smartphone. This study provided insights into SDH correlates of the digital divide, particularly among rural African Americans, and indicated that addressing affordability could be a partial solution.
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Background: Data is sparse regarding the utility of social media in engaging southern, rural communities in health awareness education and research. Community Advisory Board (CAB) members of the Mississippi (MS) Core of the Risk Underling Rural Areas Longitudinal (RURAL) Study suggested the use of a Facebook social media platform to promote the RURAL Study while providing live health education presentations that they could review and refer to others. Objective(s): Identify social media strategies using existing Facebook metrics to engage the populations of two rural counties in research on Heart, Lung, Blood and Sleep disorders. Method(s): The Principal Investigator of RURAL Study's MS Core collaborated with the University's Social Media Coordinator to implement a Facebook page for the Study. The team implemented six health awareness education programs focused on monthly health observances that best fit with HLBS disorders and COVID-19 concerns noted by the CABs. Facebook metrics including Reach (Organic and Paid Ads), Views, Likes, Comments and Shares were collected continuously. Finding(s): There were six Health Awareness events between February and June 2021 (Table 1). Paid Ads resulted in a greater reach among those in targeted rural communities. The number of views positively correlated with the number reached. The highest number of views were for short talks on Men's Health (June events) compared to hour-long panel discussions (Feb, May and Aug events). The numbers of Likes, Comments and Shares were similar among the different approaches. Clicks were greater among Paid Ads compared to Organic Ads. Between February and August the number of followers increased from 39 to 300 with the largest increase in July after the Men Health talks. Conclusion(s): Using social media may be an effective tool for reaching communities with health awareness and health education. Our findings support that Paid Ads (Boosts) focusing on targeted audiences are more effective than Organic Ads. Short talks are more effective than hour long programs.
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Introduction: Despite policy actions and strategic efforts for improving the reproductive and sexual health of adolescents by promoting the uptake of adolescent reproductive and sexual health (ARSH) services, the utilisation rate remains significantly low, especially in rural areas of India. This study aimed to assess the utilisation of these services by adolescents in rural West Bengal and its associated determinants. Method: This mixed-method study was conducted from May to September 2021 in the Gosaba rural block of South 24 Parganas, West Bengal. Quantitative data were collected from 326 adolescents using a pre-tested structured questionnaire. Qualitative data were collected via four focus group discussions among 30 adolescents and key-informant interviews among six healthcare workers. Quantitative data were analysed using SPSS, while qualitative data were analysed thematically. Results: Ninety-six (29.4%) adolescents had utilised ARSH services at least once during adolescence. The factors associated with non-utilisation of ARSH services were younger age, female sex, increasing reproductive health stigma and decreasing parent-adolescent communication related to sexual health. Qualitative exploration revealed that unawareness regarding services, perceived lack of privacy and confidentiality at healthcare facilities and disruption of services post-emergence of the COVID-19 pandemic were some major barriers to ARSH service utilisation. Conclusion: A multi-component strategy, including promotion of adolescent-friendly health clinics, community support interventions associated with motivation and counselling of parents regarding the importance of adolescent reproductive health, is needed to improve the utilisation of ARSH services. Necessary steps to correct the deficiencies at the facility level should also be prioritised.
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The object of study is the demographic characteristics of the Russian rural population of the European part of Russia (at the level of individual governorates, regions, and republics) from the beginning of the twentieth century to the beginning of the twenty-first century. These data are analyzed in the context of general demographic trends. The goal is to identify regions with similar demographic indicators during several chronological periods (1902, 1940, 2002, 2020) and to observe the transformation of demographic characteristics in different periods of history and in different regions of European Russia. This provides the necessary material for making assumptions about the connection between demographic types and natural-geographical, economic-geographical, and ethnogeographical factors. The principal research method, multivariate cluster analysis, is a tool for identifying stable groups of typologically homogeneous objects. The clustering of regions was carried out on the basis of three key demographic indicators: fertility, mortality, and natural growth. The authors came to the conclusion that, as early as the beginning of the twentieth century, Russian agrarian society was already at different demographic stages, evolving from a traditional to a modernized society. In the middle of the century, discrepancies in the rates of demographic transition became noticeable, manifested in some conventional "dividing" lines such as the ones between Russian oblasts and some national republics;the ones between agro-industrial and industrial-agrarian regions;the ones between southern and northern territories;and, finally, the ones between the regions and republics close to and distant from Moscow. The entwinement of these lines gave rise to various cluster groupings and, apparently, led to some consequent variability in the types of demographic characteristics in different regions, which is also recorded at the beginning of the twentieth century. The authors also pay attention to types of "demographic responses" of different regions to the coronavirus pandemic.
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This paper presents evidence on the short and long-term impact of the COVID-19 crisis on India's rural youth. We interviewed about 2,000 vocational trainees from Bihar and Jharkhand three times after the first national lockdown in 2020, between June 2020 and December 2021. We find that a third of respondents who were in salaried jobs pre-lockdown lost their jobs, and half of those who worked out of state returned home shortly after the lockdown. We report a stark difference between men and women: while many male workers took up informal employment, most female workers dropped out of the labour force. In the second part of the paper, we use a randomised experiment to document the effects of a government-supported digital platform designed to provide jobs to low-skilled workers. The platform turned out to be difficult to use and publicised only few job ads. We find no effect on job search intensity or employment. Our findings suggest that bridging the gap between rural young workers and urban formal labour markets requires more active and targeted policy interventions, especially for female workers. © 2023 The Authors
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Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus. Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment. Older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness. The best way to prevent and slow down transmission is to be well informed about the COVID-19 virus, the disease it causes and how it spreads. Protect yourself and others from infection by washing your hands or using an alcohol based rub frequently and not touching your face. The aim of the present study was assess the Knowledge, attitude, and practices regarding of COVID-19: among rural population.Cross-sectional questionnaire-based study was conducted on rural people A total of 200 participants hailing from rural areas were enrolled. Result(s): Most common source of information for the participants was through television (54.8%) and radio (49.2%). Only 77% claimed that they were using face mask and 72% claimed to be following social distancing. A large (60%) proportion of the participants did not know that COVID-19 could spread from asymptomatic patients. The mean (percentage) scores of knowledge, attitude, and practice were 21.26 (82%), 9.37 (92%), and 10.32 (86%), respectively. Education of participants was a key determinant for use of social distancing and face mask as a preventive tool. With increasing age, the practice of social distancing and the use of face mask were decreasing in our study. Conclusion(s): Television/Radio channels form an important source of information and need to be used more effectively to educate the people about the disease and create awareness about effective preventive measures. People need to be educated about the role of asymptomatic carriers in spreading the disease.Copyright © 2020 Ubiquity Press. All rights reserved.
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Background: Quality of life (QoL) is a multifactorial concept on the perception of the individual's wellbeing underpinned by environmental, psychological, and physical factors. Several studies have shown changes in QoL in the COVID-19 pandemic and may be due to increases in mortality rates, however, no study has investigated this among Peruvian jungle dwellers. Here, we have sought to estimate the QoL of individuals before and after the increase in cases and deaths from COVID-19. Methods: A questionnaire-based longitudinal study was conducted in 102 inhabitants (mean 40.75 ± 7.49 years). The Spanish version of the WHOQOL-BREF was used in two stages: April and June. The first stage was accomplished before the first confirmed case of COVID-19, and the second stage was when the daily mortality rate was 3.5% with an incidence of 87%. Results: Sixty (54.8%) participants were women, 67 (61.9%) were >31 years, and 38 (34.5%) and 32 (29.1%) participants had primary and secondary education, respectively. In the first and second stage we obtained an overall mean QoL of 46.65 ± 23.2 and 35 ± 27.7 points, respectively. Individuals had significantly lower QoL in the face of increased deaths in physical (p = 0.001), mental (p = 0.028) and environmental (p = 0.001) health domains, with the latter having the greatest impact (51.84 ± 5.81 vs. 16.66 ± 5.55 points). Conclusion: Quality of life of Peruvian jungle dwellers is reduced during periods of increased mortality and incidence by COVID-19. Preventive strategies aimed at reducing the impact of COVID-19 on the mental health and global wellbeing of individuals living in the Amazon are recommended to Peruvian authorities.
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INTRODUCTION: COVID-19 led to the rapid adoption of telemedicine with a significant spike in the literature concerning the patients' perspective of its use. The providers' perspective has been less well studied. Med Center Health is a healthcare network that provides services in 10 southern Kentucky counties that are home to over 300,000 people with approximately 61% of this population living in areas defined as rural. The goal of this article was to compare the experience of providers serving a predominantly rural population to their patients and compare the experience of providers between each other based on the obtained demographic data. METHODS: An online electronic survey was developed and sent out from July 13th, 2020 to July 27th, 2020 for completion to the 176 physicians of the Med Center Health Physician group. The survey gathered basic demographic information, telemedicine use during COVID-19, and perceptions of telemedicine use during and the role of telemedicine after COVID-19. Perceptions of telemedicine were gauged using Likert and Likert-style questions. Cardiology provider responses were compared to the previously published patient responses. Differences between providers were also analyzed based on the demographic data obtained. RESULTS: Fifty-eight providers responded to the survey with nine providers indicating that they did not use telemedicine during COVID-19. Significant differences between eight cardiologists' and cardiology patients' perceptions of telemedicine visits were seen for internet connectivity (p < 0.001), privacy (p = 0.01), and clinical exam (p < 0.001) with cardiologists ranking these as more concerning or worse in all instances. These results continued when comparing perceptions of patients' in-person experience and providers' perception of telemedicine visits with significant differences observed with clinical exam (p < 0.001), communication (p = 0.048), and overall experience (p = 0.02). No statistically significant differences were seen between cardiologists and other providers. Providers who indicated more than 10 years of practice rated their experience with telemedicine significantly lower in the domains of effective communication (p = 0.004), level of care provided (p = 0.02), thoroughness of clinical exam (p = 0.047), patient comfort discussing concerns (p = 0.04), and overall experience (p = 0.048). Despite this, only three providers indicated that they would not use telemedicine post-pandemic with a majority indicating that they would feel comfortable using telemedicine for follow-up visits and medication refill visits. CONCLUSION: This is the first study to our knowledge to compare patient and provider satisfaction concerning telemedicine across a wide array of topics using Likert-style and Likert scale questions and the first to investigate the perception of providers who serve a predominantly rural patient base during the COVID-19 pandemic. Similar results have been found in a few previous studies concerning telemedicine being less favorably rated by more experienced providers. Further studies need to be conducted to identify and correct the barriers that exist for providers and the adoption of telemedicine.
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The digital platforms provide rural and small-town residents with access to quality education and a variety of other services, as well as open opportunities for remote job search and the implementation of professional skills. These processes should increase the role of small towns and villages in the formation of the country's online economy, including during the COVID-19 pandemic. The purpose of the article is to compare the participation of residents of large cities and the rest of the Russian population in the field of online work, as well as to compare their skill level. The authors found that residents of small towns and rural areas of Russia are less active in the online labour market. The level of their qualifications is also relatively low. The conclusions were obtained based on the analysis of search queries on the subject of freelancing originating from these localities. Copyright © 2023 Inderscience Enterprises Ltd.
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Background: Obsessive Compulsive Disorder (OCD) can present with unusual symptomatology. Aim(s): To discuss a case of OCD with an atypical manifestation in an adult male teacher who has an obsession and compulsion of prescribing medications to the villagers and its management. Case Summary: A 35 years old male teacher presented with complaint of recurrent obsessional thoughts about prescribing medications to patients and compulsion for the same. He started having these thoughts after conducting duty at a community health center as a COVID-19 booth controller. He perceived these thoughts as intrusive, irrational, absurd, anxiety provoking and distressing;would trying to resist them, but won't be able to do so. He used to sit beside hospitals, squares in villages, and medical shops to find patients and prescribe medications to them to relieve his anxiety. After prescribing medications although his anxiety symptoms would decrease, but he would feel guilty about prescribing medication as he knew that is not an expert. He also faced financial issues as he used to buy medications for villagers, so that they allow him to prescribe medications. He was diagnosed as a case of OCD with good insight and was started on Tab. Escitalopram which was gradually built up to 20 mg over the 3 months along with psychoeducation and supportive sessions. Currently he is in remission and maintaining well since last 2 months. Conclusion(s): This case report illustrates that clinician should remain vigilant about the unusual presentations of OCD to avoid the misdiagnosis and timely management.
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Little is known about how the COVID-19 pandemic relates to child and parent functioning in a rural population. The present study investigated how disability status and parent factors related to resilience in a rural population before and after the shift to remote instruction. Parents of elementary-aged children in a rural area of the U.S. completed an online questionnaire, rating their own functioning and their child's academic, cognitive, and socioemotional functioning (1) retrospectively thinking back to a month before the pandemic, and (2) at the time of the survey, approximately four months after the onset of pandemic changes. Parents of children with disabilities perceived stronger child resilience through the pandemic transition than parents of children without disabilities. Additionally, parents who better maintained their work-life balance and support through the pandemic transition reported stronger resilience in their children. These results highlight the importance of supporting all children and parents during difficult transitions (e.g., providing additional resources so that parents can maintain similar levels of balance and support through the transition), including those students who have experienced less adversity pre-transition.
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The research describes the epidemiological situation in Uzbekistan for sexually transmitted diseases (syphilis, gonorrhea) during the Covid-19 pandemic (2019-2021).Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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Background: Phytochemicals and their derivatives/analogues represent over 50% of the current medicines worldwide in clinical use. Despite a significant contribution to the total bioactive natural plant products, aquatic plants are underestimated, and several species are extinct and in the endangered list. Objective(s): The aim of this review article is to draw the attention of common people and scientists toward a few important contributions of the aquatic plants to natural product chemistry and drug discovery by highlighting the chemical and pharmaceutical aspects of the same. Method(s): The presented data were collected and selected from the literature obtained by an online search for the ethnomedicinal properties, biological activities and bioactive chemical constituents of aquatic plants using Google Scholar, PubMed and Scifinder chemical abstract service. Result(s): The selected literature data revealed that the extract and compounds isolated from several aquatic plants possess significant biological/pharmaceutical properties. For example, the alpha-asarone (24) and asiatic acid (33) isolated from Acorus calamus and Centella asiatica, respectively, exhibited significant neuroprotective effects in vitro and in vivo. The cripowellin A (59), cripowellin C (60), cripowellin B (61) and cripowellin D (62), isolated from Crinum erubescens, exhibited potent antiplasmodial and antiproliferative activities with half maximal inhibitory concentration (IC50) in nanomolar range (11-260 nM). Several other alkaloids from different Crinum species have also shown anticancer properties against different cancer cell lines with IC50 value <5 microM. Alkaloids and resin glycosides, isolated from different Ipomoea species, have displayed significant psychotropic, psychotomimetic, anticancer, and antibacterial activities with IC50 value <5 microM. Conclusion(s): The aquatic plants play a significant role in the discovery of bioactive natural products. Although several biological activities and bioactive compounds have been reported from these plants, further assessment and scientific validation of most of their traditional usages still need to be done. There are several other similar species that are underestimated and not much explored. Many aquatic plants, such as Ipomoea carnea Jacq., Juncus lomatophyllus Spreng., Commelina benghalensis Linn, Gunnera perpensa L., Scirpus maritimus L. and Mentha longifolia (L.) L., may be considered for further evaluation. In addition to these, one should not undermine the potential of Crinum macowanii for COVID-19 pathogenesis, as its chemical constituent lycorine has shown significant SARS-CoV-2 inhibitory potential (EC50, 0.3 muM;SI >129). Furthermore, most rural communities are still using the wetland resources for their cultural, medicinal, economic, domestic, and agricultural needs. Hence, the conservation of aquatic plants and wetlands is an issue of great concern.Copyright © 2023 Bentham Science Publishers.
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In the article determined and substantiated that the public opinion that the residents of rural areas, due to less strict observance of the regime of quarantine COVID restrictions on economic activity, lower population density in the settlement network, and technological features of agriculture, suffered smaller losses in terms of employment and income than other strata, turned out to be too optimistic. According to the results of the study, social alienation is increasing as a result of the deterioration of the entire spectrum of social and labour relations. Further research on the chosen subject may be related to strengthening the institutional capacity and financial self-sufficiency of communities due to the decentralization of powers and resources, the transition to a two-level model of inter-budgetary relations, the development of local self-government and changes in the administrative-territorial system, overcoming the social alienation of self-employed persons, provision of force majeure in circumstances similar to the COVID pandemic, economic access to food, health care services, education, culture, transport, and digital infrastructure.
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Rural and depreciated regions' population is more affected by the COVID-19 pandemic while facing a number of barriers to accessing health services. The aim of this study is to examine whether there are variations in COVID-19 immunisation coverage between urban and rural areas in Bulgaria and to what extent these differences are caused by certain aspects of vaccine access. Material(s) and Method(s): Data on the number of COVID-19 vaccine doses administered by municipalities in Bulgaria from the beginning of the immunisation campaign until the end of 2021 were combined with some demographic variables and information on the availability of general practitioners and temporary immunisation sites. Correlation analysis was used to examine the relationship between datasets, supplemented by graphical analysis, grouping municipalities by the variables' average national values. Finding(s): The number of COVID-19 vaccine doses administered by municipalities has shown a moderate negative correlation with the proportion of the rural population, suggesting differences in immunisation coverage by type of settlement. In general, having more immunisation sites in a municipality does not considerably boost vaccination coverage because there is only a slight association between the number of administrated doses and the availability of vaccination points. There is no correlation between immunisations and the proportion of the adult population. Conclusion(s): Urban-rural disparities often affect the most vulnerable groups at higher risk of morbidity and mortality, and this, in turn, can exacerbate existing health inequalities. Additional efforts are needed to reduce structural barriers to access and overcome vaccine hesitance and mistrust by disseminating appropriate and reliable information and adequate communications.Copyright © 2022, Central Medical Library Medical University - Sofia. All rights reserved.