Women and violence: an everyday fact

In comparison with other countries, Mexico lacks information on the issue of violence against women, especially regarding the incidence and prevalence of battering and emotional abuse. The aim of this study was to determine the frequency and distribution of violence against women among both rural and urban populations in the state of Jalisco, Mexico. A cross-sectional study was conducted among two groups randomly selected; 1,163 rural women (RW) and 427 urban women (UW). Variables included: frequency of violence of family members against women and vice versa, socioeconomic variables and reason for violence. The results were: a) 44.2 per cent and 56.7 per cent rural and urban female population, respectively, suffered some form of violence; b) the principal aggressor was the husband in more than 60 per cent of the cases in both rural and urban areas. Significant statistical difference (p < 0.05) were found between rural and urban groups in relation to low education, middle-age and family size over 7 members.     

Prevalence of dementia in a rural setting: A report from India

A study to estimate the prevalence of dementia in a rural population was conducted in a community located on the outskirts of Madras city in South India. Seven hundred and fifty elderly 60 years of age and older, selected using the cluster sampling technique, were interviewed using the Geriatric Mental State schedule (GMS). The prevalence of dementia was 3.5%, the percentage increasing with age. These rural prevalence estimates were higher than in urban settings (WHO multicentre study on cognitive impairment and dementia in developed and developing countries, unpublished) and male/female differences were negligible. The difficulties associated with the use of the GMS in a non-literature rural population are discussed. The implications of these findings for India's growing elderly population are highlighted.     

Plasma levels of high-energy compounds compared with severity of illness in critically ill patients in the intensive care unit

OBJECTIVE: To compare the prevalence of type 2 diabetes mellitus (DM) and coronary artery disease (CAD) and hypertension in DM in the rural and urban populations of north India. DESIGN AND METHODS: Two populations of the same ethnic background were randomly selected for this cross sectional survey. There were 1769 rural (894 men, 875 women) and 1806 urban subjects (904 men, 902 women) between 25-64 years of age. The survey methods included fasting and 2 h blood glucose and electro-cardiogram and blood pressure measurement of all subjects. RESULTS: Using the criteria of World Health Organization, the prevalence of diabetes mellitus (6.0 vs 2.8%) hypertension (24.0 vs 17.0%) and CAD (9.0 vs 3.2%) was significantly (P<0.001) higher in urban compared to rural subjects. Hypertension and CAD were significantly more frequent among subjects with diabetes compared to nondiabetes. The association of CAD and hypertension with diabetes was greater in urban than rural subjects. Excess body weight and obesity, central obesity, sedentary lifestyle, higher visible fat intake (>25 g/day), and social class 1-3 (higher and middle) were significantly associated with diabetes. Multivariate logistic regression analysis showed that after adjustment of age and sex, body mass index, central obesity, sedentary lifestyle and higher visible fat intake and alcohol intake in men were significant risk factors of diabetes among all the sub-groups. CONCLUSIONS: The study showed a high prevalence of diabetes in urban north Indian population compared to rural subjects in the same ethnic group. CAD and hypertension were significantly associated with diabetes more in urban than rural subjects. The findings suggest that higher body mass index, waist-hip ratio and visible fat intake and sedentary lifestyle were risk factors of diabetes.     

Determinants of stillbirth mortality in Greece

A population-based case-control study of the determinants of stillbirths was conducted in Greece from 1989 to 1991. All reported stillbirths after 28 weeks of pregnancy (N = 2,006) during the three year study period comprised the case group. The control group derived from random sampling of 10% of all livebirths in Greece, during the same period (N = 30,705). The data were analysed by modelling through multiple logistic regression. The adjusted relative risk of stillbirth was significantly higher for males compared to females. A statistically significant monotonic increase in relative risk was observed with shorter gestational age, low maternal education, and older maternal age. Birthweight and parity showed a statistically significant U-shaped association with stillbirth risk, with a higher risk being observed among both low and high birthweight deliveries, as well as among primiparous or multiparous (4+) mothers. Positive associations of stillbirth with multiple births, out-of-wedlock marriage and non-Greek-orthodox maternal religion were noted in crude analyses, but these associations almost disappeared in logistic regression model. Maternal urban or rural residence showed no relation to risk. Overall, the prospective risk of stillbirth after the 24th week of gestation in Greece has been estimated to be higher than that in Japan (a more developed country) with more than 40% of stillbirths occurring after the 36th week of pregnancy.     

Studies on cell-mediated immune responses by human lymphocytes in vitro. III. Lymphocyte response to phytohemagglutinin and concanavalin A in patients with auto-immune diseases

A study was undertaken concerning prevalence of psychic disorders among 175-5 to 6-year-old, pre-school children randomly selected from the general population in the municipality of Aarhus and the island Sams? of Aarhus County, Denmark. Deviant behaviour was arbitrarily defined, with a symptom considered aberrant if it occurred in 10% or less of the children studied. Mental health of the children was assessed by (a) the number of deviant symptoms, (b) opinions of the parents and (c) the personal assessment of the author, who interviewed all the families. Thirty-five probands (20%) showed good adjustment, 113 (65%) were coping well with only minor symptoms, and 27 children (15%) were poorly adjusted. A high prevalence of psychosomatic, behavioural, and emotional symptoms was observed, some of them more frequently among boys than girls. No significant difference was found between urban and rural children. The need for psychiatric help even among supposedly normal, pre-school children is discussed and emphasized.     

Anesthesia-induced alteration of small vessel response to norepinephrine

To determine whether foreign medical graduates (FMGs) provide a disproportionate and increasing share of primary care in some rural areas, changes in physician distribution in a rural section of upstate New York over a 20-year period (1953-1973) were evaluated by country of medical education and type of practice. A contiguous urban area was examined for comparison. In 1953, FMGs accounted for a higher proportion of primary care physicians in rural areas (11%) than in urban practice (6%) (p less than 0.01). By 1973, this distribution had increased to 26% rural and 14% urban (p less than 0.001). During the two decades, the number of U.S. medical graduates in primary care declined by 15% in the rural areas but increased by 13% in the urban center. The number of primary care FMGs in this same period increased 88% in the rural area. With a 10% decline in (rural) FMGs trained in developed countries, this net increase in FMGs was accounted for by physicians from developing countries. Primary care physicians trained in the U.S. or in developed countries increased more in the urban center, while physicians from developing countries increased more in rural (53%) than urban (47%) practices. Finally, by 1973, rural primary care physicians were more likely than urban primary care physicians to be from developing countries (p less than 0.001).     

Psychological needs and resources as perceived by rural and urban psychologists.

Practicing psychologists in rural and urban Oregon were surveyed about their perceptions of psychological needs and resources in their communities. Both groups indicated the most salient unmet community needs as adequate access to appropriately trained medication prescribers, comprehensive psychological assessment services, and psychological services for children. When compared with urban communities, those in rural communities have more difficulties with accessing all professional services, and rural psychologists have access to fewer professional resources. However, there appear to be few differences between perceived needs and resources in rural and urban communities. Psychologists who practice in these communities perceive a strong need for more access to psychological services in both settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

National survey of ethical practices across rural and urban communities.

This study examines ethical dilemmas and problems that are encountered by psychologists across rural and urban communities. A survey instrument was created on the basis of previous surveys of ethical practices. A national sample of 1,000 psychologists stratified into urban and nonurban practitioners was surveyed; 447 usable surveys were returned. Data analysis revealed significant differences between small town/rural and urban/suburban groups for several ethical categories. Notably, small town/rural psychologists are more likely to encounter several types of multiple relationships than their urban counterparts. Small town/rural practitioners are also more likely to be highly visible, or well-known, in their communities. Qualitatively, respondents described their struggles with dual relationships, and several offered suggestions to cope with boundary issues. These findings suggest the need to study the practice of psychology in rural communities in more depth, to study the impact of rural characteristics on clients and practitioners, and to create a conceptual model of best practices for rural practitioners. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Observed cancer incidence in southwest korea

A review of the 9997 cancers recorded in the Presbyterian Medical Center Cancer Registry at this teaching hospital in Southwest Korea during the 15-year period from 1963--1977 forms the basis for this study. Gastric cancer was the leading malignant neoplasm in males, comprising 40.5%. Among women, cancer of the uterine cervix (27%) was slightly more common than gastric cancer (25.5%). All cancers with the exception of that arising in the uterine cervix were more common in rural than in urban population groups. The 15-year period was divided into three-year segments to detect any change in observed incidence during this period of rapid economic growth. No definite trends could be observed except a mild decrease in the incidence of female gastric cancer.     

Rural origin as a risk factor for maternal and child health in periurban Bolivia

Rapid migration in Latin America is settling rural women and their families next to those of urban origin in sprawling urban settings. Those born and reared in rural areas bring with them knowledge and skills learned and adapted to rural areas; those same skills may be maladaptive in urban areas. Hypothesized is that urban women of rural origin are more likely to have poorer health outcomes for themselves and their children than lifelong urban counterparts. Identification of specific risk factors affecting child and/or maternal health status in peri-urban barrios can assist health workers to target limited resources to those least likely to access available services.     

Illicit drug use among Mexicans and Mexican Americans in California: the effects of gender and acculturation

AIMS: To examine the effects of gender and acculturation on illicit drug use among the Mexican-origin population in California. DESIGN: The 3012 subjects between 18 and 59 years of age were selected under a stratified, multi-stage cluster sampling method. SETTING: Fresno County in California is primarily agricultural, with only one metropolitan area. Over 30% of the total population of 764,800, are Hispanics, of Mexican origin. MEASUREMENTS: A modified version of the World Health Organization's Composite International Diagnostic Instrument (WHO-CIDI) was used to ascertain drug use. Respondents were considered drug users if they had ever used marijuana, cocaine, hallucinogens, heroin or inhalants. Acculturation was measured with a Likert scale, assessing English vs. Spanish language preference. Other covariates of interest were nativity and place of residence. FINDINGS: Men had higher rates of use than women for every drug (men = 46.3%, women = 23.2%). Urban rates were higher than rural rates, for both women (urban = 32.8% vs. rural = 16.6%) and men (urban = 57.0% vs. rural = 36.8%). In logistic regression models, men were more likely than women to have ever used illicit drugs or inhalants (adjusted OR = 4.8), cocaine (adjusted OR = 5.3) or marijuana (OR = 4.3). However, the combined effect of United States nativity and acculturation, on drug use, was greater among women (adjusted OR = 29.3) than among men (adjusted OR = 7.4). The effect of acculturation was stronger among urban, than among town or rural residents. CONCLUSIONS: Acculturation and United States nativity are risk factors for illicit drug use among Mexican origin men and women. However, women have increased vulnerability compared with men. Findings reinforce the need for culturally based public health interventions.     

The incidence of wife assault in Alberta.

Describes a representative sample of wife assault for Alberta Province, with both rural and urban components. Respondents self-reported the use of conflict tactics by and against them during the year prior to the survey. Wife assault rates were higher in urban settings (12.8%) than in rural settings (8.3%). Overall violence rates (of all self-reported aggressive acts) were virtually identical to those found in a 1985 US survey by M. Straus and R. J. Gelles (unpublished). Of the US sample, 11.3% reported use of violence against wives, compared to 11.2% of the Canadian sample. However, use of severe violence was less in Canada (assuming Alberta to be representative of Canadian rates), with only 77% of the US incidence rate reported. Methodological issues and directions of current data analysis are discussed. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of major weight gain in adult Finns: stress, life satisfaction and personality traits

To study the epidemiology of rural populations in the context of contemporary issues in public health, a population laboratory (Health Census '89) was established in Otsego County, New York, by the Research Institute of the M.I. Bassett Hospital, affiliated with the Columbia University School of Public Health. Such a laboratory is needed because of an apparent lag in positive health indices in rural populations across the United States, resulting in rates of chronic diseases, such as coronary heart disease, for which rural areas now exceed urban ones. This was confirmed for Otsego County by the survey Health Census '89, the foundation of a rural population laboratory, in which all residents were enumerated and characterized as to their prevalent diseases, health behaviors, use of preventive services, and environmental exposures. Heart disease, cancer, and diabetes mellitus rates were found to exceed average rates for US urban areas, while the data on preventive health behaviors suggest this is a population of "late adopters." The survey, conducted in 1989, had an 86.6% response rate, and enumerated 17,147 households and 44,406 persons. The authors discuss adults aged 17-64 years, 58 percent of the total census (n=25,614). Sharp gradients in disease prevalence, risk factors, and utilization of preventive services were observed across educational strata. Data from Health Census '89 were used as the basis for a successful community intervention program, which targeted identified high risk groups. Rural populations are excellent settings for community interventions, offering laboratories where new strategies of risk reduction and provision of preventive services might be tested.     

Prevalence of wheeze and asthma and relation to atopy in urban and rural Ethiopia

BACKGROUND: Asthma and allergy in developing countries may be associated with adoption of an urbanised "western" lifestyle. We compared the rates of asthma symptoms and atopy in urban populations in Jimma, southwest Ethiopia, at an early stage of economic development with those among the population of remote, rural, subsistence areas, and assessed the potential role of environmental aetiological factors leading to the differences. METHODS: Information on wheeze of 12 months' duration, diagnosed asthma, and cough for 3 months of the year was gathered by questionnaire in random household samples of 9844 people from urban Jimma and of 3032 from rural areas. Atopy was defined by allergen skin-test response to Dermatophagoides pteronyssinus and mixed threshings measured in a one-in-four subsample of those aged 5 years and older from both groups. FINDINGS: All respiratory symptoms were rare in children and were significantly less common overall in the rural than in urban group (wheeze odds ratio 0.31 [95% CI 0.22-0.43], p < 0.0001). Asthma was reported by 351 (3.6%) of the urban group, with a median reported duration of 8.5 years (IQR 4-17 years) that was unrelated to age. Atopy was a strong risk factor for asthma in urban Jimma. In the rural areas, skin sensitivity to mixed threshings was only slightly less common than in urban Jimma (0.67 [0.40-1.12], p = 0.13), whereas sensitivity to D pteronyssinus was significantly more common (3.24 [2.40-4.38], p < 0.0001), and since none of the 119 atopic individuals in the rural area reported wheeze or asthma, atopy was possibly associated with a reduction in the risk of disease among this group. Wheeze or D pteronyssinus sensitivity were positively associated with housing style, bedding materials, and use of malathion insecticide, but no single factor accounted for the urban-rural differences. INTERPRETATION: Wheeze and asthma are especially rare in rural subsistence areas, and atopy may be associated with a reduced prevalence of these symptoms in this environment. In urban Jimma, self-reported asthma seemed to emerge as a clinical problem about 10 years before our study began, which is consistent with an effect of new environmental exposures. The factor or factors leading to the increase in asthma and allergy have not been identified, although exposures related to general changes in the domestic environment are likely to be involved.     

Change in sexual behaviour and decline in HIV infection among young pregnant women in urban Uganda

OBJECTIVE: To describe sexual behaviour that may partly explain a decline in HIV seroprevalence in pregnant women in urban settings in Uganda, East Africa. SETTINGS: Two major urban districts in Uganda. METHODS: Repeated population-based behavioural surveys in 1989 and 1995, and repeated HIV serological surveys in consecutive pregnant women attending antenatal clinics from 1989 to 1995. RESULTS: During the study period, a 2-year delay in the onset of sexual intercourse among youths aged 15-24 years and a 9% decrease in casual sex in the past year in male youths aged 15-24 years were reported. Men and women reported a 40% and 30% increase in experience of condom use, respectively. In the same study area, over the same period, there was an overall 40% decline in the rates of HIV seroprevalence among pregnant women attending antenatal clinics. It can be hypothesized that the observed declining trends in HIV correspond to a change in sexual behaviour and condom use, especially among youths. CONCLUSIONS: This is the first report of a change over a period of 6 years in male and female sexual behaviour, assessed at the population level, that may partly explain the observed decline in HIV seroprevalence in young pregnant women in urban Uganda. This result should encourage AIDS control programmes to pursue their prevention activities.     

Rural and urban adolescents' perceptions of mental health

This study investigated rural and urban adolescents' perceptions of mental health. A questionnaire containing nine vignettes (involving child abuse and adult and adolescent mental health issues) was devised based on a tool developed by Flaskerud (1980). Analysis of responses to the questionnaire indicated that there was general agreement among the students about unhealthy behaviors. However, there were some significant differences related to rural/urban setting, gender, and ethnic background. The findings provide insight into rural and urban students' perceptions of problematic behaviors, who should intervene, and how. It is recommended that health care providers assist adolescents in expanding their range of coping behaviors, especially in regard to alcohol abuse and violence.     

Predictors of high-risk alcohol consumption in young offenders on community orders: Policy and treatment implications.

The present study examined the relationship between a set of individual and contextual variables and high-risk alcohol use among young offenders placed on community orders in New South Wales, Australia. Participants (n = 777) were compared on a set of factors known to be strong predictors of high-risk alcohol use among adolescents. The authors assessed the strength of the relationship between gender, age, ethnicity, geographical region of residence, school attendance, father absence, history of childhood trauma, and the presence of severe conduct disorder on weekly levels of alcohol use. Living in rural locations, not currently attending school, being female, and not having been raised with a biological father present were associated with significantly increased odds of alcohol abuse. Father absence was a more important risk factor for rural young offenders, but school dropout was associated with more hazardous drinking among young offenders in urban areas. Accordingly, the authors suggest family-focused intervention programs for young offenders living in rural areas and school-based programs for vulnerable young people living in urban areas, although programs should consider including both factors for both groups if feasible and warranted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship of national highway with injecting drug abuse and HIV in rural Manipur, India

Earlier study reported that about 1% of general population or urban Manipur was injecting drug users (IDUs). A study was conducted to observe the IDU prevalence in rural Manipur and the role of national highway (NH) in determining the IDU prevalence if any. It was also aimed to study the HIV prevalence among IDUs of different villages. Villages were startified in to 3 categories based on distance and communication facilities from the national highway, which cuts across the villages to the neighboring state, Nagaland. Villages close to NH had the highest IDU prevalence of 1.3% and remote villages had the least prevalence of 0.2% whereas villages in between the above mentioned two groups had a prevalence of 0.9%. It was surprisingly observed that HIV was uniformly distributed among the IDUs of all villages and ranged from 50-51%. This indicates that IDU prevalence at distance is predominantly determined by the presence of drug trafficking route/s like national highway whereas HIV prevalence is mainly determined by the needle sharing behaviour of IDUs.     

Rural hospital health promotion: programs, methods, resource limitations

Most hospitals provide health promotion programs for community residents. There is little information concerning the specific types of services offered by rural hospitals. A questionnaire was sent to every acute care hospital in Iowa (N = 124), including 99 rural hospitals and 25 urban hospitals. Surveys were returned from 95 rural hospitals (96%) and 20 urban hospitals (80%). Results indicated that 98.9% of rural hospitals offered health promotion services to community residents. These services provided on average 7.5 programs on a regular basis, while using only 1.2 full-time equivalent (FTE) employees. Urban hospitals provided 9.5 regular programs with 2.4 FTE. The most common types of rural promotion programs were blood pressure screening, cholesterol screening, safety and protection programs, diet/nutrition programs, prenatal/maternal health, and breast cancer screening. Over 40% of rural respondents stated that other less common programs, including substance abuse prevention and mental health promotion, were needed but could not be offered because of resource limitations; these types of services were offered more commonly in urban hospitals. Rural hospital health promotion programs are attempting to meet a wide variety of programming needs with limited resources, and attention may be well directed towards finding how best to provide various programs with limited resources to maximize their impact on community health.