Follow-up of Children With Trait in a Rural Setting

PEDIATRICS ◽  
1989 ◽  
Vol 83 (5) ◽  
pp. 876-877
Author(s):  
Herman Harris
Keyword(s):  
Sickle Cell ◽  
Rural Areas ◽  
Urban Areas ◽  
Cost Effective ◽  
Rural Setting ◽  
Urban Centers ◽  
Hb S ◽  
The Individual ◽  
Limited Testing

The Comprehensive Sickle Cell Centers were established in 1972 to test, educate, counsel, and research sickle cell anemia and related hemoglobinopathies. Standards and protocols for testing, education, and research were readily established because similar procedures and methods were already in operation at the institutions where the centers were located. The most difficult and still the most controversial program to provide is counseling. It became evident, early, that there is no universally accepted method for informing carriers of abnormal Hb S about their results. Centers located in large urban areas with a limited testing radius do not face the same problems as centers located in rural areas where the testing radius may cover an entire state or several states. Individual, or one-on-one, counseling of persons with trait results appears to be successful for urban centers where the individual may be called to the center and given information. But, in a rural setting, it is not feasible for the center to ask a person to travel 350 miles to be told he or she has nothing to worry about. And it is not cost-effective to send a caseworker 350 miles to say the same thing. It must, therefore, be concluded that each agency or center must adopt counseling methods that meet its specific needs. Each program must be flexible, imaginative, and creative and must successfully and accurately deliver information about being a carrier for the sickle gene or other hemoglobinopathy and its implication and significance for patients and their future offspring. To do this, we must first look at the problems facing us.

An Academic-Community Collaboration to Deliver Medication Therapy Management (MTM) Services to Patients Living in Rural Counties of a Southwestern State in the United States

2021 ◽  
pp. 089719002110002
Author(s):  
David Rhys Axon ◽  
Melissa Johnson ◽  
Brittany Abeln ◽  
Stephanie Forbes ◽  
Elizabeth J. Anderson ◽  
...  
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Program Effectiveness ◽  
Small Town ◽  
The United States ◽  
Small Towns ◽  
Academic Community ◽  
Service Needs ◽  
Medication Therapy

Background: Patients living in rural communities often experience pronounced health disparities, have a higher prevalence of diabetes and hypertension, and poorer access to care compared to urban areas. To address these unmet healthcare service needs, an established, academic-based MTM provider created a novel, collaborative program to provide comprehensive, telephonic services to patients living in rural Arizona counties. Objective: This study assessed the program effectiveness and described differences in health process and outcome measures (e.g., clinical outcomes, gaps in care for prescribed medications, medication-related problems) between individuals residing in different rural-urban commuting area (RUCA) groups (urban, micropolitan, and small town) in rural Arizona counties. Methods: Subjects eligible for inclusion were 18 years or older with diabetes and/or hypertension, living in rural Arizona counties. Data were collected on: demographic characteristics, medical conditions, clinical values, gaps in care, medication-related problems (MRPs), and health promotion guidance. Subjects were analyzed using 3 intra-county RUCA levels (i.e., urban, micropolitan, and small town). Results: A total of 384 patients were included from: urban (36.7%), micropolitan (19.3%) and small town (44.0%) areas. Positive trends were observed for clinical values, gaps in care, and MRPs between initial and follow-up consultations. Urban dwellers had significantly lower average SBP values at follow-up than those from small towns (p < 0.05). A total of 192 MRPs were identified; 75.0% were resolved immediately or referred to providers and 16.7% were accepted by prescribers. Conclusion: This academic-community partnership highlights the benefits of innovative collaborative programs, such as this, for individuals living in underserved, rural areas.

scholarly journals Estimation of Building Heights and DEM Accuracy Assessment Using ICESat-2 Data Products

2021 ◽  
Vol 10 (1) ◽  
pp. 37
Author(s):  
Goddu Pavan Sai Goud ◽  
Ashutosh Bhardwaj
Keyword(s):  
Spatial Data ◽  
Rural Areas ◽  
Urban Areas ◽  
Accuracy Assessment ◽  
Urban Expansion ◽  
Population Expansion ◽  
Cost Effective ◽  
Absolute Error ◽  
Google Earth ◽  
Surface Geometry

The use of remote sensing for urban monitoring is a very reliable and cost-effective method for studying urban expansion in horizontal and vertical dimensions. The advantage of multi-temporal spatial data and high data accuracy is useful in mapping urban vertical aspects like the compactness of urban areas, population expansion, and urban surface geometry. This study makes use of the ‘Ice, cloud, and land elevation satellite-2′ (ICESat-2) ATL 03 photon data for building height estimation using a sample of 30 buildings in three experimental sites. A comparison of computed heights with the heights of the respective buildings from google image and google earth pro was done to assess the accuracy and the result of 2.04 m RMSE was obtained. Another popularly used method by planners and policymakers to map the vertical dimension of urban terrain is the Digital Elevation Model (DEM). An assessment of the openly available DEM products—TanDEM-X and Cartosat-1 has been done over Urban and Rural areas. TanDEM-X is a German earth observation satellite that uses InSAR (Synthetic Aperture Radar Interferometry) technique to acquire DEM while Cartosat-1 is an optical stereo acquisition satellite launched by the Indian Space Research Organization (ISRO) that uses photogrammetric techniques for DEM acquisition. Both the DEMs have been compared with ICESat-2 (ATL-08) Elevation data as the reference and the accuracy has been evaluated using Mean error (ME), Mean absolute error (MAE) and Root mean square error (RMSE). In the case of Greater Hyderabad Municipal Corporation (GHMC), RMSE values 5.29 m and 7.48 m were noted for TanDEM-X 90 and CartoDEM V3 R1 respectively. While the second site of Bellampalli Mandal rural area observed 5.15 and 5.48 RMSE values for the same respectively. Therefore, it was concluded that TanDEM-X has better accuracy as compared to the CartoDEM V3 R1.

scholarly journals A Study of the Understated Violence Within Social Contexts Against Adolescent Girls

2017 ◽  
Vol 8 (2) ◽  
pp. 29-41
Author(s):  
Shivangi Nigam ◽  
Niranjana Soperna
Keyword(s):  
Adolescent Girls ◽  
Rural Areas ◽  
Urban Areas ◽  
Social Issues ◽  
Well Being ◽  
Structured Interview ◽  
Social Contexts ◽  
The Social ◽  
The Difference ◽  
The Individual

Violence against women is linked to their disadvantaged position in the society. It is rooted in unequal power relationships between men and women in society and is a global problem which is not limited to a specific group of women in society. An adolescent girl’s life is often accustomed to the likelihood of violence, and acts of violence exert additional power over girls because the stigma of violence often attaches more to a girl than to the  perpetrator. The experience of violence is distressing at the individual emotional and physical level. The field of research and programmes for adolescent girls has traditionally focused on sexuality, reproductive health, and behaviour, neglecting the broader social issues that underpin adolescent girls’ human rights, overall development, health, and well-being. This paper is an endeavour to address the understated or disguised form of violence which the adolescent girls experience within the social contexts. The parameters exposed under this research had been ignored to a large extent when it comes to studying the dimension of violence under the social domain. Hence, the researchers attempted to explore this camouflaged form of violence and discovered some specific parameters such as: Diminished Self Worth and Esteem, Verbal Abuse, Menstruation Taboo and Social Rigidity, Negligence of Medical and Health Facilities and Complexion- A Prime Parameter for Judging Beauty. The study was conducted in the districts of Haryana (India) where personal interviews were taken from both urban and rural adolescent girls (aged 13 to 19 years) based on  a structured interview schedule. The results revealed that the adolescent girls, both in urban as well as rural areas were quite affected with the above mentioned issues. In urban areas, however, due to the higher literacy rate, which resulted in more rational thinking, the magnitude was comparatively smaller, but the difference was still negligible.  

scholarly journals Sickle cell disease pain management and the medical home

Hematology ◽  
2013 ◽  
Vol 2013 (1) ◽  
pp. 433-438 ◽  
Author(s):  
Jean L. Raphael ◽  
Suzette O. Oyeku
Keyword(s):  
Pain Management ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Medical Home ◽  
Cost Effective ◽  
Cell Disease ◽  
Patient Centered ◽  
Centered Care ◽  
The Individual ◽  
Effective Models

Pain is the most common cause for hospitalization and acute morbidity in sickle cell disease (SCD). The consequences of SCD-related pain are substantial, affecting both the individual and the health care system. The emergence of the patient-centered medical home (PCMH) provides new opportunities to align efforts to improve SCD management with innovative and potentially cost-effective models of patient-centered care. The Department of Health and Human Services has designated SCD as a priority area with emphasis on creating PCMHs for affected patients. The question for patients, clinicians, scientists, and policy-makers is how the PCMH can be designed to address pain, the hallmark feature of SCD. This article provides a framework of pain management within the PCMH model. We present an overview of pain and pain management in SCD, gaps in pain management, and current care models used by patients and discuss core PCMH concepts and multidisciplinary team–based PCMH care strategies for SCD pain management.

scholarly journals A Survey of Traditional and Customized Bus Transportation Planning Methodologies

2022 ◽  
Vol 10 (1) ◽  
pp. 15-19
Keyword(s):  
Rural Areas ◽  
Transportation Planning ◽  
Urban Areas ◽  
Cost Effective ◽  
Well Being ◽  
Transit Planning ◽  
Planning Strategy ◽  
Bus Transit ◽  
Mode Of Transportation ◽  
Bus Service

Transportation planning is an area of public policy that is increasingly recognized for having a significant impact on human health and well-being. Passengers all across the world are choosing bus transit as one of the most cost-effective ways of transportation. The number of passengers who use this mode of transportation is steadily increasing. According to statistics, the bus was India's most popular mode of transportation in 2014. A bus was viewed as a mode of transportation by 66 percent of families in rural areas and 62 percent of households in urban areas. With increased demand, there is a concern about efficiently organizing this service. Because a lack of planning can generate major problems in the real world, such as traffic jams and high operating expenses, it is a source of concern for corporate and government entities who provide this service. In this paper, a review on various bus transit planning approaches and stages and methodologies used in each stage of the customized bus planning strategy is presented. This study will assist bus service organizing entities, whether private or public, in efficiently organizing bus service

Indigenous Language Media, Communication, and Sickle Cell Disorder

2022 ◽  
pp. 50-69
Author(s):  
Opeyemi Olaoluwa Oredola ◽  
Kehinde Opeyemi Oyesomi ◽  
Ada Sonia Peter
Keyword(s):  
Health Communication ◽  
Sickle Cell ◽  
Rural Areas ◽  
Urban Areas ◽  
Group Discussion ◽  
Indigenous Language ◽  
Media Communication ◽  
Indigenous Media ◽  
Communication Techniques ◽  
Cell Disorder

The importance of health communication and information cannot be over emphasized especially with issues related to sickle cell disorder. Sickle cell disorder, common among Africans, has a lot of myths and misconceptions tied to it, so this chapter unearths and explores how indigenous communication can facilitate learning and understanding of the disorder majorly in rural areas and some urban areas where knowledge of the disorder is assessed low using the focus group discussion. It also reveals the importance of incorporating indigenous language and communication techniques in increasing awareness and eradicating stereotypes as regards sickle cell disorder. The findings of this chapter reflect that misinformation occurs due to lack of proper understanding of language used in sickle cell health communication-related issues. Hence, this chapter proposes that health education about the concept of SCD should be executed majorly in indigenous languages and through the indigenous media platforms.

Women and Apartheid

2017 ◽  
Author(s):  
Meghan Healy-Clancy
Keyword(s):  
Black Men ◽  
Social Reproduction ◽  
Rural Areas ◽  
Urban Areas ◽  
White Women ◽  
African Women ◽  
Urban Centers ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Racial Lines

Apartheid, the system of racial and ethnic separation introduced in South Africa in 1948, was a gendered project. The immediate goal of the white Afrikaner men who led the apartheid state was to control black men: to turn black men from perceived political and criminal threats into compliant workers. Under apartheid, African men would travel to work for whites in towns and on mines, but their homes would be in rural ethnic “reserves,” known as “homelands” or “Bantustans.” This vision depended on the labors of African women: while their men migrated to work, women were to maintain their families in the increasingly overcrowded and desolate countryside, reproducing the workforce cheaply while instilling a sense of ethnic difference in their children. “Coloured” (mixed-race) and Indian women were similarly charged with social reproduction on a shoestring, in segregated rural and urban areas. White women uniquely had the franchise and freedom of movement, but they were also constrained by sexually repressive laws. Apartheid’s gendered vision of production and social reproduction faced continual resistance, and it ultimately failed. First, it failed because African women increasingly moved from rural areas to urban centers, despite laws limiting their mobility. Second, it failed because some women organized across ethnic and racial lines. They often organized as mothers, demanding a better world for a new generation. Both their nationally and internationally resonant campaigns—against pass laws, educational and health care inequities, police brutality, and military conscription—and the fact of their collective organization gradually undermined apartheid. Officials generally underestimated the power of women, and their contributions have continued to be under-appreciated since apartheid ended in 1994, because women’s political style emphasized personal and familial concerns. But because apartheid was premised on transforming how families lived, actions of women in fact undermined the system from its core.

Water consumption patterns in a rural setting in Ngamiland district, Botswana: the case of Boro village

2014 ◽  
Vol 4 (4) ◽  
pp. 720-726 ◽  
Author(s):  
Itumeleng Oageng ◽  
Gagoitseope Power Mmopelwa
Keyword(s):  
Water Use ◽  
Significant Relationship ◽  
Rural Areas ◽  
Urban Areas ◽  
Resource Planning ◽  
Rural Setting ◽  
Demand Model ◽  
Use Patterns ◽  
Per Capita ◽  
Water Use Patterns

Water is a precious resource with a variety of uses, which include drinking, cooking, bathing, recreation, gardening, agriculture, hydropower generation, industry and maintenance of the environment. The focus of many empirical studies has been the identification of factors that determine demand for water in urban and semi-urban areas, with the aim of improving water resource planning and development. However, studies on water use patterns in rural areas, especially where water is obtained from open sources, are limited. This study aims to describe water use patterns and demand in the rural settlement of Boro in the Ngamiland district in Botswana. Data were collected from rural households using a structured questionnaire. The average per capita water use was estimated at 20.6 litres per person per day. Estimation of the water demand model showed a significant relationship between annual household income and per capita water consumed (PWC). Both the regression model and the scatter plot did not reveal any significant relationship between PWC and distance to the water source. The study recommends further work be done on the relationship between PWC and distances beyond the ‘threshold’ distance.

scholarly journals Prevalensi dan Determinan Hipertensi di Pulau Jawa, Tahun 2004

2006 ◽  
Vol 1 (2) ◽  
pp. 57
Author(s):  
Zamhir Setiawan
Keyword(s):  
Risk Factor ◽  
Rural Areas ◽  
Urban Areas ◽  
Analysis Method ◽  
Hypertension Status ◽  
Individual Level ◽  
Level Measurement ◽  
Study Results ◽  
Ecological Measurement ◽  
The Individual

Hipertensi merupakan faktor risiko utama kardiovaskuler yang merupakan penyebab utama kematian di seluruh dunia. Peningkatan umur harapan hidup dan perubahan gaya hidup meningkatkan faktor risiko hipertensi di berbagai negara. Tujuan penelitian ini (1) Mengetahui prevalensi hipertensi dan penyebarannya di Pulau Jawa tahun 2004. (2) Mengetahui faktor-faktor sosiodemografi yang berhubungan dengan kejadian hipertensi. (3) Mengetahui kontribusi dan dampak potensial masing-masing faktor tersebut. Penelitian dengan rancangan studi Ekologi Multilevel ini menggabungkan variabel tingkat pengukuran individu dengan tingkat pengukuran ekologi dalam analisis bersama, dengan unit analisis individu. Analisis kontekstual dilakukan melalui kerangka konsep hipertensi, menggunakan metode analisis regresi logistik ganda, dengan status hipertensi sebagai variabel dependen. Data variabel dependen dan variabel perancu yang merupakan data pengukuran tingkat individu diambil dari data SKRT 2004. Data sosiodemografi tingkat pengukuran ekologi sebagai variabel independen utama, diperoleh dari Profil Kesehatan Indonesia, Statistik Indonesia, Statistik Kesehatan, Statistik Kesejahteraan Rakyat, danData Departemen Dalam Negeri, unit pengamatan provinsi. Hasil penelitian ini menunjukkan prevalensi hipertensi di Pulau Jawa 41,9%, dengan kisaran di masing-masing provinsi 36,6%-47,7%. Prevalensi di perkotaan 39,9% (37,0%-45,8%) dan di perdesaan 44,1% (36,2%-51,7%). Kata kunci: Hipertensi, faktor sosiodemografiAbstractHypertension is a main risk factor of cardiovascular disease which is ranked as number one cause of death in the world. The increase of life expectancy and changes in life style have increased the prevalence of hypertension risk factor in both developed and developing countries. The objectives of this study are (1) To know the prevalence and distribution of hypertension in di Java island, in year 2004. (2) To know sosiodemographic factors related to hypertension. (3) To know the contribution of each sosiodemographic factor toward hypertension. The study used multilevel ecologic study design that integrated both individual and ecological level variables measurement. The analysis method used in this study was contextual analysis and multiple logistic regression with hypertension status as dependent variable. The individual level measurement of variables such as hypertension status and age, job, education and sex is taken from Household Health Survey (SKRT) 2004. The sosiodemographic data which was ecological measurement level served as the main independent variables were taken from Indonesian Health Profile, Indonesian Health Statistics, Public Welfare Statistics and data from Department of Internal Affair, particularly from Province Surveillance Unit. The study results showed that the prevalence of hypertension in Java Island was 41.9%, with range of prevalence in provincial level of 36.6%-47.7%. The prevalence in urban areas was 39.9% (37.0%-45.8%) and in rural areas was 44.1% (36.2%-51.7%)Keywords: Hypertension, sosiodemographic factors

scholarly journals Comparison of the clinical effect of intra-articular injection of platelet-rich plasma and methylprednisolone in primary osteoarthritis of knee: a randomized controlled trial

2019 ◽  
Vol 6 (6) ◽  
pp. 1842
Author(s):  
Darendrajit S. Longjam ◽  
Joy S. Akoijam ◽  
Meina S. Ahongshangbam ◽  
Nilachandra S. Longjam
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Osteoarthritis Of The Knee ◽  
Womac Pain ◽  
Osteoarthritis Of Knee ◽  
Primary Osteoarthritis ◽  
Steroid Group

Background: Osteoarthritis of knee is one of the commonest musculoskeletal disorder causing mobility impairment affecting 3.3% in urban areas and 5.5% in rural areas. Intra-articular injection of Platelet-Rich Plasma (PRP) delivers activated platelets that may reduce inflammation, provide pain relief, improve function and stimulate possible cartilage regeneration at the site of worn cartilage area of the knee.Methods: Eighty patients with primary osteoarthritis of the knee fulfilling inclusion and exclusion criteria were recruited in the study conducted in the Department of Physical Medicine and Rehabilitation, RIMS, Imphal from October 2014 to September 2017. Six ml of PRP prepared by conventional bench top centrifugation system was injected intra-articularly, two weeks apart in the PRP group. Steroid group received 80mg of methylprednisolone, two weeks apart by the same technique. The outcome variables (VAS and WOMAC score) were measured before starting intervention (baseline) and at 8 and 24-weeks post-intervention follow up.Results: Significant improvement seen in VAS, WOMAC-pain, stiffness and physical function and total scores in both the groups at 8- and 24-weeks follow-ups (p˂0.001). Steroid group showed better result than the PRP group in VAS (2.78±0.76 vs 3.58±1.03) and WOMAC-total (30.42±6.85 vs 36.25±10.87) scores at 8 weeks respectively (p˂0.001). But at 24 weeks follow-up, PRP showed significantly more effective than the steroid group in reducing pain (2.0±.0.87 vs 2.45±0.78) and disability (22.95±3.78 vs 25.25±6.67) respectively (p˂0.001).Conclusions: Intra-articular injection of methylprednisolone was found to be more effective in reducing pain and disability in primary knee osteoarthritis of KL grade 2 and 3 at the end of 8 weeks whereas 2 doses of PRP intra-articular injection 2 weeks apart was significantly more effective than methylprednisolone at the end of 24 weeks. However, the long-term benefit of PRP is to be determined by studies with a larger sample size and longer duration of follow-up.

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