Use of eye care services among diabetic patients in urban and rural China.

OBJECTIVE: To assess the use of eye care and its predictors among diabetic patients in China. DESIGN: Cross-sectional, clinic-based study. PARTICIPANTS: Diabetic patients 18 years of age or older were recruited consecutively from an urban tertiary and community hospitals and from a rural clinic in Guangdong, China. METHODS: Information obtained by questionnaire and chart review included: demographic and socioeconomic status, knowledge about diabetic retinopathy (DR), and ocular and medical history. MAIN OUTCOME MEASURES: Self-reported or chart history of an eye examination ever or within the preceding 12 months. RESULTS: The participation rate among 889 eligible subjects was 92.7%. Among 824 participants (mean age, 62.6+/-12.9 years; 58.8% female), 550 (66.7%) had not been examined in the last year as recommended by the American Academy of Ophthalmology, and 356 (43.2%) had never been examined. For the rural hospital, these figures were 81.1% and 68.7%, respectively. In regression analyses, factors associated with having an eye examination in the last year were: attendance at urban hospitals (odds ratio [OR], 3.46 [P<0.001] and 1.76 [P = 0.021] for the tertiary and community hospitals, respectively, compared with the rural clinic), higher DR knowledge score (OR, 1.24; P = 0.001), greater concern about vision loss (OR, 1.22; P = 0.007), and recommendation of regular eye examinations by the provider (OR, 2.36; P = 0.011). Predictors of ever having an eye examination were similar. Monthly income and health insurance status were not predictive of being examined. CONCLUSIONS: These results suggest that the low proportion of diabetic receiving recommended annual eye examinations in China may be improved through patient and physician education. Copyright © 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Do Gifts Increase Consent to Home-based HIV Testing? A Difference-in-differences Study in Rural KwaZulu-Natal, South Africa

Background Despite the importance of HIV testing for controlling the HIV epidemic, testing rates remain low. Efforts to scale-up testing coverage and frequency in hard-to-reach and at-risk populations commonly focus on home-based HIV testing. This study evaluates the effect of a gift (a food voucher for families, worth US$ 5) on consent rates for home-based HIV testing.
Methods We use data on 18,478 men and women who participated in the 2009 and 2010 population-based HIV surveillance carried out by the Wellcome Trust Africa Centre for Health and Population Studies in rural KwaZulu-Natal, South Africa. Our quasi-experimental difference-in-differences approach controls for unobserved confounding in estimating the causal effect of the intervention on HIV testing consent rates.
Results Allocation of the gift to a family in 2010 increased the probability of family members consenting to test in 2010 by 25 percentage points (95% CI 21-30; p<0.001). The intervention effect persisted, slightly attenuated, in the year following the intervention (2011), further increasing intervention value for money.
Conclusions In HIV hyperendemic settings a gift can be highly effective at increasing consent rates for home-based HIV testing. Given the importance of HIV testing for treatment uptake and individual health, as well as for HIV treatment-and-prevention strategies and for monitoring the population impact of the HIV response, gifts should be considered as a supportive intervention for HIV testing initiatives where consent rates have been low.

Prevalence of overweight and obesity in children from urban and rural Niagara

Purpose: The influence of environment in the development of overweight and obesity is an ongoing concern. This investigation examined the influence of urbanization on the rates of childhood overweight and obesity. Method: 2167 (1090M, 1077F) grade four children from 75 schools in Ontario's Niagara Region were sampled. A sophisticated algorithm overlaying electoral boundaries, population densities, and the knowledge of community members was used to classify schools into one of three location categories: urban {N= 1588), urban fringe {N= 379), and rural (A^= 234). Each subject was measured for: height, weight, and aerobic performance (Leger). Physical activity was evaluated with the self-report Participation Questionnaire (free-time and organized sport activities), and teacher's evaluations of student activity. Overweight (overweight and obesity combined) was measured both as a continuous (BMI) and categorical variable (BMI category), to evaluate the prevalence by location. A multivariate analysis was used to test for a suppression effect. Results: BMI and BMI category did not differ significantly by location or gender, and no evidence of a gender interaction existed. According to both a linear and logistic regression, physical activity or fitness levels did not suppress the influence of location on BMI and BMI category. Age, gender, free-time activity, organized sports, fitness level, and number of siblings, were all found to significantly influence overweight. Conclusions: It is plausible that the prevalence of overweight does not differ in urban and rural children from the Niagara Region. Further investigation is recommended, examining subjects by individual location of residence, in multiple regions throughout Ontario.

Competing and Conflicting Land Uses at the Rural-Urban Interface: Understanding the Impacts of Residential Development on Agricultural Landscapes

Rural communities are currently undergoing rapid restructuring as globalization impacts the future viability of many small towns. Agricultural regions throughout Canada, in particular, Niagara-on-the-Lake, are forced to adapt to changes within the industry. In addition to these challenges, sprawling residential developments from nearby urban centres are changing the dynamic of this town, resulting in conflicts between the residential and agricultural land uses. This thesis explores these conflicts from the perspective of the residents and the farmers. It was found that the initial sources of conflict related to noise-generating farm activities are no longer a concern, while the use of pesticide have become a source of contention among the residents. The farmers, alternately, were found to be proactive and strived to limit the potential for conflict with adjacent residents. Lastly, it was determined that planning legislation aggravates land use conflicts within Niagara-on-the-Lake and need to better address these land use conflicts.

Gender differences in time allocation of poor children in Colombia

This paper studies the effect of credit constraints and constraints on transfers between parents and children, on differences in labor and schooling across children within the same household, with an application to gender. When families are unconstrained in these respects, differences in labor supply or education are driven by differences in wages or returns to education. If the family faces an imperfect capital market, the labor supply of each child is inefficient, but differences across children are still driven by comparative advantage. However, if interfamily transfers are constrained so that parents cannot offset inequality between their children, they will favor the human capital accumulation of the more disadvantaged child -generally the one who works more as a child. We use our theory to examine the gender gap in child labor. Using a sample of poor families in Colombia, we conform our predictions among rural households, although this is less clear for urban households. The gender gap is largely explained by the wage gap between girls and boys. Moreover, families with the potential to make capital transfers to adult children (e.g. those with large animals), can compensate adult sons for their greater child labor and reduced educational attainment. In such families, as predicted, the male/female labor gap is greater.

El estado de la educación rural en América Latina y en África.

Es necesario tomar en serio los procesos de educación rural en ambos continentes, para lo cual sería muy importante que, más allá de las políticas nacionales, pero sin prescindir de ellas, la Comunidad Internacional y sus grandes organizaciones, se empeñasen seriamente en afrontar los problemas de una planificación estratégica para la educación rural, sin excluir Asia y que movilizase todo tipo de voluntades y recursos. Para entender y afrontar la búsqueda de soluciones a la educación en el mundo fue trascendental el Forum Mundial sobre educación celebrado de Dakar. El objetivo de 155 países reunidos fue revisar los compromisos de la comunidad internacional para la reducción del analfabetismo y el acceso universal a una educación de calidad. La fecha fijada par ese gran cambio fue el año 2000. Aunque ya en la reunión de 1995 los gobiernos tuvieron que reconocer que no se caminaba a buen paso y la pospusieron para el 2015. sin embargo, los principales organismos reunidos en torno a la campaña mundial por la educación nos advierten de que si las cosas siguen así, llegaremos a esta última fecha igual ¿Qué ha pasado? ¿Es un problema de costes? No. Los gobiernos tienen o podrían tener dinero si corrigiesen algunos errores o tendencias perversas de los recursos suficientes para hacer frente al gasto que supone la educación básica universal. Esto es, el acceso a la escuela primaria de todos los menores entre seis y doce años y la alfabetización de los adultos. Pero también podría si se invierten las tendencias actuales, ir más allá y apostar por la formación generalizada, elemento esencial para el desarrollo duradero de la humanidad. Es una cuestión de voluntad política.

Urban mammals: what does the future hold? An analysis of the factors affecting patterns of use of residential gardens in Great Britain

1Urban areas are predicted to grow significantly in the foreseeable future because of increasing human population growth. Predicting the impact of urban development and expansion on mammal populations is of considerable interest due to possible effects on biodiversity and human-wildlife conflict. 2The British government has recently announced a substantial housing programme to meet the demands of its growing population and changing socio-economic profile. This is likely to result in the construction of high-density, low-cost housing with small residential gardens. To assess the potential effects of this programme, we analysed the factors affecting the current pattern of use of residential gardens by a range of mammal species using a questionnaire distributed in wildlife and gardening magazines and via The Mammal Society. 3Twenty-two species/species groups were recorded. However, the pattern of garden use by individual species was limited, with only six species/species groups (bats, red fox Vulpes vulpes, grey squirrel Sciurus carolinensis, hedgehog Erinaceus europaeus, mice, voles) recorded as frequent visitors to > 20% of gardens in the survey. 4There was a high degree of association between the variables recorded in the study, such that it was difficult to quantify the effects of individual variables. However, all species/species groups appeared to be negatively affected by the increased fragmentation and reduced proximity of natural and semi-natural habitats, decreasing garden size and garden structure, but to differing degrees. Patterns of garden use were most clearly affected by house location (city, town, village, rural), with garden use declining with increasing urbanization for the majority of species/species groups, except red foxes and grey squirrels. Increasing urbanization is likely to be related to a wide range of interrelated factors, any or all of which may affect a range of mammal species. 5Overall, the probable effects of the planned housing development programme in Britain are not likely to be beneficial to mammal populations, although the pattern of use examined in this study may represent patterns of habitat selection by species rather than differences in distribution or abundance. Consequently, additional data are required on the factors affecting the density of species within urban environments.

Near real-time flood detection in urban and rural areas using high resolution Synthetic Aperture Radar images

A near real-time flood detection algorithm giving a synoptic overview of the extent of flooding in both urban and rural areas, and capable of working during night-time and day-time even if cloud was present, could be a useful tool for operational flood relief management. The paper describes an automatic algorithm using high resolution Synthetic Aperture Radar (SAR) satellite data that builds on existing approaches, including the use of image segmentation techniques prior to object classification to cope with the very large number of pixels in these scenes. Flood detection in urban areas is guided by the flood extent derived in adjacent rural areas. The algorithm assumes that high resolution topographic height data are available for at least the urban areas of the scene, in order that a SAR simulator may be used to estimate areas of radar shadow and layover. The algorithm proved capable of detecting flooding in rural areas using TerraSAR-X with good accuracy, and in urban areas with reasonable accuracy. The accuracy was reduced in urban areas partly because of TerraSAR-X’s restricted visibility of the ground surface due to radar shadow and layover.

A near real-time algorithm for flood detection in urban and rural areas using high resolution Synthetic Aperture Radar images

A near real-time flood detection algorithm giving a synoptic overview of the extent of flooding in both urban and rural areas, and capable of working during night-time and day-time even if cloud was present, could be a useful tool for operational flood relief management and flood forecasting. The paper describes an automatic algorithm using high resolution Synthetic Aperture Radar (SAR) satellite data that assumes that high resolution topographic height data are available for at least the urban areas of the scene, in order that a SAR simulator may be used to estimate areas of radar shadow and layover. The algorithm proved capable of detecting flooding in rural areas using TerraSAR-X with good accuracy, and in urban areas with reasonable accuracy.

Near real-time flood detection in urban and rural areas using high resolution Synthetic Aperture Radar images

A near real-time flood detection algorithm giving a synoptic overview of the extent of flooding in both urban and rural areas, and capable of working during night-time and day-time even if cloud was present, could be a useful tool for operational flood relief management. The paper describes an automatic algorithm using high resolution Synthetic Aperture Radar (SAR) satellite data that builds on existing approaches, including the use of image segmentation techniques prior to object classification to cope with the very large number of pixels in these scenes. Flood detection in urban areas is guided by the flood extent derived in adjacent rural areas. The algorithm assumes that high resolution topographic height data are available for at least the urban areas of the scene, in order that a SAR simulator may be used to estimate areas of radar shadow and layover. The algorithm proved capable of detecting flooding in rural areas using TerraSAR-X with good accuracy, classifying 89% of flooded pixels correctly, with an associated false positive rate of 6%. Of the urban water pixels visible to TerraSAR-X, 75% were correctly detected, with a false positive rate of 24%. If all urban water pixels were considered, including those in shadow and layover regions, these figures fell to 57% and 18% respectively.

Multi-scale sensible heat fluxes in the urban environment from large aperture scintillometry and eddy covariance

Sensible heat fluxes (QH) are determined using scintillometry and eddy covariance over a suburban area. Two large aperture scintillometers provide spatially integrated fluxes across path lengths of 2.8 km and 5.5 km over Swindon, UK. The shorter scintillometer path spans newly built residential areas and has an approximate source area of 2-4 km2, whilst the long path extends from the rural outskirts to the town centre and has a source area of around 5-10 km2. These large-scale heat fluxes are compared with local-scale eddy covariance measurements. Clear seasonal trends are revealed by the long duration of this dataset and variability in monthly QH is related to the meteorological conditions. At shorter time scales the response of QH to solar radiation often gives rise to close agreement between the measurements, but during times of rapidly changing cloud cover spatial differences in the net radiation (Q*) coincide with greater differences between heat fluxes. For clear days QH lags Q*, thus the ratio of QH to Q* increases throughout the day. In summer the observed energy partitioning is related to the vegetation fraction through use of a footprint model. The results demonstrate the value of scintillometry for integrating surface heterogeneity and offer improved understanding of the influence of anthropogenic materials on surface-atmosphere interactions.