Are rural health professionals also social entrepreneurs?

Social entrepreneurs formally or informally generate community associations and networking that produces social outcomes. Social entrepreneurship is a relatively new and poorly understood concept. Policy promotes generating community activity, particularly in rural areas, for health and social benefits and ‘community resilience’. Rural health professionals might be well placed to generate community activity due to their status and networks. This exploratory study, conducted in rural Tasmania and the Highlands and Islands of Scotland considered whether rural health professionals act as social entrepreneurs. We investigated activities generated and processes of production. Thirty-eight interviews were conducted with general practitioners, community nurses, primary healthcare managers and allied health professionals living and working rurally. Interviewees were self-selecting responders to an invitation for rural health professionals who were ‘formally or informally generating community associations or networking that produced social outcomes’. We found that rural health professionals initiated many community activities with social outcomes, most related to health. Their identification of opportunities related to knowledge of health needs and examples of initiatives seen elsewhere. Health professionals described ready access to useful people and financial resources. In building activities, health professionals could simultaneously utilise skills and knowledge from professional, community member and personal dimensions. Outcomes included social and health benefits, personal ‘buzz’ and community capacity. Health professionals' actions could be described as social entrepreneurship: identifying opportunities, utilising resources and making ‘deals’. They also align with community development. Health professionals use contextual knowledge to envisage and grow activities, indicating that, as social entrepreneurs, they do not explicitly choose a social mission, rather they act within their known world-view. Policymakers could consider ways to engage rural health professionals as social entrepreneurs, in helping to produce resilient communities.

The association of levels of physical activity with metabolic syndrome in rural Australian adults

Background:  Physical activity (PA) reduces risk factors related to metabolic syndrome. Rurality influences the way people incorporate physical activity into daily life. The aim of this study is to determine the association of PA level with metabolic syndrome in a rural Australian population. The influence of adiposity on these associations is also investigated.

Methods: Three cross-sectional population health surveys were conducted in south-east Australia during 2004–2006 using a random population sample (n = 1563, participation rate 49%) aged 25–74 years. PA was assessed via a self-administered questionnaire, and components of the metabolic syndrome via anthropometric measurements taken by specially trained nurses and laboratory tests.

Results: Approximately one-fifth of participants were inactive in leisure-time and over one-third had metabolic syndrome (men 39%, women 33%; p = 0.022). There was an inverse association between level of PA and metabolic syndrome (p < 0.001). Men who were inactive in leisure-time were more than twice as likely and women more than three times as likely to have metabolic syndrome compared with those having high PA. Body mass index (BMI) is a mediating factor in the association between level of PA and metabolic syndrome.

Conclusion: Some PA is better than none if adults, particularly women, are to reduce their risk of metabolic syndrome and associated vascular diseases. Specialised interventions that take rurality into consideration are recommended for adults who are inactive.

Do the individual, social, and environmental correlates of physical activity differ between urban and rural women?

In this article, associations between individual, social, and environmental factors and physical activity among 3,669 women (18-45 years) living in socioeconomically disadvantaged urban and rural areas were compared. In 2007-2008, participants reported levels of leisure-time physical activity (LTPA) and transport-related physical activity (TRPA) as well as five individual, four social, and three environmental factors. Physical activity self- efficacy demonstrated stronger associations with LTPA among urban relative to rural women; child care was associated with LTPA and intentions with TRPA among urban women only, and enjoyment was associated with TRPA among rural women only. Correlates of physical activity among urban and rural women were generally similar, although some tailoring of physical activity promotion strategies may be warranted.

Healthy-lifestyle behaviors associated with overweight and obesity in US rural children

Background

There are disproportionately higher rates of overweight and obesity in poor rural communities but studies exploring children’s health-related behaviors that may assist in designing effective interventions are limited. We examined the association between overweight and obesity prevalence of 401 ethnically/racially diverse, rural school-aged children and healthy-lifestyle behaviors: improving diet quality, obtaining adequate sleep, limiting screen-time viewing, and consulting a physician about a child’s weight.
Methods

A cross-sectional analysis was conducted on a sample of school-aged children (6–11 years) in rural regions of California, Kentucky, Mississippi, and South Carolina participating in CHANGE (Creating Healthy, Active, and Nurturing Growing-up Environments) Program, created by Save the Children, an independent organization that works with communities to improve overall child health, with the objective to reduce unhealthy weight gain in these school-aged children (grades 1–6) in rural America. After measuring children’s height and weight, we17 assessed overweight and obesity (BMI ≥ 85th percentile) associations with these behaviors: improving diet quality18 (≥ 2 servings of fruits and vegetables/day), reducing whole milk, sweetened beverage consumption/day; obtaining19 adequate night-time sleep on weekdays (≥ 10 hours/night); limiting screen-time (i.e., television, video, computer,20 videogame) viewing on weekdays (≤ 2 hours/day); and consulting a physician about weight. Analyses were adjusted 21 for state of residence, children's race/ethnicity, gender, age, and government assistance.
Results

Overweight or obesity prevalence was 37 percent in Mississippi and nearly 60 percent in Kentucky. Adjusting for covariates, obese children were twice as likely to eat ≥ 2 servings of vegetables per day (OR=2.0,95% CI 1.1-3.4), less likely to consume whole milk (OR=0.4,95% CI 0.2-0.70), Their parents are more likely to be told by their doctor that their child was obese (OR=108.0,95% CI 21.9-541.6), and less likely to report talking to their child about fruits and vegetables a lot/sometimes vs. not very much/never (OR=0.4, 95%CI 0.2-0.98) compared to the parents of healthy-weight children.
Conclusions

Rural children are not meeting recommendations to improve diet, reduce screen time and obtain adequate sleep. Although we expected obese children to be more likely to engage in unhealthy behaviors, we found the opposite to be true. It is possible that these groups of respondent parents were highly aware of their weight status and have been advised to change their children’s health behaviors. Perhaps given the opportunity to participate in an intervention study in combination with a physician recommendation could have resulted in actual behavior change.

Whole grain consumption is inversely associated with BMI Z-score in rural school-aged children

Objective To examine the relationship between intake of whole grains and BMI Z-score in rural children.

Design General linear models and logistic regression were used to examine the cross-sectional associations between whole grain intake and BMI Z-score, prevalence and odds ratios of overweight and obesity. Dietary intake was assessed using the Block Food Screener for ages 2–17 years. Children were classified into three categories according to servings of whole grain intake: <1·0 serving/d, 1·0–1·5 servings/d and >1·5 servings/d.

Setting The CHANGE (Creating Healthy, Active and Nurturing Growing-up Environments) study, an obesity prevention intervention in elementary schools in eight rural US communities in California, Mississippi, Kentucky and South Carolina.

Subjects Seven hundred and ninety-two children attending 3rd–6th grade.

Results After adjusting for age, sex, race/ethnicity, physical activity and state of residence, whole grain intake was inversely associated with BMI Z-score (0·90 v. 0·61 in the lowest v. the highest whole grain intake category; P trend = 0·01). Children who consumed >1·5 servings of whole grains/d had a 40 % lower risk of being obese (OR = 0·60; 95 % CI 0·38, 0·95, P = 0·02) compared with children who consumed <1·0 serving/d. Further adjustment for potential dietary predictors of body weight (fruit, vegetable and dairy intakes) did not change the observed associations.

Conclusions Increasing the intake of whole grains as part of an overall healthy lifestyle may be beneficial for children to achieve and maintain a healthy weight.

Associations between behavior regulation, competence, physical activity, and health for adolescent females

This study investigated the association between the different types of behavior regulation and competence on sport and physical activity (PA) and perceived health, and the influence of school year level (ie, year 7 and year 11) and setting (ie, metropolitan and rural) on these relationships.

Urbanicity and lifestyle risk factors for cardiometabolic diseases in rural Uganda: a cross-sectional study

Urban living is associated with unhealthy lifestyles that can increase the risk of cardiometabolic diseases. In sub-Saharan Africa (SSA), where the majority of people live in rural areas, it is still unclear if there is a corresponding increase in unhealthy lifestyles as rural areas adopt urban characteristics. This study examines the distribution of urban characteristics across rural communities in Uganda and their associations with lifestyle risk factors for chronic diseases.

Dementia in older people admitted to hospital: a regional multi-hospital observational study of prevalence, associations and case recognition

BACKGROUND: previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single London teaching hospital, and 21% in four Queensland hospitals. However, there is a lack of published data from any European country on the prevalence of dementia across hospitals and between patient groups. OBJECTIVE: to determine the prevalence and associations of dementia in older patients admitted to acute hospitals in Ireland. METHODS: six hundred and six patients aged ≥70 years were recruited on admission to six hospitals in Cork County. Screening consisted of Standardised Mini-Mental State Examination (SMMSE); patients with scores <27/30 had further assessment with the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Final expert diagnosis was based on SMMSE, IQCODE and relevant medical and demographic history. Patients were screened for delirium and depression, and assessed for co-morbidity, functional ability and nutritional status. RESULTS: of 598 older patients admitted to acute hospitals, 25% overall had dementia; with 29% in public hospitals. Prevalence varied between hospitals (P < 0.001); most common in rural hospitals and acute medical admissions. Only 35.6% of patients with dementia had a previous diagnosis. Patients with dementia were older and frailer, with higher co-morbidity, malnutrition and lower functional status (P < 0.001). Delirium was commonly superimposed on dementia (57%) on admission. CONCLUSION: dementia is common in older people admitted to acute hospitals, particularly in acute medical admissions, and rural hospitals, where services may be less available. Most dementia is not previously diagnosed, emphasising the necessity for cognitive assessment in older people on presentation to hospital.

A qualitative study of environmental factors important for physical activity in rural adults

PURPOSE: Despite increasing evidence that the physical environment impacts on physical activity among urban-dwellers, little attention has been devoted to understanding this relationship in rural populations. Work in this area is further hindered by a lack of environmental measures specifically designed for rural settings. This qualitative study aimed to explore the salience of urban physical activity environment constructs among rural adults. METHODS: In 2011, 49 rural men and women from three distinct areas (coastal, animal-based farming, forestry/plant-based farming) of rural Tasmania, Australia, were purposively recruited to participate in semi-structured interviews. Interviews explored features of the built and social environment commonly examined in studies of urban adults, including functional characteristics (eg, lighting, footpaths, roads/verges), road and personal safety, availability and accessibility of places to be active, destinations, and aesthetics. Interviews were recorded, transcribed verbatim and analysed using a content-thematic approach using QSR NVivo software. FINDINGS: While some urban environmental constructs were salient to these rural adults, such as availability of and accessibility to places to be active, some constructs were operationalised differently, such as road safety (where large trucks and winding roads rather than traffic density was of concern), or were not considered relevant (eg, personal safety related to crime, availability of walkable destinations, aesthetics). CONCLUSIONS: The measurement of the physical environment in rural populations may require reconsideration and/or modification to ensure salience and appropriate quantification of associations with physical activity in future studies.

The association between self-reported diet quality and health-related quality of life in rural and urban Australian adolescents

OBJECTIVE: This study examines the relationship between diet quality and health-related quality of life (HRQoL) in rural and urban Australian adolescents, and gender differences.

DESIGN: Cross-sectional.

SETTING: Secondary schools.

PARTICIPANTS: 722 rural and 422 urban students from 19 secondary schools.

MAIN OUTCOME MEASURES: Self-report dietary-related behaviours, demographic information, HRQoL (AQoL-6D) were collected. Healthy and unhealthy diet quality scores were calculated; multiple linear regression investigated associations between diet quality and HRQoL.

RESULTS: Compared to urban students, rural students had higher HRQoL, higher healthy diet score, lower unhealthy diet score, consumed less soft drink and less frequently, less takeaway and a higher proportion consumed breakfast (P < 0.05). Overall, males had higher unhealthy diet score, poorer dietary behaviours but a higher HRQoL score compared to females (P < 0.05). In all students, final regression models indicated: a unit increase in healthy diet score was associated with an increase in HRQoL (unstandardised coefficient(B)±standard error(SE); B = 0.02 ± 0.01(SE); P < 0.02); and a unit increase in unhealthy diet scores was associated with a decrease in HRQoL (-0.01 ± 0.00; P < 0.05). In rural students alone, a unit increase in unhealthy diet score was associated with a decrease in HRQoL (B = -0.01 ± 0.00; P = 0.002), and in urban students a unit increase in healthy diet score was associated with an increase in HRQoL (B = 0.02 ± 0.00; P < 0.001).

CONCLUSIONS: Cross-sectional associations between diet quality and HRQoL were observed. Dietary modification may offer a target to improve HRQoL and general well-being; and consequently the prevention and treatment of adolescent health problems. Such interventions should consider gender and locality.

A descentralização das políticas de desenvolvimento rural: uma análise da experiência do Rio Grande do Norte

MATOS FILHO, João. A descentralização das Políticas de desenvolvimento rural - uma análise da experiência do Rio Grande do Norte. 2002. 259f. Tese (Doutorado em Ciências Econômicas)– Instituto de Economia da Universidade Estadual de Campinas, Campinas, 2002.

Genetic associations between stayability and reproductive and growth traits in Canchim beef cattle

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

O turismo de base local como um possível indutor de desenvolvimento rural: uma análise da realidade e das potencialidades no distrito de dondo-moçambique

The current debate on rural development focuses on the territorial approach, recognizing the multifunctional character of rural areas. Emphasize the use of endogenous forces, the need of implement policies which valorize local specificities, the participation of social actors in revitalization of rural areas. In this context tourism enters as a means to induce a new dynamic to rural areas, since the activity is regarded as a channel for the upgrading of the natural and cultural resources and the rural way of life. This study focuses on local-based tourism as a promoter of rural development, giving an analysis of the social reality and potential for this tourism in the district of Dondo. In it, is proposed to analyze the potential for development of local-based tourism in the district of Dondo, assessing the extent to which local reality enables the inclusion of the community in the management of local tourism resources. For this, was showed the inclusion of local-based tourism in the current context of rural development, was identified and organized systematically the factors that influence the implementation of local-based tourism in the study area and was verified as far as possible the study area corresponds to the constraints identified, showing how local-based tourism can best been encouraged. Was adopted a qualitative methodological approach to both the procedures and data processing, but also by critical approach, using bibliographical research, semi-structured interviews that fell on the group of public administrators who work in tourism and community leaders. The critical analysis was based on the principles of sustainability o Sachs particular ecological, social, cultural, economic, space, beyond the analysis of political and institutional aspects. The survey results show that the district of Dondo has a potential for implementing a model of tourism development on a local basis, since it is rich in natural and cultural research, benefits from good network accessibility in the context of the market in the region, the population live according to their habits and customs and value their identity. There is also a good cooperation between community members, although not in tourism, a fact which is observed through the lever of community participation in associations, cooperatives, working in areas such as agriculture, fishing, environment, civic education etc. It also has public funding sources to augment or stimulate local investment. Despite obstacles such as inexistence of policies and local plans for tourism development, lack of awareness of tourism, lack of basic infrastructure, as well as equipment and facilities to support tourism, the results shows that these problems can be solved through a public commitment from both government, and community through a joint planning and participation

Democratização do acesso a água no semi-árido: o caso da comunidade rural de Pendências dos Emídios no município de Serrinha/RN

Brazil lives a time of experimentation and maturity as it pertains to managing the use of water, which comes institutionalising increasingly social participation. In Rio Grande do Norte, since 1997, the government has been developing actions accordingly, through the State Department of Water Resources, which has implemented a programme of adutoras within the State and created Water Users Associations, in the installation of dessalinizadores for places where the Adutora was not necessary or not yet arrived, so that should be managed by communities through associations of users. Since 2003, Civil Society Organisations - CSOs come through ASA - Articulation in the Semi-arid Brazilian, implementing the P1MC - Program of Training and Mobilization for Social Living with the Semi-Arid (One Million Rural Cisternas), in its third year of implementation in Rio Grande do Norte, in the spirit of working together with the semi arid. In the municipality of Serrinha / RN which incorporates the Semi-arid region, we find in the rural community of Pendêcias dos Emídios the experience of the State and Civil Society, which referred to a discussion about the environmental sustainability of these initiatives. The general objective of this work is to examine the strategies for participatory management in the use and access to water in the community of Pendêcias dos Emídios of the municipality of Serrinha / RN, to understand how those experiences can contribute to environmental sustainability. The methodology used envolvel bibliographic research in categories involving each article, the analysis of the terms of reference of each strategy as part of the documentary research, the application forms covering 40 families benefited, and interviews based on comprehensive analysis of the speech. This study is divided into 02 articles, where the first is a discussion held on collective action and environmental sustainability, and the second is held a discussion about the sustainability of the initiatives underway to access water. The results of the discussion held on 02 articles that had their empirical built from the experience of the Commonwealth of Pendências dos Emídios revealed how far will the ability of the State to promote collective action and the limitations of the perception of sustainability that permeates these initiatives in the search for democratic access to water in semi-arid

Características do apoio social oferecido a idosos de área rural assistida pelo PSF

Trata-se de um trabalho epidemiológico do tipo transversal, com o objetivo de descrever as características do apoio social e identificar associações entre as variáveis sociodemográficas e categorias de suporte social, em população rural do Bairro dos Aleixos, no município de Taquarituba ­ SP. Para medir o apoio social, utilizou-se da escala Medical Outcomes Study (MOS), traduzida para o português e validada em nosso meio. A população caracterizou-se por mulheres, predominantemente da raça branca, entre 60 a 69 anos, casadas e/ou vivendo em concubinatos, de baixa renda e residindo em domicílios multigeracionais. Escores de apoio médios elevados foram identificados, indicando situação favorável entre os idosos estudados. em termos médios, a categoria de apoio com pior escore foi interação social positiva. A análise bivariada demonstrou uma diferença significativa entre escore de apoio afetivo e de apoio emocional com número de pessoas no domicílio e maior freqüência de escores altos de interação social (3º tercil) em idosos do sexo masculino e naqueles com maior grau de escolaridade. O estudo apontou ainda que escores de apoio social menores foram mais freqüentes em mulheres, analfabetos, viúvos ou solteiros, idosos com renda entre um e dois salários mínimos.