Cataract surgical outcomes, visual function and quality of life in four rural districts in Vietnam.

BACKGROUND: To evaluate cataract surgical outcomes in four rural districts of Ha Tinh Province, Vietnam. DESIGN: Cross-sectional study. PARTICIPANTS: Post-cataract surgery patients sampled randomly from facilities in four rural districts of Ha Tinh Province >3 months after surgery. MAIN OUTCOME MEASURES: Postoperative visual acuity (VA), visual function and quality of life. RESULTS: Among 412 patients, the mean age was 74.5 ± 9.4 years, 67% (276) were female, and 377 (91.5%) received intraocular lenses (IOL). Nearly two-thirds of patients had no postoperative visits after discharge. Postoperatively, more than 40% of eyes had presenting VA <6/18, while 20% remained <6/60. The mean self-reported visual function and quality of life for all patients were 68.7 ± 23.8 and 73.8 ± 21.6, respectively. Most patients (89.5%) were satisfied with surgery and the majority (94.4%) would recommend surgery to others. One-third of patients paid ≥$US50 for surgery. In multiple regression modelling, older age (P < 0.01), intraoperative complications (P < 0.01) and failure to receive an IOL (P < 0.01) were associated with postoperative VA <6/60. CONCLUSION: Satisfaction with surgery was high, and many patients were willing to pay for their operations. Poor visual outcomes were common; however, and better surgical training is needed to reduce complications and their impact on visual outcomes. More intensive postoperative follow-up may also be beneficial. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

Libraries in the rural districts. (Paper read at the Library Assistant's Association, Croydon, June, 1909)

Mode of access: Internet.

State of the police in the rural districts, with some suggestions for its improvement.

Mode of access: Internet.

Ornamental gardening for Americans : A treatise on beautifying homes, rural districts, towns, and cemeteries /

Includes indexes.

Understanding the underlying mechanisms of recent Jatropha curcas L. adoption by smallholders in Kenya: A rural livelihood assessment in Bondo, Kibwezi, and Kwale districts

Between 2004 and 2007, NGOs, community based organisations and private investors promoted jatropha in Kenya with the aim of generating additional income and producing biofuel for rural development. By 2008 it became gradually evident that jatropha plantations (both mono- and intercropping) are uneconomical and risky due to competition for land and labour with food crops. Cultivation of jatropha hedges was found to have better chances of economic success and to present only little risks for the adopting farmers. Still, after 2008 a number of farmers went on adopting jatropha in plots rather than as hedges. It is hypothesised that lack of awareness about the low economic prospects of jatropha plantations was the main reason for continued adoption, and that smallholder farmers with higher resource endowments mainly ventured into its cultivation. In this study we provide an empirical basis for understanding the role of households' capital assets in taking up new livelihood strategies by smallholder farmers in three rural districts in Kenya. For that purpose, we assess the motivation and enabling factors that led to the adoption of jatropha as a new livelihood strategy, as well as the context in which promotion and adoption took place. A household survey was conducted in 2010, using a structured questionnaire, to collect information on household characteristics and capital asset endowment. Data were analysed using descriptive statistics and non-parametric statistical tests. We established that access to additional income and own energy supply were the main motivation for adoption of jatropha, and that financial capital assets do not necessarily have a positive influence on adoption as hypothesised. Further, we found that the main challenges that adopting farmers faced were lack of access to information on good management practices and lack of a reliable market. We conclude that continued adoption of on-farm jatropha after 2008 is a result of lacking awareness about the low economic value of this production type. We recommend abandoning on-farm production of jatropha until improved seed material and locally adapted agronomic knowledge about jatropha cultivation becomes available and its production becomes economically competitive.

Historicizing counterurbanization: in-migration and the reconstruction of rural space in Berkshire (UK), 1901-51

This article uses census data for Berkshire to argue that large-scale counterurbanization began much earlier than is generally recognized in some parts of southern England. This was not just movement down the urban hierarchy, which as Pooley and Turnbull have demonstrated was a long-term feature of England’s settlement system, but in some cases at least amenity-driven migration to rural areas of the kind increasingly recognized as a core component of recent counterurbanization. Despite a reduction of acreage Berkshire’s rural districts saw a 54% rise in population between 1901 and 1951. The sub-regional pattern of growth is assessed to gauge whether ‘clean break’ migration to the remote west of the county (which remained effectively out of commuting range from London throughout the period) was taking place, or whether counterurbanization was confined to the more accessible eastern districts. However, whilst population did increase in both west and east, it was in fact the central districts that grew most impressively. Three case study parishes are investigated in order to gauge the nature and consequences of counterurbanization at a local level. Professional and business migrants figure prominently, seeking to preserve and promote the rural attributes of their new communities, without however cutting their ties to urban centres. It is argued that migration to rural Berkshire in the first half of the twentieth century cannot adequately be described either as a form of extended suburbanization or an anti-metropolitan ‘clean break’. Rather, early counterurbanization marks the first stage on the long road to a post-productivist countryside, in which countryside becomes detached from agriculture, there is socio-economic convergence between town and country, and the ‘rural’ increasingly becomes defined by landscape and identity rather than economic function.

Factors affecting SME owner-managers' willingness to share knowledge online in rural local business networks

This article integrates typically separate SME research on e-commerce, business networking, and knowledge management into a model explaining factors influencing the willingness of SME owner-managers to share knowledge online in business networks in rural districts. This is important because e-commerce can assist owner-managers, often dispersed in rural districts, to share knowledge between face-to-face networking events. The main factors associated with willingness to share knowledge online were their willingness to share knowledge face-to-face and their intensity of Internet use. Entrepreneurial factors such as owner-managers' expectations of rapid growth, trading outside the district, and seeking information about customers/competitors were indirectly associated with online sharing via intensity of Internet use only. The model suggests network coordinators could encourage online knowledge sharing by assisting owner-managers to see the business value of e-commerce and by ensuring that networking events are suitable for owner-managers, whether or not they have entrepreneurial goals, to facilitate face-to-face knowledge sharing.

The Torrent : Toowoomba and the Lockyer Valley, 10 January 2011

Of all the stories to emerge from Queensland’s catastrophic summer of 2011, the most dramatic and starkly tragic were those that took place in Toowoomba and the Lockyer Valley. On January 10, 2011, after weeks of heavy rain and as floodwaters began to overwhelm much of south-east Queensland, an ‘inland tsunami’ hit the city of Toowoomba, the rural districts of Spring Bluff and Postmans Ridge, and the towns of Murphys Creek, Withcott, Helidon, and Grantham. The Torrent:Toowoomba and the Lockyer Valley, 10 January 2011 tells, for the first time, the extraordinary stories of survival and loss that emerged from that terrible day. Official figures state that twenty-four people died. Many escaped death only because they were rescued by members of the community or through sheer good fortune. Based on exclusive interviews with survivors, rescuers and with the families and friends of victims of the disaster, The Torrent is a unique and powerful account of human courage in the face of the devastating force of nature, and the enduring resilience of ordinary Australians.

Postnatal depressive symptoms amongst women in Central Vietnam: A cross-sectional study investigating prevalence and associations with social, cultural and infant factors

Background This study investigated the prevalence and socio-cultural correlates of postnatal mood disturbance amongst women 18–45 years old in Central Vietnam. Son preference and traditional confinement practices were explored as well as factors such as poverty, parity, family and intimate partner relationships and infant health. Methods A cross-sectional study was conducted in twelve randomly selected Commune Health Centres from urban and rural districts of Thua Thien Hue Province, Vietnam. Mother-infant dyads one to six months postpartum were invited to participate. Questionnaires from 431 mothers (urban n = 216; rural n = 215) assessed demographic and family characteristics, traditional confinement practices, son preference, infant health and social capital. The Edinburgh Postnatal Depression Scale (EPDS) and WHO5 Wellbeing Index indicated depressive symptoms and emotional wellbeing. Data were analysed using general linear models. Results Using an EPDS cut-off of 12/13, 18.1 % (n = 78, 95 % CI 14.6 - 22.1) of women had depressive symptoms (20.4 % urban; 15.8 % rural). Contrary to predictions, infant gender and traditional confinement were unrelated to depressive symptoms. Poverty, food insecurity, being frightened of family members, and intimate partner violence increased both depressive symptoms and lowered wellbeing. The first model accounted for 30.2 % of the variance in EPDS score and found being frightened of one’s husband, husband’s unemployment, breastfeeding difficulties, infant diarrhoea, and cognitive social capital were associated with higher EPDS scores. The second model had accounted for 22 % of the variance in WHO5 score. Living in Hue city, low education, poor maternal competence and a negative family response to the baby lowered maternal wellbeing. Conclusions Traditional confinement practices and son preference were not linked to depressive symptoms among mothers, but were correlates of family relationships and wellbeing. Poverty, food insecurity, violence, infant ill health, and discordant intimate and family relationships were linked with depressive symptoms in Central Vietnam.

Cabeceiras do Rio Pardo: ocupação e formação da região de Caconde-SP (1765-1820)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Bairros rurais paulistas: novas territorialidades - o município de Leme (SP)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A importância da cafeicultura para a permanência dos sitiantes na terra: uma análise dos bairros rurais da Laranja Azeda a da Limeira em Lerroville, Londrina – PR

Pós-graduação em Geografia - FCT

Nebraska educational survey, 1939. Studies ...

no. 5. Report ... on what are the educational requirements, the number issued, and what institutions prepare applicants for teachers certificates? Does the supply equal the demand?--no. 6. How does Nebraska compare with neighboring states in amounts appropriated for higher education? Amounts expended for higher education? Ratios of college students to population and percent of high school graduates entering college?--no. 7 [pt. 1] Methods of control of state higher education. [pt. 2] Duplication among Nebraska's state-supported higher educational institutions.--no. 8. What does the state do to equalize educational opportunity among the counties, towns and rural districts? Is the plan of district organization economical?

Task sharing within a managed clinical network to improve child health in Malawi

BACKGROUND: Eighty per cent of Malawi's 8 million children live in rural areas, and there is an extensive tiered health system infrastructure from village health clinics to district hospitals which refers patients to one of the four central hospitals. The clinics and district hospitals are staffed by nurses, non-physician clinicians and recently qualified doctors. There are 16 paediatric specialists working in two of the four central hospitals which serve the urban population as well as accepting referrals from district hospitals. In order to provide expert paediatric care as close to home as possible, we describe our plan to task share within a managed clinical network and our hypothesis that this will improve paediatric care and child health.

PRESENTATION OF THE HYPOTHESIS: Managed clinical networks have been found to improve equity of care in rural districts and to ensure that the correct care is provided as close to home as possible. A network for paediatric care in Malawi with mentoring of non-physician clinicians based in a district hospital by paediatricians based at the central hospitals will establish and sustain clinical referral pathways in both directions. Ultimately, the plan envisages four managed paediatric clinical networks, each radiating from one of Malawi's four central hospitals and covering the entire country. This model of task sharing within four hub-and-spoke networks may facilitate wider dissemination of scarce expertise and improve child healthcare in Malawi close to the child's home.

TESTING THE HYPOTHESIS: Funding has been secured to train sufficient personnel to staff all central and district hospitals in Malawi with teams of paediatric specialists in the central hospitals and specialist non-physician clinicians in each government district hospital. The hypothesis will be tested using a natural experiment model. Data routinely collected by the Ministry of Health will be corroborated at the district. This will include case fatality rates for common childhood illness, perinatal mortality and process indicators. Data from different districts will be compared at baseline and annually until 2020 as the specialists of both cadres take up posts.

IMPLICATIONS OF THE HYPOTHESIS: If a managed clinical network improves child healthcare in Malawi, it may be a potential model for the other countries in sub-Saharan Africa with similar cadres in their healthcare system and face similar challenges in terms of scarcity of specialists.

Regional Disparities in Sedentary Behaviors and Meal Frequency in Iranian Adolescents: The CASPIAN-III Study

Background: The prevalence of obesity is increasing among Iranian youngsters like other developing countries. Objectives: This study was conducted to assess regional disparities in sedentary behaviors and meal frequency in Iranian adolescents. Patients and Methods: In this national survey, 5682 students aged 10 - 18 years from urban and rural districts of 27 provinces of Iran were selected via stratified multi-stage sampling method. The country was classified into four sub-national regions, based on criteria of the combination of geography and socioeconomic status (SES). Mean of meal frequency and physical activity levels as well as prevalence of omitting meals and sedentary behavior were compared across regions with different SES after stratifying with sex and age group. Results: Meal frequency in lower socio-economic regions was significantly higher than two other regions in 10 - 13 and 10 - 18 years old groups (P trend < 0.001). However, the mean of working hours with computer was linearly increased with increasing the SES in studied regions (P trend < 0.001), whereas the corresponding figure was not significant for the mean of watching TV (P trend > 0.05). Frequency of adolescents omitting their meals was higher in higher SES regions especially in West Iran (P < 0.001) in 10 - 13 years old age group. Having personal computer and working with it more than two hours per day mainly was observed in central Iran which ranked as the highest SES group. Conclusions: Efforts to ensure Iranian youth meet healthy food habits and screen time guidelines include limiting access to screen technologies and encouraging parents to monitor their own screen time is required.