Displaying publications 101 - 120 of 192 in total

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  1. Ahmed SMM, Hasan MN, Kabir R, Arafat SMY, Rahman S, Haque M, et al.
    Rural Remote Health, 2019 08;19(3):4614.
    PMID: 31400766 DOI: 10.22605/RRH4614
    INTRODUCTION: Community orientation in medical education, which prepares medical students to become more effective practitioners, is now a global movement. Many medical schools around the world have adopted the concept as the main curricular framework in order to align learning programs with the needs of the community and the learner. Despite many changes over the past few decades, many improvements are still needed in medical education in Bangladesh. This study investigated medical students' perceptions of the community-based learning experiences incorporated into the Bachelor of Medicine, Bachelor of Surgery (MBBS) degree at Uttara Adhunik Medical College, Dhaka (UAMC), Bangladesh.

    METHODS: A total of 135 students from three undergraduate year levels of the MBBS degree at UAMC, Dhaka, Bangladesh, undertook study tours (community-based teaching, CBT) as a part of a community medicine course and visited a medical college, two rural health centres and a meteorology centre in the Cox's Bazar district, 400 km from Dhaka city. A questionnaire was used to assess the perceptions of students regarding the administration, organisation and learning experiences of the study tours. Students were required to write reports, present their findings and answer questions in their examinations related to the study tours and CBT.

    RESULTS: The majority of the students agreed or strongly agreed that the tour was a worthwhile (93%) and enjoyable (95%) learning experience that helped them to understand rural health issues (91%). More than half of the students reported that the study tours increased their awareness about common rural health problems (54%) and provided a wider exposure to medicine (61%). Only 41% of students reported that the study tour increased their interest in undertake training in a rural area. A substantial number of students also expressed their concerns about the planning, length, resources, finance and organisation of the study tours.

    CONCLUSIONS: Overall, the study tours had a positive effect, enhancing students' awareness and understanding of common rural health problems. As study tours failed to increase the motivation of the students (approximately 60%) to work in rural areas, CBT in the medical curriculum should be reviewed and implemented using effective and evidence-based models to promote interest among medical students to work in rural and underserved or unserved areas.

    Matched MeSH terms: Rural Health Services/organization & administration*
  2. Bui Van N, Vo Hoang L, Bui Van T, Anh HNS, Minh HT, Do Nam K, et al.
    High Blood Press Cardiovasc Prev, 2019 Jun;26(3):239-246.
    PMID: 31020550 DOI: 10.1007/s40292-019-00314-8
    INTRODUCTION: Hypertension (HT) is considered as a major determinant of cardiovascular complications. However, few studies have addressed HT prevalence among adults aged 60 years and older in the northern mountainous region of Vietnam.

    AIM: To determine the prevalence of HT and its risk factors in the elderly in that area.

    METHODS: A cross-sectional study was conducted in a study area in the northern of Vietnam. We interviewed 354 adults aged 60 years or over who were randomly selected, and then measured their blood pressure.

    RESULTS: The overall HT prevalence was 62.15%. The isolated systolic hypertension (ISH) prevalence was 22.88%. There was a slight decrease in the proportion of HT by stage 1, stage 2 and stage 3 respectively. The univariate and multivariate logistic regression analysis indicated some risk factors for HT including age groups, body mass index (BMI) and waist-hip ratio (WHR) (p health prevention and control campaigns for hypertension among older adults in the northern mountainous region of Vietnam.

    Matched MeSH terms: Rural Health/ethnology*
  3. Nur Hanis Y, Raman P, Premala Devi S, Mohd Khalid KH
    Med J Malaysia, 2019 08;74(4):296-299.
    PMID: 31424036
    OBJECTIVE: The Ministry of Health introduced the cluster hospital project in Kuala Pilah district in 2016 to allow sharing of resources between the hospitals in the same vicinity. The aim of this study is to compare the demographic profile, prevalence of cataract blindness and low vision among patients who presented for cataract surgery before and after the programme.

    METHODOLOGY: This is a retrospective cohort study of patients who underwent cataract surgery in Kuala Pilah Cluster Hospitals between 2010 and 2017. A total of 2539 records of patients were reviewed. Patients were assigned into two groups: Group 1 (2010-2012)- before the programme (2010-2012) and Group 2 (2015-2017) after the introduction of the programme.

    RESULTS: There was a significant increase in number of cataract cases in the district hospital after the cluster initiative. The mean age of patients undergoing cataract surgery was similar in both groups. The common comorbidities were hypertension (Group 1=57.3%; Group 2=70.8%) and diabetes mellitus (Group 1=40.6%; Group 2=51.1%). In 2010-2012, most of the patients were one eye blind (34.4%), whereas in 2015-2017 majority of patients presented with vision better than 6/18 (43.5%). The proportion of patients with cataract blindness reduced from 6% in 2010-2012 to 4.3% in 2015-2017 (p<0.01).

    CONCLUSION: There is a significant decrease in percentage of patients with cataract blindness and low vision after the introduction of Kuala Pilah Cluster Hospital Program. We believe that that cluster hospital system is effective in improving accessibility to eye care and therefore increases the cataract detection rate.
    Matched MeSH terms: Rural Health Services/organization & administration*
  4. Chen PC
    J Trop Med Hyg, 1975 Jan;78(1):6-12.
    PMID: 1121041
    One hundred and ninety-nine children brought by 181 adults to a child health clinic based in a rural health sub-centre in Peninsular Malaysia are studied. It is noted that the families from which they come are relatively poor, with a large number of children, and that they are fairly highly motivated. Forty-four per cent of children attending the clinic at the time of the study are symptomatic indicating the need to organise the child health clinic on a "preventive-curative" basis. It is also noted that the young child is initially seen in early infancy but is lost to the clinic when he is older making it judicious to formulate immunization schedules that take this into account.
    Matched MeSH terms: Rural Health*
  5. LOURDENADIN S
    Med J Malaysia, 1963 Jun;17:269-73.
    PMID: 14060503
    Matched MeSH terms: Rural Health*
  6. Chen PC
    Trop Geogr Med, 1977 Dec;29(4):441-8.
    PMID: 610030
    Since Independence, gained in 1957, major changes have occurred in the rural areas of Malaysia not least amongst which has been the provision of maternal and child care services to hitherto neglected areas. In the first part of this paper, the demographic and disease patterns are described. The second part outlines the general development efforts and describes in greater detail the rural health services that have been organized in Malaysia. In the concluding section, changes in mortality and morbidity are examined.
    Matched MeSH terms: Rural Health/manpower*
  7. Bougangue B, Ling HK
    BMC Public Health, 2017 09 06;17(1):693.
    PMID: 28874157 DOI: 10.1186/s12889-017-4680-2
    BACKGROUND: The need to promote maternal health in Ghana has committed the government to extend maternal healthcare services to the door steps of rural families through the community-based Health Planning and Services. Based on the concerns raised in previous studies that male spouses were indifferent towards maternal healthcare, this study sought the views of men on their involvement in maternal healthcare in their respective communities and at the household levels in the various Community-based Health Planning and Services zones in Awutu-Senya West District in the Central Region of Ghana.

    METHODS: A qualitative method was employed. Focus groups and individual interviews were conducted with married men, community health officers, community health volunteers and community leaders. The participants were selected using purposive, quota and snowball sampling techniques. The study used thematic analysis for analysing the data.

    RESULTS: The study shows varying involvement of men, some were directly involved in feminine gender roles; others used their female relatives and co-wives to perform the women's roles that did not have space for them. They were not necessarily indifferent towards maternal healthcare, rather, they were involved in the spaces provided by the traditional gender division of labour. Amongst other things, the perpetuation and reinforcement of traditional gender norms around pregnancy and childbirth influenced the nature and level of male involvement.

    CONCLUSIONS: Sustenance of male involvement especially, husbands and CHVs is required at the household and community levels for positive maternal outcomes. Ghana Health Service, health professionals and policy makers should take traditional gender role expectations into consideration in the planning and implementation of maternal health promotion programmes.

    Matched MeSH terms: Rural Health Services/organization & administration*
  8. Cheek C, Hays R, Allen P, Walker G, Shires L
    Rural Remote Health, 2017 Jul-Sep;17(3):4292.
    PMID: 28846850 DOI: 10.22605/RRH4292
    INTRODUCTION: Much of regional Australia continues to face challenges in recruitment and retention of medical practitioners, despite the apparently successful rural medical education initiatives funded by the Commonwealth Government. International fee-paying (IFP) medical students are a significant component of Australian medical education, contributing additional income and more diverse learning environments for universities. Their contribution to the Australian medical workforce is harder to determine. After obtaining registration, IFP graduates may apply to remain in Australia as skilled migrants. Since 1999 there has been a 325% increase in the number of international medical students in Australia, with approximately 73% of IFP graduates remaining in Australia for at least some postgraduate training. Recognising the potential contribution of IFP students to the Tasmanian medical workforce, the authors sought better understanding of the career intentions and work locations of IFP graduates from the medical program in Tasmania, Australia, through two studies. Firstly, a quantitative study was conducted of the locations of all IFP graduates from the Tasmanian medical program, and then a qualitative study exploring graduating students' intentions and factors that contribute to their decisions about work location choices.

    METHODS: This was a cohort study of IFP students who graduated from the University of Tasmania School of Medicine over the period 2000-2015. Work locations for 2016 were mapped to a Modified Monash rurality classification. Semi-structured interviews were held with 15 final year IFP medical students, exploring career intentions and location preferences.

    RESULTS: There were 261 IFP graduates, 54.4% male. The most common country of origin was Malaysia (55.2%). In 2016, 189 (72.4 %) were working in Australia, 42 (16.1%) in Tasmania and 126 (66.7%) in areas categorised as Modified Monash 1. Recent graduates in postgraduate year 1/2 (71.3%) were more likely to be working in Tasmania but most left for specialty training. All 15 interview participants intended to remain in Australia for at least their intern year, although at enrolment only six had planned to remain. Factors influencing workplace location decisions were (1) 'professional': greater appeal of Australian medical workplaces, intention to pursue a speciality, and to complete this at an Australian metropolitan hospital; (2) 'social': proximity to family/partner or opportunity to meet a prospective partner, family obligations, positive rural experiences; and (3) 'location': direct travel access to family.

    CONCLUSIONS: IFP graduates from the Tasmanian medical program make an important contribution to the Australian mainland metropolitan medical workforce, but play only a small role in workforce development for both Tasmania and the broader Australian rural and remote context. Most IFPs do not choose to work rurally. Rurally focused medical programs need to consider how they place IFP students to meet both the learning and career needs of IFP students and the goal of the rural medical programs in developing a rural workforce.
    Matched MeSH terms: Rural Health Services/manpower*
  9. Cameron NA, Molsberry R, Pierce JB, Perak AM, Grobman WA, Allen NB, et al.
    J Am Coll Cardiol, 2020 Dec 01;76(22):2611-2619.
    PMID: 33183896 DOI: 10.1016/j.jacc.2020.09.601
    BACKGROUND: Rates of maternal mortality are increasing in the United States with significant rural-urban disparities. Pre-pregnancy hypertension is a well-established risk factor for adverse maternal and offspring outcomes.

    OBJECTIVES: The purpose of this study was to describe trends in maternal pre-pregnancy hypertension among women in rural and urban areas in 2007 to 2018 in order to inform community-engaged prevention and policy strategies.

    METHODS: We performed a nationwide, serial cross-sectional study using maternal data from all live births in women age 15 to 44 years between 2007 and 2018 (CDC Natality Database). Rates of pre-pregnancy hypertension were calculated per 1,000 live births overall and by urbanization status. Subgroup analysis in standard 5-year age categories was performed. We quantified average annual percentage change using Joinpoint Regression and rate ratios (95% confidence intervals [CIs]) to compare yearly rates between rural and urban areas.

    RESULTS: Among 47,949,381 live births to women between 2007 and 2018, rates of pre-pregnancy hypertension per 1,000 live births increased among both rural (13.7 to 23.7) and urban women (10.5 to 20.0). Two significant inflection points were identified in 2010 and 2016, with highest annual percentage changes between 2016 and 2018 in rural and urban areas. Although absolute rates were lower in younger compared with older women in both rural and urban areas, all age groups experienced similar increases. The rate ratios of pre-pregnancy hypertension in rural compared with urban women ranged from 1.18 (95% CI: 1.04 to 1.35) for ages 15 to 19 years to 1.51 (95% CI: 1.39 to 1.64) for ages 40 to 44 years in 2018.

    CONCLUSIONS: Maternal burden of pre-pregnancy hypertension has nearly doubled in the past decade and the rural-urban gap has persisted.

    Matched MeSH terms: Rural Health/statistics & numerical data*
  10. Ekman B, Pathmanathan I, Liljestrand J
    Lancet, 2008 Sep 13;372(9642):990-1000.
    PMID: 18790321 DOI: 10.1016/S0140-6736(08)61408-7
    For women and children, especially those who are poor and disadvantaged, to benefit from primary health care, they need to access and use cost-effective interventions for maternal, newborn, and child health. The challenge facing weak health systems is how to deliver such packages. Experiences from countries such as Iran, Malaysia, Sri Lanka, and China, and from projects in countries like Tanzania and India, show that outcomes in maternal, newborn, and child health can be improved through integrated packages of cost-effective health-care interventions that are implemented incrementally in accordance with the capacity of health systems. Such packages should include community-based interventions that act in combination with social protection and intersectoral action in education, infrastructure, and poverty reduction. Interventions need to be planned and implemented at the district level, which requires strengthening of district planning and management skills. Furthermore, districts need to be supported by national strategies and policies, and, in the case of the least developed countries, also by international donors and other partners. If packages for maternal, newborn and child health care can be integrated within a gradually strengthened primary health-care system, continuity of care will be improved, including access to basic referral care before and during pregnancy, birth, the postpartum period, and throughout childhood.
    Matched MeSH terms: Rural Health Services/organization & administration; Rural Health Services/statistics & numerical data*
  11. Esa R, Ong AL, Humphris G, Freeman R
    BMC Oral Health, 2014;14:19.
    PMID: 24621226 DOI: 10.1186/1472-6831-14-19
    To investigate the role of geography (place of residence) as a moderator in the relationship between dental caries disease and treatment experience and dental fear in 16-year-olds living in Malaysia.
    Matched MeSH terms: Rural Health/statistics & numerical data
  12. Low LL, Sondi S, Azman AB, Goh PP, Maimunah AH, Ibrahim MY, et al.
    Asia Pac J Public Health, 2011 Sep;23(5):690-702.
    PMID: 21878464 DOI: 10.1177/1010539511418354
    Patients with issues or health problems usually plan to discuss their concerns with their health care providers. If these concerns were not presented or voiced during the health care provider-patient encounter, the patients are considered to have unvoiced needs. This article examines the extent and possible determinants of patients' unvoiced needs in an outpatient setting. A cross-sectional study was conducted in 5 Ministry of Health Malaysia primary health facilities throughout the country. Of 1829 who participated, 5 did not respond to the question on planned issues. Of the 1824 respondents, 57.9% (95% confidence interval = 47.1-68.7) claimed to have issues/problems they planned to share, of whom 15.1% to 26.7% had unvoiced needs. Extent of unvoiced needs differed by employment status, perceived category of health care provider, and study center. Perceived category of health care provider, method of questionnaire administration, and study center were the only significant determinants of unvoiced needs. Unvoiced needs do exist in Malaysia and there is a need for health care providers to be aware and take steps to counter this.

    Study site: 5 Ministry of Health Malaysia primary health facilities throughout the country
    Matched MeSH terms: Rural Health Services/statistics & numerical data
  13. Al-Mekhlafi HM, Mahdy MA, 'Azlin MY, Fatmah MS, Norhayati M
    Ann Trop Med Parasitol, 2011 Mar;105(2):135-43.
    PMID: 21396250 DOI: 10.1179/136485911X12899838683368
    Cryptosporidium is a coccidian parasite that is prevalent worldwide, some species of which cause morbidity in both immunocompromised and immunocompetent individuals. The prevalence and predictors of Cryptosporidium infection, and its effect on nutritional status, have recently been explored among 276 children (141 boys and 135 girls, aged 2-15 years) in aboriginal (Orang Asli) villages in the Malaysian state of Selangor. Faecal smears were examined by the modified Ziehl-Neelsen staining technique while socio-economic data were collected using a standardized questionnaire. Nutritional status was assessed by anthropometric measurements. Cryptosporidium infection, which was detected in 7.2% of the aboriginal children, was found to be significantly associated with low birthweight (≤2.5 kg), being part of a large household (with more than seven members) and prolonged breast feeding (>2 years). The output of a binary logistic regression confirmed that large household size was a significant predictor of Cryptosporidium infection (giving an odds ratio of 2.15, with a 95% confidence interval of 1.25-5.02). Cryptosporidium infection is clearly a public-health problem among the aboriginal children of Selangor, with person-to-person the most likely mode of transmission.
    Matched MeSH terms: Rural Health/statistics & numerical data
  14. Chin CY, Pengal S
    Asia Pac J Public Health, 2009 Oct;21(4):410-20.
    PMID: 19661103 DOI: 10.1177/1010539509343973
    It has been argued that cardiovascular disease (CVD) is not very prevalent in developing countries, particularly in a rural community. This study examined the prevalence of CVD risk of a semirural community in Malaysia through an epidemiological survey.
    Matched MeSH terms: Rural Health/statistics & numerical data*
  15. Francis K, Chapman Y, Doolan G, Sellick K, Barnett T
    Aust J Rural Health, 2008 Jun;16(3):164-9.
    PMID: 18471187 DOI: 10.1111/j.1440-1584.2008.00967.x
    OBJECTIVE:This study sought to identify and evaluate approaches used to attract internationally trained nurses from traditional and non-traditional countries and incentives employed to retain them in small rural hospitals in Gippsland, Victoria.
    DESIGN: An exploratory descriptive design.
    SETTING: Small rural hospitals in Gippsland, Victoria.
    PARTICIPANTS: Hospital staff responsible for recruitment of nurses and overseas trained nurses from traditional and non-traditional sources (e.g. England, Scotland, India, Zimbabwe, Holland, Singapore, Malaysia).
    RESULTS AND CONCLUSION: Recruitment of married overseas trained nurses is more sustainable than that of single registered nurses, however, the process of recruitment for the hospital and potential employees is costly. Rural hospitality diffuses some of these expenses by the employing hospitals providing emergency accommodation and necessary furnishings. Cultural differences and dissonance regarding practice create barriers for some of the overseas trained nurses to move towards a more sanguine position. On the positive side, single overseas registered nurses use the opportunity to work in rural Australian hospitals as an effective working holiday that promotes employment in larger, more specialized hospitals. Overall both the registered nurses and the employees believe the experience to be beneficial rather than detrimental.
    Matched MeSH terms: Rural Health Services/manpower*
  16. Tay ST, Ho TM, Rohani MY, Devi S
    Trans R Soc Trop Med Hyg, 2000 9 7;94(3):280-4.
    PMID: 10974999
    A serosurvey was conducted in 1995-97 among 1596 febrile patients from 8 health centres in Malaysia for antibodies against Orientia tsutsugamushi (OT), Rickettsia typhi (RT) and TT118 spotted fever group rickettsiae (SFGR) by using an indirect immunoperoxidase assay. A total of 51.4% patients had antibody against at least 1 of those rickettsiae. Antibody to SFGR was most prevalent (42.5%), followed by RT (28.1%) and OT (24.9%). The seroprevalences of antibodies to SFGR, RT or OT alone were 12.4, 3.6 and 4.3%, respectively. Antibodies against more than 1 species of rickettsiae were presence in 31.1% of the patients, suggesting the possibility of co-infection, previous exposures or serological cross-reactivities. Seroprevalence of the various rickettsiae varied according to locality, with SFGR antibodies being the most prevalent in most areas. There was no significant association of prevalence of rickettsial antibody with gender. The seroprevalence of OT, SFGR and RT increased with patient age but an increase of antibody titre with age was not significant. Those working in the agricultural sectors had significantly higher seroprevalence of OT, SFGR and RT than those not related with agricultural activities. Scrub typhus remains a public health problem with an estimated annual attack rate of 18.5%. Tick typhus and murine typhus as shown in this serosurvey appear much more widespread than scrub typhus in this country.
    Matched MeSH terms: Rural Health/statistics & numerical data
  17. Hargreaves JA, Matejka JM, Cleaton-Jones PE, Williams S
    ASDC J Dent Child, 1995 Sep-Oct;62(5):353-5.
    PMID: 8550926
    Little new evidence on the prevalence of injury to the anterior teeth of children has been reported in the past five years and, in South Africa, trauma to the teeth of children in different ethnic groups has not been compared respectively. The purpose of this investigation was to determine the prevalence of dental trauma using well-defined criteria and to sample a specific age-group. Five regions were chosen and 1035 children in the eleven-year age-group were examined. No statistical significance was found between the ethnic groups related to the amount of injury sustained. For all groups, boys received more injuries than girls. The most common injury was fracture of the enamel of the maxillary central incisor. With 15 percent of the children receiving some level of trauma by age eleven years, this is one of the main dental treatment needs for South African children.
    Matched MeSH terms: Rural Health/statistics & numerical data
  18. Foo LH, Khor GL, Tee ES, Prabakaran D
    Asia Pac J Clin Nutr, 2004;13(1):48-55.
    PMID: 15003914
    Iron deficiency anaemia (IDA) is the most prevalent micronutrient deficiency in the world affecting the general health and wellbeing of millions. In Malaysia, moderately high prevalences of anaemia have been reported amongst infants, young children and women of childbearing age. Data is scant for the adolescents. This study was undertaken to assess the iron status and dietary intake of 165 adolescents, comprising 74 male and 91 female subjects, aged 12 to 19 years, from the rural communities in Tuaran District of Sabah, Malaysia. Convenience sampling was used for the selection of study subjects. Multiple iron status indicators namely, serum ferritin (SF), transferrin saturation (TS), mean corpuscular volume (MCV) and haemoglobin (Hb) were determined for the study. The mean age of the subjects was 15.2 +/-2.1 years. While the majority of the subjects (77.6%) had normal body mass index (BMI) values, 17.6% were underweight and 4.8% overweight. About 35% to 40% of the subjects showed deficient values for haematocrit, serum ferritin, serum iron, mean corpuscular haemoglobin (MCH), mean corpuscular volume (MCV) and transferrin saturation (TS), and 20% were anaemic (Hb <12 g/L). Using the multiple criteria of iron status indicators, the prevalence of iron depletion, iron deficiency and IDA in the male and female adolescents were 5.4% vs. 6.6%, 18.9% vs. 26.4% and 5.4% vs. 26.4%, respectively. Iron deficiency anaemia (85.0%) contributed largely to the prevalence of anaemia. The dietary iron intake of the adolescents was unsatisfactory, with approximately 98% of subjects failing to meet the Malaysian RDA level. Almost all the female subjects (91%) had dietary iron intake below two-thirds of the RDA level compared with a much smaller proportion for the male adolescents (68%). The prevalence of IDA in the present study population, especially in the female adolescents, appears to be a significant public health problem. Priority should therefore be given to the eradication of iron deficiency in adolescents from low-income areas by dietary modification and micronutrient supplementation amongst female adolescents.
    Matched MeSH terms: Rural Health*
  19. Hairi F, Ong CH, Suhaimi A, Tsung TW, bin Anis Ahmad MA, Sundaraj C, et al.
    Asia Pac J Public Health, 2003;15(1):37-43.
    PMID: 14620496
    A cross-sectional survey was conducted to assess the level of knowledge, attitude and practices concerning dengue and its vector Aedes mosquito among selected rural communities in the Kuala Kangsar district from 16-25th June, 2002. It was found that the knowledge of the community was good. Out of the 200 respondents, 82.0% cited that their main source of information on dengue was from television/radio. The respondents' attitude was found to be good and most of them were supportive of Aedes control measures. There is a significant association found between knowledge of dengue and attitude towards Aedes control (p = 0.047). It was also found that good knowledge does not necessarily lead to good practice. This is most likely due to certain practices like water storage for domestic use, which is deeply ingrained in the community. Mass media is an important means of conveying health messages to the public even among the rural population, thus research and development of educational strategies designed to improve behaviour and practice of effective control measures among the villagers are recommended.
    Matched MeSH terms: Rural Health/statistics & numerical data*
  20. Asawa K, Bhanushali NV, Tak M, Kumar DR, Rahim MF, Alshahran OA, et al.
    Rocz Panstw Zakl Hig, 2015;66(3):275-80.
    PMID: 26400125
    Oral health care services are often sparse and inconsistent in India therefore it is often difficult for poor people to get access to the oral health care services. The approach by dental institutions with the help of community outreach programs is a step ahead in overcoming this situation.
    Matched MeSH terms: Rural Health Services/organization & administration*
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