scholarly journals It is time for rural training in family medicine in Brazil!

2018 ◽  
Vol 13 (40) ◽  
pp. 1-4
Author(s):  
Magda Moura Almeida ◽  
Mayara Floss ◽  
Leonardo Vieira Targa ◽  
John Wynn-Jones ◽  
Alan Bruce Chater
Keyword(s):  
Family Medicine ◽  
Low Income ◽  
Rural Areas ◽  
Human Resources For Health ◽  
Health Indicators ◽  
Health Needs ◽  
Rural And Remote ◽  
Barriers To Access ◽  
The Social ◽  
Rural Training

The gap between health needs and the training of human resources for health is much more evident in rural areas. In Brazil, a country of continental dimensions, these differences become more challenging. The diversity of geographical and administrative barriers to access makes the health indicators of rural and remote populations worse than those of the urban population. Family Medicine could address the social determinants of health through the provision of human services and play an important role in low-income rural residents’ health status. This essay is an urgent call for the debate on models for projecting heath workforce supply and requirements for rural areas in Brazil.

Empathy not quarantined: Association between people’s empathy to others and the COVID-19 pandemic situations based on a national survey study (Preprint)

2020 ◽  
Author(s):  
Zhibin Jiang ◽  
Fan Yang ◽  
Bu Zhong ◽  
Xuebing Qin
Keyword(s):  
Social Support ◽  
Social Media ◽  
National Survey ◽  
Low Income ◽  
Rural Areas ◽  
Critical Role ◽  
Affective Response ◽  
Survey Study ◽  
Income Levels ◽  
The Social

BACKGROUND The Covid-19 pandemic had turned the world upside down, but not much is known about how people’s empathy might be affected by the pandemic. OBJECTIVE This study examined 1) how empathy towards others might be influenced by the social support people obtained by using social media; and 2) how the individual demographics (e.g., age, income) may affect empathy. METHODS A national survey (N = 943) was conducted in China in February 2020, in which the participants read three real scenarios about low-income urban workers (Scenario I), small business owners in cities (Scenario II), and farmers in rural areas (Scenario III) who underwent hardship due to COVID-19. After exposure to others’ difficulties in the scenarios, the participants’ empathy and anxiety levels were measured. We also measured the social support they had by using social media. RESULTS Results show that social support not only positively impacted empathy, β = .30, P < .001 for Scenario I, β = .30, P < .001 for Scenario II, and β = .29, P < .001 for Scenario III, but also interacted with anxiety in influencing the degree to which participants could maintain empathy towards others, β = .08, P = .010 for Scenario I, and β = .07, P = .033 for scenario II. Age negatively predicted empathy for Scenario I, β = -.08, P = .018 and Scenario III, β = -.08, P = .009, but not for Scenario II, β = -.03, P = .40. Income levels – low, medium, high – positively predicted empathy for Scenario III, F (2, 940) = 8.10, P < .001, but not for Scenario I, F (2, 940) = 2.14, P = .12, or Scenario II, F (2, 940) = 2.93, P = .06. Participants living in big cities expressed greater empathy towards others for Scenario III, F (2, 940) = 4.03, P =.018, but not for Scenario I, F (2, 940) = .81, P = .45, or Scenario II, F (2, 940) = 1.46, P =.23. CONCLUSIONS This study contributes to the literature by discovering the critical role empathy plays in people’s affective response to others during the pandemic. Anxiety did not decrease empathy. However, those gaining more social support on social media showed more empathy for others. Those who resided in cities with higher income levels were more empathetic during the COVID-19 outbreak. This study reveals that the social support people obtained helped maintain empathy to others, making them resilient in challenging times.

Population’s perceptions and availability of primary care services in Romania- a pilot survey in County Brasov.

2019 ◽  
Author(s):  
Andrea Elena Neculau ◽  
Liliana Rogozea ◽  
Daniela Popa ◽  
Ioana Atudorei ◽  
Florin Leasu ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Low Income ◽  
National Level ◽  
Health Needs ◽  
Out Of Hours ◽  
Healthcare Planning ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
Health Services Needs

Abstract Background National health reports on Romania show that decisions in healthcare planning are not correlated with the health needs of the population and that there is a high degree of unmet healthcare needs of the population (related to cost, distance and waiting times), especially for low-income populations. Family medicine is facing underfinancing, slow pace of development. Methods The research is part of a wider project of health services needs assessment in county Brasov, Romania. A subset of questions where dedicated to identifying the perception of population on primary healthcare services. Comparison with previous national and international studies was done. Results The characteristics of the population questioned: predominantly women (67.2%), 61.1% graduates of high school or other professional schools. 97.4% are registered with a FD. The average number of visits at the FD is 11.25, higher than the national average of 7.7 reported in a previous study in 2009. Access to the FD is appreciated as satisfactory in terms of availability of doctors in the community (97.4%), opening times by (91.1%), phone access (90.5%). Only 26.6% of participants reported a same day opportunity to reach the FD. Continuity of care is reported as present in 58.7% of cases in out of hours centres. The population is appreciating the fact that FDs knows their history (90%), knows how to treat them (88.2%). Most of the preventative services are offered by FDs. 94.4% flu vaccination, 85.6% pregnancy monitoring, 90.7% well child visits. Procedures like blood draws, pap smear have less availability (46.2% respectively 63.1%). Conclusions Despite limitations in the practice of family medicine in Romania and therefore a narrow spectrum of services offered by primary care in general, the level of contentment of the population with this healthcare resource is still high. Barriers to access are related to the lack of some essential services, especially preventive and out-of-hours services. Research at national level should be done in order to better categorize population’ perceptions on primary care and be able to use their opinion to influence policies and healthcare planning. Key words: unmet health needs, population’s perception, primary care, Romania

The Health of the Poorest 50%

Pained ◽  
2020 ◽  
pp. 95-98
Author(s):  
Michael D. Stein ◽  
Sandro Galea
Keyword(s):  
Social Mobility ◽  
Low Income ◽  
Social Institutions ◽  
Health Indicators ◽  
Social Resources ◽  
Lower Income ◽  
The Past ◽  
The Social

This chapter focuses on the health of the poorest 50% of Americans. Pretax income for the poorest 50% of Americans has remained the same over the past 40 years, while their after-tax income has dropped as taxes have increased for this same group. Regressive taxation has deepened wealth gaps, virtually assuring a continuing cycle of low income earning. The national share of income owned by the richest 50% of Americans has grown commensurately during this period, and the health indicators have responded accordingly. The slope of the income–health relationship has grown even steeper since 2000; the health advantage that those with higher incomes have over those with lower incomes is greater than it has been in the past four or more decades. Why is this? Americans continue to invest less in the social resources that can mitigate the challenges that come with a lower income, even as they spend ever more on high-end medicine that is accessed principally by those who can afford it. Social institutions like education that traditionally have led to social mobility and better health have become increasingly the provenance of the well-off.

The Effect of Interpersonal Spending Pressure on Intention to Smoke among Low-Income People in China

2021 ◽  
Vol 7 (5) ◽  
pp. 967-988
Author(s):  
Bai Rui ◽  
Pan Weiyu ◽  
Li Chao ◽  
Zhong Yu ◽  
Xu Juan
Keyword(s):  
Social Exchange ◽  
Social Relations ◽  
Low Income ◽  
Rural Areas ◽  
Threshold Model ◽  
Significant Proportion ◽  
Sustainable Growth ◽  
Human Relationship ◽  
The Social ◽  
The Relationship

Objectives: Test the effect of capital on household human relationship expenditure and thus examine the effect on the willingness to smoke. Methods: Threshold model and Critical theory of capital. Results: China is a large consumer of tobacco, and tobacco account for a significant proportion of interpersonal spending in China. It is found that the percentage of social spending of low-income families is much higher than that of high-income families. In recent years, the social expenditures of extremely low-income people have far exceeded their income. At the same time, the types of urban and rural areas, traditional customs, business management, social exchange, and education level significantly impact the family’s human relationship expenditure. Conclusion: This paper shows that, unlike in Western countries, cigarettes present a huge advantage in interpersonal interactions in China, hence the phenomenon that the richer one is, the more one consumes tobacco. Social poverty has become a significant obstacle to the sustainable growth of low-income people’s income. Under the effect of capital, the relationship between people is deeply reflected as the relationship between human and material, and then presents the characteristics of materialization. The reason why people accept this way of interaction lies in the domination of rational principles. To control the materialized social relations, we need the construction of timely theory and the formation of values free from capital control to alleviate the social poverty.

scholarly journals Social security expenses with patients with back pain by the National Institute of Social Security of Brazil from 2008 to 2014

2019 ◽  
Vol 11 (5) ◽  
pp. e233
Author(s):  
Marcelo José da Silva de Magalhães ◽  
Samara Aparecida Martins Dias Silva ◽  
Fernando Ericson Almeida Vieira ◽  
Samuel Caires Martins de Lima ◽  
Thais Mendes Colares Maurício ◽  
...  
Keyword(s):  
Back Pain ◽  
Social Security ◽  
Lower Back Pain ◽  
Low Income ◽  
Rural Areas ◽  
The Public ◽  
Lower Back ◽  
The Social ◽  
Average Annual Cost ◽  
Urban And Rural Areas

Objective: To analyze all social security expenditures paid by Brazilian Institute of Social Security (INSS) of lower back pain, from 2008 to 2014. Methods: Consultation to Social Security database in order to obtain information about the main benefits offered individuals by the INSS, in the period between 2008 and 2014. Based on the Social Security database and the ICDs M51 and M54, the INSS expenditures were assessed for low-income retirement, sickness and to accidental retirement, between men and women from urban and rural areas from 2008 to 2014. Results: In this period, the most prevalent benefit was Disease Aid, with an average annual cost of R$ 88.458.511,10. The total cost of benefit was: Accidental Sickness Insurance-R$ 116.076.692,00;Accidental Retirement-R$ 6.740.052,84; Illness Assistance-R$ 373.547.294,00; Retirement Due to Disability-R$ 75.883.844,00. Among all the above mentioned beneficiaries, there was a predominance of males and individuals living in the urban area. Conclusions: Lower back pain leads to suffering for workers, costs to companies, as well as burdening the public coffers regarding the social security system and health care.

scholarly journals Social Features and Morbidity Patterns of Women with Obstetric Fistulae at an Obstetric Fistula Centre in a University Teaching Hospital in Jos, Nigeria

2021 ◽  
Vol 3 (4) ◽  
pp. 44-52
Author(s):  
Aaron Ezekiel ◽  
C. Okafor Kingsley ◽  
J. M. Ijairi ◽  
Ayobami A. Mufutau ◽  
Steve T. Olaniyan ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Low Income ◽  
Rural Areas ◽  
Financial Support ◽  
Obstetric Fistula ◽  
Family Members ◽  
University Teaching ◽  
Foot Drop ◽  
The Social ◽  
Social Features

Obstetric fistulae are largely preventable surgical conditions. Literature has shown that it is common among the low income, less privileged and marginalized members of the community. It affects mainly the poor, young, illiterate girls, and women in the remote rural areas of the world, where access to emergency obstetric care, family planning services and skilled birth attendants are unavailable. And when available are poorly utilized due to cost, distance, and other challenges. This study seeks to identify the social features and morbidity characteristics of obstetric fistulae in women at the fistula center in Bingham University Teaching Hospital, Jos, Plateau State, Nigeria. This was a descriptive study done in 2019 among all the patients who attended the obstetric fistula Centre at Bingham University Teaching Hospital. An Interviewer-administered structured questionnaire was used, and it looked at social and health aspects of obstetric fistulae in all 49 patients at the center. Data was analyzed using a computer software; Statistical Package for the Social Science (SPSS) version 20.0. Most of patients had some form of financial support especially from family members, husbands, parents, and friends. Most of the women had their relationships affected. Majority were separated, and relationships strained and had lost financial support from their spouses. Sexual Intercourse was adversely affected. On surgical outcome, 16% became completely dry and leaking had ceased, a third (36.7%) was still leaking urine after the surgery. Almost all the women have had no childbirth after the repair. Women had mental health issues like depression, anxiety, tension headache, fatigue, and suicidal ideation. Participants also had gynaecological morbidities like vulval dermatitis, irregular menstrual flow, abnormal vaginal discharge, and dysuria. These women also had lower abdominal pains, loss of weight, backache, and foot drop. Majority of the children did not survive after the pregnancy that led to the obstetric fistula. Women should seek financial support from family members to avoid delays in seeking help during pregnancy. Communities are encouraged to continue to give moral, emotional, financial, and social support to fistula patients. Healthcare workers should take advantage of the fact that most women attended ANC to educate and enlighten pregnant women on causes, risk factors, social and health consequences of obstetric fistulae. Government should initiate poverty alleviation activities and help reduce out of pocket expenses for healthcare via health insurance.

scholarly journals An Exploratory Study of a Novel Approach to Improve Readiness for a Rural Family Medicine Residency

PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Dwight Smith ◽  
Nellie Wirsing ◽  
Joyce C. Hollander-Rodriguez ◽  
Tracy Bumsted ◽  
Eric Wiser ◽  
...  
Keyword(s):  
Family Medicine ◽  
Medical School ◽  
Rural Areas ◽  
Exploratory Study ◽  
Rural Practice ◽  
Family Medicine Residency ◽  
Novel Approach ◽  
Field Notes ◽  
Curricular Elements ◽  
Rural Training

Background and Objectives: Transitioning from medical school to residency is challenging, especially in rural training programs where a comprehensive scope of practice is needed to address rural health disparities. Oregon Health &amp; Science University partnered with Cascades East Family Medicine Residency in Klamath Falls, Oregon to create an integrated fourth-year medical student experience (Oregon Family medicine Integrated Rural Student Training (Oregon FIRST). Participants may then enter this residency to complete their training with the intention to practice in rural underresourced settings.  Methods: In this exploratory study, we conducted key informant interviews with 9 of ten Oregon FIRST participants to determine how Oregon FIRST contributed both to their readiness for residency training and their choice to practice in rural underserved locations. Interviews were conducted between June 10, 2020 and July 8, 2020. We analyzed field notes taken during interviews for emergent themes using classical content analysis. Results: Emergent themes included logistical ease, relationship development, key curricular elements, and commitment to rural practice. Overwhelmingly, Oregon FIRST participants reported the experience had many challenging and demanding components because they served as subinterns for their entire fourth year of medical school, but this prepared them very well for internship. When asked if they would choose to enroll in Oregon FIRST again, given what they now know about physician training and patient care, all nine (100%) said they would. Conclusions: This study demonstrated that Oregon FIRST students felt better prepared for the rigors of residency and are committed to practicing in rural areas. 

scholarly journals Empleo femenino y su efecto sobre la distribución de la renta familiar en el medio rural

2011 ◽  
Vol 10 (1) ◽  
pp. 5
Author(s):  
Esperanza Vera-Toscano ◽  
Eduardo Moyano Estrada
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Significant Contribution ◽  
Family Income ◽  
Female Employment ◽  
Regional Survey ◽  
The Social ◽  
Low Income Families ◽  
Using Data ◽  
High Degree

Using data from a regional survey undertaken in 2008 to a sample of female rural residents of Andalucía, this paper analyzes the distributive effects of the increase in female employment on family income inequality. Results show the significant contribution of female earnings to family income and its distribution in rural areas. Nonetheless, female employment tends to be highly unstable with a high degree of seasonality and makes no contribution to the Social Security System. This situation exposes low income families, in particular, towards a high risk of social exclusion.

scholarly journals Opportunities and Challenges of Economic Development in Malaysia’s Rural Areas

2018 ◽  
Vol 1 (1) ◽  
pp. h1-5 ◽  
Author(s):  
ELLFRELSTERN ANAK EDIRIN
Keyword(s):  
Economic Development ◽  
Natural Resources ◽  
Social Services ◽  
Low Income ◽  
Rural Areas ◽  
Transport Infrastructure ◽  
Development Economic ◽  
Social Stability ◽  
The Social

Rural areas play traditionally important role for our economy as well maintaining social stability. Most of the development is entirely dependent on natural resources in the area which is specialized in a limited number of industries such as agriculture, livestock, forestry, fisheries and local tourism. People that live in rural areas have fewer choices in the social and economic terms. They are facing many problems such as low income, unemployment, low quality of social services like education and healthcare. In addition, remoteness from major urban centres is also one of the problems which is implying the need for well-developed transport infrastructure to support economic development. As stated in the Eleventh Malaysia Plan, the Malaysian Government is committed to ensuring equitable opportunities for all segments of society.Keywords: Development, economic, Eleventh Malaysia Plan, rural

scholarly journals Monitoring and Evaluation of the Agricultural and Rural Renewal Program in Algeria: case of the Ouarsenis area

2018 ◽  
Vol 56 (4) ◽  
pp. 719-728
Author(s):  
Mohamed Tebani ◽  
Khalladi Mederbal
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Monitoring And Evaluation ◽  
Short Term ◽  
Environmental Aspect ◽  
North West ◽  
The North ◽  
Renewal Program ◽  
The Social ◽  
Rural Program

Abstract: In Algeria, agriculture continues to suffer from short-term strategies and is unsuitable for the needs of populations and rural areas. This study examines the evaluation of the Agricultural and Rural Program (ARRP) initiated in Algeria for the period (2009-2014). This work was carried in the Ouarsenis area located in the north-west of the country. It is based on regular monitoring on the ground of the rate of achievement of the targets foreseen. We concentrated our efforts on the projects financed by the main intervention funds of this program. The results achieved are far from the targets for the economic component, a situation mainly expressed by the low income of the rural population and the number of jobs created. However, an improvement in the living conditions of the population was recorded in the social component. Concerning the environmental aspect, the results are considered acceptable for the restoration of the forest patrimony and low for the protection of the soil. We believe that this policy rests on foundations that have not really been translated into the field in the continuity of previous approaches and lack of governance with poorly managed material, financial and human resources.

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