• Title/Summary/Keyword: The Korean Journal of Rural Medicine

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A Qualitative Inquiry Into the Challenges of Medical Education for Retention of General Practitioners in Rural and Underserved Areas of Iran

  • Delavari, Sajad;Arab, Mohammad;Rashidian, Arash;Nedjat, Saharnaz;Souteh, Rahmatollah Gholipour
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.6
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    • pp.386-393
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    • 2016
  • Objectives: General practitioners (GPs) retention in rural and underserved areas highly effects on accessibility of healthcare facilities across the country. Education seems to be a critical factor that affects GPs retention. Thus, the present study aimed at inquiry into medical education challenges that limit their retention in rural and underserved areas. Methods: A qualitative approach was applied for the aim of this study. Data were gathered via 28 semi-structured interviews with experts at different levels of Iran's health system as well as GPs who retained and refused to retain working in rural settings. Interviews mainly were performed face-to-face and in some cases via telephone during 2015 and then coded and analyzed using content analysis approach. Results: Iran's medical education is faced with several challenges that were categorized in four main themes including student selection, medical students' perception about their field of study, education setting and approach, curriculum of medical education. According to experts this challenges could results in making GP graduates disinterested for practicing in rural and underserved areas. Conclusions: Challenges that were found could have negative effects on retention. Modification in student's perception about rural practice could be done via changing education setting and approach and curriculum. These modifications could improve GPs retention in rural and underserved areas.

Blood Pressure and Serum Lipids in Relation to Serum Gamma-glutamyltransferase Activity in Men of Rural Area (농촌 지역 남성들에서 혈청 Gamma-glutamyltransferase 활성도와 혈압 및 혈청 지질의 관련성)

  • Oh, Myoung-Joo;Cho, Byung-Mann;Hwang, In-Kyung;Lee, Sang-Don;Chung, Moon-Kee
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.123-133
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    • 2003
  • Objectives: To examine the association between serum gamma-glutamyltransferase(GGT) activity level and blood pressure, serum lipids in the male residents of rural area, we analyzed cross-sectionally the data of 379 male health examinees aged 40 years and older from rural areas in Gyeongsangnam-do prefecture in Korea. Methods: Blood pressure and concentration of serum lipids were compared between high and low level of serum GGT activity by t-test or Wilcoxon rank sum test. Possible confounding effects of age, body mass index and coffee drinking were adjusted by analysis of covariance. Results: Adjusted values of systolic and diastolic blood pressure were higher in the group of high level of serum GGT activity in non-drinkers(P=0.055 and P=0.074 respectively) and drinkers(P=0.284 and P=0.398) of alcohol. Adjusted serum total cholesterol level was also higher in the group of high level of serum GGT activity in non-drinkers(P=0.052) but not in drinkers(P=0.981) of alcohol. In serum triglyceride, adjusted level was significantly higher in the group of high level of serum GGT activity in both non-drinkers(P=0.035) and drinkers(P=0.002) of alcohol. Conclusions: These results suggest the association of serum GGT activity and serum triglyceride, total cholesterol, or blood pressure in non-drinkres of alcohol.

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Survey for the Current Status of MCH Service in Rural Area (우리나라 일부 농촌지역의 모자보건 실태조사)

  • Kim, Byung-Sung;Chon, Hae-Jung;Cha, In-Jun
    • Journal of agricultural medicine and community health
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    • v.17 no.1
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    • pp.5-16
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    • 1992
  • The maternal and child health is a basis of national health, and indicates the level of social welfare and health of the country, because it is related with community welfare status, general cultural conditions, and medical and health sciences. This is a study carried out to identify the present practices of maternal and child health care programs implemented by the private clinics located in Guns(counties ; rural area) in Kyungsangnam Province and to propose alternatives to improve their current programs through a self-administrative questionnaire. The subjects were 90 private physicians who operated their own clinics since 1990 and were general practitioners, Obstertrician/Gynecologists or pediatricians: This survey was conducted by mail from 15 January to 25 February 1992. The response rate was 94.4 percent. 1) The major manpower for MCH programs of the studied clinics was physicians and nurseaids. 70.3% of physicians were general practitioners, 81.1% of nursing manpower were nurseaids. 31.1% of the studied clinics employed lab-technicians. 89.2% of them had MCH room whatever the size and the setting, and 84.4% of Ob/Gyn clinics installed laboratory equipments. 2) 55.4% and 63.5% of the studied clinics provided 151 or above consulting services and curative services of MCH per physician a month respectively and 33.8% and 25.7% of them provided 10 or less consulting services and curative services per physician a month. 91.9% of lab-technicians had 10 or less laboratory tests per technician a month. 3) There was a difference between Ob/Gyn and pediatric clinics in terms of services delivered : for example, 80% of Ob/Gyn clinics provided pre- and post- natal care services, while 84.6% of pediatric clinics provided vaccinations for children. It was also found that only a few of general practitioners involved pre-and post- natal care services. 4) There were no clinics which had opened regular health education session but 24.3% of them had opened the sessions irregularly. Ob/Gyn clinics put emphasis on maternity and pediatric clinics did on child health, but general practitioners touched with both maternal and child health. 21.6% of the studied clinics had some kind of educational materials for MCH programs. Most of the materials were pamphlets or small booklets. 5) Proteinuria/glucosuria, blood pressure and blood type were tested in 48.6~69% of the studied clinics ; tests for blood sugar and hepatitis B were provided in 39.2~41.9% of them, most of them were done in Ob/Gyn clinics. 6) 41.9% of physicians, 29.7% of nurses and 45.9% of nurses-aids wanted to receive on-job-training for MCH programs.

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A Study on Relations between Health Status and Physical Therapy in Rural Area Elderly Women (일부 농촌지역 여성노인들의 건강특성과 물리치료와의 상관관계)

  • Ro, Hyo-Lyun;Kim, Sung-Joung;Gong, Won-Tae
    • The Journal of Korean Physical Therapy
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    • v.21 no.4
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    • pp.81-88
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    • 2009
  • Purpose: This study examined the health status and physical therapy in elderly women in rural areas to provide basic data on the promotion of health and physical therapy management of elderly women in rural areas. Methods: The subjects were 110 elderly women. The data was collected through individual interviews, and the tool developed for this study was a structured questionnaire based on the literature. The reliability coefficient was 0.57 ~ 0.79(Chronbach' $\alpha$). Results: Village 1 made the most of an oriental medicine clinic and a neighborhood clinic, whereas village 2 mainly used a public health center. Arthritis/ neuralgia and high blood pressure/low blood pressure were the most common complaints in the two villages; a medical institution was used once a month by more than 50% of subjects. Most rural elderly women used physical therapy, and the prevalence of arthritis/neuralgia was high. The most common problem in the two villages was poor health. The improvement in mobility was higher in the more healthy women, who also had less need for treatment at a medical institution. Conclusion: Most rural elderly women were concerned about poor health and used physical therapy. Therefore, rural medical institutions need to pay attention to the medical service and preventive activity to reduce the incidence and severity of neuromuscular syndrome in rural elderly women.

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Epidemiological Survey on Clonorchis sinensis in Eui - Seong Gun, Kyungpook Province (경북(慶北) 의성군(義城郡)에 있어서의 간흡충감염(肝吸虫感染) 실태조사(實態調査))

  • Rim, H.J.;Lee, J.S.;Choi, J.O.;Song, O.D.;Song, S.D.;Kim, M.S.
    • Journal of agricultural medicine and community health
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    • v.3 no.1
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    • pp.35-41
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    • 1978
  • Clonorchiasis sinensis is the most important endemic disease in In Korea, and this disease has been known to be one of public health concern in mary areas of southern part of Korea. This survey was undertaken to evaluate the status of clonorchiasis in Eui-Seong Gun, Kyungpook Province from March 1974 to August 1974. A total number of 3,771(male 2,037. female 1,734) consisting of 2,948 primary school children, 774 middle school students, 49 high school students were examined by the intradermal test with clonorchis antigen. In order to detect clonorchis egg, the stool examinations were undertaken on the residents in Bong Yang Myun. And, the intensity of the clonorchis infection was estimated by the Stoll's egg count. The following results were obtained in this survey; 1. As a whole, 6.0 per cent of the examiners showed positive reaction by the intradermal test (male 8.0%, female 3.6%). 2. Among 249 residents in Bong Yang Myun, the prevalence rate of clonorchis eggs was shown as 45.8 per cent. 3. The mean E. P. G. in Bong Yang Myun 114 inhabitants was 2,197. 4. The degree of the intensity of clonorchis infection by E. P. G. counts was distributed to the light (50.9%) medium (43.9%) and heavy infection groups(5.3%).

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Allelic Diversity of MSP1 Gene in Plasmodium falciparum from Rural and Urban Areas of Gabon

  • Mawili-Mboumba, Denise Patricia;Mbondoukwe, Noe;Adande, Elvire;Bouyou-Akotet, Marielle Karine
    • Parasites, Hosts and Diseases
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    • v.53 no.4
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    • pp.413-419
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    • 2015
  • The present study determined and compared the genetic diversity of Plasmodium falciparum strains infecting children living in 2 areas from Gabon with different malaria endemicity. Blood samples were collected from febrile children from 2008 to 2009 in 2 health centres from rural (Oyem) and urban (Owendo) areas. Genetic diversity was determined in P. falciparum isolates by analyzing the merozoite surface protein-1 (msp1) gene polymorphism using nested-PCR. Overall, 168 children with mild falciparum malaria were included. K1, Ro33, and Mad20 alleles were found in 110 (65.5%), 94 (55.9%), and 35 (20.8%) isolates, respectively, without difference according to the site (P>0.05). Allelic families' frequencies were comparable between children less than 5 years old from the 2 sites; while among the older children the proportions of Ro33 and Mad20 alleles were 1.7 to 2.0 fold higher at Oyem. Thirty-three different alleles were detected, 16 (48.5%) were common to both sites, and 10 out of the 17 specific alleles were found at Oyem. Furthermore, multiple infection carriers were frequent at Oyem (57.7% vs 42.2% at Owendo; P=0.04) where the complexity of infection was of 1.88 (${\pm}0.95$) higher compared to that found at Owendo ($1.55{\pm}0.75$). Extended genetic diversity of P. falciparum strains infecting Gabonese symptomatic children and high multiplicity of infections were observed in rural area. Alleles common to the 2 sites were frequent; the site-specific alleles predominated in the rural area. Such distribution of the alleles should be taken into accounts when designing MSP1 or MSP2 malaria vaccine.

Need of Health Center-based Integrated Healthcare Services for the Elderly in Rural Area (농촌지역 보건소 중심의 노인 통합보건의료서비스 필요도)

  • Won, Eun-Sook;Chang, Sei-Jin;Park, Jong-Ku;Hyun, Sook-Jung;Kim, Chun-Bae
    • Journal of agricultural medicine and community health
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    • v.32 no.1
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    • pp.27-39
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    • 2007
  • Objectives: The challenge of an increasing elderly population has coupled with everpresent social concerns in Korea. A major problem in health center for the frail older people is that medical, healthcare, and welfare services are often fragmented in terms of providers and settings without appropriate coordination. The purpose of this study was to investigate the need of health center-based integrated healthcare services and its related factors for the elderly. Methods: A total of 110 elderly people who had visited at a county Health Center were interviewed using a self-administered questionnaire from November to December, 2005. The questionnaire consists of five domains according to the Program of All-inclusive Care for the Elderly. Results: Respondents had high need (total mean score with the 5-point Likert-type sacle: 3.67) of health center-based integrated healthcare services including home visiting service (mean: 4.08), chronic disease care service (mean: 4.06), and transportation service (mean 4.05). According to the results of hierarchical multiple regression analysis, among three regression models the magnititude of the variance of full model that is explained by the need of welfare-domain service was significantly larger than two reduced model. Income was a significant variable in increasing the need of health care and welfare services. Conclusions: This study suggests that the health center-based integrated healthcare services for the elderly must be continuously developed and provided for the health promotion and improved the quality of life of the elderly who live in rural area in Korea.

Zoonoses for Pig Farmers in Rural Communities in Korea (농촌지역 양돈 종사자의 인수공통감염병)

  • Lee, Kwan;Lim, Hyun-Sul;Min, Young-Sun;Kim, Byoung-Seok
    • The Korean Journal of Community Living Science
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    • v.23 no.4
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    • pp.383-397
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    • 2012
  • The incidence of zoonoses in Korea has recently increased. But the study for high risk group such as pig farmers to zoonoses has not been conducted in Korea. Thus we reviewed the articles in order to obtain basic data for zoonoses among pig farmers, especially in rural communities. Pigs are one of the most important domestic livestock in Korea not only from economic standpoint but also from standpoint of food. Pigs also represent a potential reservoir for many novel pathogens, therefore may transmit these to humans via direct contact, vectors such as mosquitos, or contaminated meat. The zoonoses associated with pigs can be classified into bacterial pathogen, viruses and so on. Bacterial zoonoses include brucellosis, leptospirosis, listeriosis, enterohemorrhagic Escherichia coli infection, pasteurellosis, salmonellosis, yersiniosis, tuberculosis, anthrax, necrobacillosis, swine erysipelas, erysipeloid, melioidosis, Streptococcus suis infection, Clostrium difficile infection, and campylobactor infection. Viral zoonoses consist of Japanese encephalitis, swine influenza, Nipah virus, Reston ebolavirus, and hepatitis E virus infection. Other type of zoonoses include actinomycosis, toxoplasmosis and Taenia solium infection. These zoonoses were important in Korean health policy but lately they have been overlooked. For effective health policy, we need to study zoonoses associated with pigs, and clinicians and veterinarians must care deeply about these zoonoses.

A Case of Sparganosis (Sparganosis의 1예(例))

  • Song, O.D.;Rim, H.J.;Lee, J.S.
    • Journal of agricultural medicine and community health
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    • v.5 no.1
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    • pp.46-48
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    • 1980
  • A case of sparganosis was presented. Sparganosis is not infrequent tissue helminthiasis in Korea and the incidence has been evidently increased. The patient was a 50-year-old Korean male who had a habit of eating raw flesh of fresh water fish. He first noticed the appearance of two peanut-sized masses in the right subcostal region, however, the two masses enlarged gradually to a pigeon egg size during 5 years. On surgical exploration, one larva (61 cm in length and 4 to 6 mm in width) from two masses was extracted. It was moved actively in warm physiological saline solution.

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