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Abstract This study endeavors to formulate a sustainable development-oriented model for home-based businesses catering to rural women in Guilan province. Employing a qualitative-quantitative research approach, the study is practical in its objectives and relies on survey methods for data collection. The research population encompasses two main groups: the first group involves academic professionals, scholars, and managers or experts from provincial organizations dedicated to employment and women’s issues, while the second group comprises 274 purposefully sampled individuals, including owners, managers, and women affiliated with micro-credit funds in Guilan province, selected through the snowball technique. Semi-structured interviews were conducted to gather data, and the Smart-PLS software package utilized the partial least squares (PLS) technique for advanced multivariate analysis in structural equation modeling. Evaluation of the home-based business development model for rural women, based on the coefficients of the direct path, reveals that educational (β = 0.112), social (β = 0.232), economic (β = 0.274), and policymaking (β = 0.381) variables significantly influence the sustainable development of home-based businesses (P

The metalloid arsenic (As) induces oxidative stress is a well-known fact. However, the extent of variation of oxidative stress according to different exposure levels of As in groundwater and the mechanism responsible for As mediated oxidative stress is yet to be elucidated in a human population of West Bengal. In the present study, we have investigated the impact of low level (> 10 ≤ 50 µg/L) and high-level groundwater As (> 50 µg/L) on cellular redox status, DNA damage, and repair mechanisms in chronically exposed rural women of West Bengal. Prediction models of ordinary least square regression of nail As, forced vital capacity (FVC) %, and that of forced expiratory volume during the first one second (FEV1) % deciphered that accumulation of As in nails may predict hemoglobin deficiency. Moreover, consumption of As-laced water tends to decrease FEV1% and FVC%. A strong positive correlation was observed between water and nail As level and reactive oxygen species (ROS) generation. ROS, perturbed nuclear factor erythroid 2-related factor 2(Nrf2)/ Kelch-like ECH-associated protein 1 (Keap1) redox regulation, compromised antioxidant defense machinery-superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione transferase (GST), induced DNA damage, and suppressed DNA repair proteins-poly ADP ribose polymerase1(PARP1)/ X-ray repair cross-complementing protein 1(XRCC1)/ 8-oxoguanine glycosylase (OGG1) in a dose-dependent manner. All the low and high As areas had very high cancer risk values for the exposed population. It has been predicted that if the As level in the drinking water of a 40-year adult increases by 2 ug/L, the likelihood of the cancer risk will increase by 10%, keeping the body weight and amount of water intake constant. Thus, long-term exposure to either low or high As is seriously affecting the lives of asymptomatic women who are vulnerable to developing carcinogenic changes after a period of latency., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Women with disabilities are at increased risk of interpersonal violence compared to women without disabilities. Little is known, however, about women with disabilities' experience accessing and participating in counseling and other mental health services during and following their victimization, particularly when living in a rural setting. This study involved qualitative interviews with 33 women with diverse disabilities who experienced interpersonal violence in rural communities. Researchers used thematic content analysis to identify three key themes from the findings: (a) experiences learning about mental health service options, (b) challenges to finding an appropriate "fit" and therapy approach, and (c) access barriers to mental health services. Participants emphasized the need for provider training specific to disability, the inclusion of people with disabilities more prominently in the mental health workforce, and the importance of advancements in accessible telemental health. We discuss implications for improving mental health services., (© Copyright 2022 Springer Publishing Company, LLC.)

This secondary analysis describes sleep and health-related factors in healthy overweight and obese mid-life and older rural women enrolled in the' Women Weigh-In for Wellness' randomized clinical trial. The aim of the trial was to promote healthy behaviors and weight-loss. We analyzed demographic, anthropometric, and biomarker variables, self-reported measurements of sleep disturbance and pain interference, and objective 24-h sleep/wake patterns at baseline, 6 months, and the change over time. Although self-reported sleep disturbance reflected normal sleep, pain interference was slightly higher than normal. There were associations between higher self-reported sleep disturbance, pain interference and several other variables. Women who achieved 5 % or more weight loss exhibited positive associations between sleep, pain, and health-related factors. Weight loss and lower pain predicted lower self-reported sleep disturbance. Our results suggest that overweight and obese rural women who adopt healthy behaviors and achieve weight loss also may experience improved sleep and other health benefits. Clinical trial # NCT01307644., Author(s): Marcia Y. Shade[sup.1] , Ann M. Berger[sup.1] , Paul J. Dizona[sup.1] , Bunny J. Pozehl[sup.2] , Carol H. Pullen[sup.1] Author Affiliations: (1) College of Nursing-Omaha, University of Nebraska Medical [...]

Pakistani women living in rural areas are particularly vulnerable to violence because of their relatively weaker social position and lack of awareness about their legal rights. We investigated domestic violence against rural women and its association with women's health. A cross-sectional survey was conducted from Rural Health Center of five selected districts by conducting face-to-face interviews from 490 randomly selected women of reproductive age. The data showed that about 65 % of the interviewed women had experienced different types of violence, with psychological violence being the most common. Multivariate logistic regression analysis showed that women's low education, low income, and marriage at an early age were significantly associated with domestic violence. Additionally, Domestic violence was significantly associated with poor mental and reproductive health. These findings may be useful in developing public health programs to address domestic violence against rural women., Author(s): Rubeena Zakar[sup.1] , Muhammad Z. Zakar[sup.1] , Safdar Abbas[sup.1] Author Affiliations: (1) Department of Public Health, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan Domestic [...]

This study set out to reveal to what extent women entrepreneurs operating in rural areas have been affected by environmental pollution and climate change. Besides, it emphasises how much they will be affected over the next 5 years throughout Turkey. The study covered rural areas of all seven regions in Turkey. Findings were analysed by using SPSS 23 programme. Women entrepreneurs were younger in less developed regions of the country, such as the Central, Eastern, and South-Eastern Anatolia, and were older in the more economically developed coastal areas. One-third of the respondents were microentrepreneurs; 12% employ five or more workers. The problems of rural women entrepreneurs are further complicated by environmental pollution and climate change. Among the significant environmental issues, women entrepreneurs endure a loss of income, loss of trade stock/goods, and loss of livestock, property damage and potable water supply. Women entrepreneurs agreed that, in the next 5 years, environmental problems would adversely affect customer demand, the quality of raw materials they use and the products they offer; therefore, customer demand would reduce. On the other hand, they were divided in their opinion about whether environmental problems will be affecting their business location and the need to invest in technology and equipment. The study showed that none of the participants obtained disaster insurance, and none of them was members of an environmental organisation.

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a public nutritional assistance program for low-income women and their children up to age five. This study provides insight into maternal characteristics associated with breastfeeding among urban versus rural women. A secondary analysis was conducted using the Pregnancy Nutrition Surveillance System dataset of women enrolled in the Kansas WIC program in 2011. Geographic residency status was obtained through application of the Census tract-based rural-urban commuting area codes. Descriptive variables included maternal demographics, health, and lifestyle behaviors. A multivariable binary logistic regression was used to obtain adjusted odds ratios with 95 % confidence intervals. The outcome variable was initiation of breastfeeding. A P value of [less than or equal to]0.05 was considered statistically significant. The total sample size was 17,067 women. Statistically significant differences regarding socio-demographics, program participation, and health behaviors for urban and rural WIC participants were observed. About 74 % of all WIC mothers initiated breastfeeding. Urban women who were Hispanic, aged 18-19, high school graduates, household income >$10,000/year, and started early prenatal care were more likely to breastfeed. Urban and rural women who were non-Hispanic black with some high school education were less likely to breastfeed. Increased breastfeeding initiation rates are the result of a collaborative effort between WIC and community organizations. Availability of prenatal services to rural women is critical in the success of breastfeeding promotion. Findings help inform WIC program administrators and assist in enhancing breastfeeding services to the Kansas WIC population., Author(s): Lisette T. Jacobson[sup.1] , Philip Twumasi-Ankrah[sup.1] , Michelle L. Redmond[sup.1] , Elizabeth Ablah[sup.1] , Robert B. Hines[sup.1] , Judy Johnston[sup.1] , Tracie C. Collins[sup.1] Author Affiliations: (1) Department of [...]

Religion and spirituality (R/S) are embedded in all aspects of life in India, a predominantly rural economy. The aim of this mixed methods study was to assess the associations between a culturally tailored intervention and preexisting religious/spiritual (R/S) practices with indicators of well-being and factors which contribute to happiness among elderly rural women from Haryana state, India. The study consisted of three groups: field experimental group (FEG; n = 24); practitioners of preexisting R/S practices for at least 6 weeks Satsang (SG, n = 54), Brahma Kumaris (BKG, n = 54), and Radha Soami (RSG, n = 30), and non-practitioners of R/S practices (n = 64). All groups completed self-report measures of overall happiness and life satisfaction, global health, quality of life, and health status and physical health. Results revealed that FEG participants improved significantly on physical health, body balancing, and self-care; no changes were observed on the other well-being measures following the intervention. Practitioners of preexisting R/S practices were found significantly different from the non-practitioners on some indicators of health, quality of life, and well-being. Qualitative measures pointed to the importance of R/S and family and interpersonal relationships among elderly rural women.

Respiratory diseases' mortality and morbidity have been a major public health burden primarily attributed to widespread exposure to indoor and outdoor pollutants in the environment. The study conducted among 510 Bangladeshi women residing in the northeastern zone of the Sylhet division from semi-urban and rural settings to compare the biomass fuel users (N = 255) with the non-biomass users (N = 255). It has been observed that all the symptoms had a higher prevalence among the women who were exposed to biomass fuel compared with those exposed to clean gas fuel. Women exposed to biomass group reported frequent cough and phlegm production episodes during a 3-month timeline before the survey period which was found statistically higher (p < 0.001) compared with that of the clean gas fuel group. Moreover, the use of biomass fuel has been associated with a significant decrease in forced expiratory volume in one second (FEV 1 ), forced vital capacity (FVC), and peak expiratory flow rate (PEFR). Appropriate strategies from stakeholders and government authorities in disseminating health hazards from biomass fuel along with supporting the community by providing alternative energy sources for cooking can largely impact people's lives.

Abstract Access to reliable and affordable energy is crucial for women to carry out household duties efficiently, including cooking and cleaning. However, many women in developing countries still lack access to modern energy sources, which strains their time, health, and overall well-being. This study investigates the relationship between women’s economic empowerment and energy choices among rural households in the Southern Nations, Nationalities, and Peoples region of Ethiopia. Utilizing a multi-stage cluster sampling design, 569 households were selected from six randomly chosen woredas (districts). Employing a multinomial model, the research explores factors influencing energy source selection. The findings reveal that a majority of households rely on traditional energy sources, with a positive correlation observed between women’s economic empowerment, as measured by the CWEEI, and the adoption of modern energy sources. Additionally, household size and income significantly predict energy source choices. This study underscores the pivotal role of women’s economic empowerment in promoting cleaner energy use in rural settings. Policymakers and program implementers are urged to consider household size and income levels when formulating effective energy programs and interventions.

Women living in rural America experience significant disparities in cardiometabolic diseases warranting research to aid in understanding the contextual factors that underlie the rural and urban disparity and in planning effective primary prevention interventions. While research has established a general understanding of cardiometabolic risks individually, the combination or bundling of these risk behaviors is not clearly understood. The purpose of this study is to explore the association of social determinants of health on obesity and adiposity related cardiometabolic disease risk among rural women. Data were from the multi-state Rural Families Speak about Health Study. A total of 399 women were included in the analyses. Data were collected using a self-administered questionnaire on women's demographics, economic stability, education, and health and healthcare. Food insecurity, education, healthcare access and comprehension health literacy were associated with higher obesity and adiposity-related cardiometabolic risk. Health behaviors, tobacco use and physical activity were not associated with higher cardiometabolic risk in this sample of rural women. This is one of the first studies to focus on multiple social determinants of health and cardiometabolic risk in rural American women. Understanding combinations of risk behaviors can assist health care providers and community health professionals in tailoring multiple health behavior change interventions to prevent cardiometabolic disease among rural women. The findings support a focus on community and societal level factors may be more beneficial for improving the cardiometabolic health of rural women.

This study aims at exploring factors related to the antenatal care (ANC) utilization in rural areas of Lao PDR. A quantitative, cross-sectional interview study was conducted in the Khammouane and Champasack provinces. The study population comprised all currently pregnant women 15-45 years of age with a gestational period beyond 32 weeks plus all women who had given birth during the last 12 months. With the informed consent of all eligible women, 460 respondents were included in the study and interviewed using a structured questionnaire. Multiple logistic regression analysis was applied to determine factors significantly related to ANC use. Fifty-one percent of the respondents had at least one ANC visit. Among the users, 63% had visited ANC three times or more but only 28% attended during the first trimester. After adjusting for other factors, using a 95% Confidence Interval (CI), statistically significant associations were found between ANC use and the following factors: women whose husbands were salaried employees (OR = 2.66, CI = 1.45-4.88); women younger than 18 years old at first pregnancy (OR 0.56, CI = 0.28-0.97); women perceiving ANC as somewhat useful (OR = 2.88, CI = 1.26-6.61) or very useful (OR = 7.45, CI = 3.59-15.46). Awareness of the usefulness of ANC was related to more frequent use and could be one focus of community intervention to increase utilization. Keywords Antenatal care * Utilization * Rural area * Health centre * Lao PDR, Introduction To reach the 5th Millennium Development Goal, the Lao PDR's maternal mortality ratio must decrease from the government's estimate of 405 (per 100,000 live births) to 185 in 2015. [...]

This qualitative study assessed psychosocial concerns that rural women with HIV who had multiple psychosocial vulnerabilities were able to express and communicate during a mobile phone intervention delivered by nurses. The study is part of a pilot randomised controlled trial of an mHealth self-care intervention by nurses for women living with HIV in rural India. For the trial, 60 women were randomised to receive the mHealth intervention. All calls were recorded and call logs were maintained. Call logs of 59 women based on 1186 calls were scanned for psychosocial themes. Audio recordings of 400 calls rich in content were then transcribed and translated for analysis. Themes and subthemes were identified by two independent raters. Majority of the women had low literacy and more than half were widowed. Clinical depression was found in 18.6%. Of the 1186 call logs analysed, 932 calls had a record of at least one psychosocial concern and 493 calls recorded two psychosocial concerns. Some of the major themes that women discussed with nurses included worries about their own and their children's future; loneliness; stigma; inadvertent disclosure; death and dying; abandonment by partner; financial difficulties; body image; poor social support; emotions such as sadness, guilt, and anger; and need for social services. Almost all expressed appreciation for the intervention. Findings indicate the usefulness of mHealth-based self-care interventions delivered by nurses in hard to reach women in low- and middle-income countries, especially those with multiple psychosocial vulnerabilities.

Objectives To examine the relationships between pre-pregnancy diabetes mellitus (DM), gestational diabetes mellitus (GDM), pre-pregnancy body mass index (BMI) and county-level social determinants of health, with infant macrosomia within a sample of American Indian/Alaska Native (AI/AN) women receiving Indian Health Service (IHS) care. Methods The sample included women-infant dyads representing 1,136 singleton births from fiscal year 2011 (10/1/2019-9/30/2011). Data stemmed from the IHS Improving Health Care Delivery Data Project. Multivariate generalized linear mixed models were fitted to assess the association of macrosomia with pre-pregnancy health status and social determinants of health. Results Nearly half of the women in the sample were under age 25 years (48.6%), and most had Medicaid health insurance coverage (76.7%). Of those with a pre-pregnancy BMI measure, 66.2% were overweight or obese. Although few women had pre-pregnancy DM (4.0%), GDM was present in 12.8% of women. Most women had a normal term delivery (85.4%). Overweight, obesity, pre-pregnancy DM, and county-level rurality were all significantly associated with higher odds of infant macrosomia., Author(s): Vanessa Y. Hiratsuka [sup.1] [sup.2] , Margaret Reid [sup.3] , Jenny Chang [sup.4] , Luohua Jiang [sup.5] , Angela G. Brega [sup.6] , Amber L. Fyfe-Johnson [sup.7] , Kimberly [...]

Sexual victimization is associated with risky sexual behaviors. Limited research has examined mechanisms via which victimization affects risk behaviors, particularly following different types of sexual victimization. This study examined self-worth as a mediator of the relationship between sexual victimization history: contact childhood sexual abuse (CSA), completed rape in adolescence/adulthood (adolescent/adulthood sexual assault [ASA]), and combined CSA/ASA, and two sexual risk behaviors: past year partners and one-time encounters. Participants were diverse (57.9% African American), low-income women recruited from an OB-GYN waiting room (n = 646). Women with a history of sexual victimization, 29.8% (n = 186) reported lower self-worth, t(586) = 5.26, p < .001, and more partners, t(612) = 2.45, p < .01, than nonvictims. Self-worth was a significant mediator only among women with combined CSA/ASA histories in both risk behavior models.

Objectives Mothers in resource-limited areas face barriers in initiating care for ill newborns, leading to delays that may contribute to newborn mortality. This qualitative study conducted in rural Lufwanyama District in Zambia aimed to (1) explore mothers' healthcare-seeking related to newborn illness and (2) identify reasons for delaying care-seeking for ill newborns. Methods We examined the perspectives of 60 mothers and 77 grandmothers of children under three years of age in 14 focus group discussions as part of the Lufwanyama Integrated Neonatal and Child Health Program study. We conducted a thematic analysis of verbatim transcripts using dedicated software. Results Mothers and grandmothers were generally able to identify newborn danger signs and established a hierarchy of care-seeking based on the perceived severity of danger signs. However, inability to afford transportation, inaccessible health care facilities, high costs of medication prescribed at the health clinics, lack of respectful treatment and fear of newborns dying in the hospital prevented participants from seeking timely care. As traditional birth attendants (TBAs) and community health care workers (CHWs) have limited roles in newborns care beyond the immediate delivery setting, mothers often resorted to traditional healers for newborn care. Conclusions Based on cultural beliefs and influenced by traditions, mothers in Lufwanyama have developed hierarchical strategies to seek care for ill newborns. Barriers to treatment at health facilities often resulted in traditional care. Training both TBAs and CHWs in providing community-based newborn care and appropriate referrals could improve care-seeking and prevent newborn mortality in rural Zambia., Author(s): Lucy Thairu [sup.1] , Hanna Gehling [sup.2] , Sarah Kafwanda [sup.3] [sup.4] , Kojo Yeboah-Antwi [sup.5] , Davidson H. Hamer [sup.6] , Karsten Lunze [sup.7] Author Affiliations: (1) grid.419747.8, [...]

Objectives This study aimed to characterize patterns of worsening mental health during the postpartum period among women in rural areas of Limpopo Province, South Africa, and to identify correlates with household demographic factors. Methods We collected data on maternal mental health symptoms shortly after birth and then again 7 months postpartum using the World Health Organization self-reporting questionnaire (SRQ-20) from December 2017 to November 2018. The absolute change in SRQ-20 symptom score was calculated to determine worsening mental health over the postpartum period. Linear regressions were performed to investigate factors associated with mental health symptom scores at varying postpartum time points. Results We found increased reporting of poor mental health symptoms at 7 months postpartum as compared to shortly after birth (n = 224). Worsening maternal mental health over the postpartum period was associated with higher SRQ-20 symptom score shortly after birth (p < 0.001) and reported food insecurity at 7 months (p < 0.001). SRQ-20 symptom scores in the postpartum period were not associated with breastfeeding in the past 24 h reported at 7 months postpartum (p = 0.08). Conclusions for Practice Women in rural South Africa, like women in many settings, may be vulnerable to worsening postpartum mental health when they lack sufficient socioeconomic resources and when they have pre-existing depressive/anxiety symptoms., Author(s): David T. Silverman [sup.1] , John P. Killion [sup.1] , Denise Evans [sup.2] , Lezanie Coetzee [sup.2] , Peter C. Rockers [sup.3] , Davidson H. Hamer [sup.3] [sup.4] Author [...]

Objectives Despite known health benefits of breastfeeding, the Navajo have low reported frequency of breastfeeding initiation and support. We evaluated breastfeeding frequencies and practices in the predominately Navajo community of rural San Juan County, Utah, to identify factors that affect breastfeeding decisions and duration. Methods We performed retrospective chart review for 135 infants aged 0 to 12 months, and surveys of 85 mothers of infants aged 0 to 2 years, and eight primary care providers. We characterized demographic factors using counts/percentages and medians/inter-quartile ranges, and compared mothers who breastfed for 6 months or less versus greater than 6 months. Results In 96 infants with complete feeding documentation, 86 infants (90%) received some breast milk and 36 infants (38%) were exclusively breastfed at age 2 months. In 67 infants with complete feeding documentation at [greater than or equal to] 6 months, 22 infants (33%) were exclusively breastfed 6 months. Most mothers knew about breastfeeding benefits. In 56 mothers whose infants were aged [greater than or equal to] 6 months at the time of the survey, breastfeeding for more than 6 months had been planned by 44 mothers (79%) but performed by only 29 mothers (52%). Mothers who breastfed for > 6 months were more likely to have been influenced by WIC and less likely to have introduced formula at an early age. Barriers to breastfeeding included maternal pain, latch difficulties, and concerns about inadequate milk supply. Primary care providers reported limited confidence in providing breastfeeding support but would support telehealth-driven interventions. Conclusions for Practice Practical, culturally sensitive interventions, including telehealth and improved provider education, may improve breastfeeding outcomes and community health in this underserved population., Author(s): Laura L. Brown [sup.1] , Revina Talker [sup.2] , Gregory J. Stoddard [sup.3] , Jessica Clayton [sup.1] , Morgan M. Millar [sup.4] , Yeonjung Jo [sup.5] , Tyler Bardsley [...]

Objective This study assessed whether having continuous support during labor is associated with better person-centered maternity care (PCMC) among women in rural Kenya. Methods Data are from a cross-sectional survey with women aged 15-49 years who delivered in the 9 weeks preceding survey completion (N = 865). PCMC was operationalized using a validated 13-item scale, with a summative score developed from responses that capture dignity and respect, communication and autonomy, and supportive care from providers (excluding support from a lay companion). Continuous support was operationalized as the continuous presence of a lay companion (friend or family) during labor. We carried out bivariate analyses using chi-squared and t-tests and ran multivariable linear regression models to examine the association between continuous labor support and PCMC. Results The average PCMC score was 24.2 (SD = 8.4) out of a total score of 39. About two-thirds (68%) of women had continuous support during labor. The average PCMC scores among women who had continuous support was 25.7 (SD = 8.4) compared to 21.0 (SD = 7.6) among those who did not have continuous support (p-value [less than or equal to] 0.001). After controlling for various confounders this association was still significant (coefficient = 4.0; 95% CI 2.9, 5.2; p-value [less than or equal to] 0.001). Conclusions Women who have continuous labor support during childbirth are more likely to have improved PCMC. Efforts to promote PCMC should thus include continuous labor support., Author(s): Gift Kiti [sup.1] , Ndola Prata [sup.2] , Patience A. Afulani [sup.3] Author Affiliations: (1) grid.47840.3f, 0000 0001 2181 7878, School of Public Health, University of California, , Berkeley, [...]

Although growing research supports cancer survivor information-seeking, little is known about breast cancer prevention information-seeking among women. The purpose of the study was to examine differences in breast cancer risk factor knowledge, information sources, and desired mobile messages among Hispanic and non-Hispanic rural women. Women were recruited to complete a survey at an imaging center during a mammography screening visit. A total of 156 women (mean age = 61, SD = 12.07) completed the survey. Breast cancer risk factor knowledge was significantly higher for non-Hispanic women compared to Hispanic women (p = .035). Television, magazines, and Internet were the most frequent information sources. Providers were the most frequent interpersonal information source. Nearly 87 % used cell phones and 47 % used texting. Hispanic women were more likely to desire breast cancer prevention cell voice messages (p < .001) and text messages (p = .001) compared to non-Hispanic women. No significant differences were found for text appointment reminders by ethnicity. Health educators and clinicians must promote mobile messages for Hispanics and non-Hispanics for mammography adherence, breast cancer prevention education, and best practices to manage screening appointments.

The purpose of this study was to examine the breast cancer prevention information seeking behaviors among rural women, the prevalence of Internet, cell, and text use, and interest to receive breast cancer prevention information cell and text messages. While growing literature for breast cancer information sources supports the use of the Internet, little is known about breast cancer prevention information seeking behaviors among rural women and mobile technology. Using a cross-sectional study design, data were collected using a survey. McGuire's Input-Ouput Model was used as the framework. Self-reported data were obtained from a convenience sample of 157 women with a mean age of 60 (SD = 12.12) at a rural New Mexico imaging center. Common interpersonal information sources were doctors, nurses, and friends and common channel information sources were television, magazines, and Internet. Overall, 87% used cell phones, 20% had an interest to receive cell phone breast cancer prevention messages, 47% used text messaging, 36% had an interest to receive text breast cancer prevention messages, and 37% had an interest to receive mammogram reminder text messages. Bivariate analysis revealed significant differences between age, income, and race/ethnicity and use of cell phones or text messaging. There were no differences between age and receiving text messages or text mammogram reminders. Assessment of health information seeking behaviors is important for community health educators to target populations for program development. Future research may identify additional socio-cultural differences.

Objectives We evaluate the association between food insecurity (FI) and clinical depression, and the modifying effects of seasonality on this association. Methods Food insecurity is assessed from 175 post-partum women in the rural Ntcheu District of central Malawi using the USAID's Household Food Insecurity Access Scale (HFIAS). Clinical depression is measured using a validated Chichewa version of the Self-Reporting Questionnaire (SRQ). Interviews were conducted from October 2016 to June 2017 and spanned 5 months of the dry season (April-November) and the 4 months of rainy season (December-March). Results After adjusting for age and parity, participants who reported high FI (HFIAS score [greater than or equal to] 9) had 4.6 (95%CI 1.8-11.4) times the odds of meeting the cut-off for clinical depression (SRQ score [greater than or equal to] 8). The effect was greater during the dry season (OR 9.9; 95%CI 2.0-48.6), than in the rainy season (OR 2.6; 95%CI 0.8-8.3) though the interaction term was not statistically significant (p = 0.18) Conclusions for Practice High FI is associated with diagnostic markers of clinical depression., Author(s): Tiffany E. Mark [sup.1] , Ryan J. Latulipe [sup.2] , Martina Anto-Ocrah [sup.3] [sup.4] , Geoffrey Mlongoti [sup.5] , David Adler [sup.3] , Joseph W. Lanning [sup.5] [sup.6] Author [...]

Appalachia Kentucky is recognized for increased cervical cancer incidence, morbidity and mortality and lower rates of Pap testing. Understanding the predictors of Human Papillomavirus (HPV) vaccine uptake is warranted among this population. The purpose of this exploratory research is to determine associations between HPV-related risk perceptions and uptake of free Gardasil offered to rural Appalachian women ages 18-26 attending regional health clinics. Young women (N = 247) were recruited from health clinics in Southeastern, Kentucky from March 2008 through September 2009. After completing a brief interview assessing seven HPV-related risk perceptions, women received a HPV vaccine voucher which provided the entire three-dose vaccine series free of charge. Whether women redeemed the voucher for dose one of Gardasil served as the study outcome variable. Hierarchical logistic regression was used to estimate the independent effects of each predictor variable on vaccine uptake. Less than 50% redeemed the voucher to receive dose one of the HPV vaccine. Five of the seven variables significantly predicted uptake. In a controlled analysis, only two predictors remained significant: "in general, vaccines are a good thing" (P = .02) and "I believe that getting the vaccine will be painful" (P = .03). The remaining three predictor variables (worry about having HPV [P = .07], HPV is serious enough for vaccination [P = .43], and not sure vaccine is safe [P = .22]) were not significant in the model. Health promotion programs designed for this population may enhance HPV vaccine uptake by creating more realistic perceptions about the inherent value of vaccines and by improving perceptions relative to injection pain.

Breast cancer has emerged as an important health condition worldwide, including developing countries. Screening is limited or non-existent in resource-poor areas. The purpose of this study was to assess knowledge, attitudes, and practices of self (SBE) and clinical (CBE) breast examinations among 198 rural Nicaraguan women. Ten (5.1%) had performed a SBE, and 16 (8.1%) had a CBE. CBE was significantly associated with a pre-instruction total score of 70% or greater (OR = 13.7, 95% CI = 1.26, 149.70, p = 0.03). Family history of breast cancer was significantly associated with performing a SBE (OR = 5.5, 95% CI = 1.10, 27.81, p = 0.037) and a CBE (OR = 7.1, 95% CI = 1.40, 35.94, p = 0.018). A CBE is a significant determinant of pre-existing breast health knowledge. Physicians or physician extenders should be encouraged to perform a CBE as a routine component of health care delivery and cancer screening for women.

Objectives Antenatal care (ANC) is designed to improve pregnancy outcomes by providing screening and treatment for preventable and treatable diseases. However, data are lacking on whether ANC affects stillbirth risk. We hypothesized stillbirth risk in Uganda is lower in women attending the recommended [greater than or equal to] 4 ANC visits compared to those attending [less than or equal to] 3. Methods We performed a secondary analysis of subset of 1,785 women enrolled in a prospective cohort of postpartum infection who presented to a regional referral hospital for delivery. Our primary outcome was documented stillbirth; a secondary composite poor birth outcome included stillbirth, early neonatal death, low birth weight (< 2500 g), and 5-min APGAR score < 7. We performed multivariable logistic regression analyses to identify independent correlates of stillbirth and poor birth outcome. Results Of 1,785 participants, 58 (3%) pregnancies resulted in stillbirth and 198 (11%) had a poor birth outcome. Of 1,236 women attending [greater than or equal to] 4 ANC visits, 31 (2.5%) had a stillbirth, compared to 27/510 (5.2%) attending [less than or equal to] 3. In multivariable analyses controlling for age, parity, distance traveled, referral status to hospital, malaria prophylaxis, and syphilis infection; attending [greater than or equal to] 4 ANC visits was associated with significantly reduced odds of stillbirth (aOR 0.5, 95% CI 0.3-0.9, P = 0.02) and poor birth outcome (aOR 0.66, 95% CI 0.4-0.96, P = 0.03). Malaria prophylaxis was also independently associated with reduced odds of stillbirth (aOR 0.05, 95% CI 0.2-1.0, P = 0.04). Conclusions Attending [greater than or equal to] 4 ANC visits was associated with reduced odds of stillbirth and poor birth outcomes in this Ugandan cohort, which may be related to more comprehensive infection screening, treatment, and prevention services., Author(s): Rachel P. McDiehl [sup.1] , Adeline A. Boatin [sup.2] [sup.3] , Godfrey R. Mugyenyi [sup.4] , Mark J. Siedner [sup.3] [sup.6] , Laura E. Riley [sup.5] , Joseph Ngonzi [...]

Objective: This study was initiated by breast cancer survivors living in a rural community in California. They formed a partnership with academic researchers to develop and evaluate a low-cost, community-based Workbook-Journal (WBJ) for improving psychosocial functioning in geographically and economically isolated women with primary breast cancer., Design: A randomized controlled trial was used to compare the WBJ intervention plus educational materials to educational materials alone (usual care)., Setting: One rural cancer center and several private medical, surgical, and radiation oncology practices in 7 rural counties in the Sierra Nevada Foothills of California., Participants: One hundred women with primary breast cancer who were either within 3 months of diagnosis or within 3 months of completing treatment., Intervention: A community-initiated, theoretically-based Workbook-Journal, designed by rural breast cancer survivors and providers as a support group alternative. It included compelling personal stories, local rural resources, coping strategies, and messages of hope., Results: Community recruiters enrolled 83% of the women referred to the study. Retention at 3-month follow-up was 98%. There were no main effects for the WBJ. However, 3 significant interactions suggested that women who were treated in rural practices reported decreased fighting spirit and increased emotional venting and posttraumatic stress disorder symptoms if they did not receive the WBJ. Among women who receive the WBJ, 74% felt emotionally supported., Conclusions: This community-based Workbook-Journal may be an effective psychosocial intervention for rural, isolated, and low-income women with breast cancer. Community involvement was essential to the success of this project.

Patriarchal traditions and a history of armed conflict in Timor-Leste provide a context that facilitates violence against women. More than a third of ever-married Timorese women report physical and/or sexual domestic violence (DV) perpetrated by their most recent partner. DV violates women's rights and may threaten their reproductive health. Marital control may also limit women's reproductive control and healthcare access. Our study investigated relationships between DV and marital control and subsequent family planning, maternal healthcare, and birth outcomes in Timor-Leste. Using logistic regression, we examined 2009-2010 Demographic and Health Survey data from a nationally representative sample of 2,951 women in Timor-Leste. We controlled for age, education, and wealth. We limited our analyses of pregnancy- and birth-related outcomes to those from the 6 months preceding the survey. Rural women with controlling husbands were less likely than other rural women to have an unmet need for family planning (Adj. OR 0.6; 95 % CI 0.4-0.9). Rural women who experienced DV were more likely than other rural women to have an unplanned pregnancy (Adj. OR 2.6; 95 % CI 1.4-4.8), fewer than four antenatal visits (Adj. OR 2.3; 95 % CI 1.1-4.9), or a baby born smaller than average (Adj. OR 3.1; 95 % CI 1.4-6.7). DV and marital control were not associated with the tested outcomes among urban women. Given high rates of DV internationally, our findings have important implications. Preventing DV may benefit both women and future generations. Furthermore, rural women who experience DV may benefit from targeted interventions that mediate associated risks of negative family planning, maternal healthcare, and birth outcomes., Author(s): Rebecca Meiksin[sup.1] , Dominique Meekers[sup.2] , Susan Thompson[sup.3] , Amy Hagopian[sup.3] , Mary Anne Mercer[sup.3] Author Affiliations: (1) London School of Hygiene and Tropical Medicine, London, UK (2) Tulane [...]

Objective This study examines the determinants of utilisation of skilled birth attendants (SBAs) amongst 2886 rural women in the state of West Bengal, India, using data from a survey of 2012-2013 conducted by the Birbhum Health and Demographic Surveillance System. Method Multilevel logit regression models were estimated and qualitative investigations conducted to understand the determinants of utilisation of SBAs in rural West Bengal. Results Among women who delivered their last child during the 3 years preceding the survey, 69.1 % of deliveries were assisted by SBAs, while 30.9 % were home deliveries without any SBA assistance. Multivariate analysis revealed that apart from socio-demographic and economic factors (such as household affluence, women's education, birth order, uptake of comprehensive ANC check-ups, advice regarding danger signs of pregnancy and household's socio-religious affiliation), supply side factors, such as availability of skilled birth attendants in the village and all-weather roads, have significant effect on seeking skilled assistance. Our findings also show that unobserved factors at village level independently influence uptake of SBA-assisted delivery. Conclusions for Practice The present findings emphasise that both demand and supply side intervention strategies are essential prerequisites to enhance skilled birth attendance. Ample communication is observed at the individual level, but improving community level outreach and advocacy activities could generate further demand. SBAs can be better integrated by accommodating the socio-religious needs of local communities, such as providing female doctors and doctors with similar socio-religious backgrounds., Author(s): Saswata Ghosh[sup.1] , Md. Zakaria Siddiqui[sup.2] , Anamitra Barik[sup.3] , Sunil Bhaumik[sup.3] Author Affiliations: (1) Institute of Development Studies Kolkata (IDSK), DD-27/D, Sector-1, Near City Centre, 700 064, Salt [...]

Objectives Whether in metropoles or remote mountain communities, the availability and adoption of contraceptive technologies prompt serious and wide-ranging biological, social, and political-economic questions. The potential shifts in women's capacities to create spaces between pregnancies or to prevent future pregnancies have profound and often positive biological, demographic, and socioeconomic implications. Less acknowledged, however, are the ambivalences that women experience around contraception use-vacillations between moral frameworks, generational difference, and gendered forms of labor that have implications well beyond the boundaries of an individual's reproductive biology. This paper hones in on contraceptive use of culturally Tibetan women in two regions of highland Nepal whose reproductive lives occurred from 1943 to 2012. Methods We describe the experiences of the 296 women (out of a study of more than 1000 women's reproductive histories) who used contraception, and under what circumstances, examining socioeconomic, geographic, and age differences as well as points of access and patterns of use. We also provide a longitudinal perspective on fertility. Results Our results relate contraception usage to fertility decline, as well as to differences in access between the two communities of women. Conclusions We argue that despite seemingly similar social ecologies of these two study sites-including stated reasons for the adoption of contraception and expressed ambivalence around its use, some of which are linked to moral and cosmological understandings that emerge from Buddhism-the dynamics of contraception uptake in these two regions are distinct, as are, therefore, patterns of fertility transition., Author(s): Sienna R. Craig[sup.1] , Geoff Childs[sup.2] , Cynthia M. Beall[sup.3] Author Affiliations: (1) Department of Anthropology, Dartmouth College, 6047 Silsby Hall, 03755, Hanover, NHUSA (2) Washington University, St. Louis, [...]

Relatively little is known about rural women's intimate violence experiences in comparison to urban women's experiences, partly because of the difficulty in accessing rural women. This pilot study used a protective order sample of 23 women (15 urban and 8 rural), which provides an access point that is relatively similar for comparisons across rural and urban areas. The number of participants is low and, therefore, results are preliminary. However, several significant findings emerged. Rural women reported significantly less social support, less education, less income, more physical abuse in the preceding year, more childhood physical and sexual abuse, and worse overall health and mental health, as well as encountering abuse earlier in the relationship. Both groups reported higher rates of illegal drug and cigarette use than those among the general population. The findings highlight some overall important themes in examining rural and urban intimate violence victims by suggesting that rural and urban intimate violence victims have different victimization experiences and service needs. Implications for further research and intervention are discussed. KEY WORDS: intimate violence; rural women: health consequences: protective order.

Mothers living with HIV (MLWHs) in the United States have reported that one of their main challenges is the decision to disclose their HIV serostatus to their children and the potential consequences of their disclosure. Little is known about the experiences of MLWHs regarding disclosing their HIV serostatus to their children and the impact of maternal HIV serostatus disclosure in the island nations of the Caribbean. Study objectives were to identify the factors influencing maternal HIV serostatus disclosure, examine the breadth of maternal HIV serostatus, and understand the impact of disclosure on mothers and the children. Baseline interviews were conducted between 2006 and 2007 with 25 HIV-positive mothers and 26 children ages 10-17 participating in a pilot psychosocial support intervention for HIV-affected youth and their caregivers in Haiti. Interviews were transcribed verbatim and coded for topical themes by two investigators. Analysis of the interviews yielded several themes relevant to reasons for disclosure, including children's experience of HIV stigma in the community, social support and encouragement from psychosocial intervention workers. The main themes related to breadth of disclosure were brief disclosure and explicit disclosure with some mothers sharing information about how they learned about their illness diagnosis and their medication. Themes related to impacts of disclosure included emotional reactions of children and mothers, and children's desire to assist mothers with illness and become involved. These findings suggest the need to provide more psychosocial support to HIV-affected families in the Caribbean region. Keywords HIV serostatus disclosure * Mothers * Children Haiti, Introduction The first case of HIV/AIDS in the Caribbean was reported in 1978 in the island nation of Haiti [1]. Since then, poverty, limited access to healthcare and health-related information, [...]

Hypertension is a major global public health risk and significant precursor to cardiovascular disease, stroke, diabetes and maternal mortality. A possible strategy to reduce chronic disease in resource-poor areas is social intervention. Research into the possible relationship of social determinants and disease is needed to determine appropriate social interventions. This study aims to determine the association between social capital and hypertension in rural Haitian women. From June to August 2005, 306 women, ages 18-49, who attended one of Hopital Albert Schweitzer's five rural dispensaries as patients or accompanying patients, were interviewed. Individual interviews on social capital, demographics and anthropometrics were conducted. SAS statistical package was used to analyze the data. Groups/networks, personal empowerment, collective action/cooperation and trust components significantly decreased the likelihood of hypertension in multivariate analysis. In an additive model, the ranked index of social capital indicated that each social capital component score above the conceptual midpoint showed a 41 % reduction in the likelihood of hypertension. The findings suggest that interventions aimed to increase components of social capital may significantly lower hypertension. Keywords Social capital * Social networks * Hypertension * Rural health * Women * Haiti, Introduction Disease dynamics in developing countries are shifting such that morbidity and mortality rates associated with chronic, non-communicable conditions are comparable to communicable diseases [1]. Globalization has introduced the risks [...]

Rural Latino immigrant women at risk of family violence may perceive churches as their only source of help. However, immigrant church leaders may be poorly equipped to address family violence in their congregations. This article describes a project designed to stimulate and support appropriate responses to family violence by immigrant churches, including those identified with conservative theological views on women. The primary goal was to provide rural Latino church leaders with culturally sensitive materials and resources they were willing to use with their congregations. We collaborated with local service providers who assisted in recruiting the church leaders for the pastors' workshops where the resource materials were presented. Survey data indicated most of the pastors were receptive to the content and planned to incorporate it into their church work. Suggestions are made for future research on this culturally sensitive approach to addressing family violence in the immigrant community. Keywords Latino immigrants * Family violence * Culturally sensitive practice * Community based social services, The Latino immigrant population in the United States has grown rapidly over the last decade (U.S. Census Bureau Population Estimates 2008), especially in regions of the country like the rural [...]

Byline: Emma J. Brown (1) Keywords: rural; African-American; mothers; ethnography; cocaine. Abstract: The overall purpose of this ethnographic study was to understand the culture of rural African-American women who use cocaine, with this report focusing on their perceived mothering needs and future aspirations. Three semi-structured interviews and participant observations were conducted over four years with 30 respondents, of which 24 were mothers. Data for this article were derived from the 21 mothers who cared for dependent children. Four mothering-related needs (escape from boredom, others to help mother for them, not having others' children to mother, and having children to 'keep them going') and two categories of mothering-related aspirations (child-focused or self-focused) were identified. Given the limited resources in the area, an unexpected finding was the absence of some needs and aspirations. Theoretical explanations for the themes identified as well as those not identified are posited, and practice and research implications are presented. Author Affiliation: (1) School of Nursing College of Health and Public Affairs, University of Central Florida, P.O. Box 162210, Orlando, Florida, 32816-2210, USA Article History: Registration Date: 25/10/2005 Online Date: 21/01/2006 Article note: Emma J. Brown Ph.D., R.N. and Frances B. Smith Ed.D., R.N. are affiliated with the School of Nursing College of Health and Public Affairs in the University of Central Florida

The purpose of this study was to explore the knowledge, attitudes and barriers to use of postpartum care service among rural communities in Uganda. Study was a part of a larger reproductive health evaluation project, and was cross-sectional in nature utilizing qualitative research methods using the narrative inquiry. Two matched rural communities were used in this study; Semuto in Luwero district, and Lwamaggwa in Rakai district. Fifty key informants who were purposefully selected from each study site were interviewed. They included community leaders, political leaders, health care providers, women leaders and community members. One-on-one interviews were conducted with key community informants using an interview guide. The purpose of the interview was explained to each participant, and written informed consent was obtained before the start of the interview. Respondents were allowed to express their views, opinions and observations on several health issues including postpartum health care services. There was a low level of knowledge about postpartum care services among the respondents of the two communities. There was lack of awareness about postpartum care and it's benefits. The main barriers to use of services were; misconceptions regarding the importance of postpartum care, distance to health facilities, poverty, and health system factors notably; poor facilities, lack of essential drugs, and poor attitudes of health workers. In the effort to improve reproductive health care services, there is an urgent need to improve postpartum services, and make them more accessible and user friendly. The training of providers at all levels is essential, in addition to educating families on the importance of postpartum care services. KEY WORDS: barriers; postpartum care; rural areas; Uganda; utilization.

A multitude of responsibilities, environmental and social influences, and stressors place farm women at high risk for depressive symptoms. This cross sectional survey design study examines demographic, health status, and farm lifestyle characteristics, behaviors and beliefs as risk factors contributing to depressive symptoms among farm women in southeast Louisiana. The study was conducted in a stratified, random sample of 657 women 18 years and older. Factors predictive of depressive symptoms in adjusted logistic regression included those who experience poor health, perceive hazards associated with farming, experience recent farm-related injuries and engage in farming over longer periods of time. These findings help target interventions toward women at risk for depressive symptoms. KEY WORDS: women; depressive symptoms; farm lifestyle.

The current study sought to clarify the effects of social support on the psychological well-being of rural elders. Data were provided by 180 older men and women (mean age = 73.6 years) living in Northern Appalachia. Similar to the demographic profile of this region, most (97.2%) of the participants were Caucasian. Although mean differences in perceptions of emotional support did not emerge, the relative importance of various sources of support differed for men and women. For men, higher satisfaction with family support was associated with lower negative affect and higher positive affect. For women, although satisfaction with emotional support from family and more years of education were associated with lower levels of negative affect, emotional support from friends enhanced positive affect. The results suggest that new programs may be needed in order to help older rural men and women to maintain well-being in late life.

Minute-by-minute observation of individual women over the period of a year provides a reliable and valuable description of their daily activities. The extent to which Nepalese rural women vary their subsistence responsibilities during pregnancy and lactation is examined by comparing mothers with a non-childbearing sample. The remarkable behavioral similarity between the two groups of women when workloads are high is explained by reference to childcare practices and labor constraints prevailing in the community.

Purpose: We evaluated the feasibility, acceptability and preliminary efficacy of a standardized nurse delivered mobile phone intervention to improve adherence to antiretroviral treatment and clinical outcomes., Methods: Feasibility and acceptability of the phone intervention was assessed with rates of eligibility, completed visits, and attritions. Intervention fidelity was assessed by checking recorded calls and feedback. Efficacy was assessed using a randomized controlled trial in which 120 women living with HIV and psychosocial vulnerabilities, were randomized to Treatment as Usual (TAU = 60) or TAU plus the mobile phone intervention (N = 60). Trained basic nurses delivered the theory-guided, standardized mobile phone intervention for mental health issues and psychosocial risk factors to improve antiretroviral treatment (ART) adherence and retention in care and improve clinical outcomes. Blind raters performed the assessments at 6, 12 and 24 weeks post-randomization., Results: Adherence diminished over time in the TAU only group, while it was sustained in the TAU Plus group, only dropping at 24 weeks after the intervention had been discontinued. Among participants with depressive symptoms (CESD ≥ 16), the intervention had significant improvement in adherence rates (p < 0.01), psychological quality of life (p < 0.05) and illness perception (p < 0.05) compared to those in the TAU only group. Greater improvements of quality of life subscales were observed in the TAU Plus group among participants with less psychological vulnerability (PSV < 2). HIV RNA was not significantly different between the groups at week 24., Conclusions: The mobile-delivered counseling intervention was feasible and acceptable and shows promise among women living with HIV and psychosocial vulnerabilities in rural South India., Trial Registration: ClinicalTrials.gov Identifier: NCT02319330 [Registered on: December 18, 2014]., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Highlights 1. Egyptian rural women work significantly longer hours than men in total subsistence labor, shouldering most of the nonagricultural subsistence labor. 2. Although more rural women are engaged in agricultural subsistence labor tasks compared to men, rural men who confirm their involvement in subsistence labor spend significantly more time agricultural subsistence than women. 3. However, the impact of hours spent in subsistence agriculture by women in the household on the probability of their household’s food security was higher than that of men.

Cancer education raises disease awareness, the value of early identification and importantly the need for prompt screening and treatment when diagnosed. In this study, an effort was made to understand how well a unique cancer education program, "Cancer Education on Wheels," transfers knowledge in general public in society. The community was shown prerecorded cancer awareness videos using a TV monitor, CD player, and speaker system mounted on an eight-seat Toyota Innova. Before and after seeing the video presentation, consenting volunteers filled out questionnaires asking about demographics and understanding of cancer. Frequency and percentage calculations were done on the demographic information and a Wilcoxon signed-rank test was run on the overall subject score. Data was stratified based on demographic information and compared by applying Kruskal-Wallis test and Mann-Whitney test. p values under 0.05 were regarded as significant. A total of 584 people completed the pre-test and post-test questionnaires. The Wilcoxon signed-rank test revealed a difference between the pre-test and post-test (3.29 ± 2.48 vs. 6.78 ± 3.52; P = 0.0001). The pre-test results showed that volunteers between the ages of 18 and 30; men; students; urban residents; single volunteers; graduates; people who had known a person/or family member with cancer; and people who were aware of the suffering cancer causes had a high baseline knowledge of cancer (p = 0.015 to 0.001). The post-test results show that participants who had less baseline scores like housewives and unemployed people performed better (p = 0.006 to 0.0001). The findings unambiguously demonstrated that "Cancer Education on Wheels" was successful in raising participants' awareness of cancer signs and screening. Additionally, the findings showed that volunteers who were aged, married, housewives, and unemployed had higher scores. Most importantly, this approach to cancer education is simple to organize and carry out in a local setting. It is also affordable and simple to execute using readily available technological equipment and manageable logistics. According to the authors' knowledge, this is the first study to use "Cancer Education on Wheels" to spread awareness of cancer throughout the neighborhood especially in budget constrained areas., (© 2023. The Author(s) under exclusive licence to American Association for Cancer Education.)

Depression in the postpartum period impacts approximately 13-26% of the general population. This number can be much higher for rural veteran women who face additional barriers to accessing specialized mental health services due to isolation and cultural factors. This study reports on a program evaluation of MomMoodBooster, a coach-supported internet-delivered CBT program for the treatment of maternal depression in veteran women. Repeated measures ANOVA, run with this sample of 326 women, demonstrated an overall positive effect size across outcome measures and engagement with no differences found between rural women and their urban counterparts. Some differences between urban and rural participants were found in total and average time spent with coaches as well as ratings of coach helpfulness, possibly indicating some cultural differences between coaches and rural women that need to be addressed. These results and the results of earlier trials suggest that MomMoodBooster can be a valid and efficacious option for reaching under-served veteran populations with specialized postpartum mental health support and is as effective with rural women as with urban women, Author(s): Cara L. Solness [sup.1] [sup.2] , Emily B. Kroska [sup.1] [sup.3] , Paul J. Holdefer [sup.1] [sup.3] , Michael W. O'Hara [sup.1] [sup.3] Author Affiliations: (1) The U.S. Department [...]

Abstract This paper investigates the impact of the COVID-19 pandemic on fertility intentions among families in the Rangpur region of Bangladesh, considering various socio-economic and demographic characteristics. The study aims to understand how the COVID-19 pandemic influenced fertility decisions, patterns, and how different contextual factors are relevant to explain those intentions. This study adopted a qualitative methodological approach, utilizing a non-probability purposive sampling procedure to select sixty-five rural women as participants who conceived babies during the COVID-19 pandemic and seven health care providers. Data were collected through semi-structured interviews and KII to explore the factors influencing intentional and unintentional childbirths during the pandemic. The findings revealed that, among the respondents, intentional childbirths were more prevalent than unintentional childbirths. The perceived causes of intentional childbirth in rural areas were pandemic-induced factors, demographic characteristics and societal practices to have a baby. The factors to unintentional childbirth were limited access to reproductive health care services and contraceptives, leading to unplanned pregnancies. Additionally, the study highlights that COVID-19 related economic and health conditions did not have a significant impact on fertility decisions in rural areas. Societal norms and attitudes towards family planning, childbearing and family size played key roles in determining birth intentions. Overall, the research emphasizes the need for targeted policies and initiatives to address the challenges of fertility planning during a health crisis.

In the United States, more than 9 million rural women (15-44 years old) experience limited access and delivery of reproductive healthcare services. Rurality coupled with lower socio-economic status are associated with increased maternal and neonatal morbidity and mortality. The purpose of this qualitative study was to gain in-depth information from underserved English- and Spanish-speaking pregnant and postpartum rural women on what they would value in a health promotion program. Three focus group sessions were conducted exploring four domains: (1) physical activity, (2) dietary habits, (3) fetal movement/kick counts, and (4) breastfeeding and other support resources. Five overarching themes were observed across domains, with the following health promotion needs: (1) information on safe exercises, (2) advice on healthy food and drink, (3) breastfeeding support, (4) guidance on counting fetal movement, and (5) self- and peer-education. Study findings will inform intervention programming that aims to improve pregnancy and birth outcomes., Author(s): Lisette T. Jacobson [sup.1] , Rosalee Zackula [sup.1] , Michelle L. Redmond [sup.1] , Jennifer Duong [sup.1] , Tracie C. Collins [sup.1] Author Affiliations: (Aff1) 0000 0001 2106 0692, [...]

A systematic approach and methodology for financial appraisal of the Scheffler dish solar cooker has been presented in this study. An approach is applied to meet the useful cooking energy demand at a location with a high availability of DNI by a Scheffler type of 16 m 2 area and the effective aperture area of 11.65 m 2 , weight of 400 kg, an efficiency of 40% with 980 (kg/year/ m 2 ) steam output at 120 °C. For this analysis, 5 Scheffler dish solar cookers have been selected for preparing boiling type food like rice and pulses for 750 beneficiaries at Vivekananda Global University, Jaipur, Rajasthan, India. Presently, the cooking energy demand is fulfilled by conventional method such as LPG fuel and it makes the system costly and hazardous in certain cases. By using solar cooking at the location, it is analyzed that the cost is significantly reduced along with other socio parameters also which shows the novelty of this study. The serving time of food is taken from 12:30 to 1:30 pm. The total number of cooked rice and pulses is calculated as 586.5 and 838.38 in 325 operating days. The performance of the Scheffler dish solar cooker is found to be higher in terms of the total number of meals cooked per annum by each cooker is 1424, and the saving of LPG per annum by the Scheffler dish cooker is estimated as 679 kg per cooker. This also contributes to improving the health of women, reducing child mortality rate and CO 2 emissions. The net monetary benefit is estimated at INR 30,179.9. The payback and discounted payback periods are estimated as 5.3 years and 7.9 years, respectively. The estimated positive value of net present worth also clearly indicates the profitable application of solar cooker., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Despite significant progress in the legalization and decriminalization of abortion in Australia over the past decade or more recent research and government reports have made it clear that problems with the provision of services remain. This essay examines such issues and sets forth the view that such issues can and should be seen as (bio)ethical concerns. Whilst conscientious objection-the right to opt-out of provision on the basis of clear ethical reservations-is a legally and morally permissible stance that healthcare professionals can adopt, this does not mean those working in healthcare can simply elect not to be providers absent a clear ethical rationale. Furthermore, simple non-provision would seem to contravene the basic tenants of medical professionalism as well as the oft raised claims of the healthcare professions to put the needs of patients first. Recognizing that much of the progress that has been made over the past three decades can be attributed to the efforts of dedicated healthcare professionals who have dedicated their careers to meeting the profession's collective responsibilities in this area of women's health and reproductive healthcare, this paper frames the matter as a collective ethical lapse on the part of healthcare professionals, the healthcare professions and those involved in the management of healthcare institutions. Whilst also acknowledging that a range of complex factors have led to the present situation, that a variety of steps need to be taken to ensure the proper delivery of services that are comprehensive, and that there has been an absence of critical commentary and analysis of this topic by bioethicists, I conclude that there is a need to (re)assess the provision of abortion in Australia at all levels of service delivery and for the healthcare professions and healthcare professionals to take lead in doing so. That this ought to be done is clearly implied by the healthcare profession's longstanding commitment to prioritizing the needs of patient over their own interests., (© 2024. The Author(s).)

The global community is actively pursuing alternative energy sources to mitigate environmental concerns and decrease dependence on fossil fuels. Biodiesel, recognized as a clean and eco-friendly fuel with advantages over petroleum-based alternatives, has been identified as a viable substitute. However, its commercialization encounters challenges due to costly production processes. Establishing a more efficient supply chain for mass production and distribution could surmount these obstacles, rendering biodiesel a cost-effective solution. Despite numerous review articles across various renewable energy supply chain domains, there remains a gap in the literature specifically addressing the biodiesel supply chain network design. This research entails a comprehensive systematic literature review (SLR) focusing on the design of biodiesel supply chain networks. The primary objective is to formulate an economically, environmentally, and socially optimized supply chain framework. The review also seeks to offer a holistic overview of pertinent technical terms and key activities involved in these supply chains. Through this SLR, a thorough examination and synthesis of existing literature will yield valuable insights into the design and optimization of biodiesel supply chains. Additionally, it will identify critical research gaps in the field, proposing the exploration of fourth-generation feedstocks, integration of multi-channel chains, and the incorporation of sustainability and resilience aspects into the supply chain network design. These proposed areas aim to address existing knowledge gaps and enhance the overall effectiveness of biodiesel supply chain networks., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Oil spillage is common in oil-producing communities of Nigeria, and it impacts negatively on the residents of these communities. This study analysed available research data on oil spillage incidents in these communities to determine their main causes and impacts on the residents. This study highlights the immediate and long-term consequences of oil spills on residents of oil-host communities in Nigeria. A systematic review of published studies was carried out, and 22 studies were identified from the literature search. The main causes of oil spills were identified as sabotage (87%), leakage from corroded pipelines (62%), and equipment failure (45%). Others were mystery spills and operational failures. Unemployment, abject poverty, marginalization, and inaction of government regulatory agencies are enabling factors for sabotage and vandalism of oil pipelines. It was found that exposure to oil spills impacts directly and indirectly on residents of oil-host communities, with accompanying health, socioeconomic, and environmental implications. Oil spills in these communities impact on all facets of their life, thereby infringing on their rights to existence and survival. The major interventions were targeted at improving health services, education, infrastructure, skill acquisition, and employment. These in turn reduced the occurrence of violence, insurgency, and human trafficking in the oil-producing communities. It is recommended that government regulatory agencies should be revamped and repositioned to effectively perform their duties. Interventions should be targeted at addressing the causes of agitation by indigenes by involving them in the decision-making process. Also, appropriate remediation strategies should be adopted to clean up the oil spills., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)