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Open Access February 15, 2025

Knowledge related to umbilical cord care among mothers of neonates attending outpatient departments in Sherpur district, Bangladesh

Abstract Background: Proper umbilical cord care prevents neonatal infections and reduces neonatal mortality. Despite global recommendations for evidence-based cord care practices, traditional beliefs, and inadequate maternal knowledge often lead to unsafe practices, particularly in low-resource settings like Bangladesh. This study aimed to assess the understanding of umbilical cord care among [...] Read more.
Background: Proper umbilical cord care prevents neonatal infections and reduces neonatal mortality. Despite global recommendations for evidence-based cord care practices, traditional beliefs, and inadequate maternal knowledge often lead to unsafe practices, particularly in low-resource settings like Bangladesh. This study aimed to assess the understanding of umbilical cord care among mothers of neonates in Sherpur District, Bangladesh, and identify factors associated with knowledge levels. Methods: A descriptive cross-sectional study was conducted from July to October 2020 at Sherpur Sadar Hospital. A total of 193 mothers of neonates were recruited using a non-randomized purposive sampling method. Data was collected through a pre-tested, semi-structured, interviewer-administered questionnaire. Knowledge levels were categorized as "Good" (>6) or "Poor" (≤6) based on responses to 10 structured questions. Statistical analyses, including chi-square tests and crude odds ratios (COR), were performed to identify socio-demographic factors associated with knowledge levels. Results: Of the 193 participants, 48.7% demonstrated "Good" knowledge, while 51.3% had "Poor" knowledge. Education level (p = 0.01), occupation (p = 0.02), family type (p < 0.001), and family size (p = 0.04) were significantly associated with knowledge levels. Mothers with higher education and those from joint families exhibited better knowledge. However, 28.5% of respondents were unaware of the typical umbilical cord-shedding timeframe, and 44% could not identify signs of infection. Unsafe practices, such as using medications (14.5%) or hot compression (7.2%) for drying the cord, were reported. Conclusion: The study reveals significant gaps in maternal knowledge regarding umbilical cord care in Sherpur District, driven by socio-demographic disparities and cultural practices. Targeted health education programs, emphasizing evidence-based cord care practices and leveraging local social structures, are urgently needed to improve neonatal health outcomes in similar resource-limited settings. Future research should evaluate the effectiveness of these interventions to inform policy and practice.
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Open Access February 07, 2025

Factors Affecting Pain Scale Preferences among Populations in Indonesia: Comparison Study between Suburban and Rural Areas

Abstract Introduction: Pain is considered as the fifth vital sign that should be considered in assessing patients. For clinicians to evaluate and determine the right pain interventions, there should be parameters such as pain scale. Our objective in this study is to determine factors affecting pain scale preferences in suburban and rural populations. The pain scales used in this study are FPS-R [...] Read more.
Introduction: Pain is considered as the fifth vital sign that should be considered in assessing patients. For clinicians to evaluate and determine the right pain interventions, there should be parameters such as pain scale. Our objective in this study is to determine factors affecting pain scale preferences in suburban and rural populations. The pain scales used in this study are FPS-R (Faces Pain Scale-Revised), VRS (Verbal Rating Scale), VAS (Visual Analogue Scale), and NRS (Numering Rating Scale). Method: This study uses observational design with an interview approach and a cross-sectional study. Areas covered are within Indonesia, which are marginal areas of Tangerang district border, and two rural areas in Serukam, West Kalimantan, and Soe, East Nusa Tenggara. Data collected will be analyzed using SPSS 25 software. Result: Populations within the suburban areas prefer NRS (52.08%) as their pain scale, and populations in rural areas prefer FPS-R 76.92%). Factors affecting pain scale preferences are location areas, as well as last education, with statistical significance of p<0.05. Discussion: Our study showed that the choice of several pain scales is not appropriate for specific demographics due to the complexity of these scales. Factors that should be considered are the location areas and education level, as some population in remote areas have better understanding of simpler pain scales. Conclusion: Complexity or simpler components may be an underlying reason for the preference of score selection to assess pain scales in some population. Therefore, the selection of pain scales should be adjusted to specific demographics so that clinicians can provide appropriate management with appropriate pain scales.
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Open Access January 02, 2025

Ambient Air Quality and Human Health Risk Assessment of Heavy Metals in a Potentially Toxic Silver-Polluted Environment

Abstract Silver nanoparticles (Ag+NPs) contamination in the environment is a serious concern. This study investigated selected heavy metal (Ag+, Cd2+, Cr2+ and Pb2+) concentrations at different sampling points to assess the risk to human health (infants, children, and adults). To do this, an enclosed area (laboratory) of 12.6 m X 8.5 m (107.1 [...] Read more.
Silver nanoparticles (Ag+NPs) contamination in the environment is a serious concern. This study investigated selected heavy metal (Ag+, Cd2+, Cr2+ and Pb2+) concentrations at different sampling points to assess the risk to human health (infants, children, and adults). To do this, an enclosed area (laboratory) of 12.6 m X 8.5 m (107.1 m2) was clearly marked at different coded distances of S1, S2, S3, and S4 representing 2, 4, 6, and 8 m, while unpolluted atmosphere at 50 m away without Ag+NPs served as the control (S5). The silver fireworks were allowed to burn for an approximate 00h03m30s at each sampling points using a high-volume air sampler mounted at the Environmental Engineering Departmental Laboratory, Rivers State University, with windows and doors closed to simulate indoor conditions. Samples were digested using a mixture of analytical-grade nitric acid, analytical-grade hydrochloric acid and analyzed to evaluate the levels of heavy metals by atomic absorption spectrophotometry. The Ag+ result at S1 shows 30,000 µg/cm3, S2 was 29,000 µg/cm3, while S3 was 28000 µg/cm3 and then S4 was 13,000 µg/cm3. These results exceeded the permissible values of the United States National Ambient Air Concentration for rural, urban and industrial areas (0.0005, 0.004 and 0.6 µg/cm3, respectively). The result for the control (S5) (0.037 µg/cm3) was within the maximum allowable value. Results from other heavy metals such as Cd were 1000, 743, 401, 153, 0.001 µg/cm3, Cr was 5000, 4000, 3729, 2960, 0.002 µg/cm3, Pb was 0.048, 0.041, 0.035, 0.034 and 0.01, µg/cm3, respectively. However, higher values of Ag+, Cd, and Cr indicated a higher propensity for the metals to be toxic (bioavailable). In addition, the assessment of the potential health risk posed by these metals proved contaminated and harmful. Visitors recorded high values in exposure concentration (EC) and low values in average daily dose (ADD).
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Open Access December 19, 2023

Conservation of Cuabal from Community Environmental Education: Results of an Implemented Proposal

Abstract The spiny xeromorphic shrublands on serpentine (cuabales) constitute outstanding plant formations for the conservation of Cuban biodiversity, due to their floristic richness, high number of endemic species and local endemism, as well as their economic, social, cultural value and functions environmental. In the Callejón de Los Patos of Santa Clara, there are relicts of cuabal, although they show a [...] Read more.
The spiny xeromorphic shrublands on serpentine (cuabales) constitute outstanding plant formations for the conservation of Cuban biodiversity, due to their floristic richness, high number of endemic species and local endemism, as well as their economic, social, cultural value and functions environmental. In the Callejón de Los Patos of Santa Clara, there are relicts of cuabal, although they show a high level of deterioration due to human activity. This article presents the main results of an investigation, which focused on implementing actions for the development of Community Environmental Education, with emphasis on the conservation of cuabal, in Callejón de Los Patos. For the intervention process, the Community Self-Development Methodology was used, which is qualitative par excellence, and the investigative methods: document analysis, participant observation, in-depth, group and structured interviews, drawing directed, the reflective group, techniques group and triangulation of data. The main results of the research are: the diagnosis and implementation of actions, designed from the process of Community Environmental Education, which was developed at the Carlos Manuel de Céspedes National Rural School, of said settlement. During the intervention process, the development of cognitive, procedural and attitudinal knowledge for the conservation of cuabal was verified in the schoolchildren, contributing to the strengthening of the school as the most important cultural center of the community, as aspired in the Cuban National Education System.
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Open Access November 24, 2022

Contribution to the Ethnobotanical Knowledge of Serre Calabre (Southern Italy)

Abstract This work presents the results of an ethnobotanical research carried out in the territory of Serre Calabre, province of Vibo Valentia (Calabria, southern Italy). In this territory, the bond between the residents and the rural environment is still strong, because the small urban centers are placed in a predominantly agricultural and forestry environment still managed in a traditional way. The [...] Read more.
This work presents the results of an ethnobotanical research carried out in the territory of Serre Calabre, province of Vibo Valentia (Calabria, southern Italy). In this territory, the bond between the residents and the rural environment is still strong, because the small urban centers are placed in a predominantly agricultural and forestry environment still managed in a traditional way. The survey took place between January 2019 and July 2021. Data were collected through semi-structured interviews with locals. As many as 17 informants were interviewed and a total of 185 interviews were recorded. Plant specimens were collected under the indication of the informants and then deposited at the herbarium of the Mediterranean University of Reggio Calabria (REGGIO). The data were stored on a digital database and then statistically analyzed some synthetic indexes have also been calculated, such as Relative Frequency of Citation (RFC) and the Cultural Importance Index (CI). The investigation allowed to identify 84 taxa belonging to 39 different families, among which the most represented are Lamiaceae (23 interviews, 9 taxa), Asteraceae (22 interviews, 12 taxa). The identified taxa were prevalently cited for alimentary (46 interviews, 32 taxa) and healing (55, 27) uses. The results obtained show how the traditional knowledge about plants in the Serre Calabre area is still alive, however it is exclusive heritage of elderly people and often only in one or just a few informants. In fact, many practices are no longer in use and will not be transferred to the new generations.
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Open Access June 23, 2022

Priority tree and shrubs for use in Landscape Architecture based on the dynamic states of native vegetation with the highest ecological value in mainland Portugal

Abstract The reduction of the native forests coverage in mainland Portugal increased in the past centuries, leading to a marked decrease in biodiversity in general, especially on typical species of mature forest environments. However, urban biodiversity seems to resist more effectively than rural to disturbances due to the lower incidence of fires, as well as to agriculture expansion. Thus, in this work, [...] Read more.
The reduction of the native forests coverage in mainland Portugal increased in the past centuries, leading to a marked decrease in biodiversity in general, especially on typical species of mature forest environments. However, urban biodiversity seems to resist more effectively than rural to disturbances due to the lower incidence of fires, as well as to agriculture expansion. Thus, in this work, we analyzed the dynamics of the natural vegetation potential in each biogeographic sector, and selected, based on the evolutionary stages of the vegetation, a set of priority taxa for conservation. The criteria used are intended to highlight plants with ornamental value, but at the same time, some of them have high patrimonial value, belonging to the Red List of Vascular Flora of Mainland Portugal or protected by Annexes II, IV and V of the Sectorial Plan of the Natura 2000 Network at the European level. Our analysis resulted in the identification of 62 plants that can be increased in public spaces in order to improve their conservation status. For each biogeographic sector, the plants best adapted to the local edaphoclimatic conditions are presented. Forest habitats can now, through micro-reserves in urban areas, ensure their long-term conservation and greater awareness among the population. An integrated planning, where the socio-ecological strategy is designed for the long term, will benefit the quality of life of citizens in an urban environment. Furthermore, the creation of micro-reserves in urban parks (gardens) can prevent the extinction of many botanical values in the landscapes of the western Mediterranean Basin.
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Open Access May 04, 2022

First contribution to the ethnobotanical knowledge in the Peloritani Mounts (NE Sicily)

Abstract This paper presents the results of an ethnobotanical survey carried out in the Peloritani Mounts (NE Sicily). This investigation aims to illustrate the first record known of the traditional uses of plants in this territory through the case study of a small rural suburb named Tipoldo (Messina). The data were collected from 20 informants over the age of 66, who were mainly farmers and shepherds, and were analyzed using two quantitative ethnobotanical indicators. For each plant was reported the Latin name, life form, vernacular name, parts used, ethnobotany category, claimed uses, status, and their relative indexes. Based on semi-structured interviews carried out between February 2017 and May 2018, a listing was compiled of 126 wild plants belonging to 51 families, the most predominant being Asteraceae (19 species) and Fabaceae (15 species). The most common ethnobotanical uses reported are medicinal (30%) and agropastoral use (19%). Among the preparation methods indicated, leaves (39%) were the most commonly used parts of the plants, while the species most mentioned in connection with ethnobotanical applied indexes were: Crepis vesicaria, Dittrichia graveolens, Hypochaeris radicata, Salvia Rosmarinus and Clinopodium nepeta [...] Read more.
This paper presents the results of an ethnobotanical survey carried out in the Peloritani Mounts (NE Sicily). This investigation aims to illustrate the first record known of the traditional uses of plants in this territory through the case study of a small rural suburb named Tipoldo (Messina). The data were collected from 20 informants over the age of 66, who were mainly farmers and shepherds, and were analyzed using two quantitative ethnobotanical indicators. For each plant was reported the Latin name, life form, vernacular name, parts used, ethnobotany category, claimed uses, status, and their relative indexes. Based on semi-structured interviews carried out between February 2017 and May 2018, a listing was compiled of 126 wild plants belonging to 51 families, the most predominant being Asteraceae (19 species) and Fabaceae (15 species). The most common ethnobotanical uses reported are medicinal (30%) and agropastoral use (19%). Among the preparation methods indicated, leaves (39%) were the most commonly used parts of the plants, while the species most mentioned in connection with ethnobotanical applied indexes were: Crepis vesicaria, Dittrichia graveolens, Hypochaeris radicata, Salvia Rosmarinus and Clinopodium nepeta. These practices are presently performed only by a few elderly people, who rely on plants solely for a few activities. Furthermore, ethnobotanical studies are fundamental to clear up the knowledge on the traditional plant uses that are still current in this part of Sicily, to preserve this cultural heritage for future generations.
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Open Access October 01, 2025

Place-Based Diminished Returns of Economic Resources in Rural America: A Framework for Understanding Geography-Conditioned Inequality

Abstract Background: Socioeconomic status (SES) is widely associated with improved health, behavioral, and educational outcomes. However, emerging research suggests that these benefits are not uniformly experienced across populations or contexts. The theory of Marginalization-related Diminished Returns (MDRs) has primarily focused on racial and ethnic disparities, showing that individuals from [...] Read more.
Background: Socioeconomic status (SES) is widely associated with improved health, behavioral, and educational outcomes. However, emerging research suggests that these benefits are not uniformly experienced across populations or contexts. The theory of Marginalization-related Diminished Returns (MDRs) has primarily focused on racial and ethnic disparities, showing that individuals from racially marginalized groups often experience weaker protective effects of SES. There is a lack of evidence on geography—particularly rural residence—as a moderator of SES effects. Objective: This review explores how place, especially rural contexts in the U.S., shapes the extent to which SES translates into improved outcomes. We extend the MDRs framework to include place-based and geography-based marginalization, arguing that even among non-Hispanic White populations, rural residence can lead to diminished returns on education, income, and other forms of capital. Content: Drawing on theoretical models such as Fundamental Cause Theory and Bronfenbrenner’s Ecological Systems Theory, and synthesizing empirical findings from studies of academic achievement, substance use, and educational aspirations, this review highlights how structural disadvantages in rural areas weaken the effectiveness of individual and family-level resources. Conclusion: Rural health and educational disparities are not solely due to a lack of resources but may also reflect systemic conditions that erode the value of existing resources. Policy interventions must be place-aware and address the contextual constraints that limit opportunity. Future research should more explicitly test how geography moderates the effects of SES across a range of outcomes and populations.
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Perspective Article
Open Access August 22, 2025

Status Epilepticus in Sub-Saharan Africa: A Literature Review on Epidemiological Challenges, Socio-Cultural Barriers, and Public Health Impact

Abstract This literature review delves deeply into the epidemiology, structural and cultural challenges, and management strategies of status epilepticus (SE) in sub-Saharan Africa (SSA). Incidence rates of SE vary significantly between countries, with notable disparities associated with socio-economic contexts, healthcare infrastructures, and cultural perceptions of epilepsy. The management of SE in this [...] Read more.
This literature review delves deeply into the epidemiology, structural and cultural challenges, and management strategies of status epilepticus (SE) in sub-Saharan Africa (SSA). Incidence rates of SE vary significantly between countries, with notable disparities associated with socio-economic contexts, healthcare infrastructures, and cultural perceptions of epilepsy. The management of SE in this region is often hindered by constraints in medical infrastructure, inadequate access to specialist diagnostics such as electroencephalogram, and limited availability of essential anti-epileptic drugs, which are frequently out of reach for rural populations. These challenges are further exacerbated by the social stigma and cultural beliefs surrounding epilepsy, impeding access to care and widening inequalities. Moreover, the scarcity of qualified medical personnel undermines the efficient and prompt management of this neurological emergency. The review underscores the pressing need to enhance healthcare infrastructures, boost the capabilities of healthcare professionals, and conduct community awareness initiatives to destigmatize epilepsy and lessen prejudice. Additionally, practical recommendations are put forward for enhancing local capacity, fostering equity in care access, and mitigating regional health disparities in SSA.
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