Rural Education (2001)

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Baker, A., Linhart, R., & Dunham, M. (1999). Effectiveness of Secondary Education Programs as Perceived by Rural High School Graduates. The Rural educator, 20(3), 14.

Ballou, D., & Podgursky, M. (1995). Rural Schools: Fewer Highly Trained Teachers and Special Programs, but Better Learning Environment. "Rural Education and Training." Entire issue available from EDRS, see RC 020 673. Paper presented at the Theme issue. Analysis of data from the Schools and Staffing Survey, 1987-88, reveals that compared to metropolitan schools, nonmetropolitan schools are smaller, have fewer teachers with advanced degrees, and offer fewer advanced or remedial classes. However, smaller rural schools often provide smaller classes, more teacher attention, and a less stressful learning environment. Contains 24 references and 9 data tables. (Author/SV) EJ528303

Barker, B. O. (Oct 1990). National Rural Education Endorsed Research Centers: Current Activities and Future Directions., 9pp. Paper presented at the Annual Conference of the National Rural Education Association (82nd, Colorado Springs, CO, October 5-8, 1990). Any public or private, non-profit agency, organization, or institution committed to research in rural education may apply for official endorsement from the National Rural Education Association (NREA) to establish a recognized Rural Education Research Center. The major objectives of NREA endorsement of ongoing or future research include: (1) keeping rural education a prominent item on the agenda of state and federal offices, public agencies, and institutions of higher education; (2) providing an increased research focus to public entities serving rural populations; (3) providing public or private non-profit agencies, institutions, or organizations with added creditability when seeking internal or external funds to conduct research with a rural focus; (4) serving as a mechanism for data gathering and dissemination that will provide local, state, and federal policymakers with accurate and timely information for decisionmaking; and (5) allowing for a network of rural researchers to coordinate efforts and share information. The NREA endorsement is initially for a period of 3 years with successive renewals of 5 years. Endorsement requirements are: (1) expertise in and publicly available reports on rural education research; (2) support from parent organization, colleagues, and a variety of schools or intermediate service units; (3) commitment of a minimum of 2 fulltime personnel and $10,000 of operating expenses and support services; (4) evidence of an appropriate plan and willingness to disseminate research results; and (5) a written 5-year research agenda with annual progress reports. Two endorsed NREA Research Centers are the Center for Rural and Small Schools at Kansas State University and the Rural Education Research and Service Consortium at Tennessee Technological University. (ALL) ED329399

Barker, B. O., ERIC Clearinghouse on Rural Education and Small Schools., & United States. Office of Educational Research and Improvement. (1987). Interactive distance learning technologies for rural and small schools: a resource guide. [Las Crucas, N. Mex.]: ERIC Clearinghouse on Rural Education and Small Schools. Ed 1.310/2:286698

Barker, B., & Chance, E. (1993). A Description of National Rural Education Association Sponsored Research Activities. Paper presented at the Rural Educator, 14, 2, 4-8 Win 199 1993. Discusses ongoing efforts of the National Rural Education Association (NREA) to support rural research and data collection activities. Describes research activities and projects at three university-based rural education research centers established with NREA endorsement. Provides criteria and application procedures for NREA-endorsed research centers. (SV) EJ463076

Barnett, R. (1 September 1999). The Coming of the Global Village: a tale of two inquiries. Oxford Review of Education, 25(3), 293-306(214). In 1963, in the UK, a government-appointed Committee on Higher Education (chaired by Lord Robbins) produced its Report, Higher Education. A generation later, a corresponding exercise was undertaken in the UK, through a National Committee of Inquiry into Higher Education, chaired by Sir Ron Dearing. Its Report, Higher Education in the Learning Society, was published in 1997. The two reports share many features, addressing largely similar matters, having overlapping concerns and placing their analyses in an international context. Access, participation, curricula, teaching, standards and academic freedom are just some of the issues that both reports tackle. However, in their envisaged positioning of higher education, their discourse and their vision, discontinuities can be detected between the two reports. The Robbins Report can be understood as an internal report of an academic community, assured of itself and of higher education as an existing social and educational good. Its audience was the wider society and the polity: it was a document arguing for an expansion of the sector on its own terms. The Dearing Report, in contrast, can be understood as an external document of the wider society and the polity. It attempted to draw together the interests of multiple stakeholders and, with higher education as its major audience, sought to reposition higher education such that it became a force for continuing economic regeneration. Robbins is the internal voice of a rural village, that of higher education itself. Dearing is an external set of voices telling a story especially of an emerging urban village of the global economy.

Baxter, J., Bryant, L. L., Scarbro, S., & Shetterly, S. M. (January 2001). Patterns of Rural Hispanic and Non-Hispanic White Health Care Use: The San Luis Valley Health and Aging Study. Research on Aging, 23(1), 37-60(24). This cross-sectional study examines utilization of health care resources, including nursing homes, among 1,433 rural Hispanic and non-Hispanic White participants in the San Luis Valley Health and Aging Study. Results show substantially greater non-Hispanic White residence in nursing homes, greater Hispanic use of professional home nursing services, but little ethnic difference in outpatient care or hospitalization. Analyses based on the behavior model of utilization find health care use strongly associated with need factors. In particular, outpatient care correlated with disease and instrumental daily living activity dependence, home nursing care with basic daily living activity dependence, and nursing home use with daily living activity dependence and cognitive impairment. Predisposing characteristics (age, marital status, education) and enabling supports and barriers (insurance, availability of no- or low-cost care, transportation difficulties) also influenced utilization. The differential ethnic pattern of nursing home use persisted after controlling for these important characteristics.

Beckner, W., & Barker, B. O. (1994). Technology in Rural Education. Fastback No. 366., 35p. The use of educational technology in rural schools can maximize the natural advantages of rural schools and alleviate the disadvantages. Rural schools often face geographic isolation, shortages in specialized staff, low student enrollments, small numbers of special needs students, limited program offerings for students, and limited opportunities for staff development for teachers and administrators. In 1992, the National Congress on Rural Education identified barriers to the improvement of rural education in the areas of funding, provision for special circumstances of rural education, staff development, adequate and qualified teaching personnel, administrator work overload, and remedial education. Technology can overcome or alleviate these barriers. Technology available for rural schools includes personal computers and software, and distance learning and telecommunication technologies, such as audiographics, two-way interactive television, electronic mail, electronic bulletin boards, online databases, and information networks. Library technologies offer specialized CD-ROM discs for reference services and telecommunications networks for online library searches. Technology use in rural schools should be evaluated in terms of whether or not it serves the purpose for which it is employed and what data supports the evaluation. To make successful improvements, rural school leaders must establish a climate of trust and openness, evaluate and screen the various possibilities for improvement, and provide administrative and financial support for the change effort. (KS) ED369586

Beeson, E., & Strange, M. (2000). Why Rural Matters: The Need for Every State to Take Action on Rural Education. Journal of Research in Rural Education, 16(2), 63-140.

Beeson, E., & Strange, M. P. L. (2000). Why Rural Matters: The Need for Every State To Take Action on Rural Education. This study describes the importance of rural education in each of the 50 states, and suggests the urgency with which state policymakers should address the needs of rural schools and communities. The study compared states on two gauges of concern for their rural schools and communities. The rural importance gauge examines how important it is to the overall educational performance of each state to explicitly address the particular needs of its rural schools. Eight indicators of the scale, proportion, and challenge of rural education in the state are considered. The rural urgency gauge examines how urgent it is in each state that policymakers develop explicit rural education policies, given conditions in the state's rural schools and communities. Eleven indicators are used to quantify the need for concern, some of which compare the state's rural and nonrural schools. States were ranked and placed into quartiles along a spectrum ranging from "useful" to "crucial" on the importance gauge, and from "fair" to "urgent" on the urgency gauge. Results identify Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Montana, Oklahoma, and West Virginia as the top 10 states where rural education is important and needs are urgent. While the rankings are useful in identifying states where rural education is paramount to good schooling, they also identify states where rural communities' educational needs may be lost in the political shuffle of state politics. Results are presented for each state in data tables and figures, and state-by-state comparisons for each indicator are presented in bar graphs. (TD) ED445847

Bloodsworth, G. ([1993). Rural Education and the Urban Reform Movement., 11p. There are major differences between rural and urban education, yet most educational reform efforts have been heavily urban oriented. While reform movements of the 1980s may have benefited urban schools, they have only added to the problems of rural education. Some of the conditions often associated with rural schools are: poverty, reform generated problems stemming from the promotion of national standards and assessments, failure to consider basic inequities among schools, an unwillingness on the part of rural students to seek individual recognition or to engage in individual competition, and the diversity of cultures within rural areas. It is suggested that in order to improve rural education the unique needs of rural schools and the characteristics of rural students must be understood and addressed. Teacher education programs must include rural education as a legitimate entity in curricular studies and pedagogical approaches; educational textbooks need to distinguish between rural and urban education; multicultural education programs should address the diversity found in rural areas; and rural education must be based on academically demanding rural, not urban standards. (LL) ED366590

BONDEVIK, G. T., ULSTEIN, M., LIE, R. T., RANA, G., & KVALE, G. (May 2000). The prevalence of anemia in pregnant Nepali women - a study in Kathmandu. Acta Obstetricia et Gynecologica Scandinavica, 79(5), 341-349(349). Background. Anemia in pregnancy is associated with maternal and perinatal morbidity and mortality. The World Health Organization has suggested that where up-to-date information is not available, prevalence studies should be undertaken.Methods. The distribution of hematocrit in 2280 pregnant women attending Patan Hospital, Kathmandu, for their first antenatal visit in a twelve month period, 1994-95, was studied. Anemia was defined as a hematocrit value 34% in the first and third trimesters, or 33% in the second trimester. Severe anemia was defined as a hematocrit value 24%. The prevalence of anemia and severe anemia, and associations with socio-demographic (age, ethnic group, living area, maternal and paternal education and occupation) and biological (height, body mass index, parity, gestation) variables were investigated.Results. The hematocrit values ranged from 11-49% with a mean value of 32.6% (s.d. 3.9). The prevalences of anemia and severe anemia were 62.2% and 3.6%, respectively. High prevalence of anemia was observed among teenagers, farmers, women of short height, the ethnic groups LamaSherpaTamang, and women married to industrial workers or illiterate men. Also, the risk of anemia increased with gestation. Work within the service professions, higher education and high body mass index, were associated with a lower risk of anemia.Conclusions. A high prevalence of anemia among pregnant women in Kathmandu was observed. The hematocrit values were related to socio-demographic and biological factors. In order to plan focused and effective intervention, studies on the etiology of anemia among pregnant women in rural and urban areas of Nepal need to be carried out.

Borrego, M., Rhyne, R., Hansbarge, L., Geller, Z., Edwards, P., Griffin, B., McClain, L., & Scaletti, J. (2000). Pharmacy Student Participation in Rural Interdisciplinary Education Using Problem Based Learning Case Tutorials. American Journal of Pharmaceutical Education, 64(4), 355-362.

Boucaut, R. (1998). Health education activities conducted by physiotherapy students on field trips to rural areas: A case study. The Australian journal of rural health, 6(4), 208.

Bowen, S. (2000). Hispanic Deaf Students in Rural Education Settings: Complex Issues., In: Capitalizing on Leadership in Rural Special Education: Making a Difference for Children and Families. Conference Proceedings (Alexandria, VA, March 16-18, 2000); see RC 022 337. Page Length: 6. This paper reviews issues surrounding Hispanic students who are deaf or hard of hearing. Research indicates that Hispanic deaf and hard of hearing students generally have lower academic success than their deaf or hearing peers. In addition, they are more likely to drop out of school or be tracked into vocational programs and less likely to attend college. The most prominent characteristic of Hispanic deaf students is language option and choice. Language options include spoken English or Spanish, various sign languages, or an invented system of home signs. Cultural considerations are also important. Hispanics are family-oriented, mothers and fathers often follow traditional roles, and strong religious beliefs may influence family attitudes toward disabilities. Evaluation teams must collect sufficient data on the student's language use at home to ensure learning in school. The evaluation team should include family members, an audiologist, a speech-language pathologist, an ESL/bilingual teacher, a teacher of the deaf, a general educator, Spanish and sign language interpreters, and paraprofessionals. School personnel must encourage families to participate and take specific steps to avoid communication barriers and breakdowns. A comprehensive naturalistic assessment will provide a wealth of information for academic placement and social support. Rural school districts may pool resources to form a regional assessment team and regional learning centers. (Contains 19 references.) (SV) ED439875

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Callas, P. W., Ricci, M. A., & Caputo, M. P. (1 December 2000). Improved Rural Provider Access to Continuing Medical Education Through Interactive Videoconferencing. Telemedicine Journal and e-Health, 6(4), 393-399(397). We sought to describe use patterns and user evaluation of remotely-attended continuing medical education (CME) programs in Vermont and upstate New York. Remote attendees were required to return an evaluation form to receive CME credit. The form included name and date of the program; name, location, and specialty of the respondent; and questions regarding program quality, value, effectiveness, and attendee plans if the program had not been available via telemedicine. From April, 1996, through December, 1998, health care providers from 14 remote sites used the network 927 times to attend 394 CME programs at Fletcher Allen Health Care in Burlington, Vermont. After the start-up period, an average of over three programs per week was attended, with an average of 2.4 remote attendees per program. Seventy-seven percent of remote attendees stated that they would not have attended the program if it had not been available over telemedicine, while the remaining 23 said that they avoided traveling due to videoconferencing. When asked the effectiveness of telemedicine technology for attending, 73 said it was as effective as having the presenter in the room, 23 said it was less effective, and 4 said it was more effective. Major technical problems, such as having the call disconnect during the presentation, decreased over time. There were continuing minor logistical problems common to large group videoconferencing. The telemedicine system has increased availability of CME programs for rural providers in Vermont and upstate New York. Most attendees have found the programs to be worthwhile, and technological advancements have improved the quality of the system.

Carpenter, L., Quigley, M., Kinsman, J., Nakiyingi, J., Kamali, A., Pool, R., & Whitworth, J. (February 2001). Evaluation of a comprehensive school-based AIDS education programme in rural Masaka, Uganda. Health Education Research, 16(1), 85-100(116). A 19 activity extracurricular school-based AIDS education programme lasting 1 year was conducted in rural southwestern Uganda using specially trained teachers, and was evaluated using mutually supportive quantitative and qualitative methods. In total, 1274 students from 20 intervention schools and 803 students from 11 control schools completed questionnaires at baseline, and their classes were followed up. In addition, 93 students from five of the intervention schools participated in 12 focus group discussions. The programme had very little effect-seven of the nine key questionnaire variables showed no significant increase in score after the intervention. Data from the focus group discussions suggest that the programme was incompletely implemented, and that key activities such as condoms and the role-play exercises were covered only very superficially. The main reasons for this were a shortage of classroom time, as well as teachers' fear of controversy and the unfamiliar. We conclude that large-scale comprehensive school-based AIDS education programmes in sub-Saharan Africa may be more completely implemented if they are fully incorporated into national curricula and examined as part of life-skills education. This would require teachers to be trained in participatory teaching methods while still at training college.

Carroll, S. E. (15 Jan 1990). Rural Education Problems: Current Status and Future Focus., 78p. This literature survey examines rural problems and potential improvement strategies that have emerged on the agendas of rural educators and policymakers. The report discusses diverse rural conditions, demographic shifts, economic changes, technological improvements in education, increased demand for reform in curriculum and classroom management, teacher shortages, low educational attainment, financial support, and current federal and state rural education policies. Historically, states have taken responsibility for education, with the Federal Government acting to insure equal opportunity and to disseminate new approaches. Rural people are culturally diverse, but generally hold a relationship with the land and natural resources. Population growth and composition affect the wealth of the economy, career opportunities, tax collection and allocation, teacher availability, and accessibility of potential partnerships. New demands on rural teachers are high, and their retention poses a problem. Rural schools' curriculum and classroom management have also been subject to change due to public pressures for reform. The sparsity of rural population means education is more expensive than it is elsewhere. Financial support for rural schools remains a problem, and rural America continues to have a disproportionate share of educational deprivation. Rural youth generally enter school later, they progress more slowly, and leave earlier. Positive changes will not be possible unless governments and private foundations address the fundamental problems and causes underlying these deficiencies. The document concludes that rural educators must build on the strengths of diversity, learn to use technology effectively, use community resources, and build effective partnership programs. The document includes a bibliography with approximately 60 entries. (TES) ED321935

Cash, K., Khan, S. I., Nasreen, H.-E. -., Bhuiya, A., Chowdhury, S., & Chowdhury, A. M. R. (1 April 2001). Telling Them Their Own Stories: legitimizing sexual and reproductive health education in rural Bangladesh. Sex Education, 1(1), 43-57(15). Most people in Bangladesh are rural, poor and underprivileged. The incidence of sexual disease has increased, but little has been done to educate rural people about sexual and reproductive health. In 1997, a sexual and reproductive health project was initiated within a collaborative research agreement between the International Centre for Diarrhoeal Disease Research (ICDDR,B) and the Bangladesh Rural Advancement Committee (BRAC), an indigenous non-governmental organization which pursues integrated rural development strategies. Qualitative in-depth interviews with 65 different women, men, boys and girls revealed significant sexual health problems and a lack of knowledge of sexual and reproductive health. The interviews were transformed into composite problem-solving picture stories and information about sexual and reproductive health. Stories mirrored respondents' interpretations of sexual behavior. Those who had achieved or ascribed legitimacy to talk about sex, e.g. traditional health providers, were trained to utilize the methods and materials. Qualitative evaluations revealed important changes in health providers' self-confidence, business and personal interactions as well as changes in clients' behavior. This project found that sexual and reproductive health education can be integrated into indigenous health activities if the sociocultural context in which sex, relationships, risks, diseases and communication occur is reflected in a program's content and methods. Unquestionably, there is a great need for sex education in rural Bangladesh.

Castaneda, X., Brindis, C., & Camey, I. C. (1 April 2001). Nebulous margins: sexuality and social constructions of risks in rural areas of Central Mexico. Culture, Health & Sexuality, 3(2), 203-219(217). This paper reports on research conducted among young people in two rural communities in the state of Morelos, Central Mexico. Methods used included participant observation, indepth interviews and focus groups. Findings suggest that a person's constitution or 'nature', their gender and perceived risks during agricultural work were strongly associated with riskrelated sexual behaviour. Those who perceive themselves as having a strong constitution see themselves at low risk of acquiring STIs/AIDS. Young people reported receiving little information about reproductive matters at school, including condom use. When information was provided, it was often in a form disassociated from its cultural context. Efforts to control female sexuality between puberty and marriage were particularly marked in the communities studied and may interfere with risk reduction among both young women and young men. Policy recommendations for the future development of sexual education in rural areas in Mexico are outlined.

Chadha, G., Sahu, P., & Rout, B. (2001). Education, Skills, and Working Environments of Workers in India's Rural Industry. International Journal of Occupational and Environmental Health, 7(2), 153-164.

Chowdhury, A. M., Helman, C., & Greenhalgh, T. (1 August 2000). Food beliefs and practices among British Bangladeshis with diabetes: implications for health education. Anthropology & Medicine, 7(2), 209-226(218). In order successfully to promote 'healthier' food choices, health professionals must first understand how people classify and select the foods they eat. We explored the food beliefs and classification system of British Bangladeshis by means of qualitative interviews with 40 first-generation adult immigrants with diabetes. Methods included audiotaped, unstructured narrative interview in which participants were invited to 'tell the story' of how diabetes affects them, pile sorting of food items, and participant observation of meals. We found considerable heterogeneity of individual food choices against a background of structural and economic factors (i.e. food choices were partly determined by affordability and availability), as well as cultural influences. Important themes included strong religious restrictions on particular food items (chiefly the Islamic prohibition of pork), and widely held ethnic customs based on the availability of foods in rural Bangladesh. Modification of the diet on immigration did not generally incorporate many 'Western' foods but included increased quantities of 'special menu' Bangladeshi foods such as meat and traditional sweets. Foods were not classified or selected according to Western notions of food values (protein, carbohydrate, etc.). Rather, within religious and ethnic patterns, further food choices were determined by two interrelated and intersecting binary classification systems: 'strong'/'weak' and 'digestible'/'indigestible', which appear to replace the 'hot'/'cold' classification prevalent elsewhere in South Asia. Different methods of cooking (especially baking and grilling) were perceived to alter the nature of the food. A desire for dietary balance, and a strong perceived link with health, was apparent. These findings have important implications for the design of health education messages. Dietary advice should reflect religious restrictions, ethnic customs and the different cultural meaning of particular foods, while also acknowledging the ability of the individual to exercise choice within those broad limits.

Chun, W. (1999). More Energetic Efforts for the Development of Community Education in Rural Areas. Chiao y{‡}u yen chiu, 20(9), 30.

Clark, G., & Zimmerman, E. (2000). Greater Understanding of the Local Community: A Community-based Art Education program for Rural Schools. Art Education, 53(2), 33.

Clark, S. (Jun 1990). Rural Education: The State of the Art. "Think Tank" Introductory Paper., 62pp. In: "Think Tank" on Research into Rural Education. Proceedings of the Conference Held by the Rural Education Research and Development Centre (Townsville, Queensland, Australia, June 10-14, 1990); see RC 020 271. This paper reviews and analyzes the research in rural education in Australia in recent decades. Research undertaken in other countries is examined where comparisons, differences, or explanations are useful in understanding the Australian context. Following an introduction to the Australian education system and summaries of demographic features of rural areas and schools, key concepts emerging from the literature are discussed. These concepts include rurality, isolation and remoteness, rural education, and distance education. The literature review is structured around four major themes. The theme of schooling covers teachers (recruitment, retention, training for rural areas, and affective factors); students (achievement, dropout rate, and education of minority groups); school-community relationships (community participation, school closing, school size, rural lifestyle, and rural school characteristics); and accommodation of rural students in boarding schools. Theme 2, technology, covers geographic isolation, technological innovation, and distance education. Theme 3, educational delivery, encompasses equal educational opportunity, curriculum, decentralization, service delivery, and educational models. Theme 4 examines distinctions between rural education and education in rural areas. This paper concludes with 23 research questions. Recommended research priorities are rural definition, teacher preparation, curriculum design, community participation, access to services, secondary education for isolated students, and educational provision to facilitate gender and cultural equity. Contains over 200 references. (SV) ED386365

Cleverley, J. (1991). "On the Evidence before Me..." Putting the Case for Rural Educational Reform in China. Paper presented at the Comparative Education, 27, 1, 53-60 1991. Evaluating Chinese publications about rural education and needed reforms presents several problems: political limits on educational debate; paucity of statistical data and reference citations; and complex ideological statements. Examination of nine journal and newspaper articles reveals that they cautiously endorse rural education reforms within the limits of current policy. (SV) EJ423600

Cochran, J. (1990). A Comparison between Rural Education in Egypt and the U.S. Paper presented at the Rural Educator, 11, 2, 3-5 Win 198 1990. Compares Egypt and United States rural school systems. Countries share financial limitations, low salaries, and teacher turnover. Discusses Egypt's national curriculum, high student dropout rate, administrative problems, and possible solutions. Concludes that countries' rural education problems are similar but differ as to cause. (TES) EJ410854

Coe, J., & Elliott, D. (1999). An Evaluation of Teaching Direct Practice Courses in a Distance Education Program for Rural Settings. Journal of social work education, 35(3), 353.

Collins, B., Schuster, J., & GrishamBrown, J. (1999). So You're a Distance Learner? Tips and Suggestions for Rural Special Education Personnel Involved in Distance Education. Rural Special Education Quarterly, 18(3/4), 66-71.

Collins, R. P. (1996). Rural Education: Clarkton School of Discovery. Paper presented at the Clearing House, 69, 3, 132 Jan-Feb 1996. Describes the Clarkton School of Discovery in Clarkton, North Carolina, a gifted- and-talented magnet middle school that is open to all students in the school district. (SR) EJ529116

Collins, T. (1999). Charter Schools: An Approach for Rural Education? ERIC Digest. Charter schools have emerged in the 1990s as a prominent and controversial school reform idea. This digest discusses characteristics of charter schools, tentative research findings, advantages and disadvantages, and implications for rural communities. Since 1991, 33 states and the District of Columbia have passed charter school legislation. An estimated 1,129 charter schools existed nationwide in September 1998, mostly in the South and West. Differences in state laws produce wide diversity in the organization, operation, and philosophies of charter schools. Recent studies funded by the U.S. Department of Education show that individual states vary widely in policies related to charter schools, that charter schools tend to be small, that parents tend to choose charter schools because of dissatisfaction with public schools, and that charter schools tend to have different grade configurations from other public schools. Chart er schools are generally intended to produce high-performing students, but hard data on their effectiveness are lacking and results appear mixed. Argum ents for and against charter schools are listed. Charter schools may offer educational alternatives to rural communities, which might set up schools that are community-based, educationally appropriate to local needs, innovative, accountable, and focused on student success. However, inadequate resources in many rural communities could cause problems. Communi ty influences on a rural charter school's success are discussed. (Contains 21 references.) (SV) ED425896 Available from: ERIC/CRESS, Appalachia Educational Laboratory, P.O. Box 1348, Charleston, WV 25325-1348; Web site: http://www.ael.org/eric/ (free). You may be able to order this document from the ERIC Document Reproduction Service.

Corral, L., & Reardon, T. (March 2001). Rural Nonfarm Incomes in Nicaragua. World Development, 29(3), 427-442(416). This paper examines nonfarm incomes of rural Nicaraguan households using a nationwide survey (LSMS) from 1998. The key findings are as follows. (a) Rural nonfarm income (RNFI) constitutes 41% of rural household incomes. (b) RNFI is much more important than farm wage-labor income. (c) RNFI tends to be relatively concentrated geographically and socioeconomically, toward the rural areas of the Managua zone and the Rest-of-Pacific zone, which are denser in infrastructure and population, and toward the upper income quartile of rural households. This concentration implies high entry barriers and capital requirements for rural nonfarm activity that the poor are simply not equipped to overcome. Equipping the rural poor through training and acquisition of diverse forms of capital to have a chance at the higher return nonfarm jobs would be a major step toward helping them to share the benefits of the rural nonfarm economy. (d) Self-employment (small enterprise) income in manufactures is very minor, probably due to the ease of obtaining manufactured goods from urban industries and imports. Wage employment constitutes the bulk of RNFI (despite it receiving little attention in development programs and debate). (e) Three-quarters of RNFI is in the service sector, and only one-quarter is from manufactures; that can be contrasted with the emphasis on small manufactures enterprises in rural development programs and research. (f) Education, road access, as well as access to electricity and water were found to be important to nonfarm incomes.

Cossaro, K., & United States. Office of Vocational and Adult Education. (1981). Rural education programs that work: sharing ideas. Washington, D.C.: Office of Vocational and Adult Education Dept. of Education. Ed 1.310/2:212402

Costantini, M., Balzi, D., Garronec, E., Orlandini, C., Parodi, S., Vercelli, M., Bruzzi, P., & Correspondence:, D. M. C. (January 2000). Geographical variations of place of death among Italian communities suggest an inappropriate hospital use in the terminal phase of cancer disease. Public Health, 114(1), 15-20(16). This study aimed to assess geographic variations of place of death among Italian communities, to investigate the determinants of home death, and to examine trends in the proportion of home deaths over a period of 8 y. A cross-sectional analysis was performed on 13 provinces from two Italian regions (Liguria and Toscana), and the geographic variations and determinants of home death were studied for the 17 597 residents, who died of cancer in 1991. Trends for both the regions of the proportion of home deaths were examined for the period 1987 and 1995. A remarkable heterogeneity in the observed proportion of home deaths among the 13 provinces was observed, ranging between 31.4 and 40.4 in Liguria and between 37.7 and 73.3 in Toscana. The estimated proportion of home deaths after adjustment for age, gender, marital status, education, place of birth, characteristics of the living area, and cancer site remained substantially the same. The proportion of home deaths significantly increased with increasing age, and years of education. It was higher among females, married and widowed patients, native patients, and for residents in a semi-urban or rural areas. A significant decrease in the percentage of patients who died at home between 1987 and 1995 in both regions was observed. The wide geographical and social differences observed between and within the communities for the frequency of home deaths are not explained by the distribution of known determinants, and possibly suggest patterns of inappropriate hospital admissions in the terminal phase of disease. Public Health (2000) 114, 15-20

Cowher, S. J. (1994). Rural Education Initiatives: Preparation for a Changing Workforce. Paper presented at the Human Services in the Rural Environment, 18, 2, 18-20 Fall 1994. Stresses the importance of developing rural education initiatives that address the changing workforce in rural areas and the accompanying need for career preparation beyond high school. Describes a program at Edinboro University (Pennsylvania) that prepares rural high school students for career decision making and builds connections between rural youth and colleges in rural areas. (LP) EJ546393

Cox, C. G., White, D., Brinson, H., & Ramey, D. (10 August 2000). Distance learning: health education for ninth-grade students. Journal of Telemedicine and Telecare, 6(4), 8-10(13). A telehealth programme for schools was established by staff at the East Carolina University schools of nursing, health education, social work, nutrition, education and medicine, in conjunction with the Eastern Area Health Education Center. A health education curriculum was developed for rural high schools using the North Carolina Information Highway for delivery. A Web page provided additional resources for teachers, teenagers and health professionals. Four telehealth sessions were conducted over three years: two with the pilot school and two with a second school on-line simultaneously. A total of 76 ninth-grade students completed the courses. Evaluation indicated successful outcomes in student learning. Respondents to a follow-up survey of members of the first telehealth class had positive comments about the experience. Utilization of the Web page increased steadily from 1997.

Crittenden, R. (1999). Commentary--The Balanced Budget Act of 1997 and Rural Training Supported by Medicare Graduate Medical Education Funds. Journal of Rural Health, 15(1), 21.

Cruz-Dona, R. D., & Martina, A. (1 October 2000). Some Links Between Education, Household Well-being and Credit Markets: Evidence from Rural Philippines. Oxford Development Studies, 28(3), 289-308(220). Two diverse Filipino village communities were intensively surveyed and then focus-group discussions were held among their members. These discussions indicated that members of the less well-off community, compared with the one which was better-off, see fewer benefits to be derived from investing in education. This information has implications for determining how the level of community well-being should be measured. In addition, those households with better access to credit and basic infrastructure invested more in the education of children. This insight suggests how the design of poverty-alleviation expenditure programmes might be improved in rural Philippines at least.

Cunningham, L. E., Michielutte, R., Dignan, M., Sharp, P., & Boxley, J. (February 2000). The value of process evaluation in a community-based cancer control program. Evaluation and Program Planning, 23(1), 13-25(13). The Cancer Awareness Program was a four-year community health education project conducted in six rural North Carolina counties. The educational program was designed to increase breast, cervical, and skin cancer screening behaviors in low income women. Female clients of the health department in each county, aged 20 and older, were eligible for the program. Program intervention activities were targeted both to the health departments and to the individual women, in addition to the community. Intervention activities included media messages, telephone counseling of participants, community presentations, printed materials, bulletin boards, and direct education. Process evaluation allowed for regular monitoring of all program components, identifying any areas in need of modification, and was developed for the long distance supervision of the project as well. Measures consisted of videotaping of presentations, meetings with key individuals and staff, participant evaluations and feedback, focus groups, and weekly activity reports from staff. The results of the process evaluation enabled investigators to pinpoint effective intervention components that led to desired results. In addition, it allowed investigators to define areas in need of modification, and adjust specific components. Final evaluation of the project indicated that the intervention significantly increased participation in screening for skin cancer and breast cancer. Included in the paper are the purposes of each process method, problems identified, and their resolution. Suggestions are made for use of process evaluation in community health education programs.

Curran, V. R. (September 2000). An Eclectic Model for Evaluating Web-Based Continuing Medical Education Courseware Systems. Evaluation & the Health Professions, 23(3), 318-347(330). World Wide Web and compact disc-read only memory technologies have introduced new prospects for delivering continuing medical education (CME) to rural and remote physicians. However, evidence concerning the effectiveness of these technologies in providing CME, and approaches to their evaluation, is limited. The rationale for this study was to design a model for evaluating the effectiveness of computer-mediated CME courseware. An eclectic evaluation planning matrix was designed by selecting various concepts from the literature and was used in planning and developing the evaluation model. The model was field-tested by evaluating a computer-mediated courseware program on dermatological office procedures, and a metaevaluation was conducted to assess the effectiveness of the evaluation methods and procedures. The findings suggest that the model was useful in collecting data to inform decision making and to improve the instructional product. The field test results revealed that computer-mediated instruction was effective in delivering CME at a distance.

Curtner-Smith, M., Todorovich, J. R., McCaughtry, N. A., & Lacon, S. A. (June 2001). Urban teachers' use of productive and reproductive teaching styles within the confines of the National Curriculum for Physical Education. European Physical Education Review, 7(2), 177-190(114). The main purpose of this study was to describe the teaching styles employed by a sample of 18 teachers working in an urban setting under the conditions of the first revision of the National Curriculum for Physical Education. A second purpose was to compare the teaching styles used by this urban sample of teachers with those employed by a rural sample we had studied previously. Two lessons taught by each teacher to pupils in Years 7, 8, or 9 during one summer term were videotaped and coded with the Instrument for Identifying Teaching Styles, a systematic observation instrument designed to record the percentages of time in which teachers employ each of eight teaching styles. Descriptive statistics were computed across all 36 lessons and for lessons on striking/fielding games, track and field events, and tennis. Independent t-tests were used to compare the teaching styles used by the urban sample of teachers in the present study and those used by the rural sample previously studied. Results indicated that the teachers in the present study spent most of their time using direct styles of teaching. Their pattern of teaching style use was very similar to that of the rural teachers observed in the earlier study. Possible reasons for these findings are discussed.

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Chen, H.-S., Guo, F.-R., Chen, C.-Y., Chen, J.-H., & Kuo, T.-S. (May 2001). Review of telemedicine projects in Taiwan. International Journal of Medical Informatics, 61(2), 117-129(113). Taiwan is a heavily populated country, with a small land area and many mountains and isolated islands. Because medical resources are unequally distributed, high quality accessible medical care is a major problem in rural areas. Medical personnel are unwilling to practice in rural areas because of fear of isolation from peers and lack of continuing medical education (CME) in those areas. Telemedicine provides a timeless and spaceless measure for teleconsultation and education. The development of telemedicine in Taiwan began under the National Information Infrastructure (NII) Project. Distance education and teleconsultation were the first experimental projects during the initiation research stage. The cost and effectiveness of the hardware and network bandwidth were evaluated. In the promotion research stage, applications in different medical disciplines were tested to promote multipoint videoconference, electronic journals and VOD. Investigation of user satisfaction put on more emphasis on improving application functions. In 1998, a new Cyber Medical Center (CMC) international collaboration project was begun, integrating technologies of multimedia, networking, database management, and the World Wide Web. The aim of the CMC is to create a multimedia network system for the management of electronic patient records, teleconsultation, online continuing medical education, and information services on the web. A Taiwan mirror site of Virtual Hospital and two international telemedicine trials through Next Generation Internet (NGI) were done at the end of 1998. In the future, telemedicine systems in Taiwan are expected to combine the Internet and broadband CATV, ADSL, and DBS networking to connect clinics, hospitals, insurance organizations, and public health administrations; and, finally, to extend to every household.

Chen, Y.-F., Dewey, M. E., & Avery, A. J. (April 2001). Self-reported medication use for older people in England and Wales. Journal of Clinical Pharmacy & Therapeutics, 26(2), 129-140(112). Objectives: To describe the patterns of self-reported medication use, including both prescription and non-prescription drugs, for older people in five areas in England and Wales, and to identify the effects of socio-demographic features on medication use.Design: A cross-sectional survey on population random samples of people aged 65 and over. The survey is a part of the screening interviews at the first stage of the Medical Research Council Cognitive Function and Ageing Study (MRC CFAS) carried out between 1991 and 1994. The sample was stratified to provide equal numbers in the 65-74 years and 75 years and over age groups.Setting: Three urban (Newcastle, Nottingham and Oxford) and two rural (Cambridgeshire and Gwynedd) centres. Older people living in both the general community and institutions were included.Participants: 12489 older people whose medication data were collected among the 13009 participants of the CFAS, of which the participation rate is 80.Results: Overall prevalence of medication use was 75 (95 confidence interval 74-76) for people aged 65-74 and 84 (83-85) for people aged 75 and over, with a mean number of 203 (standard deviation 195) and 247 (202) drugs reported per respondent in each group, respectively. Concurrent use of five or more drugs (polypharmacy) was found in 11 (10-12) of people in the 65-74 age group and in 15 (14-16) in the 75 and over age group. People aged 75 and over were more likely to be taking at least one drug than people aged 65-74 (OR=169, 154-185), and women were more likely to be so compared with men (OR=143, 130-156). Centre variation was found but none of the centres consistently showed higher or lower usage of medications across the major drug categories. People living in institutions were more likely to be taking gastrointestinal drugs, central nervous system drugs and experience polypharmacy. The use of respiratory and central nervous system drugs (except hypnotics and anxiolytics) increased in lower social class and decreased in people attending full-time education for 10 years or more. The use of haematology/dietetic drugs (85 of which were vitamin and mineral preparations) decreased in lower social class.Conclusion: This study provides representative estimates of medication usage among older people in England and Wales and identified associated factors and regional variations for medication use in a category-specific manner. The findings, suggesting the existence of centre variation and the association between type of accommodation, social class and medication use warrant further investigation.

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Darkwa, O. (1 June 2000). An exploratory survey of the applications of telemedicine in Ghana. Journal of Telemedicine and Telecare, 6(3), 177-183(177). We examined the use of telemedicine at two major medical institutions in Ghana. Doctors and administrators were surveyed to assess their knowledge of computers and familiarity with telemedicine. The use of modern telecommunications and information technology products within the health service was also examined. Thirty questionnaires were distributed to staff at the two hospitals, one urban and one rural. Twenty were returned (a response rate of 67%). Although most of the respondents were computer literate, they were less familiar with telemedicine applications. Only a minority of the respondents were participating in an information-sharing network, transmitting information by fax or telephone, or had Internet access. Financial constraint appeared to be the major barrier to establishing information-sharing networks. Other constraints were technological and organizational. The respondents expressed an interest in using telemedicine, having access to health-care databases and specific telemedicine applications such as tele-education and videoconferencing. Staff in the urban hospital were more likely to be familiar with telemedicine and more likely to have access to information technology than those in the rural hospital.

Darnell, F. (1992). Adequacy and Equity: Prerequisites to Excellence in Rural Education. Paper presented at the Education in Rural Australia, 2, 2, 1-13 1992. Rural school improvement requires that state educational policies empower rural educators to attempt innovative programs. After extensive grassroots input, the Alaska Legislature defined seven statewide educational needs relating to poor school performance. A Washington education reform bill allows schools to do anything not expressly forbidden by state law. (SV) EJ456348

Davison, C., & Stevens, K. (1997). Mobile Pre-School Units and Early Childhood Education in Rural New Zealand. The Rural educator, 18(3), 28.

Dean, T. (1999). Education and Community in the Rural Midwest: A Review Essay. Annals of Iowa, 58(4), 413.

Degang, W. (1998). A Review and Prospect of the Ten Years' Overall Reforms of Rural Education in China. Chiao y{‡}u yen chiu, 19(8), 20.

DelanyBarmann, G., Prater, G., & Minner, S. (1997). Preparing Native American Special Education Teachers: Lessons From The Rural Special Education Project. Rural special education quarterly, 16(4), 10.

Dennis, B. H., Pajak, A., Pardo, B., Davis, C. E., Williams, O. D., Piotrowski, W., & Correspondence:, S. H. I. (November 2000). Weight gain and its correlates in Poland between 1983 and 1993. International Journal of Obesity, 24(11), 1507-1513(1507). BACKGROUND: Weight gain and its unfavorable consequences on coronary heart disease (CHD) risk have been observed worldwide. Determinants of weight gain were studied in a Polish cohort of 1042 men and women age 35-64 at baseline. Participants were randomly selected from an urban population in Warsaw and a rural population in Tarnobrzeg Province surveyed by investigators in Krakow. The surveys, part of the Pol-MONICA project, were conducted in 1983-1984, 1987-1988, and 1992-1993. The purpose of this report is to gain insight into the dynamics of weight gain in this population that could be helpful in identifying high-risk groups for intervention, and to determine if economic changes that took place shortly after the second survey had any impact on weight gain. METHODS: Weight, height and demographic characteristics were measured at each visit according to Pol-MONICA standard protocol. Body mass index (BMI) was calculated as kgm2. Years of schooling, 7-day alcohol history and smoking history were self-reported. RESULTS: Sixty percent of the cohort gained some weight, averaging 0.3-0.7 kgy. Weight gain was highest in younger rural women, in urban men and in rural women with low education. In multiple linear regression, low education was related to a 1.29 kg greater weight gain (P<0.01), ex-smoking status was related to a 2.54 kg greater weight gain (P<0.001), and younger age was related to a 1.14 kg greater weight gain (P<0.001). CONCLUSION: Our results indicate a need to target intervention programs at young low SES adults. Developing effective means of reaching these vulnerable groups is a critical research goal. International Journal of Obesity (2000) 24, 1507-1513

Detang-Dessendre, C., & Molho, I. (1 February 2000). Residence Spells and Migration: A Comparison for Men and Women. Urban Studies, 37(2), 247-260(214). This paper models migration probabilities in a duration context, where migration may occur at the end of an observed residence spell. The analysis is based on a sample of young women in rural locations in France, and relates to their first move after leaving full-time education. We distinguish between residence spells that end in long- as compared to short-distance moves. The results for women are compared with those in an earlier analysis for men. Single women are found to be significantly less likely than non-single (for example, married) women to move, and this effect is stronger than the corresponding effect for men. Women appear to develop weaker job attachments than men over time, but stronger attachments to their home. Finally, women appear to respond less strongly than men to employment status transitions.

DeYoung, A. J. (1991). Rural education: issues and practice. New York: Garland Pub. Lc5146.r846 1991 370.19/346/0973 Lc5146.r846 1991

DeYoung, A. J. (1998). Parent Participation, School Accountability and Rural Education: The Impact of KERA on School Consolidation in Kentucky., 31pp. Paper presented at the Annual Meeting of the American Educational Research Association (San Diego, CA, April 14-17, 1998). This paper discusses the Kentucky Education Reform Act (KERA) and its impact on school facilities planning and community involvement in related decision making. Since 1900, the pattern of rural school reform, nationally and in Kentucky, has been one of increased state and federal control, with cost effectiveness and equity the primary criteria in setting school budgets. As a result, school districts in Kentucky declined from over 1,000 to 176. School buildings, despite increasing enrollment, declined from over 8,500 to fewer than 1,400. Changes in the way school facilities are improved or closed have come about indirectly from KERA. KERA was enacted in 1990 in response to a class action fiscal equity suit, and replaced all previous educational legislation. In addition to fiscal and curricular reforms, KERA mandated governance reforms that include site-based decision making, state-level administrative reorganization, and revision of the state school facilities manual (the "Grey Book"). The Grey Book had frequently forced consolidation by focusing almost exclusively on economies of scale criteria and forbidding state aid for facilities construction or repairs when those criteria were not met in every building in a school district. The obvious contradictions between the Grey Book and KERA's site- based decision making led to new facilities criteria. However, there remains a cost to those districts retaining very small schools. Case studies of proposed school closings and consolidation in Henderson and Floyd Counties illustrate the revised facilities planning process but also show how local political dysfunction can overwhelm even the best schools. KERA's decentralized and participatory decision-making model may not be applicable in other states, and it is too soon to see if it will make profound differences in Kentucky. But the opportunities in KERA for accommodation of small rural schools and parent participation should be useful to small-school advocates elsewhere. (SAS) ED421314

DeYoung, A. J., Ed. (1991). Rural Education: Issues and Practice. Source Books on Education, Vol. 25. Garland Reference Library of Social Science, Vol. 473., 481p. This collection of essays on rural education in the United States aims to fill a gap in the educational literature by highlighting the available research on rural schools and their contexts. The three sections of the book focus on the historical, social, political, and economic contexts of rural education; topics of practical interest for rural practitioners; and the future of American rural schooling. The chapters are: (1) "Historical Scholarship in Nineteenth Century Rural Education" (Paul Theobald); (2) "Adult Education and Rural America: An Analysis of Selected Topics and Sources" (Harvey G. Neufeldt, James E. Akenson); (3) "The Rural Education Dilemma As Part of the Rural Dilemma: Rural Education and Economics" (Craig Howley); (4) "Identifying, Recruiting, Selecting, Inducting, and Supervising Rural Teachers" (Dwight Hare); (5) "The Organization and Reorganization of Small Rural Schools" (David H. Monk); (6) "Technological Delivery Systems and Applications for K-12 Instruction in Rural Schools" (Bruce O. Barker); (7) "Meeting the Needs of Special Student Populations in Rural Locales" (Terry R. Berkeley, Barbara L. Ludlow); (8) "Equality of Educational Opportunity in Rural America" (Margaret S. Phelps, George Allen Prock); (9) "Resources in Rural Education" (Teri A. Lipinski); (10) "A Proposed Federal and State Policy Agenda for Rural Education in the Decade of the 1990s" (E. Robert Stephens, Willis J. Perry); (11) "Rural Grassroots School Organizations: Their Agendas for Education" (Paul Nachtigal); and (12) "Why Reform Doesn't Apply: Creating a New Story about Education in Rural America" (Toni Haas). Contains an index. (SV) ED382438

Diouf, W., Sheckley, B. G., & Kehrhahn, M. (November 2000). Adult Learning in a Non-Western Context: The Influence of Culture in a Senegalese Farming Village. Adult Education Quarterly, 51(1), 32-44(13). In Senegal, as in many developing countries, the education of adults is often guided by theories of adult learning developed in Western societies. There is little evidence, however, that such theories are useful for educating farmers living in rural African villages. This study, conducted in a rural farming village in Senegal, explored what, when, why, how, and from whom do adults in African villages learn? Using ethnographic research methods, information was collected from the village chief, six key informants, and individual villagers (N = 38). The results suggest that a community's social-cultural norms and values exert a powerful influence on the learning of African adults. For this reason educational programs in African villages would be most effective if they were woven into the social-cultural fabric of the community. The results also suggest that cultural traditions influence the what, when, why, and from whom-but not the how-of adult learning.

Dona, R., & Martina, A. (2000). Some Links Between Education, Household Well-being and Credit Markets: Evidence from Rural Philippines. Oxford Development Studies, 28(3), 289-308.

Dorrell, L. D. (11 Oct 1992). Just Take Your Time and Keep It between the Lines: Rural Education and the At- Risk Student., 32pp. Paper presented at the Annual Convention of the National Rural Education Association (84th, Traverse City, MI, October 9-13, 1992). As many as 40 percent of America's school-aged children are at-risk of failure within the current educational system. Many factors outside of school, such as poverty and debilitating parent and family influences, contribute to student failure. Within the school, the most effective factor of intervention for at-risk students is the individual classroom teacher. The best teachers are not always those with the most content knowledge, but rather those who are willing to risk themselves and care about the whole child. Schools that have diversity in curriculum, an adequate support staff, and a variety of student extra-curricular activities, yet are small in size generally are more effective with those students who do not achieve. The size of student population is of most importance within the individual classroom. The fewer students assigned to an individual teacher, the greater the opportunities for effective intervention strategies to deal with the marginal student. Efforts to provide marginal students with appropriate educational opportunities should include parents, the community, educational leaders, teachers, and the student. A key element for the success of all students is encouraging positive self-image. Labeling, grouping, and retaining students create the development of educational push-outs, students who are forced out of the system. The rural educator can take advantage of the small numbers and the sense of community to meet the needs of at-risk students. Contains 50 end notes and 5 tables. (KS) ED355073

Dorrell, L. D. (13 Oct 1991). A Bridge over Troubled Water: Rural Education and the At-Risk Student., 13pp. Paper presented at the Annual Convention of the National Rural Education Association (83rd, Jackson, MS, October 10-14, 1991). America's educators have the ability and the responsibility to help at-risk students learn that they can succeed and that they must make the most of life. Educators should provide a caring environment, encourage students to take risks, and provide support when risk taking is not always successful. Rural students, like urban and suburban students, face difficulties caused by poverty, drugs, child abuse, teenage pregnancy, violent crimes, and the social welfare system. The classroom teacher must teach the child and not a subject. Before teachers can teach a subject, they must teach students to like themselves, to get along with others, and to know right from wrong. It is also essential for the teacher to teach a child to take appropriate chances. Too many students limit their possibilities by being afraid to take a risk. Students must be taught to believe in themselves. Teachers must be concerned about the students who are less capable of success, regardless of the reasons for that reduced capacity. The environment and small size of the rural school provides advantages for the teacher and student to overcome the elements which lead to a diminished educational capacity. (KS) ED339573

Dowell, A., Crampton, P., & Parkin, C. (March 2001). The first sunrise: an experience of cultural immersion and community health needs assessment by undergraduate medical students in New Zealand. Medical Education, 35(3), 242-249(248). ContextCultural factors in health and illness, and an awareness of community health needs analysis, are important issues for medical education. Both have received relatively little recognition in the medical education literature. This paper describes the development of an educational attachment to remote predominantly Maori rural communities in New Zealand. The twin purposes of the programme were to encourage students to adopt broad public health approaches in assessing the health needs of defined communities, and to increase their awareness of the importance of cultural issues.MethodsDuring a one week attachment, 51 students from the Wellington School of Medicine were hosted in six small communities in the East Cape region of New Zealand. Students gained an insight into the health needs of the communities and were encouraged to challenge their own attitudes, assumptions and thinking regarding the determinants of health and the importance of cultural factors in health and illness. The programme included both health needs assessment and cultural immersion. Students made visits with primary health care professionals and were also introduced to Maori history and cultural protocol, and participated in diverse activities ranging from the preparation of traditional medicines to performing their own songs in concert.ConclusionsThe students evaluated the course extremely highly. Attachments of this sort provide an opportunity for students to appreciate how cultural values have an impact on health care, and how they also make the teaching and learning of topics such as community health needs analysis an enjoyable and dynamic experience.

dPlesse, P. (1997). Australian Rural Education Research Association. Education in rural Australia, 7(2), 33.

Dreze, J., & Kingdon, G. G. (February 2001). School Participation in Rural India. Review of Development Economics, 5(1), 1-24(24). This paper presents an analysis of the determinants of school participation in rural north India, based on a recent household survey which includes detailed information on school characteristics. School participation, especially among girls, responds to a wide range of variables, including parental education and motivation, social background, dependency ratios, work opportunities, village development, teacher postings, mid-day meals and infrastructural quality. Mid-day meals are particularly effective: the provision of a mid-day meal in the local school roughly halves the proportion of girls excluded from the schooling system. School quality matters, though it is not related in a simple way to specific inputs.

DSouza, R., & Hustig, H. (2001). Telehealth in rural and remote mental health - A Review of the use of telepsychiatry in education, training, treatment and discharge planning. Technology and Health Care, 9(4), 327.

Duerst, B., Boh, L., & Hanson, J. (1997). Fostering Interdisciplinary Education for Pharmacy Students in a Rural Health Care Setting. American journal of pharmaceutical education, 61(4), 371.

Duncan, C. M. (4 March 2001). Civic life in Gray Mountain: sizing up the legacy of New England's blue-collar middle class. The Journal of Socioeconomics, 30(2), 133-137(135). When President Clinton took Congressional and business leaders on a tour early this summer to places where chronic poverty has persisted despite the nation's booming economy, they visited Appalachia's coalfields, the Mississippi Delta, the Pine Ridge Indian reservation and inner-city neighborhoods in East St. Louis and Los Angeles. They did not visit New England. Not that New England's inner cities aren't plagued with poverty and social problems; they are. And many poor families are struggling to get by in rural Maine, New Hampshire, and Vermont. Yet the notoriously bad conditions that took the president to the nation's ''poverty pockets'' are exceedingly rare in the six-state region. Why? Why have poverty rates stayed so high in the South compared with New England? And what can the region expect in the future?The answers lie in the kind of civic culture generated by each community's economy and social structure. Chronically poor places are divided by race and class and saddled with corrupt politics, ineffective schools, and self-interested elites. Distrustful of one another, people in these places look out only for their own families. Escaping poverty is possible only for the lucky few who have a kind relative, caring teacher, or coach who pushes and inspires them to finish school and aim high. But most stay trapped in the same poor conditions their parents and perhaps grandparents knew.In contrast, when communities have a large middle class, the poor are less likely to be cut off from the mainstream. And they are more likely to have the set of contacts, habits and skills-the cultural tool kit-they need to leave poverty behind. More importantly, the community institutions that poor families rely upon are more likely to be effective because the middle class is committed to them. The poor can get ahead without relying solely on personal intervention from a mentor or other benefactor.During the 1990s, I studied poverty and community change in three remote, rural communities: a poor Appalachian coal county I call ''Blackwell,'' a poor Mississippi Delta plantation community I call ''Dahlia'' and a more stable and economically diverse northern New England mill community, ''Gray Mountain.'' The idea was to learn why poverty persisted generation after generation in Appalachia and the Delta, what made the difference when people did achieve upward mobility, and why it was so hard to bring about change. I examined 100 years of Census data detailing changes in population, patterns of work, income distribution and education. I read histories of each region, as well as the local weekly newspapers. But the heart of the study is the 350 in-depth interviews colleagues and I conducted with people living in these communities-not only the poor, but also the rich and those in between. These open-ended conversations revealed how each community's civic culture-its level of trust, participation and investment-shapes opportunities for both individual mobility and social change.

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_____. (December 2000). Book Reviews. The Journal of the Royal Anthropological Institute, 6(4), 577-595(544). Books reviewed:ArchaeologyGrove, David C. and Rosemary A. Joyce, (eds). Social patterns in Pre-Classic Mesoamerica: a symposiumNiles, Susan A., The shape of Inca history: narrative and architecture in an Andean empireSpielmann, Katherine A., (ed.) Migration and reorganization: the Pueblo period in the American SouthwestGeneralAt'ayan, Robert, The Armenian neume system of notationBoltanski, Luc, Distant suffering: morality, media and politicsCronk, Lee, That complex whole: culture and the evolution of human behaviorDarnell, Regna, And along came Boas: continuity and revolution in Americanist anthropologyDas, Veena, Dipankar Gupta and Patricia Uberoi, (eds) Tradition, pluralism and identity: in honour of T. MadanHenaff, Marcel, Claude Levi-Strauss and the making of structural anthropologyHudson, Mark J., Ruins of identity: ethnogenesis in the Japanese islandsKan, Sergei, Memory eternal: Tlingit culture and Russian Orthodox Christianity through two centuriesKiste, Robert C. and Mac Marshall, (eds) American anthropology in Micronesia: an assessmentMcDermott, Joseph P., (ed.) State and court ritual in ChinaMolendijk, Arie L. and Peter Pels, (eds) Religion in the making: the emergence of the sciences of religionMoore, Henrietta L., (ed.) Anthropological theory todayNordenskiold, Erland, The cultural history of the South American IndiansRenfrew, Colin and Daniel Nettle, Nostratic: examining a linguistic macrofamilySamson, Colin, (ed.) Health studies: a critical and cross-cultural readerStarrett, Gregory, Putting Islam to work: education, politics, and religious transformation in EgyptTarrow, Sidney, Power in movement: social movements and contentious politicsSocial AnthropologyAdelkah, Fariba, Being modern in IranBeatty, A., Varieties of Javanese religion: an anthropological accountBesteman, Catherine, Unraveling Somalia: race, violence, and the legacy of slaveryBulag, Urdyn E., Nationalism and hybridity in MongoliaEllis, Stephen, The mask of anarchy: the destruction of Liberia and the religious dimension of an African civil warGell, Alfred. The art of anthropology: essays and diagramsGreen, James N., Beyond carnival: male homosexuality in twentieth-century BrazilParker, Richard, Beneath the equator: cultures of desire, male homosexuality, and emerging gay communities in BrazilIbrahim, Zawawi, The Malay labourer: by the window of capitalismIwabuchi, Akifumi, The people of the Alas valley: a study of an ethnic group in northern SumatraJeffery, Roger, (ed.) The social construction of Indian forestsLedeneva, Alena V., Russia's economy of favours: blat, networking and informal exchangeMortimore, Michael, Roots in the African dust: sustaining the sub-Saharan drylandsNourse, Jennifer W., Conceiving spirits: birth rituals and contested identities among Lauje of IndonesiaPandolfo, Stefania, Impasse of the angels: scenes from a Moroccan space of memoryParry, Jonathan P., Jan Breman & Karin Kapadia, (eds) The worlds of Indian industrial labourRabinow, Paul, French DNA: trouble in purgatoryWanner, Catherine, Burden of dreams: history and identity in post-Soviet UkraineGreen, Linda, Fear as a way of life: Mayan widows in rural GuatemalaZur, Judith N., Violent memories: Mayan war widows in Guatemala

Abel, R., Rajaratnam, J., Kalaimani, A., Kirubakaran, S., & Correspondence:, R. A. (June 2000). Can iron status be improved in each of the three trimesters? A community-based study. European Journal of Clinical Nutrition, 54(6), 490-493(494). Objective: Intervention with iron supplementation, deworming, and information, education and communication (IEC) to improve the haematological status among each of the three trimesters of pregnant women in a rural community. Design: A community-based study was carried out using a two-group pre-post experimental design in a rural community. Setting: Two rural blocks in Vellore district were selected for the study. KV Kuppam block with a population of 120,000 and the adjacent Gudiyatham block with a population of 132,000 served as study and control areas for the study. Subjects: Using a multistage sampling, initially 50 of the panchayats, the local village administrative units, were randomly selected and all pregnant women were the subjects. In the pre-intervention survey 458 and 387 pregnant women had haemoglobin tested and the post-intervention survey covered 403 and 425 pregnant women in the study and control areas, respectively. Similarly serum ferritin was tested in a randomly selected sub-sample with 254 and 191 pregnant women before intervention and in 216 and 223 pregnant women after intervention in both study and control areas, respectively. Intervention: Iron supplementation and deworming were provided to all pregnant women in the study area from the fourth month of their pregnancy. An intensive information, education and communication was carried out with facts on anaemia and diet modification to each pregnant woman, using a one-to-one approach in the community, and a group method in the mobile clinics. This was carried out for a period of 18 months. Results: A significant decrease in the prevalence of anaemia was found, from 56.1 to 25.07 (P<0.001), 73.4 to 49.2 (P<0.001) and 68.8 to 56.8 (P<0.01) among women in the first, second and third trimesters, respectively, in the intervention area. Significant (P<0.001) increases in the mean haemoglobin of 0.85 gdl (95 CI 10.18-10.84, 11.09-11.63), 0.59 gdl (95 CI 9.98-10.34, 10.55-10.95) and 0.36 gdl (95 CI 9.93-10.33, 10.25-10.73) were also observed in each of the groups. Conclusion: A comprehensive community-based intervention with iron supplementation, helminthic treatment and increase in knowledge using IEC through effective strategies can improve the haematological status of pregnant women in each trimester. Sponsorship: Mother Care Project, John Snow Inc., Funded by the United States Agency for International Development (USAID). European Journal of Clinical Nutrition (2000) 54, 490-493

Eckermann, A. (1999). Aboriginal education in rural Australia: A case study in frustration and hope. The Australian journal of education, 43(1), 5.

Educational Resources Information Center (U.S.). (1990). Rural education in Iowa a collection of papers. [Cedar Falls, Iowa] Washington, DC]: Institute for Educational Leadership at the University of Northern Iowa ; U.S. Dept. of Education Office of Educational Research and Improvement Educational Resources Information Center. Ed 1.310/2:329402

Educational Resources Information Center (U.S.). (1995). Rural education data user's guide. [Washington, DC]: U.S. Dept. of Education Office of Educational Research and Improvement Educational Resources Information Center. Ed 1.310/2:380269

Edwards, B. (1997). Hoosier Schoolmaster, 1920-1940: A Case Study in Rural Elementary Education in South Central Indiana. Indiana magazine of history, 93(3), 244.

Elliott, T. E., Elliott, B. A., Regal, R. R., Renier, C. M., Crouse, B. J., Gangeness, D. E., Witrak, M. T., & Jensen, P. B. (January 2001). Lake Superior Rural Cancer Care Project Part II: Provider Knowledge. Cancer Practice, 9(1), 37-46(10). Purpose: The purpose of this article is to report the main learning outcomes of the Lake Superior Rural Cancer Care Project.Description of Study: The authors designed and tested a multimodal intervention directed at rural providers and their healthcare systems in a large rural area in the north central United States. An experimental design was used to randomize rural providers at the group level. The intervention consisted of providing increased education for rural providers with a number of approaches, including the use of clinical opinion leaders. The main outcome of the intervention was knowledge scoring on discipline-specific cancer management tests.Results: Knowledge scores for providers in the experimental group significantly increased from pretest to post-test: 66 to 79 for physicians (and physician assistants) (P =.02); 58 to 71 for nurses (P =.01); and 54 to 64 for pharmacists (P =.01). At post-test, participating providers in the experimental group performed significantly better on the knowledge tests (P <.01) than those in the control groups.Clinical Implications: This study may be the first to test educational interventions to improve rural providers knowledge about cancer practice using an experimental design. The intervention may possibly change provider practice behaviors and, thus, patient outcomes, data that will be reported in a future issue. Finally, this educational intervention may prove useful for providers in other rural areas.

Escobal, J. (March 2001). The Determinants of Nonfarm Income Diversification in Rural Peru. World Development, 29(3), 497-508(412). This paper shows that in Peruvian rural areas, there has been substantial growth over the past decade in household employment outside of own-farming. At present 51% of the net income of rural households comes from these off-farm activities, and thus they certainly cannot be considered as ''marginal.'' The reasons households diversify their incomes are several. Access to public assets such as roads and private assets such as education and credit is an important factor in diversification. Increasing access to these assets will help rural households to increase their self-employment as well as wage employment in the nonfarm sector.

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Fagbenle, R. O. (November 2001). National renewable energy policy objectives and programmes in Botswana. Renewable Energy, 24(3), 419-437(419). Government policy objectives and their implications for the development of new and renewable energy resources are examined. Renewable energy resources of major importance in Botswana are biomass, solar, and wind. Government policy and programmes, and the effects of regional and international developments in these aspects of renewable energy are considered in detail. Woody biomass exploitation and issues of sustainability of harvesting rates and the environment are also discussed. The place of renewable energy within the long established and well developed rural electrification programme is also examined, and a case for a comprehensive and separate rural energy policy is made. Research and Development as well as Demonstration, Dissemination, and Diffusion of renewable energy technologies are discussed, particularly in relation to energy technology acquisition, adaptation, education and job creation.

Fan, S., Hazell, P., & Thorat, S. (November 2000). Government Spending, Growth and Poverty in Rural India. American Journal of Agricultural Economics, 82(4), 1038-1051(1014). Using state-level data for 1970-93, a simultaneous equation model was developed to estimate the direct and indirect effects of different types of government expenditure on rural poverty and productivity growth in India. The results show that in order to reduce rural poverty, the Indian government should give highest priority to additional investments in rural roads and agricultural research. These types of investment not only have much larger poverty impacts per rupee spent than any other government investment, but also generate higher productivity growth. Apart from government spending on education, which has the third largest marginal impact on rural poverty and productivity growth, other investments (including irrigation, soil and water conservation, health, and rural and community development) have only modest impacts on growth and poverty per additional rupee spent.

Faulk, D., & Mancuso, F. (1999). A Collaborative Effort for Sex Education in Rural School Settings. Nursing and health care perspectives, 19(6), 271.

Fazzone, P. A., Barloon, L. F., McConnell, S. J., & Chitty, J. A. (January 2000). Personal Safety, Violence, and Home Health. Public Health Nursing, 17(1), 43-52(10). A critical issue facing the health care industry today is the potential impact of community and interpersonal violence on home health care. The purposes of this study were to (1) serve as a source for understanding the personal safety risk issues facing home care staff in a large Midwest region and its surrounding rural areas; (2) provide an understanding of how perceived threats to personal safety may impact patient care and patient outcomes; (3) identify strategies for increasing the personal safety of direct care staff; and (4) identify organizational, educational, and procedural issues that impede or enhance staff safety. A triangulated qualitative design was used including focus groups, in-depth individual interviews, critical event narratives, and a participant self-report form. The study used a purposive sample consisting of 5 men and 56 women who were either administrators or direct care staff from 13 home health agencies. Seven major themes emerged: (1) unsafe conditions that direct care staff must face; (2) organizational and administrative issues that impede or promote the personal safety of staff; (3) ethical issues staff face daily; (4) protective factors associated with maintaining safety; (5) issues of gender, race, age, and experience; (6) education and training; and (7) the potential impact that staffs fear of interpersonal and community violence can have on patient care and patient outcomes.

Fentiman, A., Hall, A., & Bundy, D. (1 November 1999). School Enrolment Patterns in Rural Ghana: a comparative study of the impact of location, gender, age and health on children's access to basic schooling. Comparative Education, 35(3), 331-349(319). The aim of this article is to discuss the results from three censuses conducted on school age children in rural Ghana which reveal contemporary patterns in enrolment. The data provide a profile of the school age population in basic education and contribute novel quantitative data on children out of school. The article examines the age at first enrolment, the gender disparities between classes, the classes where children drop out, and the proportion of children who never enrol in school. The stark contrast in enrolment between the disadvantaged north and the south of the country is also confirmed. Qualitative data from focus group discussions with parents, teachers and children highlight the major obstacles confronting education-these include a diversity of factors such as child labour, health, location and gender. Suggestions of policy options needed to increase access and attainment to schooling include reducing the over-age entry, increasing female access and participation, adapting culturally sensitive strategies, collecting better statistical data, improving the health of school age children and lessening the gap between the north and south of the country.

Fentiman, A., Hall, A., & Bundy, D. (2001). Health and cultural factors associated with enrolment in basic education: a study in rural Ghana. Social Science and Medicine, 52(ER3), 429-439.

Fentiman, A., Hall, A., & Bundy, D. (February 2001). Health and cultural factors associated with enrolment in basic education: a study in rural Ghana. Social Science and Medicine, 52(3), 429-439(411). This inter-disciplinary study compares the health status of school-age children in Ghana, both enrolled and non-enrolled, and examines these results within a wider socio-economic and socio-cultural context including kinship and livelihood. Children matched for age and sex who were not enrolled in Primary School were significantly shorter and more stunted than enrolled children were, and 70% of all Primary school-age children were anaemic. Young children from farming communities were significantly more undernourished than children from fishing communities. Adolescent non-enrolled boys were more heavily infected with Schistosoma haematobium, and were more likely to be anaemic than enrolled adolescent boys. The data indicate how health and health related factors may influence and affect enrolment and how socio-economic indicators, livelihood, and kinship may also constrain enrolment and, in turn, affect child health. This study sheds light on the complex factors that may influence enrolment in education and provides novel data on the similarities and differences between the health of enrolled and non-enrolled children in rural Ghana.

Fereshteh, M. H. (1993). International Rural Education Teachers and Literary Critics: Samad Behrangi's Life, Thoughts, and Profession., 23pp. Paper presented at the Annual Meeting of the Comparative and International Education Society (Kingston, Jamaica, March 16-19, 1993). This paper provides a critical, analytical, and evaluative study of Samad Behrangi's educational life, writings, and thoughts by exploring the influence of Behrangi's ideas, theories, and educational practices on the past, present, and future of the Iranian education system. Samad Behrangi was an Iranian teacher who wrote extensively on a variety of topics. He was influenced by Maslow and Rogers who claimed that children's physical, emotional, and intellectual needs must be given a great deal of attention in schools. He was mainly concerned with the quality and suitability of textbooks and how they were taught to rural and village students. He was concerned also with the living conditions, educational survival, and societal responsibilities to these Iranian children. The paper is organized under the following headings: Who Is Samad Behrangi? Behrangi's Popular Publications; What Did Behrangi Live, Fight, and Die For? Behrangi's Suggestions for Educational Reforms; How Should Stories and Folklore Be Taught? How Should Teachers Be Trained? What Is Wrong with Iran's School System? Behrangi's Masterpiece: "What is "Mahi-e Seyah-e Kocholo?" and How Did Behrangi's Life End? (LL) ED364542

Fereshteh, M. H. (1994). International Rural Education Teacher and Literary Critic: Samad Behrangi's Life and Thoughts. Paper presented at the Journal availability: Global Awareness Soc. Intl., Inc., Bloomsburg Univ. of Pennsylvania, Bloomsburg, PA 17815-1301. Considers the career and contributions of Samad Behrangi, Iranian educator and childrens' author. Behrangi worked as an itinerant rural teacher in Iran during the 1960s and 1970s. Supporters link his suspicious death in 1977 to his criticism of the Reva Pahlavi regime. (MJP) EJ533306

Ferreira, F. H. G., & Lanjouw, P. (March 2001). Rural Nonfarm Activities and Poverty in the Brazilian Northeast. World Development, 29(3), 509-528(520). This paper combines two complementary data sets to present a disaggregated spatial profile of poverty in the Brazilian Northeast, and to investigate the importance of nonagricultural activities for its rural dwellers. We present both univariate and multivariate profiles of nonagricultural employment and discuss its determinants. While the main occupational difference between the rural poor and the rural nonpoor in Brazil seems to be the greater reliance of the former on paid agricultural employment (vis-a-vis own cultivation), rather than access to nonagricultural activities, the evidence nevertheless suggests that diversification into this growing sector provides both an important complement to the budgets of the poor, and possibly a self-insurance mechanism against negative shocks. Despite the substantial heterogeneity of the sector, two general findings are robust: returns to education are comparatively high; and location in relation to urban areas is an important determinant of both employment and earnings in rural nonagricultural activities.

Fitzgerald, D. W., & Simon, T. B. (1 June 2001). Telling the Stories of People with AIDS in Rural Haiti. AIDS PATIENT CARE and STDs, 15(6), 301-309(309). For 20 years, Hospital Albert Schweitzer (HAS) in Haiti's Artibonite Valley has struggled with the evolving acquired immune deficiency syndrome (AIDS) epidemic. Initial efforts to confront the disease met numerous obstacles including denial, stigmatization, powerlessness, and mistrust. Over time, HAS and local community organizations developed a new approach to the AIDS problem. The first step in this approach flowed from the founding principle of HAS: Reverence for Life; hospital staff and community leaders provided hospice care to people dying of AIDS. Caring for people with AIDS and hearing the stories of people with AIDS quickly generated sympathy and a personal sense of vulnerability among community leaders and created a desire for community human immunodeficiency virus (HIV) education and prevention. Using the stories of people with AIDS as a basis, a community education program was launched. More than 1,000 church leaders, voodoo priests, and schoolteachers were trained. The majority of these leaders returned to their communities and started creative and unexpected initiatives to confront the AIDS problem.

Fletcher, R., & Cole, J. T. (1992). Rural Educational Collaboratives: An Economic and Programmatic Viewpoint. Paper presented at the Journal of Rural and Small Schools, 5, 1, 30-34 1992. Describes a three-tiered educational system where local education agencies (LEAs) organize into educational collaboratives responsible to the state education agency (SEA). Synthesizes the findings of current studies that address the economic and programmatic variables related to the operation of effective educational collaboratives in rural areas. (KS) EJ438274

FletcherCarter, R. (1998). Writing For Publication in The Rural Special Education Quarterly. Rural special education quarterly, 17(2), 23.

Flynn, B., Gavin, P., & Carpenter, J. (1997). Community Education Programs to Promote Mammography Participation in Rural New York State. Preventive medicine, 26(1), 102.

Francis, N. (1 January 2000). Rincones de Lectura Comes to San Isidro: New Contexts for Biliteracy and Language Maintenance. Language Culture and Curriculum, 13(1), 31-50(20). Findings from a bilingual Spanish-Nahuatl school in Central Mexico are examined to determine the impact of Spanish language literacy materials on the indigenous language. The new Spanish materials were introduced into the school, located in one of the most linguistically conservative localities in the region of Tlaxcala and Puebla states, as part of a nation-wide progamme to expand access to children's literature in outlying rural school districts. Observation centred on three aspects of students' participation in the progamme: (1) language choice and language alternation, (2) interactions with literacy materials, and specifically, (3) the use of the indigenous language in reading and writing activities. The question is raised, whether the goals of generalised literacy and universal access to primary education may be incompatible with the goal of maintaining indigenous languages that have historically been restricted for the most part to oral domains.

Freeman, M., Ramanathan, S., & Aird, J. (1998). Rural palliative care volunteer education and support program. The Australian journal of rural health, 6(3), 150.

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George, J. (1999). World View Analysis of Knowledge in a Rural Village: Implications for Science Education. Science education, 83(1), 77.

George, J. W. (1996). Action Research for Quality Development in Rural Education in Scotland. Paper presented at the Journal of Research in Rural Education, 12, 2, 76-82 Fall 1996. At the British Open University (a distance education institution), rural tutors working in remote areas of Scotland felt that professional isolation interfered with self-assessment and professional development. Describes action research into student and tutor perceptions of teaching and learning that provides a basis for reflective teaching and staff and instructional development. Contains 22 references. (SV) EJ534741

Gfeller, E. (1997). Why should I learn to read? Motivations for literacy acquisition in a rural education programme. International journal of educational development, 17(1), 101.

Gibbs, R. M. (1995). Going Away to College and Wider Urban Job Opportunities Take Highly Educated Youth Away from Rural Areas. "Rural Education and Training." Entire issue available from EDRS, see RC 020 673. Paper presented at the Theme issue. Rural high school graduates are less likely to graduate from college than their urban counterparts, mostly because they are less likely to attend college. Half of rural college attendees leave home and do not return by age 25. Those that do return are drawn largely by home ties and intervening life choices rather than local job opportunities. (Author/SV) EJ528306

Gibbs, R. M., Ed., Swaim, P. L., Ed., & Teixeira, R., Ed. (1998). Rural Education and Training in the New Economy: The Myth of the Rural Skills Gap., 199pp. For related document, see ED 398 018. This book examines the education, training, and skill supply of the rural workforce; the role of rural workforce quality in rural development; and the barriers that prevent many rural people from obtaining the skills needed for good jobs. Data are drawn from large national surveys of schools, students, and households. The first three chapters address educational quality in rural elementary and secondary schools. Chapters 4-6 go beyond high school to examine college attendance, adult literacy, and job training. The final two chapters investigate employers' demands for labor and their perceptions of the rural workforce. Major themes emerging from the analyses were: (1) although rural higher education and job training are areas of weakness, rural school systems educate their students as well as do urban systems, with fewer resources; (2) institutions matter, and rural development strategies must support rural employers' shift to high-tech competitive strategies; and (3) in contrast to previous decades, rural employers' skill requirements are rising rapidly in the 1990s. Following an introduction by Paul L. Swaim, Robert M. Gibbs, and Ruy Teixeira, the chapters are: (1) "Rural Teachers and Schools" (Dale Ballou, Michael Podgursky); (2) "Educational Achievement in Rural Schools" (Elizabeth J. Greenberg, Ruy Teixeira); (3) "Rural High School Completion" (Kathleen M. Paasch, Paul L. Swaim); (4) "College Completion and Return Migration among Rural Youth" (Robert M. Gibbs); (5) "Literacy of the Adult Rural Workforce" (Elizabeth J. Greenberg, Paul L. Swaim, Ruy Teixeira); (6) "Job Training for Rural Workers" (Paul L. Swaim); (7) "Rural Employer Demand and Worker Skills" (Ruy Teixeira, David A. McGranahan); and (8) "Current Trends in the Supply and Demand for Education in Rural and Urban Areas" (David A. McGranahan, Linda M. Ghelfi). Contains references in each chapter, many data tables and figures, and an index. (SV) ED422148 Available from: Iowa State University Press, 2121 South State Ave., Ames, IA 50014-8300; phone: 800-862-6657; World Wide Web: www.isupress.edu ($54.95).

Gibbs, R. M., Swaim, P. L., & Teixeira, R. A. (1998). Rural education and training in the new economy: the myth of rural skills gap ( 1st ed.). Ames: Iowa State University Press. Lc5146.5.r87 1998 370/.9173/4

Gibson, I. W. (Apr 1994). Preparing Teachers for Rural Education Settings in Australia: Issues of Policy, Practice and Quality., 22pp. Paper presented at the Annual Meeting of the American Educational Research Association (New Orleans, LA, April 4-8, 1994). This paper analyzes current policy and practice relating to the preparation and selection of teachers for rural areas of Australia, and contrasts these to perceptions of rural teachers concerning the adequacy of their preservice preparation. Nine recent Australian national and state reports and policy statements were analyzed. National policy recognizes the uniqueness of Australian rural schools, and the need for specialized training for future rural teachers in such areas as rural culture and society, Aboriginal culture, climate, mechanisms for adapting to local limited resources, and multigrade teaching methods. By contrast, the pervasive attitude in state education department documents appears to assume no need for specialized training or selection practices for rural and isolated personnel. Interviews with representatives of state and regional teacher recruitment offices revealed no standard approach to selection of rural teachers and little effort to match appropriate skills with rural placements. In-depth structured interviews were conducted with 24 teachers newly appointed to small communities in "outback" regions of Queensland. Most had requested rural placement. Half were in one-teacher schools, and 79 percent were teaching three or more grade levels. Three-quarters of interviewees were dissatisfied with their preparation for rural teaching, and indicated the need for better training in multigrade classroom strategies and teaching methods, organization, student evaluation and placement, school administration, and dealing with the community. (Contains 33 references.) (SV) ED368538

Glass, J. C., & Flynn, D. K. (1 March 2000). RETIREMENT NEEDS AND PREPARATION OF RURAL MIDDLE-AGED PERSONS. Educational Gerontology, 26(2), 109-134(126). Review of preretirement and retirement literature suggests that attention is placed on similarities of rural and urban persons in their retirement needs and concerns. The existing literature shows a lack of data on perceptions of future retirement needs and retirement actions implemented by rural middle-aged persons (45-64 years old). This study, conducted in three rural counties, had as its purpose to identify the following: (a) issues important in retirement for rural middle-aged persons; (b) preparation plans being made by rural middle-aged persons; (c) rural middle-aged persons perceptions of future needs regarding certain aspects of retirement; and (d) relationship of issues, plans, and perceptions to selected demographic variables. A number of relationships were found between issues identified as Important to Me and items labeled Actions I Have Taken. Study conclusions have implications for those concerned with preretirement education.

Glen, J. (2001). Cobb, Radical Education in the Rural South: Commonwealth College, 1922-1940. Journal of American History, 88(1), 246.

Glover, P., James, H., & Byrne, J. (2001). Midwifery in the land down under: rural education issues. British Journal of Midwifery, 9(7), 428-433.

Goduka, I. (1997). Rethinking the Status of Early Childhood Care and Education (ECCE) in Rural and Urban Areas of South Africa. Early education and development, 8(3), 307.

Gold, A. (2001). Education: New Light in New Times Women's Songs on Schooling Girls in Rural Rajasthan. Paper presented at the Manushi.

Goodell, E., Visco, R., & Pollock, P. (1999). A Program to Enhance K--12 Science Education in Ten Rural New York School Districts. Academic medicine, 74(4), 332.

Greenberg, E. (1996). Uncertainties in Federal Funding Situation Cause Problems for Rural Education and Training Programs. Paper presented at the Theme issue: "Federal Programs.". Following a series of continuing resolutions, the omnibus fiscal year 1996 appropriations bill restored federal education funding to 1995 levels or made smaller cuts than specified in the continuing resolutions. However, most job training and employment programs were cut significantly. Examines effects on rural education for Title I, impact aid, Star Schools, postsecondary financial aid, and job training. (SV) EJ541712

Greenberg, E. J. (1995). More Metro than Nonmetro Students Have Access to Computers, but Their Rates of Usage Are Similar. "Rural Education and Training." Entire issue available from EDRS, see RC 020 673. Paper presented at the Theme issue. National survey data indicate that 91% of metropolitan high school seniors and 78% of nonmetropolitan seniors had computers available in math classes. Computer availability was lowest in nonadjacent rural counties and in the South. Nevertheless, metro and nonmetro students reported similar frequency of computer use; 71% and 69%, respectively, never or hardly ever used computers. (SV) EJ528309

Greenberg, E. J., & And, O. (1995). Workers with Higher Literacy Skills Not As Well Rewarded in Rural Areas. "Rural Education and Training." Entire issue available from EDRS, see RC 020 673. Paper presented at the Theme issue. According to the 1992 National Adult Literacy Survey, rural workers score somewhat lower than urban workers in ability to use written and quantitative materials. However, scores of rural and urban young adults are similar, reflecting recent improvements in rural education. Rural workers earn less than urban workers with similar literacy skills; this gap increases at higher literacy levels. (Author/SV) EJ528307

Greenberg, E. J., & Teixeira, R. A. (1995). Nonmetro Student Achievement on Par with Metro. "Rural Education and Training." Entire issue available from EDRS, see RC 020 673. Paper presented at the Theme issue. Analysis of National Assessment of Educational Progress achievement scores, 1975- 92, indicates that nonmetropolitan 17-year-old students scored only slightly lower than metropolitan students in reading and mathematics, and at the same level in science. Comparatively faster improvement during the period was seen in Southern nonmetro scores and scores of minorities and the lowest scoring students. (Author/SV) EJ528304

Gregory, L., Comp. (1993). National Congress on Rural Education Proceedings (1st, Traverse City, Michigan, October 11, 1992)., 21p. The first National Congress on Rural Education, organized and conducted in conjunction with the 84th annual convention of the National Rural Education Association, convened an assembly of 458 advocates of rural education which came together to analyze common problems that tend to disaffect education in rural America and to plan corrective action. This report summarizes the events of the Congress. Following a general assembly, participants separated into 24 forum groups led by trained facilitators and identified disabling and chronic barriers to the improvement of rural education. A general town hall assembly then heard each group's findings and voted to determine the most important obstacles. Three major ones were identified; they concerned: (1) awareness and image; (2) equity and resources; and (3) separatism and provincialism. Participants returned to their groups and discussed solutions and strategies for addressing these three main barriers to improvement. A total of 16 strategies were identified that focused on public relations, lobbying federal and state goverments, policy formation, networking, use of technology, and lifelong learning. An appendix lists Congress leaders, forum facilitators, and members of the 1992 and 1993 executive committees of the National Rural Education Association. (SV) ED357929

GrishamBrown, J., Knoll, J., & Baird, C. (1998). Multi-University Collaboration via Distance Learning to Train Rural Special Education Teachers. Journal of special education technology, 13(4), 110.

Gruenhagen, K., McCracken, T., & True, J. (1999). Using Distance Education Technologies for the Supervision of Student Teachers in Remote Rural Schools. Rural Special Education Quarterly, 18(3/4), 58-65.

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Haas, T., & Boelke, E. ([1990). The Rural Education Agenda: Education for Individuals with Disabilities. The quality of life for individuals with disabilities depends on access to quality services and employment opportunities. It is also important that the disabled be accepted as participating, contributing, and cherished members of the community. Distance and isolation, which typify rural areas, directly impact each of these issues. Individuals with disabilities have significant contributions to make to rural communities, and education of the rural disabled has a twofold purpose: (1) to increase their skills and knowledge as individuals; and (2) to educate communities about their potential. The Education for All Handicapped Children Act (Public Law 94-142) established that public education has a responsibility to provide education for all children and required substantial and system-wide changes in providing such education. These changes have had a disproportionate impact on the budgets of rural schools and have created problems. Small, rural schools need waivers from categorical funding requirements so that all children experiencing problems in school can benefit from the skills, technologies, and processes developed by special education. Pull-out programs need to be replaced by specialized support and consultative help from itinerant specialists for classroom teachers. Small schools have few self-contained classrooms and need permission to experiment with model programs. Computers and augmentative communication boards need to be provided by PL 94-142 to rural schools. These waivers and special provisions to PL 94-142 would enable rural schools to educate the disabled to be productive in the rural community. (ALL) ED327360

Hadi, A. (September 2000). A participatory approach to sanitation: experience of Bangladeshi NGOs. Health Policy and Planning, 15(3), 332-337(336). This study assesses the role of participatory development programmes in improving sanitation in rural Bangladesh. Data for this study came from a health surveillance system of BRAC covering 70 villages in 10 regions of the country. In-depth interviews were conducted with one adult member of a total of 1556 randomly selected households that provided basic socioeconomic information on the households and their involvement with NGO-led development programmes in the community.The findings reveal that households involved with credit programmes were more likely to use safe latrines than others who were equally poor but not involved in such programmes. The study indicates that an unmet need to build or buy safe and hygienic latrines existed among those who did not own one. Such latent need could be raised further if health education at the grassroots level along with supervised credit supports were provided to them. Unlike conventional belief, the concept of community-managed jointly owned latrines did not seem a very attractive alternative. The study argues that social and behavioural aspects of the participatory development programmes can significantly improve environmental sanitation in a traditional community.

Hall, K., Gao, S., & Hendrie, H. (2000). Low education and childhood rural residence: Risk for Alzheimer's disease in African Americans. Neurology, 54(1), 95.

Hamilton, C., Smith, C., & Butters, J. (1997). Interdisciplinary Student Health Teams: Combining Medical Education and Service in a Rural Community-based Experience. The Journal of rural health, 13(4), 320.

Hammer, P. C. (1997). Rural Education and Rural Community Viability., 176pp. Master's thesis, Marshall University. This thesis examines the ways in which rural schools support or undermine rural community viability in the United States. Beginning in the late 19th century, the diverse people of the United States came under the power of a single ideology of modernization and the superiority of urban culture. This ideology has resulted in the American transition from a rural people who labored on the land to an industrialized people compelled to wander from place to place in search of work in the industrial artifice. Such lack of connection to place has had negative impacts on the environment and on the viability of rural communities. As part of the story, schools have produced and reproduced human, cultural, and social capital; supported the ideology of "progress"; and promoted the departure of rural youth to urban opportunities. The history and present circumstances of three rural groupsthe Old Order Amish, the Menominee Nation, and rural Appalachians in West Virginiaillustrate how events of the national rural-to- urban transition played out locally and how schools continue to impact community viability in terms of cultural, social, human, ecological (or natural), and financial capital. Meaningful reform of rural schools requires greater understanding of the local context in which they are situated and increased attention to learning to live well in a rural place. Contains 88 references. (Author/SV) ED411108

Hammond, H., & And, O. (1995). Rural Education Teams: A Team Building Project. Paper presented at the Rural Special Education Quarterly, 14, 1, 3-10 Win 1995. Educators from nine rural school districts in Idaho participated in a transdisciplinary team training program aimed at improving educational services for disabled students. Pretest and posttest analysis revealed that training was effective in improving collaboration among team members but that further work was needed on teams developing and implementing individualized education programs. (LP) EJ500111

Han, D. (2001). Impact of the Cultural Revolution on Rural Education and Economic Development. Modern China, 27(1), 59.

Han, D. (January 2001). Impact of the Cultural Revolution on Rural Education and Economic Development: The Case of Jimo County. Modern China, 27(1), 59-90(32).

Handa, S. (January 2000). The Impact of Education, Income, and Mortality on Fertility in Jamaica. World Development, 28(1), 173-186(114). The socioeconomic determinants of cumulative and recent fertility are investigated with micro data from Jamaica, a middle-income country with low rates of infant mortality and total fertility. Infant mortality has a significant nonlinear influence on fertility, peaking at a mortality rate of 0.46. Both education and income have strong negative effects on births but the impact of education is larger; for rural women the birth elasticities are -0.15 and -0.45 for income and education, respectively. Finally, the transmission of the education effect appears to be through raising the value of time of the woman rather than changing preferences.

Hannum, E. (1999). Political Change and the Urban-Rural Gap in Basic Education in China, 1949-1990. Comparative education review, 43(2), 193.

Hanuske, S., ERIC Clearinghouse on Rural Education and Small Schools., & National Institute of Education (U.S.). (1984). Shared services for rural and small schools. [Las Cruces, N.M.?]: ERIC Clearinghouse on Rural Education and Small Schools. Ed 1.310/2:259874

Harrington, G. (1997). Rural Education in Tasmania. Education in rural Australia, 7(2), 21.

Harvey, D., WebbPullman, J., & Strasser, R. (1999). Rural health support, education and training program (RHSET): Where to now? The Australian journal of rural health, 7(4), 240.

Hastie, P., & Sharpe, T. (1999). Effects of a Sport Education Curriculum on the Positive Social Behavior of At-Risk Rural Adolescent Boys. Journal of education for students placed at risk, 4(4), 417.

Hong, J. (2001). Rural Education Reform in China since the 1980s: An Examination of the New Policies, Approaches, and Implications. International Journal of Educational Reform, 10(1), 14-33.

Hoque, B. A., Mahmood, A. A., Quadiruzzaman, M., Khan, F., Ahmed, S. A., Shafique, S. A. K. A. M., Rahman, M., Morshed, G., Chowdhury, T., Rahman, M. M., Khan, F. H., Shahjahan, M., Begum, M., Hoque, M. M., & Correspondence:, B. A. H. (November 2000). Recommendations for water supply in arsenic mitigation: a case study from Bangladesh. Public Health, 114(6), 488-494(487). Arsenic problems have been observed in several countries around the world. The challenges of arsenic mitigation are more difficult for developing and poor countries due to resource and other limitations. Bangladesh is experiencing the worst arsenic problem in the world, as about 30 million people are possibly drinking arsenic contaminated water. Lack of knowledge has hampered the mitigation initiatives. This paper presents experience gained during an action research on water supply in arsenic mitigation in rural Singair, Bangladesh. The mitigation has been implemented there through integrated research and development of appropriate water supply options and its use through community participation. Political leaders and women played key roles in the success of the mitigation. More than one option for safe water has been developed andor identified. The main recommendations include: integration of screening of tubewells and supply of safe water, research on technological and social aspects, community, women and local government participation, education and training of all stakeholders, immediate and appropriate use of the available knowledge, links between intermediateimmediate and long term investment, effective coordination and immediate attention by health, nutrition, agriculture, education, and other programs to this arsenic issue. Public Health (2000) 114, 488-494

Hosig, K., & Rodibaugh, R. (1998). Parent Newsletters to Strengthen a School-based Community Nutrition Education Program in the Rural Arkansas Delta. Journal of nutrition education, 30(5), 340B.

Hosig, K., DollahiteJamie, & Adeletti, K. (1998). Development and Evaluation of a Consortium to Support a School-based Community Nutrition Education Program in the Rural Arkansas Delta. Journal of nutrition education, 30(5), 281.

Hou, X., & Li, W. (1990). The New Type of Farmers: Training Objectives of Rural Education. Paper presented at the Chinese Education: A Journal of Translations, 22, 4 p59-62 Win 198 1990. Proposes that education reform serve economic development. Claims that rural education must provide necessary training to meet local economic conditions and further modernization efforts. Calls for policy adjustment, additional investment, and the utilization of new research in science and technology. (NL) EJ407698

House, A. K., & House, J. (May 2000). IMPROVING BASIC SURGICAL SKILLS FOR FINAL YEAR MEDICAL STUDENTS: THE VALUE OF A RURAL WEEKEND. Australian and New Zealand Journal of Surgery, 70(5), 344-347(344). Background: Hospitals employing medical graduates often express concern at the inexperience of new interns in basic surgical skills. In self assessment questionnaires, our senior medical students reported little clinical procedural experience. A practical skills workshop was staged in order to set learning goals for the final study year. This gave the students an opportunity to learn, revise and practice basic surgical techniques.Method: The Bruce Rock rural community sponsored a surgical camp at the beginning of the academic year. Ninety-five (80) of the class registered at the workshop, which rotated them through teaching modules, with private study opportunities and the capacity to cater for varied skill levels. Eight teaching stations with multiple access points were provided, and ten mock trauma scenarios were staged to augment the learning process.Results: The teaching weekend was rated by students on an evaluative entrance and exit questionnaire. Sixty-five (73) students returned questionnaires. They recorded significant improvement (P < 0.05) in their ability to handle the teaching stations. All students had inserted intravenous lines in practice prior to the camp, so the rating change in intravenous line insertion ability was not statistically significant.Conclusions: The weekend retreat offers students a chance to focus on surgical skills, free from the pressures of a clinical setting or the class-room. The emphasis was on the value of practice and primary skills learning. Students endorsed the camp as relevant, practical and an enjoyable learning experience for basic surgical skills.

Howley, C. (1997). How to Make Rural Education Research Rural: An Essay at Practical Advice. Journal of research in rural education, 13(2), 131.

Howley, C. B. (1992). National and Local Economic Structures: Conflicting Views of Rural Education. Paper presented at the Journal of Rural and Small Schools, 5, 1, 22-29 1992. Compares and contrasts two economic views, political economy and neoclassical economics, as they pertain to the development of human capital and education in rural areas. The concluding discussion draws implications for rural educators. (Author/KS) EJ438273

Howley, C. B. (1997). How To Make Rural Education Research Rural: An Essay at Practical Advice. Paper presented at the Journal of Research in Rural Education, 13, 2, 131-38 Fall 1997. Argues that the primary purpose of mass education in Americanation-buildingis collapsing and that educational researchers must develop different commitments; among these are local purposes for education. Distinguishes rural (local) and cosmopolitan commitments; suggests readings and other means of preparation for rural educational research; and emphasizes the importance of critique. Contains 20 references. (SV) EJ557356

Howley, C. B. (20 Jan 1990). Critical Issues in Rural Education, Writ Large: Aims, Curriculum and Instruction, and School Finance., 41pp. Paper presented at the Annual Western Leadership Conference of the National Education Association (Omaha, NE, January 20, 1990). This paper examines issues in rural education related to aims, curriculum, and finance. It questions the notion that educational restructuring is necessary for the purpose of improving economic competitiveness. Wigginton, a rural educator, proposes that the aims of education should be: (1) to provide a firm grounding in the basic skills; (2) to develop an understanding of how the world works; (3) to cultivate an appreciation for the arts; and (4) to foster a determination to make a contribution. Another rural educator, Keizer, feels schools should do more than mirror and foreshadow the real world. Rural education should help students to construct meaning out of and in their lives. In terms of curriculum and instruction, rural schools tend to be small-scale, enabling them to be more responsive to students. Research shows a small but consistent advantage of small schools over large schools in terms of achievement when the effect of socioeconomic status is controlled. Although the use of technology is often advocated for rural school improvement, technology as a tool to achieve efficiency may not be so attractive; it may do more to refine the "one best system" model than to help responsive teaching. American school finance typically focuses on efficiency rather than effectiveness. There is a need for better funded schools. Rather than trying ineffectively to provide social services in schools, the aim should be to guarantee that every child will learn in school. (KS) ED344719

Howley, C. B., & Howley, A. (1995). The Power of Babble: Technology and Rural Education. Paper presented at the Phi Delta Kappan, 77, 2, 26-31 Oct 1995. Systemic approaches like outcome-based education can't accommodate the common good of rural areas; rural scholars are rightly skeptical of "the one best system" and supporting technologies. Educators should also question new technologies (distance education, computer-assisted instruction, and telecommunications) promising an even more efficient, homogeneous, and ubiquitous "best system." (24 references) (MLH) EJ513380

Howley, C., & Stern, J. (1993). A New Age for Research in Rural Education? Paper presented at the Rural Education Newsletter for a Special Interest Group of the American Educational Research Association, suppl 2 Spr 1993. The National Center for Education Statistics (NCES) new classification system for location of public schools and the NCES databases will provide new opportunities for rural education researchers. NCES developed a coding system called "Johnson codes" based on zip codes and Census definitions both of rural and nonrural places and of metropolitan and nonmetropolitan counties. The system locates all public schools on a continuum of seven "types of locale" from the most extreme rural location to the most concentrated urban location. In an effort to improve use of and access to its databases, NCES is gathering new data, producing new products, providing technical assistance, and conducting training activities. NCES produces public-use files and restricted-use files. In the past, mainframe computer tapes constituted the principal format for the NCES databases. Now, NCES has begun to make data available in CD-ROM format. The National Data Resource Center, operated by NCES, is a source of free technical assistance for the educational research community. NCES envisions a substantial effort to train those interested in accessing and using its data and new products through training seminars and possibly a national conference. This article describes the following NCES statistical databases in terms of type, scope, format, kinds of data, and contacts for information: (1) Common Core of Data; (2) School District Databook; (3) National Educational Longitudinal Survey of 1988; and (4) Schools and Staffing Survey (SASS) and SASS Teacher Followup Survey. (KS) ED370734

Hoyal, F. (1999). `Swallowing the medicine': Determining the present and desired modes for delivery of continuing medical education to rural doctors. The Australian journal of rural health, 7(4), 212.

Hu, F. B., Chen, C., Wang, B., Stampfer, M. J., Xu, X., & Correspondence:, F. B. H. (January 2001). Leptin concentrations in relation to overall adiposity, fat distribution, and blood pressure in a rural Chinese population. International Journal of Obesity, 25(1), 121-125(125). OBJECTIVE:: To examine the associations between leptin levels and body mass index (BMI), fat distribution (reflected by waist to hip ratio and skinfold measurements), and blood pressure in a rural Chinese population.DESIGN AND SUBJECTS: A cross-sectional study of 294 participants who provided blood samples.MEASUREMENTS: Plasma concentrations of leptin, BMI, waist to hip ratio, skinfold thickness, and blood pressure.RESULTS: The average leptin concentration was 5.2 gl (3.1 for men and 7.3 for women). In univariate analyses, leptin levels were significantly correlated with BMI (r=0.47), abdominal skinfold thickness (r=0.53), triceps skinfold thickness (r=0.56), waist circumference (r=0.41), hip circumference (r=0.51), waist to hip ratio (r=0.17), and diastolic blood pressure (r=0.13). In multivariate analyses controlling for age, sex, education, current smoking, and alcohol use, independent associations between leptin levels and BMI, waist to hip ratio, waist circumference, and abdominal skinfold thickness remained. However, the significant association between leptin and blood pressure disappeared after adjusting for BMI, whereas the association between BMI and blood pressure persisted after adjusting for leptin level.CONCLUSIONS: We observed a strong positive relationship between overall adiposity and leptin levels in both men and women in a rural Chinese population. In addition, leptin concentrations were significantly associated with central obesity measured by waist to hip ratio and abdominal skinfold, independent of overall obesity. The observed positive association between leptin and blood pressure was largely explained by BMI.International Journal of Obesity (2001) 25, 121-125

Huang, G. G. (1999). Sociodemographic Changes: Promise and Problems for Rural Education. Drawing information from federal statistical sources, this digest summarizes recent changes in rural demographic and economic conditions relevant to rural school systems. Since the early 1990s, the U.S. economy has been strong, and rural areas have been growing at the same rate or faster than the nation's economic pace. Benefiting from the steady growth of employment, income, and local revenue, some rural schools may be able to improve their financial conditions, although the stability of such improvement is uncertain. Since 1990, real income has increased for rural workers at all educational levels, but gains were greater for women and minorities than for men and Whites. However, rural public school teachers showed slight decreases in real income. Despite rural income gains, the poverty rate, the rate of those just above the poverty line, and the number of working poor have remained consistently higher in rural than urban areas in the 1990s. Rural schools must develop effective strategies to alleviate the difficulties facing poor children. Also relevant to rural schools is the growth in rural population in the 1990s. In addition to overall population growth, rural areas have seen increases in the younger population, minority groups, and immigrants. Recent immigrants present particular challenges to rural schools as they tend to have greater numbers of children and lower educational attainment and may require instruction in English as a second language. (Contains 12 references.) (SV) ED425048 Available from: ERIC/CRESS, P.O. Box 1348, Charleston, WV 25325-1348; phone: 800-624-9120 (free). You may be able to order this document from the ERIC Document Reproduction Service.

Hui, W. (1999). Young volunteers devoted to rural education. Paper presented at the Australia-China review.

Hulick, C., Ed. (1990). Southern Rural Education Association Journal, 1990. Paper presented at the 25pp. Only issue ever published. This journal contains the following articles pertaining to education in rural areas: (1) "The State of the Association" (William Peter) reviews the mission and progress of the Southern Rural Education Association; (2) "Arts Enrichment Programs in Middle Tennessee Rural Schools" (Howard Brahmstedt and Patricia Brahmstedt) describes how these programs began through university-school cooperation and grants; (3) "Mandated Teacher Evaluation Does Improve Teaching and Learning" (William Kurtz) discusses benefits of and problems with the new Texas evaluation process; (4) "National Award Winning Community-At-School Program" (Casher Choate) describes a model community education program in rural Tennessee; (5) "PAEC: A Pacesetter in Rural Education" (Paula Waller) explains how resources are shared among nine Florida counties in an education cooperative; (6) "The Development of Teacher Recruitment Materials for Rural Schools: Three Examples" (Dwight Hare) compares the differences among recruitment efforts in three parishes in Louisiana; (7) "Unexpected Benefits for Rural Education from a Beginning Teacher Internship Program" (Chuck Hulick and Bobby Malone) highlights the impact of the program; (8) "Urban Chauvinism and Rural Values" (Keigh Hubel) provides a personal account of rural life; and (9) "Technology in Rural Schools: The Future Is Now" (Kenneth Brookens) provides examples of telelearning, distance learning, and satellite communication in rural schools. (KS) ED379116

Humphreys, J. S., Lyle, D., Wakerman, J., Chalmers, E., Wilkinson, D., Walker, J., Simmons, D., & Larson, A. (April 2000). ROLES AND ACTIVITIES OF THE COMMONWEALTH GOVERNMENT UNIVERSITY DEPARTMENTS OF RURAL HEALTH. Australian Journal of Rural Health, 8(2), 120-133(114). ABSTRACTSince 1996, University Departments of Rural Health (UDRH) have been established at Broken Hill, Mount Isa, Shepparton, Launceston, Whyalla, Alice Springs and Geraldton. Each UDRH is underpinned by Commonwealth funding for an initial period of 5 years. The role of the UDRHs is to contribute to an increase in the rural and remote health workforce through education and training programs, as well as a reduction in the health differentials between rural and urban people and between indigenous and non-indigenous peoples. A strong population health focus involving partnerships between existing health providers in a targeted region and the university sector underpins their operation. While UDRHs have been established as a means of addressing a national workforce problem, their organisational arrangements with universities and local service providers vary widely, as does the program mix of activities in education, research service development, facilitation and advocacy. This article outlines some of the activities and progress of the UDRHs to date.

Hunt, L., Twynam, G. D., Haider, W., & Robinson, D. (1 December 2000). Examining the Desirability for Recreating in Logged Settings. Society and Natural Resources, 13(8), 717-734(718). This study examines the impacts of logged settings on the opportunities for nature-based tourism and outdoor recreation. By employing the experience-based setting management model and developing a desirability scale for recreating in logged settings, comparisons were made between desirability for recreating in logged settings and activity interest, psychological outcome importance, and sociodemographic characteristics. Results from the desirability and activity interest analyses suggest that consumptive and motorized activities are well suited to areas with multiple use/integrated resource management. Conversely, promotion of many physically demanding nonconsumptive activities is better suited to areas spatially segregated from logging. Only a tenuous link between desirability for a logged setting and importance of psychological outcomes was found. Finally, individuals with greater desirability for logged settings were more likely to be older, married, retired or blue collar employed, rural individuals, with lower levels of formal education than other individuals.

Hunter, W. M., Jain, D., Sadowski, L. S., & Sanhueza, A. I. (September 2000). Risk Factors for Severe Child Discipline Practices in Rural India. Journal of Pediatric Psychology, 25(6), 435-447(413). Objectives: To determine the type and severity of discipline practices in rural India and to identify risk and protective factors related to these practices.Methods: Five hundred mothers, ages 18-50, participated in face-to-face interviews as part of a cross-sectional, population-based survey. One of the mother's children was randomly selected as the referent child. The interview focused primarily on discipline practices and spousal violence. Sociodemographic characteristics, neighbor support, residential stability, and husband's drinking behavior were also assessed.Results: Nearly half of the mothers reported using severe verbal discipline and 42% reported using severe physical discipline. While common, severe discipline practices occurred less frequently than moderate practices and had different risk factors, notably low maternal education and spousal violence.Conclusions: Results suggest that increased formal education for rural women in India may have the added benefit of reducing family violence, including spouse and child abuse.

Huss, K., Winkelstein, M., Calabrese, B., & Rand, C. (2001). Role of Rural School Nurses in Asthma Management. Paediatric Drugs, 3(5), 321-328(328). Environmental, socioeconomic, psychological and familial factors in rural communities predispose children to asthma. This is not only the case in the US but also in the UK, New Zealand and other Western countries. Asthma prevalence ranges from 2.2 to 15%.Because children spend at least 6 hours of their day in school, school health personnel must be attentive to, and skilled in managing the needs and issues faced by children with asthma while at school. Rural school nurses or their deputies need to advise children with asthma about avoiding aeroallergens from hay, smoke, dust, grain in silos and animal dander from cattle and sheep.In the case of children with asthma in rural areas, symptoms may be accepted as long as the child can go to school and play. Parents in rural areas may not believe in routine preventive care for asthma as part of public health practice. Rural nurses need to be aware of current asthma guidelines and apply the concepts to prevention. They need to be proactive and engage in primary, secondary and tertiary prevention. Rural school nurses can begin by using existing resources and adapting these resources for use in rural school environments. Worldwide asthma education is fundamental to asthma patient management.

Huss, K., Winkelstein, M., Calabrese, B., Nanda, J., Quartey, R., Butz, A., Resto, M., Huss, R., & Rand, C. (2001). Rural School Nurses' Asthma Education Needs. Journal of Asthma, 38(3), 253-260.

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Haas, T. ([Mar 1990). Keeping School in Rural America: A New Paradigm for Rural Education and Community Development., 18p. This paper differentiates between the "old story" of rural education and the emerging "new story." It describes the tradition (old story) in which rural education is related to the local and national economies and lays out fragments of the new story, a paradigm that combines rural education and the rural economy in a way that strengthens them both. The old story reflects society's continuing shift from agriculture to industry and from industry to information. It suggests that rural schools have two purposes, to educate students either as participants in communities that are perpetually dependent on natural resources, or to take their places in urban industrial America. The result has been urbanization and rural decline. The new story says rural education is responsive to changing economics, demographics, and societal expectations. It holds promise for improving opportunities for rural children and communities. The characteristics of rural education are decentralization, diversity, unpredictability, evolving outcomes, high value for flexible generalists, and small scale. The mission of rural education is to meet community needs. Schools should provide choices for students who choose to stay in rural America, as well as for those who leave. Local boards regain central importance. Bureaucracy is limited. Curriculum is redesigned for authentic, relevant learning. Course delivery more closely predicts learning situations students experience throughout their lives. Teachers are generalists trained to help students find and use information. Schedules fit the task. Schools change from isolated hierarchical bureaucracies to networks of flexible, interdependent agencies acting in symbiosis with their communities. In conclusion, several examples of the "new story" in action are described and a list of 44 references is also provided. (TES) ED323041

Harmon, H. L., & And, O. (1996). Doctoral Research in Rural Education and the Rural R & D Menu. Paper presented at the Journal of Research in Rural Education, 12, 2, 68-75 Fall 1996. A search of Dissertation Abstracts International, 1989-93, identified 196 doctoral dissertations concerned with rural education. Dissertations were assigned to one or more topics and subtopics of the Rural Education Research and Development Menu. "Overall effectiveness of rural schools" received 121 of 248 assignments, followed by human resources, school-community partnerships, curriculum, financial support and governance, and technology use. (SV) EJ534740

Harrington, G. (1997). Rural Education in Tasmania. Paper presented at the Education in Rural Australia, 7, 2, 21-24 1997. Addresses factors affecting rural education in Tasmania (Australia), including population trends, financial support, student enrollment, socioeconomic status of rural residents, and geographic isolation. Issues that need to be addressed include the status of small schools in Tasmania, costs associated with transporting students, staffing, low student retention, and limited availability of special services. (LP) EJ552826

Harrison, A., Montgomery, E. T., Lurie, M., & Wilkinson, D. (December 2000). Barriers to implementing South Africa's Termination of Pregnancy Act in rural KwaZulu/Natal. Health Policy and Planning, 15(4), 424-431(428). Introduction: South Africa's Termination of Pregnancy Act, the most liberal abortion law in Africa, took effect early in 1997. In spite of the anticipated benefits to women's health, however, public reaction has been mixed. In the country's most populous province, KwaZulu/Natal, opposition is strong and most health care providers have refused to provide the service. This study explored attitudes and beliefs about abortion and the Termination of Pregnancy Act among primary care nurses and community members in a rural district in order to better understand barriers to implementation of the new law.Methods: As part of a community survey on women's reproductive health (n = 138), questions on knowledge, attitudes and beliefs about abortion were asked, as well as awareness of the provisions of the Termination of Pregnancy Act. To better understand the perspectives of health care workers, a survey among primary care nurses on duty (n = 25) was also conducted. In-depth interviews were conducted with both nurses and women in the community to further pursue issues raised in the two surveys.Results: Support for the Act was low (11) among both community members and nurses, and few supported abortion on request (18 and 6, respectively). Within each group, however, a clear hierarchy of support was observed: a majority of nurses (56) and community members (58) supported abortion in the case of rape or incest, or if the continued pregnancy would endanger a woman's health (61 and 56, respectively), but few supported abortion for social or economic reasons. In-depth interviews revealed that abortion is seen as contrary to prevailing community norms; nurses were poorly informed about the Termination of Pregnancy Act and felt confused in their professional responsibilities.Conclusions and recommendations: Legalization alone cannot ensure implementation of abortion services. In South Africa, extensive media coverage prior to passage of the law ensured almost universal awareness of the Act, but little public education took place at the same time. In spite of general opposition to the law, however, there is an encouraging level of support for abortion in some circumstances. These findings suggest that abortion services can be implemented, even in conservative rural areas, but that a process of information dissemination and community consent prior to implementation is essential. Locating abortion within broader reproductive health services could be an effective way to improve access and acceptability.

Hartley, R. (April 2000). AREA HEALTH SERVICES AS LEARNING ORGANISATIONS: THE RURAL EXPERIENCE. Australian Journal of Rural Health, 8(2), 77-80(74). ABSTRACTStaff development units (SDUs) across New South Wales Health are in a state of flux. Traditional models of training may no longer be meeting the continuing professional education needs of staff. This paper outlines how one SDU, the Rural Health Education and Research Centre at Tamworth, with few resources, has successfully negotiated the transformation from delivering ad hoc, face-to-face teaching, to a model encompassing competency-based training, recognition of prior learning, workplace assessment and distance education.

Hawkins, J. N. (12 October 2000). Centralization, decentralization, recentralization - Educational reform in China. Journal of Educational Administration, 38(5), 442-455(414). China's educational leaders have long debated the pluses and minuses of decentralization of control and resources of China's vast educational enterprise. During various periods of post-1949 China, the central authorities have devolved control to the provinces, key cities, and rural communes, only to recentralize later usually due to political reforms. In this chapter various stages of the educational reform movement begun in 1985 will be considered and we will focus on what motivated the reforms in the context of China's unique political culture. Some specific features of educational decentralization will be examined such as finance, curriculum and management. We conclude that while the current leadership appears to be committed to decentralization, they remain conflicted over the need to maintain control while at the same time respond creatively to the needs of the new market economy.

He, D. (1990). Rural Education Should Principally Serve Local Development. Paper presented at the Chinese Education: A Journal of Translations, 22, 4 p9-22 Win 198 1990. Stresses national concern with rural education which is viewed as the key factor in future economic development. Points out that 80 percent of the population lives in the countryside, and findings show that they are disadvantaged in both basic education and technical training. Author provides specific policies to institute change. (NL) EJ407693

Helge, D., ERIC Clearinghouse on Rural Education and Small Schools., & National Institute of Education (U.S.). (1985). Planning staff development programs for rural teachers. Las Cruces, NM: ERIC Clearinghouse on Rural Education and Small Schools. Ed 1.310/2:260874

Hendryx, M., Fieselmann, J., & Bentler, S. (1998). Outreach Education to Improve Quality of Rural ICU Care: Results of a Randomized Trial. American journal of respiratory and critical care medicine, 158(2), 418.

Herzog, M. (1998). Guest Editor's Introduction: The Neglect of Rural Education. The Teacher educator, 33(3), v.

Herzog, M. J. R. (1996). Conditions, Attitudes and Concerns in Rural Education: An Examination of the Appalachian Counties of North Carolina., 15pp. Paper presented at the Annual Meeting of the National Rural Education Association (San Antonio, TX, October 1996). This paper examines rural conditions from three perspectives: education, demographics, and economics from national, state and regional data sources; Rural Attitude Survey data from students at Western Carolina University in the Appalachian mountain region; and concerns of teachers about education in the region derived from focus group discussions. A brief review points out that North Carolina's rural population is decreasing and growing older, has a lower median income than the urban population, and has higher proportions of poverty and the working poor. Nationally, the gap in high school completion rates between rural and urban populations has narrowed but the gap in college completion rates has increased. Western North Carolina is deficient in the areas of quality child care, adult functional literacy, college completion rates, and implementation of new technologies. Definitions of rural are ambiguous and ambivalent and characterized by negative images. Negative attitudes and stereotypes about rural people and Appalachians are prevalent and affect student self-concept. Nevertheless, a survey of 155 students in education classes at Western Carolina University revealed overwhelmingly positive feelings for rural areas and their home communities, a strong sense of community and connection, and positive attitudes toward the university and its surroundings. The responsibility of a rural university to its region's rural communities is discussed. (SV) ED411104 Herzog, M. J. R. P., Robert B.. Home, Family, and Community: Ingredients in the Rural Education Equation. Discusses certain educational, demographic, and economic trends challenging rural education and summarizes Rural Attitude Survey results. Despite consolidation efforts, rural schools are poorer and smaller than nonrural schools. Despite their marginalization by the dominant culture, rural communities have precisely the qualities valued by critics of American education. (24 references) (MLH)

Hess, D. R. (April 2000). Nurse Practitioner Students' Experiences in a Rural Interdisciplinary Education Program. National Academies of Practice Forum, 2(2), 101-107(107). This qualitative phenomenological study is intended to be useful to persons who are involved with interdisciplinary educational programs and who educate and/or work with nurse practitioner (NP) students. The study's purpose was to determine the effect of NP students' participation in a rural interdisciplinary project upon the participant's professional practice. Using unstructured, in-depth, face-to-face interviews, six NPs describe their subjective experiences. The results revealed six themes: opportunity, rewards/benefits, problems, experience of being a nurse, suggestions, and current practice. The findings provide support for the benefits of interdisciplinary learning experiences for NPs. Psychological benefits include the development of professional self-esteem and increased self-confidence. Students learned how to be part of a team and to recognize how differing approaches could be used to solve problems. This study supports the use of problem-based learning as a pedagogical technique for NP students. The effects that interdisciplinary learning experiences have on the development of later interdisciplinary professional practices remain questionable. Considerations for faculty are discussed.

Higgins, A. H. (1994). A Background to Rural Education Schooling in Australia. Paper presented at the Theme issue topic: "Rural Development, Policy, and Education in Australia.". Traces the history of rural education in Australia, including the influence of early British colonists, the emergence and eventual consolidation of state systems of education, and the implementation of distance education. Focuses on the development of education in remote areas of Queensland and government impact on rural education. (LP) EJ488513

Higgins, L. T., & Sheldon, K. (1 June 2001). Teaching of Mandarin in an English Comprehensive School: a case study. Educational Studies, 27(2), 109-127(119). A group of English children in a rural comprehensive are learning Mandarin, taught by a Chinese teacher. This article describes the background to this development and follows three cohorts of students, giving the pupils' views about learning Chinese and why they chose it. As a psychologist who has interests in education and who is also a part-time student of Chinese, the author welcomed the chance to share the pupils' experience. In the final cohort, sensation-seeking tendencies and intellectual achievement responsibility were investigated as personality traits which may influence a child's choice of foreign language study.

Hillier, L., Harrison, L., & Bowditch, K. (February 1999). "Neverending Love" and "Blowing Your Load": The Meanings of Sex to Rural Youth. Sexualities, 2(1), 69-88(20). This article reports on qualitative and quantitative research, conducted with senior secondary school students in small rural Australian towns, which explored the meanings of sex and relationships. Through a survey, the researchers identified the many ways in which these young people construct meanings around sex and sexuality and, combined with their beliefs about relationships, what impact these meanings might have on their ability to negotiate safe sexual relationships. Single-sex focus discussion groups that explored aspects of developing sexuality within the context of small town culture were also held in each town. Not surprisingly, the research revealed that young people in rural areas (like many of their urban peers) assumed heterosexuality as the norm, and penis-vagina sexual intercourse as the pivotal activity in sex. Beyond this (although there was overlap), the young men and women tended to attach different meanings to sex around issues such as its place in a relationship, the pleasure it affords and the dangers it presents. There were significant gender differences in the perceived advantages and disadvantages of relationships with the expectation to have sex being seen as a deterrent for young women and an advantage for young men. We examine the common meanings of sex and the gender differences in meaning for the ways in which they might impact on young people's ability and motivation to practise safe sex, in particular, ways in which gender and power impact on sexual encounters. Finally, the article focuses on the role that sexuality education might play in helping young people critique their own understandings about sex.

Hindman, D. B., Ernst, S., & Richardson, M. (1 May 2001). The Rural-Urban Gap in Community Newspaper Editors' Use of Information Technologies. Mass Communication & Society, 4(2), 149-164(116). This is an analysis of the social structural context of community newspaper editors' use of a variety of information technologies, including technologies that can be conceptualized as being (a) compatible with and (b) incompatible with the routine production of the newspaper. Findings were that newspapers in more pluralistic, more urban communities were more likely to use all varieties of information technologies than were newspapers in less pluralistic, rural communities. Nationally, the gap between rural and urban communities with online newspapers was widening. Other indicators of social resources, the editor's education level and the newspaper's organizational complexity, did not explain the newspaper's use of information technologies that are compatible with normal news gathering operations.

Hoare, K., Hoare, S., & Weaver, L. (1999). Effective Health Education in Rural Gambia. Journal of tropical pediatrics, 45(4), 208.

Holloway, G., Nicholson, C., Delgado, C., Staal, S., & Ehui, S. (September 2000). Agroindustrialization through institutional innovation - Transaction costs, cooperatives and milk-market development in the east-African highlands. Agricultural Economics, 23(3), 279-288(210). Some small-holders are able to generate reliable and substantial income flows through small-scale dairy production for the local market; for others, a set of unique transaction costs hinders participation. Cooperative selling institutions are potential catalysts for mitigating these costs, stimulating entry into the market, and promoting growth in rural communities. Trends in cooperative organization in east-African dairy are evaluated. Empirical work focuses on alternative techniques for effecting participation among a representative sample of peri-urban milk producers in the Ethiopian highlands. The variables considered are a modern production practice (cross-bred cow use), a traditional production practice (indigenous-cow use), three intellectual-capital-forming variables (experience, education, and extension), and the provision of infrastructure (as measured by time to transport milk to market). A Tobit analysis of marketable surplus generates precise estimates of non-participants' 'distances' to market and their reservation levels of the covariates - measures of the inputs necessary to sustain and enhance the market. Policy implications focus on the availability of cross-bred stock and the level of market infrastructure, both of which have marked effects on participation, the velocity of transactions in the local community and, inevitably, the social returns to agroindustrialization.

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Jackson, D. R., Ed. (1990). Rural Education in Iowa: A Collection of Papers from the Invitational Rural Education Conference (Cedar Falls, IA, April 7-9, 1989). Monograph Series, Volume I, Number 1., 167p. This volume contains short papers and commentaries from a conference on rural education in Iowa. Prefatory notes compare the characteristics of Iowa rural students and rural schools to those of the North Central states in general, and discuss two rural education issues repeatedly identified at the conference equity of educational opportunities and efficiency of rural school operations. Overall, conference participants suggest that equity and efficiency issues are best addressed through continued innovation in the areas of funding for rural districts, collaboration among rural educators, and coordinated application of technology to rural education. Section I, the keynote address, discusses "Urban Chauvinism and Rural Values." Other sections discuss: (1) school size and curriculum diversity in Iowa, new state curriculum standards, and improving quality and equity of curriculum delivery through whole-grade sharing, interactive television, and magnet vocational schools; (2) school effectiveness in the rural community setting, inherent advantages of small community schools, the importance of the school to its community, and the ongoing threat of school closings and school district reorganization; (3) the Iowa state funding formula, and equity, quality, and efficiency with respect to rural schools; (4) student needs and how rural education can meet them; (5) ways of redesigning Iowa rural schoolssharing, restructuring, and consolidating; (6) elements of effective staff development in rural schools; and (7) planning and implementing technology applications in rural education in Iowa. (SV) ED329402

Jahan, M. (1998). A Review of Past Efforts of Rural Development and Role of Education in Its Promotion. The Journal of the Institute of Bangladesh Studies, 21, 141.

Jahan, R. A. (December 2000). Promoting health literacy: a case study in the prevention of diarrhoeal disease from Bangladesh. Health Promotion International, 15(4), 285-291(287). The relationship between health education and health literacy is examined through a case study of a project to prevent diarrhoea in rural Bangladesh by CARE-Bangladesh in 1993. Health professionals in Bangladesh typically define health education as a one-way approach of information dissemination. Achieving health literacy implies that health education not only relays information, but also enhances a persons ability to think about healthy behaviours, seek and use information, and motivates people to take action to improve health. This paper illustrates how a traditional health education program failed to bring expected changes in the community to improve health. It then describes the development and implementation of the SAFE (Sanitation and Family Education) project by CARE-Bangladesh. SAFE is a diarrhoea prevention program which illustrates the concept of health literacy as a step to improved health outcomes. Emphasis is given on the dynamic process of communication, community needs and participation, identification of problems related to socio-economic and environmental factors, and role of the field workers. It argues that health promotion interventions must respond to the local context and needs to be continually reviewed and revised as necessary. Lessons learned and achievements of SAFE are highlighted. The paper suggests that readers review whether their existing programs are doing enough to raise health literacy and improve health outcomes, or if they are merely increasing awareness of related issues.

Jamaica., United States., & United States. Dept. of State. (1979). Rural education: agreement between the United States of America and Jamaica, signed at Kingston November 13, 1975 and amending agreement signed at Kingston November 25, 1977. Washington, D.C.: Dept. of State. S 9.10:9160 S 9.12:

Janvry, A. d., & Sadoulet, E. (March 2001). Income Strategies Among Rural Households in Mexico: The Role of Off-farm Activities. World Development, 29(3), 467-480(414). Off-farm activities generate on average more than half of farm households' incomes in the Mexican ejido sector. Participation in these activities helps reduce poverty and contributes to greater equality in the distribution of income. This paper analyzes the determinants of access to off-farm sources of income across households. We find that education plays a major role in accessing better remunerated nonagricultural employment. Adults of indigenous ethnic origin suffer from an educational lag and have less access to off-farm nonagricultural employment than non-indigenous adults at identical educational levels. The regional availability of off-farm employment strongly affects participation. In addition, women are differentially limited by distance to urban centers in their ability to gain off-farm employment.

Jaramillo, G. (2000). The Charter School Movement in Support of Rural Educational Reform: A History of Our Struggle for Local Autonomy. Paper presented at the Rural Educator, 21, 2, 28-32 Win 1999-2000. Describes how two rural Colorado communities, threatened by the loss of their elementary schools, established a charter school based in two existing facilities. Discusses the benefits of local autonomy, the value of networking with other rural charter schools, the role of the community in school innovations, and emphases on staff development and school program evaluation. (SV) EJ600069

Johansson, E., Long, N. H., Diwan, V. K., & Winkvist, A. (May 2000). Gender and tuberculosis control - Perspectives on health seeking behaviour among men and women in Vietnam. Health Policy, 52(1), 33-51(19). This study explores the perspectives of tuberculosis patients on which factors influenced their health seeking behaviour, with special reference to gender differentials in terms of delays in health seeking. In 1996, a multi-disciplinary research team carried out 16 focus group discussions. The study was done in four districts in Vietnam, both in the south and north of the country and in urban and rural areas. Qualitative analysis of data was performed following general principles of modified grounded theory technique. Participants in the focus groups described three main factors as contributing to delay in health seeking. These were fear of social isolation, economic constraints and inadequate staff attitudes and poor quality of health services. A model illustrating different factors influencing health seeking was elaborated and served as a basis for discussion of the findings. The main factor contributing to delay among women was described as fear of social isolation from the family or the community. Stigma was described as closely related to contextual factors such as gender-roles, socio-economic status and level of education and seemed to be mediated via denial and concealment of tuberculosis diagnosis and disease, thus causing delay. The main factor contributing to delay among men was described as fear of individual costs of diagnosis and treatment. Staff attitudes and quality of health service facilities were described as not always corresponding to people's expectations of appropriate health services. Women saw themselves and were seen by others as being more sensitive than men to poor service conditions and staff attitudes. A typical feature of the described health seeking behaviour of men was that they neglected symptoms until the disease reached a serious stage, by which time they tended to go directly to public health services without first visiting private health practitioners. Women, on the other hand, were described as having a tendency to seek out private services and practice self-medication before seeking care at public services. In conclusion, there is a need for better understanding of behavioural factors and for developing strategies, that take these into account. Health workers need to better understand gender and social aspects of tuberculosis control, particularly aspects that influence the likelihood for achieving equity in diagnosis and cure.

John, P. L. C. (Aug 1994). Rural Education: January 1984-May 1994. Quick Bibliography Series: QB 94-46. Updates QB 92-15., 55p. This bibliography contains 214 entries related to rural education. The entries were derived from the AGRICOLA database produced by the National Agricultural Library and include journal articles, extension bulletins, books, conference papers, and government reports. Entries cover topics such as agricultural education, adult education, colleges, community education, educational policy, rural education, educational programs, educational reform, distance education, special education, rural areas, public schools, and rural development. Each entry includes title, author, publisher, publication date, journal or conference information (where appropriate), language, descriptors, and the National Agricultural Library call number. Some entries contain an abstract. Also included are indexes by author and subject and information about interlibrary loan from the National Agricultural Library. (LP) ED385416

John, P. L. C., & National Agricultural Library (U.S.). (1990). Rural education: January 1979 - March 1990. Beltsville, Md.: National Agricultural Library. A 17.18/4:90-85

John, P. L. C., & National Agricultural Library (U.S.). (1992). Rural education: January 1979 - September 1991. Beltsville, Md.: National Agricultural Library. A 17.18/4:92-15

John, P. L. C., & National Agricultural Library (U.S.). (1994). Rural education: January 1984-May 1994. Beltsville, Md.: National Agricultural Library. 016.37/019/3460973 A 17.18/4:94-46

John, P. L. C., Comp. (Jan 1992). Rural Education: January 1979-September 1991. Quick Bibliography Series. QB 92- 15., 38p. This bibliography contains 140 citations (some with annotations) for selected rural education literature entered into the AGRICOLA database between January 1979 and September 1991. The publications, all in English, include books, commission papers, journal articles, legal documents, reports, academic theses, and audiovisual materials. Each entry contains information on title, author, publisher, date and place of publication, and the call number of the National Agricultural Library. Topics related to rural education include: (1) alcohol and drug use; (2) education reform; (3) rural development; (4) economic development; (5) characteristics of rural youth and rural schools; (6) educational and occupational aspirations of rural youth; (7) community education; (8) vocational education; (9) school finance; and (10) higher education. The document includes information about document delivery services provided by the National Agricultural Library to individuals and libraries. It also contains a description of the Rural Information Center, which provides information and referral services to local government officials, community organizations, health professionals and organizations, cooperatives, libraries, and rural citizens. (KS) ED344713

John, P. L., Comp. (Sep 1990). Rural Education: January 1979-March 1990. Quick Bibliography Series: QB90-85., 19p. This bibliography contains 108 citations (some with annotations) for selected rural education literature entered into the AGRICOLA database between January 1979 and March 1990. The publications include books, commission papers, journal articles, legal documents, reports, and academic theses. Some of the topics covered in the bibliography as they relate to rural education are: (1) alcohol and drug use; (2) educational reform; (3) community schools; (4) educational and occupational aspirations of rural youth; (5) economic development; (6) rural development; (7) school finance; (8) health care; (9) educational partnerships; (10) vocational education; (11) adult education; and (12) extension education. Entries are organized by title and are indexed by author. The document includes information about document delivery services to individuals and libraries, which are provided by the National Agricultural Library. (KS) ED330541

Johnstone, S. J., Boyce, P. M., Hickey, A. R., Morris-Yates, A. D., & Harris, M. G. (February 2001). Obstetric risk factors for postnatal depression in urban and rural community samples. Australian and New Zealand Journal of Psychiatry, 35(1), 69-74(66). Objective: The objective of this study was to examine obstetric risk factors for postnatal depression in an urban and rural community sample, with concurrent consideration of personality, psychiatric history and recent life events.Methods: This was a prospective study with women planning to give birth in one of the four participating hospitals recruited antenatally. Obstetric information was obtained from the New South Wales Midwives Data Collection, completed shortly after delivery. Personality, psychiatric history and life-events information were obtained from a questionnaire, administered within 1 week postpartum. Depression status was assessed at 8 weeks postpartum using the Edinburgh Postnatal Depression Scale.Results: Complete data were obtained from 490 women. Several non-obstetric risk factors for the development of postnatal depression at 8 weeks postpartum were reported including: sociodemographic (up to technical college level education, rented housing, receiving a pension/benefit), personality (those who described themselves as either nervy, shy/self-conscious, obsessional, angry or a worrier), psychiatric history (familial history of mental illness, personal history of depression or anxiety or a history of depression in the participant's mother) and recent life-events (major health problem, arguments with partner and friends/relatives). None of the obstetric variables were significantly associated with increased risk for postnatal depression, but several showed marginally significant increases (multiparous women, antepartum haemorrhage, forceps and caesarean section deliveries).Conclusions: The results emphasize the importance of psychosocial risk factors for postnatal depression and suggest that most obstetric factors during pregnancy and birth do not significantly increase risk for this depression. Early identification of potential risk for postnatal depression should include assessment of sociodemography, personality, psychiatric history and recent life events, as well as past and present obstetric factors.

Ju, J. S. (December 2000). Nutrition in the Republic of Korea. British Journal Of Nutrition, 84(S2), 195-198(194). Until the 1970s, the Korean economy was dominantly agriculture, but nowadays, less than 10 % of the population lives in a rural area, and it is expected that within a generation the proportion of the population engaged in agriculture will be less than 5 %. The living standard is rising as the national economy benefits from the increased sale of industrial products. The dietary patterns are being changed. The diet has changed from one based predominantly on starch based food such as cereals or roots and vegetables to one in which animal products take great prominence with consequent increases in animal fat and protein. The move from simple unrefined foods to more refined and complex manufactured foods has become commonplace. As a result, the general nutritional situation has been improved. Such improvement, however, has brought about an increase in overnutrition in more affluent sections of the population, whereas dietary inadequacy among the lower socio-economic groups and vulnerable classes still persists. Overall, Korea suffers from both undernutrition and overnutrition. The national school feeding program started in 1953 after the Korean War with the support of UNICEF, CARE, and USAID as a relief food program and is now expanding successfully to a self-supporting nationwide scale. The applied nutrition project in rural areas introduced in 1967 with the support of UNICEF, FAO, WHO, and the Korean government continues successfully to the present day. A national dietary survey has been carried out once a year since 1969, and once every 3 years from 1998. Korean recommended dietary allowances were established in 1962 and have been revised every 5 years. The government intends to establish national dietary guidelines for health promotion and prevention of chronic degenerative diseases. Nutrition education and research are also very important national undertakings.

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Kallaway, P. (2001). The need for attention to the issue of rural education. International Journal of Educational Development, 21(ER1), 21-32.

Kallaway, P. (January 2001). The need for attention to the issue of rural education. International Journal of Educational Development, 21(1), 21-32(12). This paper argues that strategies for vocational education in Africa, with particular regard to rural communities, which were highlighted as a key aspect of development strategies in the '60s and '70s - such as Education for Self Reliance or the Brigades of Botswana (see Nyerere, J., 1967. Education for Self-Reliance. Ministry of Information and Tourism, Dar es Salaam; Foster, P., 1969. Education for self reliance: A critical evaluation. In: Jolly, R. (Ed.), Education in Africa: Research and Action. East African Publishing House, Nairobi, pp. 81-102) and the World Bank programmes in support of Non-Formal Education (Coombs, P., Ahmed, M., 1974. Attacking Rural Poverty: How Non-formal Education Can Help. World Bank/Johns Hopkins University Press, Baltimore) - have never been replaced with a viable alternative in subsequent years. Whatever the reasons for the failure or demise of such programmes, which aimed at linking the school curriculum to the world of (rural) work in the past, the need for careful attention to that linkage has increased rather than decreased in the interim given the overall decline in access to secondary and tertiary education and the prospects for finding alternative employment in the formal sector. The paper focuses on recent reform initiatives in South Africa and seeks to make the point that new policy, in so far as it has been shaped by global trends, has failed to engage with the specific interests of the rural poor.

Kallembach, S. C., & And, O. (Jul 1991). Selected Vocational Preparation Resources for Serving Rural Youth and Adults with Special Needs., 85p. This resource guide helps state and local administrators of vocational special needs programs, special needs educators, counselors, researchers, and policymakers serving rural youth and adults to locate resources. Resources cited in this guide are publications; newsletters; journals; special issues of journals; agencies, associations, and organizations; centers for educational information/services; clearinghouses; computer-based information networks; and databases. The materials are categorized according to relevant issues and strategies that include rural education reform, youth at risk, teen parent, transition, support services/programs for adults, and delivery system models. References on rural conditions/rural development and general background literature highlight the demographics and challenges facing rural education. For each entry, author, title, publication date, publisher, annotation, price, ordering information, and address are provided, when applicable. Indexes by title and author are included. (NLA) ED334453

Karim, G. P., Ed., & Weate, N. J., Ed. (1994). Toward the 21st Century: A Rural Education Anthology. Rural School Development Outreach Project. Volume 1., 140pp. For selected individual articles, see RC 020 798-802. This anthology focuses on rural education improvement that will prepare students for the 21st century. Articles address issues related to school funding, educational technology, curriculum offerings, state and federal policies, the role of rural teachers and administrators in school reform, cultural diversity, and changing socioeconomic factors in rural communities. An introduction by Gordon P. Karim overviews themes of the articles and discusses the role of rural schools in strengthening rural communities. Articles include: (1) "The Rural Context for Education: Adjusting the Images" (Daryl Hobbs); (2) "Rural Education in a Period of Transition: Are the Public Schools Up to the Task?" (Paul Nachtigal); (3) "Looking at Rural Schools and Communities in the 21st Century: The Impact of Changing Demographics and Economics" (James G. Ward); (4) "Better Together: Rural Schools and Rural Communities" (Toni Haas); (5) "The 'New' Federal and State Education Agenda" (E. Robert Stephens); (6) "Small Is Necessary: Strengthening Rural Schools" (Anne C. Lewis); (7) "The Evolution of a Rural Learning Community" (Dennis D. Gooler); (8) "Technology, Television, and an Out-the-Window Rural Interdisciplinary Curriculum: Or How Thoreau Teaches Social Studies, Language Arts, and Science" (Jim Page); (9) "The Changing Educational Needs of the Rural Student" (V. Pauline Hodges); (10) "Natural Metaphors of Change for Sustainable Rural School Communities" (James A. Lewicki); (11) "Why Rural Education Has Not Received Its "Fair Share" of the Fundingand What To Do about It" (Jonathan Sher); (12) "'At-Risk' Rural Students Benefit from Integrated Approach" (V. Pauline Hodges); (13) "The Critical Role of Rural Teachers in the Educational Reform Movement" (David Leo-Nyquist); (14) "Preparing Students for the Real World" (John Wilcox); (15) "What Administrators of Smaller Schools Do" (Constance M. Perry, Thomas H. Perry); (16) "Rural School Counseling: Turning Obstacles into Opportunities" (Catherine McConnell); (17) "Affirming Culturally Diverse Students with a Literature of Their Own" (Ginny Carney); and (18) "Reform in Mathematics Education: What's a Rural or Small School To Do?" (Jerry Johnson). (LP) ED401073

Karim, G. P., Weate, N. J., & Educational Resources Information Center (U.S.). (1994). Toward the 21st century Rural School Development Outreach Project. [Oak Brook, IL] [Washington, DC]: Ncrel ; U.S. Dept. of Education Office of Educational Research and Improvement Educational Resources Information Center. Ed 1.310/2:401073

Kassouf, A. L., McKee, M., & Mossialos, E. (March 2001). Early entrance to the job market and its effect on adult health: evidence from Brazil. Health Policy and Planning, 16(1), 21-28(28). Objective: To determine the effect of employment in childhood on self-reported health in adulthood.Method: A cross-sectional household survey, with households selected through two-stage sampling, in urban and rural areas in the northeast and southeast of Brazil. A total of 4940 individuals, aged between 18 and 65 years, were included. The main outcome measure was self-reported health.Results: There has been a marked reduction in the proportion of people starting work during childhood although, even in the youngest age group, nearly 20 of males began work when under 10. Early entrance into the labour market is strongly associated with low levels of both education and income, with income differentials remaining at later ages. Age starting work is also linked to current household income, with approximately 35 of those starting work when 15 or over currently in the top quartile of household income, compared with 12 of those starting work when under 10. Males, those living in rural areas, and non-whites are most likely to start work early. In univariate analyses, the younger a person started working, the greater the probability of reporting less than good health status as an adult. This persists through all ages, although the difference attenuates with increasing age. In multivariate analyses, adjustment for education or household income substantially reduces the effect but fails to eliminate it in several age bands up to the age of 48, indicating that age starting work has an independent effect on self-reported health in adulthood.Conclusions: The debate about the appropriate policy response to child labour is complex, requiring a balance between protecting the health of the child and safeguarding the income of the family. These findings indicate the need for more research on the long-term sequelae of beginning work at an early age.

Kaur, M., Singh, S., & Gill, S. (1998). Reforming Primary Education in Rural Punjab. Man & development, 20(4), 103.

Kelley, M., & MacLean, M. (1997). Interdisciplinary Continuing Education in a Rural and Remote Area: The Approach of the Northern Educational Centre for Aging and Health. Educational gerontology, 23(7), 631.

Kenney, L. M., & Collet-Klingenberg, L. (1 July 2000). Manufacturing and Production Technician Youth Apprenticeship Program: A Partnership. Peabody Journal of Education, 75(3), 51-63(13). For 3 years, a university, a public secondary school, and a manufacturing company have been collaborating in offering an alternative education program to juniors and seniors who are not expected to graduate. The program takes place at the manufacturing site where students who are youth apprentices spend about 20 hr each week in work and another 20 hr in the classroom at the site-all at pay. After 2 successful calendar years in this competency-based program, youth apprentices earn a high school diploma. They are graduating from this program with useful skills, improved behavior, and academic qualifications for higher education. The Youth Apprenticeship (YA) Program meets the manufacturer's demand for skilled high school graduates in a rural area where such candidates are scarce. The program also provides the university with an alternative field site for preparing teachers and conducting research while rendering valuable services in areas of curriculum. Most important, the YA Program adds educational options for the apprentices themselves. The program has been recognized regionally and nationally for its design and effectiveness.

Khan, A., Walley, J., Newell, J., & Imdad, N. (January 2000). Tuberculosis in Pakistan: socio-cultural constraints and opportunities in treatment. Social Science and Medicine, 50(2), 247-254(248). This study explores the extent to which factors related to individuals, the care provision process, and the cultural context influence the behaviour of tuberculosis patients attending TB clinics in rural Pakistan, and examines the effects of disease on their personal lives. Thirty-six patients attending three TB treatment clinics were interviewed in depth. These patients were stratified by stage of treatment (treatment proceeding, treatment completed, default), sex and by rural/urban status. Results indicate that the majority of patients were very poor, but nonetheless initially chose to attend private practitioners. Normally their disease was correctly diagnosed as tuberculosis only after repeated visits to a succession of health care providers. Patients' knowledge about their disease was limited, and doctors gave incorrect or only very limited health education. Most patients reported dissatisfaction with care provided. Almost all patients reported problems with access to treatment, both in terms of time and money; this was particularly true of women, whose freedom to travel in Pakistan is limited. Potential causes of default appeared to be more closely linked to deficiencies in treatment provision rather than patients' unwillingness to comply. Largely because of a perception that TB was incurable, respondents were generally unwilling to disclose that they were undergoing or had undergone TB treatment. For reasons related to confidential access to treatment, this could lead to default, perpetuating the perception of incurability, and hence causing a vicious circle. For TB programmes to be successful in Pakistan, it is essential that this circle is broken; and this can only be done through provision of good quality TB care and education to improve the population's understanding that TB can be cured. In addition, patients' unwillingness to disclose to health care providers that they had already received previous treatment meant that many patients were prescribed incorrect treatment regimes, potentially leading to the emergence of drug-resistant TB. In common with other researchers' findings, no clear differences were found between those who had completed treatment and those who had defaulted from treatment. This study was performed to provide information to assist the researchers to design potential TB treatment delivery strategies, and has proved invaluable for this purpose. Strategies based on findings from the study are currently being assessed using a randomised controlled trial.

Kidala, D., Greiner, T., & Gebre-Medhin, M. (December 2000). Five-year follow-up of a food-based vitamin A intervention in Tanzania. Public Health Nutrition, 3(4), 425-431(427). Objective: To evaluate the long-term effects of a horticultural and nutrition education intervention in rural Tanzania.Design: A quasi-experimental post-test design was used.Setting: The research was carried out in 10 villages in Singida region, Tanzania.Subjects: Mothers and their children aged 6-71 months (n = 236) from an experimental (Ilongero) and control (Ihanja) area were interviewed regarding knowledge and practices related to vitamin A nutrition. Intake of vitamin A-rich foods by the children during the 7 days prior to the interview was recorded. Stools were examined for helminths and serum samples were analysed for retinol and C-reactive protein (CRP) (n = 146) for the children aged 12-71 months.Results: Knowledge and practices were more favourable to vitamin A intake in the experimental area than in the control area, and an increased frequency of intake of green leaves was associated with higher serum retinol values. The experimental area had lower mean serum retinol levels (13.7 mug dl1, n = 75) than the control area (19.3 mug dl1, n = 71). One likely confounder was the higher helminth infestation in the experimental area (n = 75, 79%) than in the control area (n = 71, 49%) (P < 0.001). Children with helminths (n = 94) had a lower mean serum retinol level than those without (n = 52) (12.3 +- 5 vs. 24 +- 10 mug dl1; P = 0.001).Conclusions: Food-based vitamin A programmes can make sustainable improvements in knowledge and dietary practices but these may not necessarily be reflected in increases in serum retinol. Programme implementation and evaluation should take confounders into consideration as, in this case, helminth infestation.

Kilpelainen, M., Terho, E. O., Helenius, H., & Koskenvuo, M. (February 2000). Farm environment in childhood prevents the development of allergies. Clinical & Experimental Allergy, 30(2), 201-208(208). BackgroundA protective effect of infections in early life might explain the firmly reported finding of an inverse association between atopic disorders and large sibships.ObjectiveTo study the effect of childhood farm, rural non-farm and urban environment, as well as family size and other factors on the occurrence of asthma, wheezing and atopic disorders up to young adulthood.MethodsData on lifetime prevalence of physician-diagnosed asthma, allergic rhinitis and/or allergic conjunctivitis, atopic dermatitis, as well as self-reported episodic wheezing from 10 667 Finnish first-year university students aged 18-24 years were collected by a postal questionnaire. Associations of lifetime prevalence of the diseases with living on a farm, in a rural non-farm and urban environment during childhood were estimated by logistic regression analysis. Adjustment was made for potential confounding by gender, parental atopy, parental education, number of older siblings, day care outside the home and passive smoking.ResultsThe childhood farm environment independently reduced the risk for physician-diagnosed allergic rhinitis and/or allergic conjunctivitis (adjusted odds ratio 0.63, 95% CI 0.50-0.79, P < 0.001), and for diagnosed asthma and episodic wheezing analysed together (OR 0.71, 95% CI 0.54-0.93, P < 0.05), but not for atopic dermatitis during lifetime. Urban childhood environment did not show independent increased risk when compared with rural non-farm residence. The inverse association of sibship size with the occurrence of allergic rhinitis and/or allergic conjunctivitis was found among subjects with one (OR 0.86, 95% CI 0.77-0.96, P < 0.01) or at least four older siblings (OR 0.47, 95% CI 0.26-0.84, P < 0.05).ConclusionChildhood farm environment seems to have a protective effect against allergic rhinitis and/or conjunctivitis, and more weakly against asthma and wheezing irrespective of family size. Environmental exposure to immune modulating agents, such as environmental mycobacteria and actinomycetes, favouring manifestation of a nonatopic phenotype could explain the finding.

Kimmel, J. (1997). Rural Wages and Returns to Education: Differences Between Whites, Blacks, and American Indians. Economics of education review, 16(1), 81.

Kinsman, J., Nakiyingi, J., Kamali, A., & Whitworth, J. (1 April 2001). Condom awareness and intended use: gender and religious contrasts among school pupils in rural Masaka, Uganda. AIDS Care, 13(2), 215-220(216). A cross-sectional questionnaire survey examining knowledge, attitudes and intended use of condoms was conducted among 1,821 pupils (mean age = 14.2 years, range = 9-24) from 27 primary and secondary schools in rural south western Uganda. Condom education is not provided in Ugandan schools, but both boys and girls had relatively high overall levels of knowledge, even though boys demonstrated a higher level than girls. This suggests that respondents had successfully obtained reliable information from other sources. Boys and girls had similar and fairly positive attitudes towards condoms, although considerable shyness was expressed, both about discussing condoms with a partner and buying them. Fifty-eight per cent said that they themselves would use a condom if one were available, but girls were far less likely than boys to say so. Roman Catholics (46% of the sample) were less knowledgeable and less positive about condoms than non-Catholics, and the boys in this group, but not the girls, were also much less likely to say they would use one. Possible interventions based on these findings are discussed, and a research agenda for the delivery of assertiveness training to girls is proposed.

Kinsman, J., Nakiyingi, J., Kamali, A., Carpenter, L., Quigley, M., Pool, R., & Whitworth, J. (2001). Evaluation of a comprehensive school-based AIDS education programme in rural Masaka, Uganda. Health Education Research, 16(1), 85-100.

Kitchen, P. R. B., Cawson, J. N., Krishnan, C. M., Barbetti, T. M., & Henderson, M. A. (June 2000). AXILLARY DISSECTION AND DUCTAL CARCINOMA IN SITU OF THE BREAST: A CHANGE IN PRACTICE. Australian and New Zealand Journal of Surgery, 70(6), 419-422(414). Background: Axillary dissection may be associated with significant morbidity and, while it is necessary in the treatment of invasive breast cancer, is not indicated for the treatment of pure ductal carcinoma in situ (DCIS), although it is being performed in a significant number of cases. The present study examined the incidence of elective axillary dissection in the treatment of DCIS cases detected in a mammographic screening programme over a 4-year period, and whether surgeons have changed their practice in this respect.Methods: BreastScreen Victoria records were examined retrospectively for the period from January 1995 to December 1998 to identify patients treated for DCIS. The incidence and indications for axillary surgery were investigated.Results: There were 579 cases of DCIS and 93 (16) had some form of axillary surgery, which was thought to be inappropriate in 57 (10), the latter being performed by 21 city surgeons and 20 rural surgeons. Before surgery, 36 (63) cases were diagnosed by core biopsy or excision, and 21 (37) had imaging and cytology alone for diagnosis. The rate of unnecessary axillary dissections dropped steadily from 14 in 1995 to 4 in 1998, a significant reduction (P = 0.01).Conclusion: The incidence of axillary dissection for DCIS has dropped significantly over the last 4 years in Victoria, possibly due to increased awareness through education and guidelines. Surgeons are now more aware that in situ lesions do not need axillary dissection, and that axillary dissection should not be performed for breast cancer unless invasion has been proved histologically.

Knapczyk, D., Rodes, P., Chung, H., & Chapman, C. (1999). Collaborative Teacher Education in Off-Campus Rural Communities. Rural Special Education Quarterly, 18(3/4), 36-43.

Knodel, J., VanLandingham, M., Saengtienchai, C., & Im-em, W. (May 2001). Older people and AIDS: quantitative evidence of the impact in Thailand. Social Science and Medicine, 52(9), 1313-1327(1315). Discussions of the AIDS epidemic rarely consider the impact on older people except as infected persons. Virtually no systematic quantitative assessments exist of the involvement of parents or other older generation relatives in the living and caretaking arrangements of persons with AIDS in either the West or the developing world. We assess the extent of such types of involvement in Thailand, a country where substantial proportions of elderly parents depend on adult children for support and where co-residence with an adult child is common. Interviews with local key informants in the public health system in rural and urban communities provided quantitative information on a total of 963 adult cases who either had died of AIDS or were currently symptomatic. The results indicate that a substantial proportion of persons with AIDS move back to their communities of origin at some stage of the illness. Two-thirds of the adults who died of an AIDS-related disease either lived with or adjacent to a parent by the terminal stage of illness and a parent, usually the mother, acted as a main caregiver for about half. For 70%, either a parent or other older generation relative provided at least some care. The vast majority of the parents were aged 50 or more and many were aged 60 or older. This extent of older generation involvement appears to be far greater than in Western countries such as the US. We interpret the difference as reflecting the contrasting epidemiological and socio-cultural situations in Thailand and the West. The fact that older people in Thailand, and probably many other developing countries, are extensively impacted by the AIDS epidemic through their involvement with their infected adult children has important implications for public health programs that address caretaker education and social and economic support.

Konadu-Agyemang, K. (August 2000). The Best of Times and the Worst of Times: Structural Adjustment Programs and Uneven Development in Africa: The Case Of Ghana. The Professional Geographer, 52(3), 469-483(415). Since 1983, Ghana has been undergoing World Bank and International Monetary Fund (IMF) sponsored Structural Adjustment Programs (SAPs). The implementation of the SAPs, it is claimed, has arrested Ghana‡s economy from complete collapse, resulted in consistent growth in GDP averaging 6% over the past decade, reduced inflation levels, created budget surplus, and increased export earnings. Compared to the 1970s, these are the best of times indeed. But while these SAPs-derived improvements in the national economy have been recorded at the macro level, the benefits at the micro level are a matter of considerable debate. This study revisits the issue of socioeconomic and spatial disparities that have characterized Ghana since colonial times, emphasizing the period from 1983 when Ghana‡s SAPs began. It examines current patterns of socioeconomic disparities with emphasis on the distribution of, and access to, health, education, basic services, and the like. The study focuses on urban-rural as well as interregional disparities in the country.

Kovacich, J., Arndt, J., & Clark, N. (1998). New Technologies in Distance Education to Increase Access to Rural Health Care. Journal of health education / Association for the Advancement of Health Education, 29(5supp), S41.

Kreitlow, B. W. (1954). Rural education: community backgrounds. New York,: Harper. Lc5146 379.173 379.173.K877r

Kristjansdottir, G., & Vilhjalmsson, R. (1 April 2001). Sociodemographic differences in patterns of sedentary and physically active behavior in older children and adolescents. Acta Paediatrica, 90(4), 429-435(427). Numerous studies have found that involvement in moderate-intensity and strenuous activity has positive effects on health. This study considered the prevalence of different aspects of physical activity and sedentary behavior in 11-16-y-olds based on a representative national survey of 3270 Icelandic primary schoolchildren (91% response rate). All-day sedentary behavior was extremely rare (<1%), and the vast majority (91%) were physically active ( 3 times per week) during school or leisure time, thanks largely to school physical education. Only 39% were physically active ( 3 times per week) during leisure time, and only 29% engaged in regular ( 3 times per week) leisure time strenuous exercise. Girls were more sedentary, less leisure time physically active, and less involved in leisure time strenuous exercise. Sedentary behavior increased and physically active behavior decreased with age, especially after early adolescence. However, there were no age differences in strenuous leisure time exercise. Upper-class students were less sedentary and more physically active during leisure time than working-class students. Finally, rural students were more sedentary during leisure time, and less physically active than students from urban areas. An interaction was found between age and residence when predicting leisure time physical activity, indicating that the inverse age-activity relationship in urban areas is partly reversed in rural areas. Conclusion: Compulsory school physical education frequently failed to translate into voluntary physical involvement. Sociodemographic differences in physical activity were greater during leisure time, than during school and leisure time combined.

Kulkarni, V. (1998). Prof. Sukhatme's Philosophy of Social Change, Rural Development and Education. Journal of the Indian Society of Agricultural Statistics, 51(2/3), 203.

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Laisheng, Y. (1999). Non-native Women in Rural Jiangsu: Management and Education of Marriage and Childbearing. Paper presented at the Jen k‡ou yen chiu.

Lambert, R. P. (19 Mar 1991). Broad Policies, Local Schools: Re-Thinking Rural Education in an Age of Reform., 12pp. In: Reaching Our Potential: Rural Education in the 90's. Conference Proceedings, Rural Education Symposium (Nashville, TN, March 17-20, 1991); see RC 018 473. This paper claims that broad educational policies and the "one best model" approach are not conducive to rural school improvement. It examines the problems with state policies and offers some solutions. Teacher certification has become increasingly narrow. Certification should allow for more generalist certifications, easier access to obtaining additional certifications, and sharing of specialists among schools. Curriculum problems include tracking, an emphasis on improving standardized test scores, and a standardized curriculum based on urban schools. Curriculum should be integrated, non-tracked, hands-on, and community-relevant. Teacher training tends to be biased toward urban, suburban, and affluent schools. Teacher training should offer more rural practicums and exposure to rural issues. Funding strategies based on a "head count" formula do not account for rural transportation costs and local ability to supplement state funds. Funding formulas should be weighted for sparsity and the state should provide funding for specialists it requires each school to have. Accreditation standards are generally based on what is put into a particular school, not on the quality that comes out of the school. Accreditation should be based on such qualities as leadership, high expectations, and respect. Consolidation does not account for the human and financial costs of aggregating students in rural areas. The strengths of small schools should be recognized. (KS) ED342533

Lanjouw, P. (March 2001). Nonfarm Employment and Poverty in Rural El Salvador. World Development, 29(3), 529-547(519). This paper analyzes two complementary data sets to study poverty and the nonfarm sector in rural El Salvador. We find that rural poverty in El Salvador remains acute and significantly higher than in urban areas. While the rural poor are mainly agricultural laborers and marginal farmers, some nonfarm activities are also of importance to the poor. In fact, nonfarm activities in El Salvador account for a significant share of rural employment and income for both the poor and the nonpoor. The poor, on the one hand, are engaged in ''last resort'' nonfarm activities that are not associated with high levels of labor productivity. The nonpoor, on the other, are engaged in productive nonfarm activities which are likely to present a potent force for upward mobility. Significant correlates of these high-productivity occupations include education, infrastructure, location, and gender. While most of the analysis is at the household level, the data also permit some focus on small-scale rural enterprise activities. It appears that in El Salvador very few rural enterprises report utilizing formal credit in setting up their activities. In addition, a significant proportion of enterprises are engaged in subcontracting arrangements with some larger, often urban-based, firm.

Lantz, P., Weigers, M., & House, J. (1997). Education and Income Differentials in Breast and Cervical Cancer Screening: Policy Implications for Rural Women. Medical care, 35(3), 219.

Larsen, E. (Dec 1993). A Survey of the Current Status of Rural Education Research (1986-1993)., 16p. This report reviews research on rural education produced between 1986 and 1993. The review focuses on equity of educational opportunity; financial, curricular, and staffing issues; research agendas; and educational reform. The literature demonstrates that educational opportunity for rural school populations often is substandard, especially when compared to those in urban settings. The difficulties involved in achieving educational equity in rural areas include eliminating disparity in educational funding, reaching an agreement on what constitutes a rural school district, and finding alternative ways to provide educational services to special student populations. Frequently cited as a major problem is the recruitment, training, and retention of teachers in rural school districts. This is compounded by geographic isolation for both teachers and administrators in rural areas. Another concern is the need for school personnel to receive additional training to increase awareness of rural school and community relations. In recent years, the U.S. Department of Education has established a commitment to promote educational parity in rural schools. To strengthen this commitment, the federal government must establish research priorities through the development of empirical databases on rural education policy and practice. Current research on rural education reveals that most, if not all, of the solutions provided by educational policymakers fail to recognize the unique differences and needs of rural settings. Contains 47 references. (LP) ED366482

LaSala, K., Hopper, S., & Shipe, D. (1997). Rural Health Care and Interdisciplinary Education. Nursing and health care perspectives, 18(6), 292.

Latimer, M. (1 July 2000). A CONTEXTUAL ANALYSIS OF THE EFFECTS OF GENDER AND PLACE ON WORKERS INCOMES. Sociological Spectrum, 20(3), 345-356(312). This research uses the 1987 National Longitudinal Surveys of Youth to construct a national and Appalachian subsample of workers at the initial stages of their labor force participation and during a national economic recovery. This contextual research examines the impact of education, work effort, type of job, marital status, family size, Appalachian residence, urban or rural location, unemployment rate, and manufacturing concentration on the incomes of women and men. The results document the overall depressive effect that living in Appalachia has on the incomes of both male and female workers.

Lawrence, B. K. (May 1999). Praxis to Practice: Putting Qualitative Methods To Work for Rural Education., Paper presented at the Annual Qualitative Research in Rural Education Conference (1st, Morgantown, WV, May 20-21, 1999). This paper examines issues and areas of concern for the educational researcher moving from the relative safety of academic research to the more perilous arena of practice-oriented or action-oriented qualitative research. The first question is one of purity or objectivity: giving credibility to research results by imposing adequate rigor on methods and interpretation to offset the agenda of a financial supporter or to balance the researcher's own perspective or ambitions. The second question regards the ethics of research. The action researcher has no more license to harm than does the academic researcher. It is argued that the applied or action researcher must have higher standards of ethics as the research subjects will not be anonymous and their lives or careers could be negatively affected. Next is the question of powerthe aura around "research" that elevates the researcher over his or her subjects, as well as the power of the qualitative research process to distort the researcher's perspective and judgment. Finally, there are the double questions of applicability and accountability. The action researcher must face not only the prospect of sharing research findings but also of seeing those findings tested and applied. Seven questions are posed to researchers concerning how to put qualitative methods to work for rural education. A table compares 10 aspects of academic, pedagogical, and applied/action research. (SV) ED436326

Lawson, K., Chew, M., & VanDerWeyden, M. (2000). A revolution in rural and remote Australia: bringing health education to the bush. Medical Journal of Australia, 173(11/12), 618-624.

Lee, M. H., Ed. (20 Mar 1991). Reaching Our Potential: Rural Education in the 90s. Conference Proceedings. Rural Education Symposium (Nashville, Tennessee, March 17-20, 1991)., 916pp. For selected individual papers, see ED 334 082, RC 018 474-513, and RC 018 515-533. This proceedings contains approximately 92 presentations focusing on rural education and rural special education. Topics include: meeting the needs of handicapped and disabled students in rural areas; education and inservice training of special education teachers; teacher cooperation models; higher education of at-risk students; rural teacher education; job satisfaction and burnout among rural teachers; transition from school to work for learning disabled and other special education students; school-community and school- business partnerships; teaching methods, educational strategies, and alternative instruction for at-risk students; educational cooperation between districts; culturally relevant education for rural areas; distance learning technology for rural education and information access; vocational special education; dropout prevention programs and strategies; issues for rural public colleges and universities; effects on rural schools of reform legislation and "one best model" approaches; issues related to educational diagnosis and identification of at-risk students; national survey of at-risk status in rural, urban, and suburban schools; multigrade instruction; substance abuse prevention; organizational structure of rural schools; supported employment in rural areas; education for gifted students; negative effects of grade repetition on at-risk students; the role of the rural special education administrator; and social skills instruction for rural special education students. (SV) ED342521

Lee, W. (1997). Music Education and Rural Reform: 1900-1925. Journal of research in music education, 45(2), 306.

Leggat, P. A. (1 May 2000). Learning experiences in medical education. Medical Teacher, 22(3), 288-292(285). This paper explores learning experiences from both a general and a medical education perspective. A broad range of learning experiences, both planned and incidental, are identified. The former is dealt with in greater detail as it would seem to have more immediate practical relevance. Ultimately, all learning experiences should in some way be linked to the stated learning objectives. Planned learning experiences cover such traditional teaching-learning methods as lectures, tutorials, projects and assignments. The application and explosion of new technologies is also discussed. Modern computer, video and Internet technology is playing an increasing role in medical education, particularly in bringing rural and remote participants into closer contact with their city counterparts. The advantages and disadvantages of each approach are examined. A successful approach to teaching and learning in medical education is likely to involve the application of a number of different types of learning experiences.

Lentz, R. G., & Oden, M. D. (June 2001). Digital divide or digital opportunity in the Mississippi Delta region of the US. Telecommunications Policy, 25(5), 291-313(223). This study analyzes the interdependence of telecommunications manufacturing, services, and user industries in the Mississippi Delta region of the US to understand the social and economic prospects of poorer rural areas of the US as advanced technologies rapidly proliferate. An underlying assumption is that telecommunications industries should not be viewed only by the employment they directly support; they should also be analyzed in terms of their linkages to other industries and how those linkages influence the competitiveness and growth prospects of businesses and public institutions in the region by building a capable community of technology users. The absence of leading telecom manufacturing and service firms in rural Delta counties together with low levels of connectivity suggest that digital divide problems are very real for the region. The central economic development challenge should be to ensure that rural businesses, government, health care, education, and non-profit institutions gain access to an advanced telecommunications infrastructure and that they develop the capacity to leverage this access to enhance their performance and expand their reach.

Leversha, A. (1999). Rural health education. Australian journal of hospital pharmacy, 29(2), 117.

Leversha, A., Strasser, R., & Teed, A. (February 2001). Training and support program for pharmacists in rural Victoria. Australian Journal of Rural Health, 9(1), 7-11(15). The `Rural Pharmacist Training and Support Program' was a pilot project that was conducted by the Monash University Centre for Rural Health. It examined the implementation of Pharmacy Board of Victoria Guidelines to Residential Care Facilities in the Loddon Mallee region of Victoria. Through a series of workshops, pharmacists were encouraged to discuss and address difficulties that were impeding implementation of the guidelines. These included upskilling in clinical pharmacy and ways to overcome the shortage of pharmacists in rural areas. Furthermore, the project was a catalyst for eight additional outcomes. This project highlighted the challenges facing rural pharmacists as they seek to implement the guidelines and resulted in a number of recommendations that addressed workforce issues, training and continuing education, Pharmacy Board requirements, improved communication with other health professionals and undergraduate training.

Liangiu, Y. (1999). A Summary of the National Working Conference on Community Education in Rural Areas. Chiao y{‡}u yen chiu, 20(9), 37.

Liesenfeld, B., Renner, R., Neese, M., & Hepp, K. D. (20 December 2000). Telemedical Care Reduces Hypoglycemias and Improves Glycemic Control in Children and Adolescents with Type 1 Diabetes. Diabetes Technology & Therapeutics, 2(4), 561-567(567). Education programs for intensive insulin therapy were found to be valuable in improving glycemic control, but, due to low prevalence of type 1 diabetes in children and adolescents, access to those programs varies considerably in rural areas. We report on a telemedical care program that overcomes geographical isolation of patients on intensive insulin therapy. Sixty-one children and adolescents under the age of 26 participated in a telemedical care program. They stored daily information on blood glucose, injected insulin, meals and exercise in a glucosemeter with electronic memory and transferred the data via modem go a remote diabetes center outside of the region. By individual telephone consultations from home, they reviewed the data with a diabetologist at the diabetes center and adjusted their intensive insulin therapy in order to achieve predefined treatment goals. Patients were trained for 19 (6-48) weeks in the program and measured blood glucose 4.9 (1.7-4.9) times daily. Compared to the run-in-period, mean blood glucose had decreased (167 to 158 mg/dL, p < 0.01), standard deviation of blood glucose had decreased (81 to 70 mg/dL, p < 0.001), and frequency of hypoglycemia had decreased (5.2 to 3.3 in 4 weeks, p = 0.01) at the end of the program. The proportion of blood glucose values within the target range (80-180 mg/dL) had increased (47-55%, p < 0.001). HbA1c was reduced by 0.4% (-3.8 to +2.2%, p < 0.05). Telemedical care for intensive insulin therapy is safe, can improve glycemic control, and reduce the number of hypoglycemias in children and adolescents with type 1 diabetes.

Liu, L., & Miyazaki, M. (10 August 2000). Telerehabilitation at the University of Alberta. Journal of Telemedicine and Telecare, 6(4), 47-49(43). We established a telerehabilitation system to link staff at the University of Alberta with clinicians and students located in Two Hills, a rural community approximately 180 km east of Edmonton. From February 1996 to March 1999, the Faculty of Rehabilitation Medicine conducted a total of 254 telehealth sessions, most of which involved participants in the rehabilitation discipline. Of these connections, only 11 were unsuccessful owing to technical or telecommunication problems (i.e. 96% were successful). The average duration of a session was 1 h 15 min. There were benefits to the Faculty in the areas of clinical supervision of students, clinical consultation, undergraduate and graduate education as well as professional development. The future benefits of such an initiative will depend on how well we address challenges pertaining to training, human resource and infrastructure.

Lloyd-Williams, M., Wilkinson, C., & Lloyd-Williams, F. (September 2000). General Practitioners in North Wales: current experiences of palliative care. European Journal of Cancer Care, 9(3), 138-143(136). Much work on the role of general practitioners within palliative care has focused on those working in densely populated inner city areas. This study was undertaken to evaluate the provision of palliative care and training needs of general practitioners in North Wales, a predominantly rural area. Questionnaires were sent to all 240 GPs and 94 responded (40); those GPs responding were younger and mainly worked within partnerships. During the preceding year a median of four terminally ill patients had been cared for by each GP (range 0-21). General practitioners believed that palliative care was an important part of their role and applicable to patients with all end stage diseases. Use was made of community hospital beds as these were perceived as being more convenient for the patients and allowed the GPs to continue their involvement in patient care. Where services-e.g. palliative care consultants, day care and Marie Curie care-is available this was perceived as being very useful and of benefit. General practitioners believed they would benefit from further education and teaching on all aspects of palliative care, and this was supported by just over 50 of doctors knowing the correct breakthrough doses of morphine and many stating they would not prescribe more than a certain dose of opiates. Training in palliative care during vocational training was poor or non-existent and a preference was expressed for experiential teaching.

Long, K., Scharff, J., & Weinert, C. (1997). Advanced Education for the Role of Rural Nurse Generalist. JNE. Journal of nursing education, 36(2), 91.

Lopez, R., & Valdes, A. (2000). Fighting Rural Poverty in Latin America: New Evidence of the Effects of Education, Demographics, and Access to Land. Economic Development and Cultural Change, 49(1), 197-212.

Luchs, M. (2001). The Education of the Rural Librarian: Advantages and Obstacles. Rural Libraries, 21(1), 51-63.

Ludlow, B. (1998). Preparing Special Education Personnel for Rural Schools: Current Practices and Future Directions. Journal of research in rural education, 14(2), 57.

Ludlow, B., & Brannan, S. (1999). Distance Education Programs for Preparing Personnel for Rural Areas: Current Practices, Emerging Trends, and Future Directions. Rural Special Education Quarterly, 18(3/4), 5-20.

Lund, P. M. (February 2001). Health and education of children with albinism in Zimbabwe. Health Education Research, 16(1), 1-7(7). Albinism is a relatively common genetic condition in Zimbabwe, a tropical country in southern Africa. Those affected have little pigment in their hair, skin or eyes, in sharp contrast to the normal dark pigmentation. This article describes the responses to a self-report questionnaire covering health, social and educational aspects completed by 138 schoolchildren with albinism living in rural areas of Zimbabwe. They reported persistent skin and a myriad of eye problems. Relationships between siblings appeared good, although problems of antagonism, avoidance and fear were encountered among strangers. Knowledge about albinism was patchy; pupils were keen to be better informed. This research highlights the need for widespread dissemination of accurate information about the genetics and health management of albinism to counter the many myths and misconceptions surrounding this condition. A management programme to promote the health and education of these children in southern Africa is proposed. In conclusion, this study indicated that pupils with albinism could participate in mainstream education, with appropriate intervention to help them manage the problems associated with their low vision and sensitive skins.

Luo, J., & Wendel, F. (1999). Elementary School Education in Rural China. The Rural educator, 21(1), 1.

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Ma, W. H.-t., Lee, J. C.-k., & Leung, H. C.-w. (1997). Consolidation of Rural Education in Hong Kong and Australia. Paper presented at the Education in Rural Australia, 7, 2, 13-19 1997. Overviews factors that influenced school consolidation and the development of centralized elementary schools in rural Hong Kong since the mid-1980s, including changes in urban development, population redistribution, and government policy on rural education. Also describes the context of rural school consolidation in the Wimmera, Victoria, Australia. Addresses the economic, educational, and community consequences of school consolidation. (LP) EJ552825

Ma, W., Lee, J., & Leung, H. (1997). Consolidation of Rural Education in Hong Kong and Australia. Education in rural Australia, 7(2), 13.

Martorell, R., Kettel, K. L., Hughes, M. L., Grummer-Strawn, L. M., & Correspondence:, R. M. (March 2000). Obesity in women from developing countries. European Journal of Clinical Nutrition, 54(3), 247-252(246). Objectives: The key objective was to estimate obesity (30 kgm2) in women 15-49 y from developing countries. A second objective was to study how obesity varies by educational level and by residence in urban and rural areas. A third objective was to investigate how national incomes shape the relationship between obesity and eduction or residence. Design: The analyses use cross-sectional data from nationally representative surveys from developing countries carried out in the last decade. Most of the surveys were Demographic Health Surveys (DHS). Data from a survey from the USA are used for comparison. Setting:The 39 surveys used come from 38 developing countries and the USA. Subjects: A total of 147,938 non-pregnant women 15-49 y were included in the analyses. Results: The percentage of obese women was 0.1 in South Asia, 2.5 in Sub-Saharan Africa, 9.6 in Latin America and the Caribbean, 15.4 in Central Eastern EuropeCommonwealth of Independent States (CEECIS), 17.2 in the Middle East and North Africa, and 20.7 in the USA. Levels of obesity in countries increased sharply until a gross national product of US1500 per capita (1992 values) was reached and changed little thereafter. In very poor countries, such as in Sub-Saharan Africa, obesity levels were greatly concentrated among urban and higher educated women. In more developed countries, such as those in Latin America and the CEECIS regions, obesity levels were more equally distributed in the general population. Conclusions: Based on the analyses presented and on a review of the literature, it is concluded that obesity among women is a serious problem in Latin America and the Caribbean, the Middle East and North Africa, and the CEECIS region. Obesity is less of a concern in Sub-Saharan Africa, China and South Asia. Obesity levels increased over time in most of the limited number of countries with data, but at varying rates. Rising national incomes in developing countries and increased `Westernization' will most likely lead to increased levels of obesity in the future. Sponsorship: Financial support was provided by the Food and Nutrition Program of the Pan American Health Organization and by the World Bank. European Journal of Clinical Nutrition (2000) 54, 247-252

Martorell, R., Khan, L. K., Hughes, M. L., Grummer-Strawn, L. M., & Correspondence:, R. M. (August 2000). International Journal of Obesity, 24(8), 959-967(959). OBJECTIVES: To estimate levels and trends in overweight and obesity in preschool children from developing countries; to study how overweight varies by the educational level of the mother, by urban or rural residence, and by gender; to investigate how these relationships are related to the gross national product (GNP). DESIGN: 71 national nutrition surveys since 1986 from 50 countries were used. SUBJECTS: 150,482 children 12 to 60 months from the most recent survey from each country were the primary sample. MEASUREMENTS: Overweight and obesity were defined as weight-for-height (>1 or >2 s.d., respectively) of the WHONCHS reference curves. Stunting was <2 s.d. of the same reference. Urban was as defined in each of the surveys and higher education was defined as at least one year of secondary schooling or higher. RESULTS: 32 of 50 countries had a prevalence of obesity below 2.3, the value in the reference population. The prevalences of overweight and obesity were lowest in Asia and in Sub-Saharan Africa. In 17 countries with serial data, no consistent regional trends could be detected. Overweight was more common in urban areas, in children of mothers with higher education, and in girls; these relationships did not differ by GNP but GNP was related negatively to stunting and positively to overweight. CONCLUSIONS: Obesity does not appear to be a public health problem among preschool children in Asia and Sub-Saharan Africa. In a number of countries in Latin America and the Caribbean, the Middle East and North Africa, and the region of Central Eastern EuropeCommonwealth of Independent States, levels are as high as in the United States. International Journal of Obesity (2000) 24, 959-967

Maudlin, R., Newkirk, G., Snook, M., & Cooper, G. (2000). Changes and Challenges in Rural Graduate Medical Education: The Family Medicine Spokane Rural Training Track Experience in Colville, Wash. Journal of Rural Health, 16(3), 232-236.

Maxwell, T. W. (1991). Professional Development Policy in a Small Rural Education System. Paper presented at the Australian Journal of Education, 35, 1, 89-106 Apr 1991. Professional development policy of a small, rural education system in New South Wales (Australia) allows control of staff development at system, school, and individual levels; and identifies a rationale and aim, assumptions, principles of procedure, and characteristics of a healthy professional learning environment. These features guide implementation models and processes. (MSE) EJ430196

McCosker, H., Madl, R., & Mannion, J. (1999). Evaluation of a self-paced education package on violence against women for rural community-based health workers. The Australian journal of rural health, 7(1), 5.

McGranahan, D. (2001). New Economy Manufacturing Meets Old Economy Education Policies in the Rural South. Rural America, 15(4), 19-27.

McKee, M., Pomerleau, J., Robertson, A., Pudule, I., Grinberga, D., Kadziauskiene, K., Abaravicius, A., & Vaask, S. (May 2000). Alcohol consumption in the Baltic Republics. Journal of Epidemiology & Community Health, 54(5), 361-366(366). Study objectivesPremature mortality associated with alcohol intake is of particular concern in several countries of the former Soviet Union. This study explored self reported alcohol consumption (beer, wine, spirits) and its determinants in the Baltic Republics.DesignCross sectional surveys conducted in 1997.SettingsEstonia, Latvia and Lithuania.ParticipantsRepresentative samples of adults age 19-64 (Estonia n=2010; Latvia n=2258; Lithuania n=2139).MethodsBetween country differences in the frequency of alcohol intake were estimated. The odds of consuming alcohol weekly according to socioeconomic characteristics (age, ethnicity, rural/urban area, education, income) were calculated using multiple logistic regression analyses, adjusting for all variables simultaneously.Main resultsThe proportion of respondents consuming alcohol weekly varied by country (p<0.001) (men: Estonia=61 Latvia=41 Lithuania=55; women: Estonia=26 Latvia=8 Lithuania=14). Within each country, this proportion decreased with age in both sexes (p<0.001), and increased with income in women (p<0.01). In Estonia, the odds of drinking alcohol weekly was significantly lower in respondents of Russian than of Estonian ethnicity (odds ratios (OR) and 95 confidence intervals (95CI): men=0.51 (0.36, 0.71); women=0.57 (0.39, 0.81)). In Lithuania, the odds was higher in highly educated men than in those with a low education level (OR=1.48 (1.01, 2.17)). Daily alcohol intake was higher in Estonia than in the other countries, as was the percentage of respondents drinking heavily (equivalent to 80 g/day).ConclusionsApproximately half the men and one in six women in the Baltic States reported consuming alcohol at least weekly. Age and income were the strongest and most consistent correlates of the likelihood of consuming alcohol weekly. Ethnic differences were observed only in Estonia.

McLean, D. (1997). Rural Alaska Native Perceptions of Cultural Transmission: Implications for Education. Journal of American Indian education, 36(3), 16.

McShane, M., Ed., & Walton, J., Ed. (Jun 1990). "Think Tank" on Research into Rural Education. Proceedings of the Conference Held by the Rural Education Research and Development Centre (Townsville, Queensland, Australia June 10-14, 1990)., 210pp. For three selected individual papers (out of 21), see RC 020 272-274. A conference was held to develop a plan of research into rural education in Australia and to form a consortium of rural education researchers. Part I of this proceedings contains an introductory paper, "Rural Education: The State of the Art" (Steve Clark), which analyzes research in rural education in Australia in recent decades with regard to four themes: schooling (teachers, students, school- community relationships, accommodation); technology; educational delivery (equal opportunity, curriculum, decentralization, service delivery, models); and the dichotomy between education in rural areas and rural education. Part II contains papers or summaries of papers on Australian rural research, criteria for prioritizing research, education of Aborigines and Torres Strait Islanders, education and training needs of rural women and girls, applications of communications technology in education, symbiotic relationships between rural schools and their communities, education in rural Scotland, national assessment of the Country Areas Program, and a model of educational delivery in remote areas. Part III outlines the "think tank" discussion and decision making process; summarizes working groups and plenary sessions; presents reflections of working group members; lists and ranks all research recommendations of the working groups; and lists immediate research priorities in the areas of schooling, community, delivery, technology, and special needs groups. Appendices contain the conference schedule, list of participants, and description of research activities at the University of Western Australia. (SV) ED386364

McSwan, D. (1994). The Rural Education Research and Development Centre. Paper presented at the Theme issue topic: "Rural Development, Policy, and Education in Australia.". Discusses the history, structure, activities, and goals of the Rural Education Research and Development Centre (RERDC), an academic unit of James Cook University (North Queensland, Australia). Since the 1980s, RERDC has conducted educational research, provided training for rural teachers and other rural professionals, and held conferences concerning rural education issues. (LP) EJ488512

McSwan, D. I. (1992). Rural Education Research & Development Center Report 1992., 50p. This report describes the activities of the Rural Education Research and Development Centre at James Cook University (Queensland, Australia). The center is responsible for implementing research into rural education, training teachers to work in rural areas, and implementing projects related to rural education. The center is an academic unit administratively supported by the university, but largely funded from community, business, and industry sources. Center activities have included: (1) a conference in 1990 highlighting rural education research that led to the formation of the Rural Education Research Association and the establishment of a network for parents, teachers, community groups, and researchers to focus on research issues and priorities in rural education; (2) development of a rural education database that promotes communication among researchers, teachers, parents, and community organizations; (3) implementation of rural education undergraduate and graduate courses, and development of a Masters and Ph.D. program in rural education; (4) sponsoring research relating to access of rural communities to higher education, statistical comparison of rural and urban completion rates in tertiary education, and needs analysis of federally funded education programs. The report also contains a listing of national and international associations affiliated with the center; future developments concerning teaching, research, and conferences; and information pertaining to management and finances. Appendices include information on program endowment and development. (LP) ED363461

Mennen, L. I., Jackson, M., Cade, J., Mbanya, J. C., Lafay, L., Sharma, S., Walker, S., Chungong, S., Wilks, R., Balkau, B., Forrester, T., Cruickshank, J. K., & Correspondence:, L. I. M. (July 2000). Underreporting of energy intake in four populations of African origin. International Journal of Obesity, 24(7), 882-887(886). OBJECTIVE: To investigate the frequency of dietary underreporting in four African populations in different geographic and cultural settings. SUBJECTS: Seven-hundred and forty three men and women from rural Cameroon, 1042 men and women from urban Cameroon, 857 men and women from Jamaica and 243 male and female African Caribbeans from the UK. Subjects who reported dieting or weight control were excluded. MEASUREMENTS: Habitual dietary intake was estimated with a quantitative food frequency questionnaire, developed specifically for each country. Underreporting was defined using three cut-off levels for energy intakeestimated basic metabolic rate (EIBMRest), based on age, sex and weight, in each site. RESULTS: The EIBMRest was highest in rural Cameroonian men at 3.07 (95 confidence interval: 2.97, 3.17) and women at 2.84 (2.74, 2.94), intermediate in urban Cameroon and Jamaica and lowest in the UK men and women at 1.44 (1.26, 1.62) and 1.41 (1.21, 1.61). This trend existed even after adjustment for age, BMI and education (P for trend<0.0001). The trend in the frequency of underreporting using the lowest cut-off level for EIBMRest of 1.15 was 6 and 6 in rural Cameroon for women and men, respectively, 4 and 5 in urban Cameroon, 24 and 19 in Jamaica and 28 and 39 in the UK. With higher cut off levels this trend was similar. CONCLUSION: The results suggest that the frequency of dietary underreporting differs between societies and that Westernization may be one of the factors underlying this phenomenon. International Journal of Obesity (2000) 24, 882-887

Merrett, C. D., & Gruidl, J. J. (August 2000). Small Business Ownership in Illinois: The Effect of Gender and Location on Entrepreneurial Success. The Professional Geographer, 52(3), 425-436(412). Forty percent of all firms in the United States are owned and operated by women. At current growth rates, women could own 50% of the nation‡s businesses by the turn of the century. Women have been prompted to start their businesses for many reasons, including the desire to avoid gender-based discrimination in the workplace. But female entrepreneurs who venture out on their own must still contend with gender discrimination. This study examines female entrepreneurship in Illinois through rural versus urban comparisons of male and female business owners. We surveyed 4,200 business owners to test the hypothesis that gender and geographic location combined to hinder the entrepreneurial success of women. Business owners were asked about personal attributes including gender, work experience, education, training, and prior career status. Entrepreneurs were also asked about firm characteristics such as financing sources, number of employees, revenues, problems encountered during startup, sector of new firm, geographic location, and the importance of selected community characteristics. Our results show that rural female entrepreneurs face more obstacles to business success than their male or urban female counterparts.

Meyer, L. H. (1 March 2001). The Impact of Inclusion on Children's Lives: multiple outcomes, and friendship in particular. International Journal of Disability, Development and Education, 48(1), 9-31(23). This paper describes the work of a Consortium for Collaborative Research on the Social Relationships of Children and Youth with Diverse Abilities. The Consortium was a 5 year research institute funded by the US Department of Education, carrying out research in the Los Angeles, San Francisco, and Sacramento areas of California; the Seattle and rural-suburban regions of Washington State; New York State including New York City, Syracuse and rural regions; and Maryland. The work was undertaken in rural, urban, and suburban school districts, with a demographically diverse population, and also directly with families. This paper shares the results of research findings on children's social lives in inclusive settings, while weaving a theme throughout the presentation of how this research was done. The focus was upon the role research should play and was directed toward closing the gap between research and practice.

Miller, W. W., & And, O. (1995). A Perspective on Rural Education. Paper presented at the Theme issue. Includes "Perspective on Rural Education" (Miller); "You Want Them to Learn What?" (Jones); "Rural Education" (Baker, Burns); "Metnet" (Frick); "Rural Education and Training in Egypt" (Swan, Aly); "Mentors, Youth at Risk, and Rural Education Programs" (Wingenbach); "Designing Effective Adult Education Programs: Needs and Objectives" and "Design, Delivery & Evaluation" (Wilson, Talbert). (SK) EJ514308

Misra, R., & Aguillon, S. (2001). Predictors of health behaviors in rural adolescents. Health Education, 101(1), 22-31(10). he aim of this study was to examine the relationships between cognitive variables, health perceptions and knowledge, and health behaviors in a sample of rural adolescents using Bandura's Social Cognitive Theory. The dependent variables are the dietary habits and physical activity. An anonymously written survey was administered to 124 students at a high school serving primarily lower-income to middle-income children in a small mid-western city in the USA. Personal, environmental, and behavioral factors were examined. The results showed that boys perceived themselves as healthier, and were more active, than girls. However, girls had slightly better dietary habits, a difference which was significant, and displayed a higher score in personal characteristics than boys. The amount of physical activity was the strongest predictor of respondents' dietary habits. Respondents' perception of their health condition emerged as the strongest predictor of their level of physical activity followed by their nutrition score, leadership characteristics, and age. Age was negatively associated with physical activity; in other words younger respondents had higher activity levels. Although health knowledge predicted respondents' dietary habits, it did not influence their level of physical activity. Communities must be prepared to provide age-appropriate health education and prevention programs for the adolescent population. The assessment and the enhancement of health education for adolescents in rural areas can lead to improved health behaviors and help reach the goals set for health. Missouri. Dept. of Education., & Missouri. Dept. of Education. Division of Public Schools. Report of the public schools of the State of Missouri. Jefferson City: Carter & Regan state printers and binders. L168.b15 379.778 23-Ed8 1:

Montella, M., Buonanno, M., Biondi, E., Crispo, A., De, M. M., Tamburini, M., Botti, G., Fabbrocini, G., Capasso, I., & DAiuto, G. (February 2000). Changing Patterns of Breast Cancer Stage at Diagnosis in Southern Italy: Hospital Data as Indicators of Progressive Changes. Preventive Medicine, 30(2), 174-177(174). Background. In southern Italy diagnostic delay in breast cancer patients has been demonstrated to be related to the level of education and residency in rural areas. In order to verify whether late breast cancer diagnosis was actually in decline as a result of improving socioeconomic conditions and ongoing prevention programs, we evaluated clinical data from the tumor registry of the National Cancer Institute, Naples.Methods. Four thousand two hundred forty consecutive breast cancer patients admitted to our institution from 1986 to 1997 were grouped into four 3-year periods according to their admission date. Using multiple logistic regression, chi2 for trend and beta-coefficient were calculated in each pT and pN categories in order to discover the trend for the 1986-1997 period.Results. A progressive, statistically significant decrease in the number of patients with advanced cancer at the time of diagnosis was observed over the study period. In particular, chi2 values for trend for each pT category, over the study period, were pT1 119.4 (P < 0.001) with positive chi-coefficient, pT2 13.4 (P = 0.003) with negative beta, and pT3-pT4 152.2 (P < 0.001) with the strongest negative beta.Conclusions. Changing patterns of breast cancer stage at diagnosis have been demonstrated in women living in Southern Italy. They are consistent with an increasing orientation toward prevention. Data from hospital tumor registries are a useful source of information on diagnostic delay. Copyright 2000 American Health Foundation and Academic Press.

Mostafa, G., & van, G. J. K. (March 2000). Trends in and determinants of mortality in the elderly population of Matlab, Bangladesh. Social Science and Medicine, 50(6), 763-771(769). Longitudinal data collected from the Demographic Surveillance System (DSS) in Matlab, a rural area in Bangladesh, are used for determining trends in and determinants of mortality of the elderly population (60 yr and over) in 1974-1996. The old-age mortality rate is high in Matlab, 1.2 times that of Sri Lankan and 1.5 times that of the Swedish elderly population in a comparable period. Mortality among the elderly population declined in 1974-1982, but much less so in 1982-1996.Proportional hazards models were used for examining determinants of mortality in a sample of about 10,000 elderly persons. This multivariate analysis used information on several social and economic variables derived from the 1982 census and mortality data of this population which was followed prospectively in 1982-1992. Marital status was the single most important determinant: widows and widowers had 1.5 to 2 times higher risk of death compared to couples where both husbands and wives were alive. Social support in old age by children also plays a role, especially for women: women living with at least one son or daughter had 18% lower mortality than women living in a household without sons or daughters. Socioeconomic factors are also important. Those who had at least some education or were relatively affluent had lower mortality than those with no education or who were less affluent.

Mukherjee, S., Lightfoot, J., & Sloper, P. (1 April 2000). The inclusion of pupils with a chronic health condition in mainstream school: what does it mean for teachers? Educational Research, 42(1), 59-72(14). This paper reports on a study which investigated the support needs of pupils in mainstream school with a chronic illness or physical disability. The research was carried out in three local education authorities covering both rural and urban areas. In-depth, qualitative data were collected from 33 pupils in secondary school; 58 parents of primary and secondary school pupils; and 34 primary and secondary school teachers. Overall, the data from young people suggest variability in the support offered to pupils by teachers, even by teachers within the same school, and highlights the importance of teachers' awareness and understanding of special health needs. A number of areas where young people need support from teachers were identified, including: dealing with school absence; taking part in school activities; peer relationships; explaining the condition to other pupils; and having someone to talk to about health-related worries. Data from teachers and parents indicate that school staff need assistance with obtaining health-related information; ensuring health-related information is passed between and within schools; providing emotional support; the provision of medical care; and coordinating support for this group of pupils. The implications of the findings for teachers, schools and educational policy are discussed.

Murdoch, C., Ed., & Wood, G., Ed. (1997). Celebrating Rural Education. Proceedings of the National Conference of the Society for the Provision of Education in Rural Australia (SPERA) (13th, Adelaide, South Australia, July 6-8, 1997)., For selected individual papers, see RC 021 944-954. Page Length: 177. This conference proceedings of the Society for the Provision of Education in Rural Australia (SPERA) contains 19 presentations and workshops. An introductory section includes SPERA's mission, goals, and history; a brief welcome address by SPERA president Sheila King; a list of past conference proceedings; and abstracts of presentations. The presentations are: (1) "Celebrating Connnectedness" (Robin Maslen); (2) "Successes of a Rural University: Whyalla Campus, University of South Australia" (Jim Harvey); (3) "Health and Safety for Young People in Rural Areas" (Stephen Parker); (4) "Self-Esteem in Rural Schools: Dreams and Aspirations" (Deidra J. Young); (5) "Rural and Remote Professional Practice Placements for Children's Studies Students" (Stephanie Jackiewicz, Rosa Lincoln, Kristen Brockman); (6) "First Year University in Retrospect: The Voices of Rural Students" (Brian Hemmings, Doug Hill, David Ray); (7) "Rural Students Continuing Their Studies in University Contexts" (Brian Hemmings, Russell Kay, Doug Hill); (8) "Leigh Creek Area School-Royal Zoological Society of South Australia Yellow-Footed Rock-Wallaby (Andu) Reintroduction Project" (Colin Murdoch, Katie Bedding); (9) "Delivering the Arts Curriculum in Isolated Settings: Outback Eisteddfod" (Ray Marino); (10) "Partnerships, Technology and Teaching: Celebrating the Link between Universities and Rural Communities" (Ian W. Gibson, Sheila King); (11) "Incidental Education (for Women) in Rural Communities" (Valmai Crosby); (12) "Celebrating Distance Teaching Innovations: The Certificate in Distance Teaching" (Colin Boylan, Juhani Tuovinen); (13) "Literacy Networks in the Community" (Karen Gardner, Sue Fairley, Henry Condon); (14) "A Picture Postcard Perspective of Rural Communities" (Sheila King); (15) "Identification of Barriers That Confront Rural Students Entering the University System" (Jennifer Roe); (16) "The Emotional Transition of Twelve Year Olds from Home to a Boarding Situation" (Katrina Mason); (17) "A Focus on Rural Australia for Students at the University of Ballarat" (Keith Moore); (18) "Forum: Student Reflection on Successful Rural Education" (Carrie-ann Mickan, Neralie Rowan); and (19) "What Is Ag-Ed?" (Judy Lindley). (SV) ED429788

Murray-Harvey, H. C. S. A. R. (19 July 2000). Students as a central concern School, students and outcome measures. Journal of Educational Administration, 38(3), 230-246(217). Recent preliminary research in secondary schools suggests that indicators other than the traditional performance outcome measures of school achievement can be used to differentiate between school performance. These indicators are student factors that have been associated with accepted notions of quality schooling outcomes, such as student attitude to school, their approaches to learning and their academic self-concept. This study examined student survey data collected from 30 schools in rural and metropolitan South Australia, including independent and public schools. The nature and strength of the relationships between student factors and selected school variables were tested against a range of school outcome measures such as school retention, academic results and SACE certification completion. The implications of these results for the kind of teaching and learning environment that promotes valued school outcomes is explicated and discussed.

Murry, K., & Herrera, S. (1998). Crisis in the Heartland: Addressing Unexpected Challenges in Rural Education. Journal of research in rural education, 14(1), 45.

Murry, K., & Herrera, S. (1998). Crisis in the Heartland: Addressing Unexpected Challenges in Rural Education. Paper presented at the Journal of Research in Rural Education, 14, 1, 45-49 Spr 1998. Recent increases in cultural and linguistic diversity in Kansas have raised three challenges for educators, especially rural educators: geographic isolation, capacity building, and professional development. Describes innovative, nontraditional programs developed by Kansas State University to help educators meet these challenges, including distance education, collaborative site-specific adaptations of curriculum and instruction, and cross-cultural sensitivity training. (TD) EJ574239

Muse, I., ERIC Clearinghouse on Rural Education and Small Schools., & National Institute of Education (U.S.). (1984). Excellence in rural education: "a nation at risk" revisited. [Las Cruces, N. Mex.: ERIC Clearinghouse on Rural Education and Small Schools. Ed 1.310/2:261819

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Mabey, D., Grosskurth, H., Rwakatare, M., Mwijarubi, E., Ndeki, L., Mayaud, P., Buve, A., Cleophas, B., Mkanje, R., Gavyole, A., Todd, J., Orroth, K., & Hayes, R. (December 2000). Operational performance of an STD control programme in Mwanza Region, Tanzania. Sexually Transmitted Infections, 76(6), 426-436(411). Objectives:To describe important details of the design and operational features of the Mwanza sexually transmitted diseases (STD) control programme. To assess the feasibility of the intervention, the distribution of STD syndromes observed, the clinical effectiveness of syndromic STD case management, the utilisation of STD services by the population, and the quality of syndromic STD services delivered at rural health units.Methods:The intervention was integrated into rural primary healthcare (PHC) units. It comprised improved STD case management using the syndromic approach, facilitated by a regional programme office which ensured the training of health workers, a reliable supply of effective drugs, and regular support supervision. Five studies were performed to evaluate operational performance: (i) a survey of register books to collect data on patients presenting with STDs and reproductive tract infections (RTIs) to rural health units with improved STD services, (ii) a survey of register books from health units in communities without improved services, (iii) a survey of register books from referral clinics, (iv) a home based cross sectional study of STD patients who did not return to the intervention health units for follow up, (v) a cross sectional survey of reported STD treatment seeking behaviour in a random cohort of 8845 adults served by rural health units.Results:During the 2 years of the Mwanza trial, 12 895 STD syndromes were treated at the 25 intervention health units. The most common syndromes were urethral discharge (67) and genital ulcers (26) in men and vaginal discharge (50), lower abdominal tenderness (33), and genital ulcers (13) in women. Clinical treatment effectiveness was high in patients from whom complete follow up data were available, reaching between 81 and 98 after first line treatment and 97-99 after first, second, and third line treatment. Only 26 of patients referred to higher levels of health care had presented to their referral institutions. During the trial period, data from the cohort showed that 12.8 of men and 8.6 of women in the intervention communities experienced at least one STD syndrome. Based on various approaches, utilisation of the improved health units by symptomatic STD patients in these communities was estimated at between 50 and 75. During the first 6 months of intervention attendance at intervention units increased by 53. Thereafter, the average attendance rate was about 25 higher than in comparison communities. Home visits to 367 non-returners revealed that 89 had been free of symptoms after treatment, but 28 became symptomatic again within 3 months of treatment. 100 of these patients reported that they had received treatment, but only 74 had been examined, only 57 had been given health education, and only 30 were offered condoms. Patients did not fully recall which treatment they had been given, but possibly only 63 had been treated exactly according to guidelines.Conclusions:This study demonstrated that it is feasible to integrate effective STD services into the existing PHC structure of a developing country. Improved services attract more patients, but additional educational efforts are needed to further improve treatment seeking behaviour. Furthermore, clear treatment guidelines, a reliable drug supply system, and regular supervision are critical. All efforts should be made to treat patients on the spot, without delay, as referral to higher levels of care led to a high number of dropouts. The syndromic approach to STD control should be supported by at least one reference clinic and laboratory per country to ensure monitoring of prevalent aetiologies, of the development of bacterial resistance, and of the effectiveness of the syndromic algorithms in use.

MacDonald, S. (1999). The Cardiovascular Health Education Program: Assessingthe Impact on Rural and Urban Adolescents' Health Knowledge. Applied nursing research, 12(2), 86. Mackay, M. The provision of networked access to hybrid resources at small or remote sites.

MacKinnon, D. (1998). A Line in the Sand: What's Worth Fighting For in Rural EducationExcerpts From a Keynote Address. Paper presented at the Journal of Educational Administration and Foundations, v13, 1, 67-76 Jul 1998. Discusses the changing nature of rurality in Canada, due to increasing urbanization, and the need to redefine rural education. School district consolidation has resulted in larger schools and loss of community. Medium-sized schools have great affiliative advantages for students. Citizens should fight for the right to construct the kind of schools and communities they want. (12 references) (MLH) EJ571781

Makino, A. (1997). A Study on the Structure and Characteristics of Tao Xingshi's "Life Education" Thought in the Period of the Rural Reform Movement. Nagoya Daigaku Ky{‡}oikugakubu kiy{‡}o. Ky{‡}oikugakka, 44(1), 11.

Malcolm, H. (June 2000). A PRIMARY MENTAL HEALTH-CARE MODEL FOR RURAL AUSTRALIA: OUTCOMES FOR DOCTORS AND THE COMMUNITY. Australian Journal of Rural Health, 8(3), 167-172(166). ABSTRACTTo address the high rate of depression and suicide in rural Australia requires a multifaceted approach to educate the community, improve the skills of health workers and provide user-friendly patient counselling. The present paper describes a model that covers each of these aspects and details the outcomes with respect to the doctors and the community. Improved awareness in the community of mental illness and the availability of treatment, decreasing the stigma of such a diagnosis, and increasing the skills and reducing the isolation of doctors in rural areas who treat mental illness were all positive benefits from this cost-effective way of providing mental health care in a primary setting. The adoption of this model in all primary care settings is advocated.

Marcopulos, B., McLain, C., & Giuliano, A. (1997). Cognitive Impairment or Inadequate Norms? A Study of Healthy, Rural, Older Adults with Limited Education. The Clinical neuropsychologist, 11(2), 111.

Marnetoft, S.-U., Selander, J., Bergroth, A., & Ekholm, J. (1 March 2001). FACTORS ASSOCIATED WITH SUCCESSFUL VOCATIONAL REHABILITATION IN A SWEDISH RURAL AREA. Journal of Rehabilitation Medicine, 33(2), 71-78(78). The objective of this study was to identify factors associated with a positive outcome of vocational rehabilitation, and to identify groups that have been successfully rehabilitated in a Swedish rural area. In this study vocational rehabilitation is defined as medical multidisciplinary, psychological, social and occupational activities aiming to re-establish, among sick or injured people with previous work history, their working capacity and prerequisites for returning to the labour market. The study was based on 732 people on registered long-term sick-leave who, in a rural area in northern Sweden during 1992-94, became objects for vocational rehabilitation. Bivariate and stepwise logistic regression analysis was used to identify factors associated with the outcome. By successful vocational rehabilitation is meant reporting well (no economical benefit) at all three time-points 6, 12 and 24 months after termination of rehabilitation, or lowered benefit levels. The results indicate that younger, male, employed persons, with an early start on rehabilitation, in a programme entailing education, and partly sick-listed before the start of this programme, had the greatest chance of successful rehabilitation. In contrast, older, female, unemployed people, with a delayed start on rehabilitation, without education, and fully sick-listed before the start, greatly risked being unsuccessful with vocational rehabilitation. The results indicate how to improve the rehabilitation process: several process-related factors shown to be connected with successful vocational rehabilitation include time before the start of rehabilitation, partial instead of full sickness benefit, and education programmes.

Marshall, R. (January 2001). Rural Policy in the New Century. International Regional Science Review, 24(1), 59-83(25). This article outlines the evolution of U.S. rural policy and identifies some likely policy gaps if current trends continue. During the 1930s, the New Deal stabilized agricultural prices and provided greater access to electricity, telephones, and transportation facilities for rural people. Rural nonfarm development was built on natural resources and low cost manufacturing, which became less viable in a global economy. Competitiveness in the new economy requires greater development of human resources and information infrastructures. Rural areas have closed their education gaps with central cities, but not with suburban populations or world class standards. Rural workforce development also lags, although emerging high performance companies demand skilled workers. Information infrastructures improve the quality of life and promote high value-added rural development. Two likely policy gaps are inadequate human resource development and the lack of a coherent rural policy, which responds to unique rural conditions. Such a policy would be in the national interest.

Martens, P. (2000). Does Breastfeeding Education Affect Nursing Staff Beliefs, Exclusive Breastfeeding Rates, and Baby-Friendly Hospital Initiative Compliance? The Experience of a Small, Rural Canadian Hospital. Journal of Human Lactation, 16(4), 309-318.

Martens, P. J. (November 2000). Does Breastfeeding Education Affect Nursing Staff Beliefs, Exclusive Breastfeeding Rates, and Baby-Friendly Hospital Initiative Compliance? The Experience of a Small, Rural Canadian Hospital. Journal of Human Lactation, 16(4), 309-318(310). The effectiveness of a breastfeeding education intervention consisting of a 1-hour mandated session for all nursing staff, with an optional self-paced tutorial, was evaluated in a small rural Canadian hospital. The intervention was designed to increase exclusive breastfeeding rates, create positive beliefs and attitudes among staff members, and increase compliance with the World Health Organization/UNICEF Baby-Friendly Hospital Initiative (BFHI). Staff surveys and chart audits were conducted at both the intervention and control site hospitals prior to the intervention and 7 months after the intervention. Over a 7-month period, the intervention hospital experienced an increase in BFHI compliance (24.4 vs. 31.9, P<.01), breastfeeding beliefs (55.0 vs. 58.8, P<.05), and exclusive breastfeeding rates (31% vs. 54% of breastfed babies, P<.05) but no change in breastfeeding attitudes (44.0 vs. 44.9, P=.80). The control site experienced no change in BFHI compliance, beliefs, or attitudes but a significant decrease in exclusive breastfeeding rates (43% vs. 0%, P<.05).

Martinez, P. J., Luengo, M., Alcazar, C., Moreno, L., Pasan, M., & Santamaria, J. (September 2000). Infectious diseases. Immunoresponse to routine hepatitis B vaccination in pre-adolescents in the province of Guadalajara, Spain. European Journal of Public Health, 10(3), 168-170(163). Background. Although hepatitis B vaccine has been available in Spain since 1986, acute and chronic hepatitis B virus infection remains a public health problem. The comprehensive national strategy to prevent hepatitis B virus transmission includes hepatitis B vaccination of pre-adolescents. Our objective was to investigate the immunoresponse to routine hepatitis B vaccination in pre-adolescents in the province of Guadalajara and to study the relationship between the immunoresponse and other variables such as height, weight, Quetelet index, sex and home environment (rural or urban).Method. We considered a cross-sectional descriptive study in the school population of eighth year primary education. Hepatitis B recombinant vaccine immunoresponsiveness was studied in 338 students vaccinated with a 0, 1 and 6 months vaccination schedule. Anti-hepatitis B post-vaccination titres were quantified considering levels of protection 10 Ul l-1.Results. The seroprotection rate was 97.6%. The response of more than 46% of the children was very satisfactory and their anti-hepatitis B post-vaccination titres exceeded 1000 Ul l-1. No statistically significant differences could be found between sexes. The relation study between anti-hepatitis B post-vaccination levels and Quetelet index showed a statistically significant inverse correlation (p<0.001).Conclusion. Obesity is a predictor of poor immunoresponse and this response is not influenced by sex. We consider the seroprotection that this vaccine offers to pre-adolescents to be excellent.

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_____. (Nov 1990). Towards an Understanding: Rural Education in Manitoba., 24pp. Document produced for the conference: Prairie Forum on Rural Education (Brandon, Manitoba, November 8-9, 1990). This document provides current and historical information about rural education in Manitoba, Canada. The report's eight sections and the information they provide are as follows: (1) "Background" emphasizes the importance of education to rural residents, and describes the trend toward education for all ages; (2) "Early Education in Manitoba" traces the history of public education in the area; (3) "Modern Rural Society" presents statistics dealing with the decline of agricultural activity and changes in the composition of the population; (4) "Rural Schools and the Community" stresses the responsibility of rural schools to serve the needs of the community and to use community resources to improve education; (5) "The Costs" suggests ways rural schools fund education while faced with rural depopulation, lower farm income, and an aging population; (6) "Myths Surrounding Rural Schools" disputes the myths that bigger schools are better and that rural schools are all the same and considers the advantages and disadvantages of small schools; (7) "Teachers in Rural Schools" indicates problems with teacher turnover and describes skills and characteristics needed by rural teachers; and (8) "Training and Post Secondary Education" provides statistics on university and non-university enrollment since 1960 and explains how universities are meeting the needs of the rural population. (KS) ED332847

Nachtigal, P. ([1990). Rural Education in a Period of Transition: Are the Public Schools Up to the Task?, 9pp. In: National Rules Studies Committee: A Proceedings (Cedar Falls, IA, May 17- 18, 1990), 95-102. Rural public schools can be perceived as economic drains on community resources; they also can be perceived as being of inadequate quality, hence demanding more support. Educational critics, however, are questioning the notion that more is better and are recommending teaching fewer, more integrated courses, in longer time periods. In analyzing indicators of input, process, and performance, rural secondary schools are closer to these recommendations than large or urban schools. They offer fewer courses with teachers often teaching more than one content area. Teaching strategies such as cooperative learning and peer teaching are an integral part of multi-grade teaching assignments of the small, rural school. These are being recognized as good instruction, particularly for at-risk students. Despite these rural strengths, the evidence for rural schools' better outcome is not clear. One reason for such obscurity is that education is dominated by urban values and standards. To recapture the relevance of learning, a style of schooling and classroom organization is needed to actively engage students with the natural and human world around them, not just in the context of science or social studies, but as subject matter for artistic expression, mathematical analysis, astronomy, history, and reading and writing. Because of their small scale and ready access to the environment, rural schools are able to implement these activities more easily than large urban schools. Rural schools have the opportunity to be leaders in redesigning schools for the future. Includes 25 references. (ALL) ED339552

Nachtigal, P. M. (1982). Rural education: in search of a better way. Boulder, Colo.: Westview Press. Lc5146.r83 1982 370.19/346/0973 Lc5146.r83 1982

Nagendran, S., Moores, D., Spooner, R., & Triscott, J. (10 August 2000). Is telemedicine a subset of medical informatics? Journal of Telemedicine and Telecare, 6(4), 50-51(52). Summary Informatics has a key characteristic of a new discipline in a technically transient environment-there is no universal definition of it. This is not surprising, given its complex and diverse nature. In a broad sense informatics is the interface between developing technologies and the decision sciences, in particular clinical sciences. Telemedicine has no universally accepted definition either. Telemedicine requires the use of electronic communication networks for the transmission of information and data related to the diagnosis and treatment of, as well as education about, medical conditions. The debate ensues over whether it is or is not a subset of medical informatics. The care of the elderly diploma programme is a telemedicine project within the department of family medicine at the University of Alberta; it is a distance learning programme directed towards educating and training physicians in rural Alberta. This project provided us with the practical experience of addressing both informatics and telemedicine issues jointly.

Nath, S., & Hadi, A. (2000). Role of Education in reducing child labour: evidence from rural Bangladesh. Journal of biosocial science, 32(3), 301.

Nath, S., Sylva, K., & Grimes, J. (1999). Raising Basic Education Levels in Rural Bangladesh: The Impact of a Non-Formal Education Programme. International review of education. Internationale Zeitschrift f{‡}ur Erziehungswissenschaft. Revue internationale de p{‡}edagogie, 45(1), 5.

Nelson, W. (1994). TQM in Rural Education: Managing Schools from a Business Perspective. Paper presented at the Rural Educator, 15, 2, 21-24 Win 199 1994. Outlines the 14 points of Deming's business philosophy of Total Quality Management in terms of rural education, including adoption of a common mission, movement from mass inspection (standardized testing) to individualized assessment, constant system improvement, training for those involved in the process, improved communication, employee rewards and empowerment, and upgrading employees' skills. (KS) EJ480081

NetLibrary Inc. (1998). Rural education and training in the new economy the myth of rural skills gap (Version 1st) [xvii, 182 p.:]. Ames: Iowa State University Press. LC5146.5.R87 1998b Lc5146.5.r87 1998 370/.9173/4 Iowa State University Press

Nicaragua., United States., & United States. Dept. of State. (1980). Rural education development: agreement between the United States on America and Nicaragua, signed at Managua August 30. 1978. [Washington, D.C.?]: Dept. of State: For sale by the Supt. of Docs. U.S. G.P.O. S 9.10:9502 S 9.12:

No, s. a. (2000). 2000 Australian Rural Education Award. Paper presented at the Education in Rural Australia, 10, 1, 57-63 2000. Provides contact information and brief descriptions of 13 high schools, colleges, community programs, and distance education schools receiving the Australian Rural Education Award in 2000. (SV) EJ611979

No, s. a. P. L. (2000). Revitalizing Rural Education. Community Facilities Programs & Organizations Concerned about Rural Education. This handbook informs school personnel and the business community about the opportunities available to assist rural community's efforts in revitalizing their education systems. The handbook's first two sections examine the different funding sources available for school improvement programs and loan eligibility, and discusses the benefits lenders can realize when providing these loans. The third and final section details the components of the Qualified Zone Academy Bonds (QZAB) financing tool covering eligibility criteria, the required business pledges, how to qualify for a QZAB, tax treatments, and benefits to lenders. An example of a QZAB success story is also provided. An addendum lists examples of different community facilities programs. (GR) ED447677

Norris, T. (2000). Commentary-Education for Rural Practice: A Saga of Pipelines and Plumbers. Journal of Rural Health, 16(3), 208-212.

Novotny, R., Hla, M. M., Kieffer, E. C., Park, C.-B., Mor, J., & Thiele, M. (June 2000). Breastfeeding Duration in a Multiethnic Population in Hawaii. Birth, 27(2), 91-96(96). Background: The increasing ethnic diversity in the United States necessitates a study of variations in infant feeding patterns among ethnic groups. This study was conducted as part of Hawaiis surveillance system to identify infant feeding patterns in Hawaii; specifically, to identify factors influencing duration of breastfeeding among ethnically diverse mothers. Methods: All women who delivered an infant in Hawaii between January 1 and March 31, 1989, were mailed surveys 14 to 19 months after delivery. Fifty-one percent (n = 2011) of women responded, of whom 1574 (78) did some breastfeeding and are included in the analysis of prediction of weaning (cessation of breastfeeding). Cox regression (survival) analysis was used to predict weaning. Results: The median duration of breastfeeding was 150 days; 45 percent of infants were still breastfeeding at age 6 months and 16 percent at age 1 year. Factors associated with early weaning were Japanese ethnicity; mother born in a country other than the United States, Japan, or the Philippines; first language other than English, or two languages at home; employed full-time outside the home; introduced formula or fruit before age 6 months; received formula from the WIC program; and stopped breastfeeding for convenience, breast problems, problems getting breastfeeding started, insufficient milk, baby refusing the breast, and a sick baby. Factors associated with late weaning were older maternal age; college education; living on a rural island; previous breastfeeding experience; helpful breastfeeding advice from family or friends; receiving WIC for breastfeeding mothers; introducing the cup before age 6 months; and not giving fruit to the baby. Conclusion: In Hawaii, programs that address how and when to introduce foods, use of formula, and management of outside employment and breastfeeding should be made available to those groups of women at risk for early weaning to lengthen their duration of breastfeeding.

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O'Meara, P., Strasser, R., Marrow, A., & Leivre, P. L. (March 2001). An integrated approach to the role of the ambulance medical officer in rural Australia. PRE-HOSPITAL IMMEDIATE CARE, 5(1), 24-26(23). Monash University School of Rural Health (MRH) and Rural Ambulance Victoria (RAV) have taken an innovative approach to providing medical support to rural ambulance paramedics in Gippsland. After the formation of RAV in 1999, a cooperative approach to the Ambulance Medical Officer (AMO) role was adopted. A team consisting of consultant emergency physician, three general practitioners with emergency life support qualifications, and a rural health academic was formed. This approach has the advantage of sharing scarce skills and improving the sustainability of the AMO role. The primary objectives are to provide support and advice in the management of clinical operations and to contribute to clinical policies and strategies. The system is providing: medical direction; professional education; integration activities; and some research and evaluation activities. Ambulance paramedics are teaching final year medical students and general practice trainees emergency life support skills. Training equipment, video conferencing venues and specialist skills are now shared. A more integrated approach to the AMO role provides a framework for the development of closer and more cooperative relationships between rural ambulance staff and other rural health professionals. In similar circumstances, the approach could be replicated in other rural areas.

Odebode, S. (1999). Adult education needs of rural women in Nigeria. Australian journal of adult and community education, 39(3), 172.

OECD, O. f. E. C.-o. a. D. (November 2000). Basic Science and Technology Indicators - Government Expenditure on Research and Development by Sector of Performance and Socio-economic Objective (Table 4) Vol 2001 Release 01. SourceOECD Science and Technology Database, 1(1). This table contains research and development (RandD) expenditure statistics. Data include gross domestic RandD expenditure by sector (business enterprise, government, higher education, private non-profit, and total intramural) and by socio-economic objective, such as agriculture, forestry and fishing; industrial development; energy, transport and telecommunications; urban and rural planning; science and technology (ST) infrastructure; prevention, identification and treatment of pollution; ST environment; health; social development and services; earth and atmosphere; advancement of research; general university funds; ST advancement of knowledge; civil space; and defence.YEARS COVERED: 1981 onwardCOUNTRIES COVERED: Australia, Austria, Belgium, Canada, the Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Japan, Korea, Luxembourg, Mexico, the Netherlands, New Zealand, Norway, Poland, Portugal, Spain, Sweden, Switzerland, Turkey, the United Kingdom, and the United States

Offredy, M. (February 2000). Advanced nursing practice: the case of nurse practitioners in three Australian states. Journal of Advanced Nursing, 31(2), 274-281(278). Advanced nursing practice: the case of nurse practitioners in three Australian statesThis paper provides insight into the work of nurse practitioners in three Australian states. Using a case study approach, the aim of the study is to give an account of some of the types of cases/patients who consult with the nurse practitioners in the states visited and to offer insight into one of the policy changes required to support the introduction of the nurse practitioner role. A snowball sampling technique was used to obtain the sample population of both 10 nurse practitioners and other health care personnel. Semi-structured interviews were conducted with the 39 respondents in both samples. The analysis of the 10 nurse practitioner interviews reported here shows that these nurses undertook a wide range of roles. The results of the semi-structured interviews with the nurse practitioners are described using four of the 10 interviews and reporting them as case studies. The results highlighted the need to address legislation issues and to prepare nurses adequately for their clinical setting and address the difficulties of continuing education of rural nurses.

Ogwu, N. E., Taiwo, K. A., & Ajibola, O. O. (September 2001). Assessment of household kitchen equipment: factors influencing its acquisition and its impact on food consumption in Osun State of Nigeria. Technovation, 21(9), 613-621(619). Women in Nigeria are faced with drudgery during food preparation. The acquisition of modern kitchen equipment (MKE) can help in reducing this problem. The study was carried out to investigate the factors influencing the acquisition of household kitchen equipment (KE). Data were collected from users in Ife Central and Ife East Local Government Areas of Osun State using questionnaires as well as interviews and observations. Quantitative analysis was undertaken using the SPSS computer package.The results showed that acquisition of MKE is influenced by socio-economic factors such as age, marital status, income, occupation, educational level and place of residence. The acquisition of MKE was higher among respondents in the age group 31-50 years. Monogamous families have more MKE than polygamous homes. Acquisition of MKE is higher among respondents with tertiary and secondary education. More MKE is also acquired by respondents earning above N4,000.00. Respondents in urban areas possessed more MKE than those in rural areas. The study also revealed that the type of KE acquired affects the food consumption pattern of respondents. Respondents having high- and medium-class KE eat more protein foods and more regularly than others. The policy implications of the results both at domestic and national levels are discussed.

Oliver, R., & Lake, M. (1996). A Teaching Program in Rural Education: Learning through Experiential Activities. Paper presented at the Education in Rural Australia, 6, 2, 1-7 1996. Describes a preservice teacher education course dealing with rural education, based on contemporary learning theories and delivered through telematics at an Australian university. Students learned about teaching and learning with telematics through being taught with telematics and through independent learning activities. Outcomes and findings demonstrate the project to be an efficient, effective alternative to conventional teaching. Contains 20 references. (TD) EJ538184

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Paasch, K. M., & Swaim, P. L. (1995). More Rural Students Are Graduating from High School, but a Serious Dropout Problem Remains. "Rural Education and Training." Entire issue available from EDRS, see RC 020 673. Paper presented at the Theme issue. The nonmetropolitan dropout rate fell sharply, 1975-93, closing the nonmetro- metro gap. National longitudinal data on dropout risk factors related to family, community, and local labor market reveal that low parental education and income are the greatest barriers to reducing rural dropouts. High school students had unrealistic educational and occupational aspirations, indicating a serious school- work disconnection. (Author/SV) EJ528305

Pan, S., & Straub, L. (1997). Returns to Nursing Education: Rural and Nonrural Practice. The Journal of rural health, 13(1), 78.

Panwar, B., & Punia, D. (1998). Food intake of rural pregnant women of Haryana State, Northern India: relationship with education and income. International journal of food sciences and nutrition, 49(3), 243.

Parsons, E., Chalkley, B., & Jones, A. (1 March 2000). School Catchments and Pupil Movements: a case study in parental choice. Educational Studies, 26(1), 33-48(16). Although parental choice of secondary schools is a subject of considerable public and academic interest, there has been relatively little research on the extent to which choice is undermining the traditional role of geographically defined school catchments. This paper, therefore, uses data provided by a case-study local education authority to examine the nature and scale of pupil flows across catchment boundaries. It does so by adopting a form of Geographic Information System as the principal research tool. The results show over a third of Year 7 pupils moving to schools other than their catchment comprehensive. Interestingly, the inner-city catchments were the most permeable: by contrast, children in middle class and rural areas were the least likely to enter a school outside their local area.

Pathak, B. (1 April 1999). Sanitation is the key to healthy cities - a profile of Sulabh International. Environment and Urbanization, 11(1), 221-229(229). Sulabh International is an Indian NGO which developed a cheap and effective sanitary toilet - a two-pit, pourflush, water-seal system - that does not need sewers or expensive treatment plants. Sulabh toilets are now used by more than a million households in India and in over 3,000 community toilets. This profile of Sulabh International by its founder describes how this sanitation programme first began and how it has spread and diversified. The profile also describes Sulabh's other work, including training and education for "scavengers" who previously emptied latrines, the model village and rural sanitation programmes, research and the integrated health care model.

Pathman, D., Steiner, B., & Konrad, T. (1999). Preparing and Retaining Rural Physicians through Medical Education. Academic medicine, 74(7), 810.

Paul, L., Johnson, A. O., & Cranston, G. M. (1 July 2000). A SUCCESSFUL VIDEOCONFERENCE SATELLITE PROGRAM: PROVIDING NUTRITIONAL INFORMATION ON DEMENTIA TO RURAL CAREGIVERS. Educational Gerontology, 26(5), 415-425(411). A videoconference satellite program proved to be an effective method of distance education for rural caregivers seeking information on nutrition and dementia. A team of specialists designed the 90-min program by implementing the components of successful videoconferencing: (a) defining the audience and their needs, (b) identifying key topics in the subject area, (c) designing an interactive program format, (d) coordinating activities at the downlink sites, (e) promoting the program, and (f) evaluating the project. The objectives of the teleconference, discussed in this article, were to provide rural caregivers with up-to-date nutrition interventions, to create a local environment in which caregivers and providers could interact, and to assess the general acceptance of videoconferencing as an educational medium in rural Montana. A panel consisting of a narrator, a physician, an occupational therapist, and a registered dietitian, provided an overview of nutritional concerns, discussed problem-solving techniques, and answered questions. Twenty-three Montana communities hosted the KU/C satellite frequency band downlink program for both family and professional caregivers. The program was simultaneously broadcast on public television. Program participants rated both program content and delivery method highly, and 100% of survey respondents indicated that they would attend another teleconference.

Peach, H. G. (March 2000). Comparison of rural and non-rural students undertaking a voluntary rural placement in the early years of a medical course. Medical Education, 34(3), 231-233(233). ObjectiveThe experiences of rural and non-rural students undertaking a voluntary rural placement in the early years of a medical course were compared.MethodEighty percent (28) of the rural and 70% (114) of the non-rural students completed a post-placement questionnaire.ResultThe two groups did not differ on their overall rating of the placement, whether they felt welcome, adequacy of the time with doctors or their rating of the accommodation provided. However, 46% (13) of the rural students reported the placement had changed their feelings towards rural practice to the maximum/almost maximum extent compared with only 24% (27) of the non-rural students.

Peery, A., Darrow, M., Hardee, S., & Kolasa, K. M. (November 2000). Including Nutrition in an Ambulatory Care Path for Patients with Type 2 Diabetes. Nutrition in Clinical Care, 3(6), 371-379(379). AbstractCare paths are known to improve the performance of health care providers in delivering diabetes education. This paper describes the efforts of a rural family practice to implement a provider-and patient-focused care path for the improved management of Type 2 diabetes. Dietary and lifestyle advice were included elements in the care path. Family physicians with limited access to dietetic services need to provide more diet and lifestyle advice than other physicians. Patient-focused care paths are expected to enhance provider-patient communication and improve patient adherence.

Peltzer, K. (2000). Opinion on AIDS Prevention and Education Among Rural Secondary School Pupils in the Northern Province of South Africa. Psychological Reports, 87(2), 593-595.

Perez-Padilla, R., Perez-Guzman, C., Baez-Saldana, R., & Torres-Cruz, A. (May 2001). Cooking with biomass stoves and tuberculosis: a case control study. The International Journal of Tuberculosis and Lung Disease, 5(5), 441-447(447). OBJECTIVE: To search for an association between tuberculosis and use of biomass stoves found recently in a cross sectional study.DESIGN: In a case-control study based in a chest referral hospital, the cases were 288 patients with active smear-positive or culture-positive tuberculosis, and the controls were 545 patients with ear nose and throat ailments with no evidence of chest disease studied at the same time as the cases. Exposure to present or previous biomass smoke by history of cooking with traditional wood stoves was assessed by positive or negative response.RESULTS: Exposure to biomass smoke was significantly higher in cases than in controls. Crude odds ratios for tuberculosis and biomass smoke exposure were 5.2 (95%CI 3.1-8.9) for current exposure, 3.4 (95%CI 2.4-5.0) for past or present exposure and 1.8 (95%CI 1.1-3.0) for past exposure. The association was observed only for patients living in Metropolitan Mexico City and urban or suburban areas in the center of Mexico providing most cases and controls. For rural areas, the power of the study was low and the origin of the patients heterogeneous. Odds ratio for Mexico City Metropolitan area and the center of Mexico was 2.4 (95%CI 1.04-5.6), adjusted for age, sex, level of education, crowding, smoking, socio-economic level, zone of residence and state of birth. In the same model smoking had an OR of 1.5 (95%CI 1.0-2.3) for tuberculosis.CONCLUSION: Our results support a causal role of current domestic biomass smoke exposure in tuberculosis.

Perroncel, C. B. P. L. (2000). Getting Kids Ready for School in Rural America. Rural Education Issue Document. National Education Goal One, "All children in America will start school ready to learn," seems simple, but being ready for school requires meeting certain needs related to physical, social, emotional, cognitive, and language development. Families, schools, and communities each have responsibilities in these areas. Families in "ready" homes provide opportunities for children to interact with people, places, and objects; know how to handle stress; have access to high-quality child and health care; and know whom to call for information and help. "Ready" schools allow space for children to work alone or in groups and to move about; do not require children to sit still for long periods of time, participate in countless skill drills, or spend their time filling out workbook pages; allow children to explore the classroom; and provide opportunities for play. The "ready" school is also equipped to cope with differences among young children, expects all children to learn, and is open to community members. In "ready" communities, families and community groups collaborate with the school and agencies that serve families and children. Everyone agrees on a long-term vision for young children. Rural areas have trouble meeting these expectations because of factors arising from geographic isolation and limited resources. Increasing rural families' access to health care and affordable, high-quality child care are the two major challenges for rural areas. Six suggestions for helping rural children succeed are: support high-quality and developmentally appropriate programs, assess children appropriately, link community resources, encourage joint staff development, offer parent training and support, and improve access to quality health care. (Contains 43 references.) (TD) ED445849

Perry, W. J., & Harmon, H. L. (1992). Costs and Benefits of an Investment in Rural Education: The Perspective of a Rural State. Paper presented at the Journal of Rural and Small Schools, 5, 1, 3-9 1992. Discusses consolidation as a method to reduce the costs of rural education. Describes the interrelatedness of the rural economy and rural education. Enumerates advantages and disadvantages of small schools. Suggests that educational reform should focus on the unique circumstances of rural schools. (KS) EJ438270

Peterson, R., Hakendorf, M., & Guscott, T. (1999). Improving Aged Care Education for Australian Rural Nurses Using Problem-Based Learning. The Journal of continuing education in nursing, 30(3), 120.

Pfeiffer, J., Gloyd, S., & Li, L. R. (July 2001). Intrahousehold resource allocation and child growth in Mozambique: an ethnographic case-control study. Social Science and Medicine, 53(1), 83-97(15). This study examines the effect of intrahousehold cash income control and decision-making patterns on child growth in the rural town of Sussundenga in Manica Province, Mozambique. A case-control study design was used to examine the influence of men's and women's disaggregated cash incomes on child growth. The research tested whether greater maternal share of household cash income was associated with (1) increased maternal decision-making and bargaining power in the household, and (2) better child growth. Fifty case households, with children 1-4 years old exhibiting poor growth, were matched with 50 control households of similar socioeconomic status in which all children under five demonstrated healthy growth. Data were gathered on gender-specific income generation and expenditure, specific intrahousehold allocation processes, diet, and sociodemographic variables using a formal survey. Key informant interviews, focus groups, and observation over one year provided ethnographic context for the case-control findings. Case-control differences were analyzed using McNemar's test, paired t-test, and conditional logistic regression. In spite of matching households for socioeconomic status, control household incomes were still slightly greater than cases. Male spouse income was also higher among controls while maternal income, and maternal proportion of household income, were not significantly different. Household meat, fish and poultry consumption, and maternal education were significantly greater among control households than cases. Greater maternal share of household income was not associated with greater maternal decision-making around cash. However, mothers must spend what little cash they earn on daily food supplies and usually request additional cash from spouses to cover these costs. There is evidence that if mothers earn enough to cover these socially prescribed costs, they can spend cash for other needs. Above this threshold, women's earnings may confer more bargaining power. The research also revealed a nuclearization of households, attenuation of community bonds of mutual aid, and increasing importance of cash for survival.

Phiri, K., Whitty, C. J. M., Graham, S. M., & Ssembatya-Lule, G. (1 June 2000). Urban/rural differences in prevalence and risk factors for intestinal helminth infection in southern Malawi. Annals of Tropical Medicine and Parasitology, 94(4), 381-387(387). Urbanization may increase the risk of human infection with intestinal helminths. A cross-sectional survey was conducted to investigate the prevalence, intensity and potential risk factors of acquiring such infection, among children aged 3-14 years in similar urban and rural communities in southern Malawi. Stool samples were collected from 553 children (273 urban and 280 rural). The overall prevalence of helminth infection was significantly higher in the urban subjects than in the rural (16.5% v. 3.6%; P< 0.001), mostly because of differences in the prevalence of Ascaris lumbricoides infection. Living in an urban community was associated with a significantly higher risk of infection [odds ratio (OR)= 5.3; 95% confidence interval (CI)= 2.6-12.1], even after controlling for potential confounding factors. In the urban community, risk factors included having pools of water/sewage around houses (OR= 3.0; CI = 1.4-6.5), not wearing shoes (OR= 7.1; CI = 2.7-19.2), not attending school (OR= 2.8; CI = 1.2-6.5), having mothers with 4-8 years of education (OR= 5.2; CI = 2.0-14.0), and having mothers below 35 years of age (OR= 4.09; CI= 1.39- 16.28). In this part of Africa, efforts to reduce helminth infections may best be focused on reducing geohelminth burden in urban areas.

Pickard, A. E. (1915). Rural education; a complete course of study for modern rural schools. St. Paul, Minn.,: Webb Publishing Company. Lb1567.p5 379.7

Pillai, P. (1999). Using Technology to Educate Deaf and Hard of Hearing Children in Rural Alaskan General Education Settings. American annals of the deaf, 144(5), 373.

Pittman, R., McGinty, D., & GerstPepin, C. (1999). Educational Attainment, Economic Progress, and the Goals of Education in Rural Communities. Journal of research in rural education, 15(1), 19.

pizhen, Y., & Ping, Z. (1998). Science, Technology and Education Are Basis of Rural Industrialization and Modernization. Paper presented at the Ching chi wen ti t‡an so.

Poftak, A. (1999). Expert Advice: Technology and Rural Education: A Talk with WestEd's Harvey Barnett. Technology & learning, 19(7), 40.

Pomerleau, J., Pudule, I., Grinberga, D., Kadziauskiene, K., Abaravicius, A., Bartkeviciute, R., Vaask, S., Robertson, A., & McKee, M. (March 2000). Patterns of body weight in the Baltic Republics. Public Health Nutrition, 3(1), 3-10(18). Objective: Previously recorded rates of obesity in the Baltic Republics have been among the highest in the world although little is known about how they vary within the population. This study investigates the distribution of body mass index (BMI) and obesity in these countries.Design: Three cross-sectional surveys conducted in the summer of 1997.Setting: Estonia, Latvia and Lithuania.Subjects: Representative national samples of adults with measured weight and height (Estonia: n = 1154; Latvia: n = 2292; Lithuania: n = 2096).Results: Between-country differences are particularly large among women: women from Latvia and Lithuania are approximately three times as likely to be obese as those from Estonia (17.4%, 18.3%, 6.0% respectively); only about one-third of this difference is explained by the sociodemographic and behavioural factors studied. In men, the prevalence of obesity varied only slightly among countries (Estonia: 9.9%; Latvia: 9.5%; Lithuania: 11.4%). While the prevalence of obesity increases with age within each republic, particularly in women, it is not associated with nationality or urban/rural region, and no consistent association is observed with income. Obesity is inversely related to education in Latvia and in Lithuanian women. Latvian men and women and Lithuanian men who smoked had a lower prevalence of obesity than non-smokers. Leisure time physical activity was not associated with obesity.Conclusions: Obesity is a major health problem in the Baltic Republics, particularly among Latvian and Lithuanian women. The lack of association between obesity and most demographic, socioeconomic and behavioural factors suggests that the problem is generalized. Health promotion strategies aiming at preventing and controlling excess weight gain in the Baltic Republics will need to target the general population.

Powell, C., Chang, S., & GranthamMcGregor, S. (1998). Nutrition and education: a randomized trial of the effects of breakfast in rural primary school children. The American journal of clinical nutrition, 68(4), 873.

Powers, A. (1997). The Preparation of Educational Interpreters for Rural Education Settings. Rural special education quarterly, 16(2), 24.

Powers, A. R. (1997). The Preparation of Educational Interpreters for Rural Education Settings. Paper presented at the Rural Special Education Quarterly, 16, 2, 24-32 Spr 1997. A consortium of four Alabama universities was formed to prepare educational interpreters to serve deaf and hard-of-hearing students in inclusive rural settings and to work in multicultural environments. The proposed Specialty in Educational Interpreting program would offer some courses via the interactive intercampus television system. Contains 18 references and course requirements and competencies. (Author/TD) EJ549649

Prideaux, D., Saunders, N., Schofield, K., Wing, L., Gordon, J., Hays, R., Worley, P., Martin, A., & Paget, N. (May 2001). Country report: Australia. Medical Education, 35(5), 495-504(410). IntroductionThe last 10 years has been an interesting time for Australian medical education despite reduced funding.WorkforceThere are five main workforce trends: a rural/urban maldistribution, a need for more specialists, public hospital staffing difficulties, increasing female practitioners and under-representation of indigenous practitioners.Issues facing the DeansLack of resources is a problem facing Deans, with pressure for clinical service in teaching hospitals. Entrepreneurial activities have been undertaken including the enrolment of overseas students. Medical schools have also responded to important government initiatives.Developments in medical educationAustralia's 11 medical schools have undergone significant reform in the last decade. There is a mix of four (graduate), five and six year courses.Australia's new medical schoolJames Cook University opened the first medical school in northern Australia in 2000. The School admits students from rural, northern Australian and indigenous backgrounds. It has a strong regional mission.Rural and community-based educationGovernment funding to address the maldistribution of the workforce has led to the establishment of rural clubs, Departments of Rural Health and community-based programs.The first two postgraduate yearsThere have been recent moves to improve education in the two years following graduation. This includes the initiation of national projects in curriculum and assessment.Postgraduate and continuing medical educationPostgraduate programs in Australia are being reformed to build on the changes in undergraduate education. CME is also under review.ConclusionAustralian medical educators should build on the recent reforms and take on some of the new directions in medical education.

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Rabinowitz, H., & Paynter, N. (2000). The Role of the Medical School in Rural Graduate Medical Education: Pipeline or Control Valve? Journal of Rural Health, 16(3), 249-253.

Rafi, M., & Chowdhury, A. M. R. (1 February 2000). Human rights and religious backlash: the experience of a Bangladeshi NGO. Development in Practice, 10(1), 19-30(12). As part of a human rights education campaign, the Bangladesh Rural Advancement Committee (BRAC) fixed 700,000 posters throughout Bangladesh. This met with opposition from the religious organisations. This paper investigates the nature and cause of the backlash and sets out strategies for how development organisations can achieve their objectives in the face of opposition. The opposition was found to be in response to interpretations of the posters based on the Holy Koran and Islamic practices, and a perceived intrusion into the professional territory of religious organisations, which affected the socio-economic interests of these organisations' representatives. It was therefore concluded that development organisations should pre-empt such opposition by spelling out their objectives to potential critics, and formulating programmes that do not provide scope for opponents to undermine their development activities.

Rao, D. R., Kumari, R. V., & Haribabu, E. (1 September 2000). Agricultural education in India: a sociological perspective. Outlook on Agriculture, 29(3), 177-184(178). The paper traces the evolution of agricultural education in India in terms of its organization, its perceived role in rural development, and the changing social backgrounds of students enrolling in agricultural education. It focuses on issues such as inequalities, changing attitudes among graduates, technology transfer, job segmentation and gender in agricultural education. The paper identifies shortcomings in the present education system with regard to meeting societal needs. The authors propose the institutionalization and expansion of lower-level agricultural education and an aggressive programme of positive discrimination in favour of rural sections of the community, both in education and employment, so as to make agricultural education and those it trains relevant to the Indian context.

Rashid, S. F. (1 July 2000). Providing sex education to adolescents in rural Bangladesh: experiences from BRAC. Gender and Development, 8(2), 28-37(10). The Bangladesh Rural Advancement Committee (BRAC) set up an Adolescent Reproductive Health Education (ARHE) programme in 1995, to provide information about reproductive health to adolescents in rural areas. New ideas and information are breaking the silence and shame about `sensitive' topics, and proving a positive influence on the relationships between adolescents and their parents and teachers, and among adolescents themselves.

Reardon, T., Berdegue, J., & Escobar, G. (March 2001). Rural Nonfarm Employment and Incomes in Latin America: Overview and Policy Implications. World Development, 29(3), 395-409(315). Rural nonfarm employment (RNFE) and incomes (RNFI) are crucial to Latin American rural households. The 11 rural household income studies in this volume, reviewed in this paper, use 1990s data and show that RNFI averages 40% of rural incomes. RNFI and RNFE have grown quickly over the past three decades. The review of evidence provided some surprising departures from traditional images of nonfarm activities of Latin American rural households. In terms of shares of rural incomes: (1) nonfarm wage incomes exceed self-employment incomes; (2) RNFI far exceeds farm wage incomes; (3) local RNFI far exceeds migration incomes; (4) Service-sector RNFI far exceeds manufactures RNFI. These findings suggest the need for more development program attention to wage employment in the service sector, versus the traditional focus on small enterprise manufactures. Moreover, poor households and zones tend to have higher shares in their incomes but lower absolute levels of RNFI as compared to richer households and zones. The RNFE of the poor tend to be the low-paid nonfarm equivalent of semi-subsistence farming. Raising the capacity of the poor to participate in the better-paid types of RNFE is crucial - via employment skills training, education, infrastructure, credit. Finally, RNFE has grown fastest and been most poverty-alleviating where there are dynamic growth motors, in particular in the agricultural sector, but also in tourism, links to urban areas, mining and forestry. This means that developing RNF jobs cannot be done at the expense of programs promoting agricultural development.

Record, N. B., Harris, D. E., Record, S. S., Gilbert-Arcari, J., DeSisto, M., & Bunnell, S. (July 2000). Mortality impact of an integrated community cardiovascular health program. American Journal of Preventive Medicine, 19(1), 30-38(39). Background: Preventing cardiovascular disease through community interventions makes theoretical sense but has been difficult to demonstrate. We set out to determine whether a community cardiovascular health program had an impact on mortality.Design: Program evaluation plus ecologic observational analysis of program encounters and mortality rates with external comparisons.Setting: Franklin County and two comparison counties in rural Maine.Participants: Program encountered >50% of regional adults, broadly distributed by site, gender, and age.Interventions: From 1974 to 1994, a community program, integrated with primary medical care and staffed by professional nurses, provided education, screening, counseling, referral, tracking, and follow-up for cardiovascular risk factors.Main Outcome Measures: Age-adjusted mortality rates (total, heart, coronary, cerebrovascular, cancer) for three counties and Maine, plus annual program encounters.Results: Relative to Maine, the Franklin heart disease death rate was 0.97 at baseline (1960-1969; 95% confidence interval, 0.91 to 1.03), 0.91 during the program (0.85 to 0.97), 0.83 during the 11 years of program growth (0.78 to 0.88), but 1.0 during the 10 years of decreasing encounters. Franklin's total death rate was 1.01 at baseline, 0.95 during the program (0.92 to 0.98), and 0.90 during program growth (0.86 to 0.94). Results were similar for coronary disease, stroke, and cancer. Relative death rates did not fall in either comparison county. Nurse-client encounters totaled 120,280 over 21 years. Relative to Maine, heart disease death rates correlated inversely with program encounters (r = -0.53) but not with unemployment or physician supply.Conclusions: Integrated with primary medical care, a comprehensive, nurse-mediated community cardiovascular health program in rural Maine has been associated with significant time-dependent and dose-dependent reductions in cardiovascular and total mortality.

Reynolds, J. (1998). Do Rural schools Need Character Education? The Rural educator, 20(2), 33.

Ribchester, C., & Edwards, B. (1999). The Centre and the Local: Policy and Practice in Rural Education Provision. Journal of rural studies, 15(1), 49.

Ribchester, C., & Edwards, B. (1999). The Centre and the Local: Policy and Practice in Rural Education Provision. Paper presented at the Journal of Rural Studies, 15, 1, 49-63 Jan 1999. Examines factors currently affecting the viability of small elementary schools (90 students or less) in England and Wales. While centralization of educational control since 1988 has worsened the educational and economic environment for small schools, locally based support strategies (interschool cooperation, anti-closure campaigns, voluntary fund raising) have been effective in maintaining small-school viability. Contains 70 references. (Author/SV) EJ578181

Rice, M. (1999). 1999 NREA Edward W. Chance Rural Education Dissertation Award Winner. The Rural educator, 21(2), 33.

Rich, D., DSouza, R., & Hustig, H. (2001). Outcomes of a pilot tele-education and training programme for rural and remote mental health clinicians in South Australia. Technology and Health Care, 9(4), 328.

Riedler, J., Eder, W., Oberfeld, G., & Schreuer, M. (February 2000). Austrian children living on a farm have less hay fever, asthma and allergic sensitization. Clinical & Experimental Allergy, 30(2), 194-200(107). Background and objectivesIn some studies, the prevalence of hay fever and asthma has been found to be lower in children from rural areas than in children from an urban environment. We hypothesized that living on a farm might be protective against development of allergic sensitization and allergic diseases.MethodsIn a cross-sectional survey, parents of 2283 children aged 8-10 years from a mostly rural area in Austria answered a standardized questionnaire on allergic diseases and environmental factors. 1137 children performed a skin prick test to seven local allergens.ResultsThe prevalence of hay fever (3.1 vs 10.3%, P = 0.0002), asthma (1.1 vs 3.9%, P = 0.017) and a positive skin prick reactivity to at least one of the common local allergens (18.8 vs 32.7%, P = 0.001) was significantly lower in children living on a farm than in children from a non-farming environment. In a multivariate logistic regression model, adjusting for genetic background, parent education, living and housing conditions and dietary factors did not change the odds ratio for the association of farming and allergic sensitization. Only after including `regular contact with livestock and poultry' into the model did the odds ratio change significantly (cOR 0.48 95% CI 0.30-0.75 to aOR 0.75 95% CI 0.37-1.52) indicating an association between regular contact with farm animals and reduced risk of atopic sensitization.ConclusionPossible explanations for the lower prevalence of hay fever, asthma and allergic sensitization in children living on a farm might be the development of immunotolerance or the stimulation of TH1 cells and suppression of TH2 cells by increased exposure of farm children to microbial antigens in the stables or farmhouses.

Rincones, R., & ERIC Clearinghouse on Rural Education and Small Schools. (1988). Exploring alternatives to consolidation. [Las Cruces, N. Mex.: ERIC Clearinghouse on Rural Education and Small Schools. Ed 1.310/2:296817

Riney-Kehrberg, P. (April 2001). The limits of policy - Rural children and work in the United States and New Zealand, 1870-1920. The History of the Family, 6(1), 51-67(17). This article uses public documents and first-hand accounts of late 19th and early 20th centuries child life to examine attempts by public policymakers in the United States and New Zealand to change the quality of rural child life in those countries through compulsory schooling and other related measures. These attempts, however, largely failed due to the demands of the farming economy and the unwillingness of public officials to go to extraordinary lengths on behalf of farm children, as opposed to urban children. Rural children's lives would be changed, not by policy, but by technological developments and the vagaries of the farm economy.

Rios, B. R., ERIC Clearinghouse on Rural Education and Small Schools., Rural/Regional Education Association., & United States. Office of Educational Research and Improvement. (1986). A directory of organizations and programs in rural education. [Las Cruces, N.M.] [Fort Collins, CO]: ERIC Clearinghouse on Rural Education and Small Schools ; Rural Education Association. Ed 1.310/2:273423

Ritz, B., & Yu, F. (April 2000). Parkinson's disease mortality and pesticide exposure in California 1984-1994. International Journal of Epidemiology, 29(2), 323-329(327). Background. In the last two decades reports from different countries emerged associating pesticide and herbicide use with Parkinson's disease (PD). California growers use approximately 250 million pounds of pesticides annually, about a quarter of all pesticides used in the US.Method. We employed a proportional odds mortality design to compare all cases of PD recorded as underlying (1984-1994) or associated causes (1984-1993) of death occurring in California with all deaths from ischaemic heart disease (ICD-9 410-414) during the same period. Based on pesticide use report data we classified California counties into several pesticide use categories. Agricultural census data allowed us to create measures of percentage of land per county treated with pesticides. Employing logistic regression models we estimated the effect of pesticide use controlling for age, gender, race, birthplace, year of deaths, and education.Results. Mortality from PD as the underlying cause of death was higher in agricultural pesticide-use counties than in non-use counties. A dose response was observed for insecticide use per county land treated when using 1982 agricultural census data, but not for amounts of restricted pesticides used or length of residency in a country prior to death.Conclusion. Our data show an increased PD mortality in California counties using agricultural pesticides. Unless all of our measures of county pesticide use are surrogates for other risk factors more prevalent in pesticide use counties, it seems important to target this prevalent exposure in rural California in future studies that use improved case finding mechanisms and collect pesticide exposure data for individuals.

Roberts, K. D. (Spring 2001). The determinants of job choice by rural labor migrants in Shanghai. China Economic Review, 12(1), 15-39(25). Based upon data collected in 1993 on 54,372 individuals in the Fifth Sampling Survey of the Floating Population of Shanghai, this paper examines the characteristics and occupations of 32,967 rural labor migrants, defined as those migrants whose previous occupation was in agriculture and who held an agricultural household registration. These migrants comprised approximately three-fifths of Shanghai's floating population in 1993. The data support the conventional wisdom that labor migrants are most often young males who work in the ''hard and dirty'' jobs of construction and manual labor - jobs left vacant by Shanghai's educated and aging registered population. But there also exists significant sorting of rural labor migrants among occupations and sectors (state, collective, township and village enterprises (TVEs), and private enterprises) by gender, age, marital status, education, and especially region of origin. Thus, it appears that these characteristics and village-based networks are important in channeling migrants into particular occupations and destinations, undermining the notion of a ''blind'' migration from rural areas to coastal cities during China's rapid economic transition.

Rosenthal, T., & Danzo, A. (2000). Rural-based Graduate Medical Education: An Issue Whose Time Has Come. Journal of Rural Health, 16(3), 196-197.

Rouk, U., Ed. (Oct 1991). Rural Education. "A Preview of the Best Emerging Educational R&D Outcomes.". Paper presented at the 13pp. Journal sub. This journal issue is devoted to the theme topic "Rural Education." The first article, "Science is Everywhere," by Chris Taylor, presents a project which uses local experts as an integral part of the school's science curriculum. "Better Teachers, Better Readers" by Scott Steen describes a system of strategic reading used in rural Wisconsin school districts. Summaries of emerging research and development outcomes cover the topics of school cooperatives, distance learning, teacher recruitment and retention, at-risk students, school leadership, staff development, school and business partnerships, community relations, audiographics, and thinking skills. "Are Our Rural Students Getting a 'Fair Shake?'" by Ullik Rouk summarizes a report to Congress on the condition of education in rural, small schools. The final article, "You Bet Partnerships Make a Lot of Sense for Rural Schools " by Paul Nachtigal, discusses school-community partnerships involving public and private sector institutions, organizations, and other schools and higher education institutions. The journal contains a diagram showing the service areas for the 10 regional educational laboratories that make new educational products and publications available. Also provided are the names, locations, and directors of the regional laboratories. (KS) ED343738

Rourke, J. (2000). Postgraduate Medical Education for Rural Family Practice in Canada. Journal of Rural Health, 16(3), 280-287.

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Sadjjadi, S., Khosravi, M., Mehrabani, D., & Oryan, A. (December 2000). Seroprevalence of Toxocara infection in school children in Shiraz, Southern Iran. Journal of Tropical Pediatrics, 46(6), 327-330(324). The presence of anti-Toxocara antibodies in the sera of school children of Shiraz, southern Iran, was studied by means of an indirect enzyme linked immunosorbent assay with excretory/secretory antigen of infective stage larva. A total of 519 individuals of both sexes aged 6-13 years were analysed. The total prevalence was 25.6 per cent. A higher rate of infection was observed in urban (30.15 per cent) than rural (20.2 per cent) residents. Most potential risk factors were not related to Toxocara prevalence and no differences existed between socioeconomic classes except for parental education. Neither age or sex was found to be significantly associated with positive serology.

Saeki, K., Izumi, H., Ohyanagi, T., Sugiyama, A., Sawada, I., Suzuki, K., Hatazawa, M., & Ohuch, M. (10 August 2000). Distance education for health centre staff in rural Japan. Journal of Telemedicine and Telecare, 6(4), 67-69(63). We have evaluated a course delivered by videoconferencing to rural health centre staff in Hokkaido. The course focused on the planning and evaluation of community health interventions. It included four 90 min sessions and two follow-up sessions. Fourteen professional staff members (public health nurses, nutritionists and dental assistants) attended each class. Knowledge of community health-care planning and evaluation was higher at post-education testing than pre-education testing. Ratings for 'using a computer', 'using some computer software', 'using the Internet' and 'interest in telehealth' increased significantly in post-education testing compared with pre-education testing. The course had an additional benefit in increasing the collaboration between community health workers and university staff.

Schrock, L. (1998). Review of Cost Efficiency and Efficacy of Delivering a Diabetes Education Program in a Southwest Rural Healthcare Facility. The Diabetes educator, 24(4), 485.

Sen-Hai, Y., Jones, J., Long-Shan, X., Bao-Jun, P., Jin-Xiang, L., & Li-Ping, C. (September 2000). Creating health-promoting schools in rural China: a project started from deworming. Health Promotion International, 15(3), 197-206(110). Intestinal helminth infection is highly endemic in rural areas of China. This project was implemented to determine if deworming efforts through schools could reduce helminth infections and successfully serve as an entry point for developing a more comprehensive approach to school health, i.e. the components of `health-promoting schools'. Six primary and junior secondary schools with 6188 students were involved in the project. Major interventions in four experiment schools included: examination and treatment of helminth infections; health education; improvement of school physical environment; establishment of relevant school policies and regulations; and strengthening relationship between school and community. The only intervention taken by the other two schools as controls was deworming. After 1 year of implementation, helminth infection in students and environmental contamination by helminth eggs in experiment schools decreased by ~80%, significantly higher than that in control schools. Remarkable improvements in students knowledge, behaviour and skills of health protection, in school physical facilities, in school/community relationship, and in relevant policies and practices, were also observed in the experiment schools. The conclusions are that the concept of the health-promoting school has been well accepted by the students, teachers, parents and local government officers, and that helminth reduction is an effective and feasible entry point for establishing health-promoting schools in rural areas where helminth infection has been an important public health problem.

Shaoyuan, L. (1999). Current Problems of Community Education in Rural Areas and Recommendations. Chiao y{‡}u yen chiu, 20(9), 33.

Sheppard, L., & Mackintosh, S. (1998). Technology in education: What is appropriate for rural and remote allied health professionals? The Australian journal of rural health, 6(4), 189.

Sher, J. P., & Centre for Educational Research and Innovation. (1981). Rural education in urbanized nations: issues and innovations. Boulder, Colo.: Westview Press. Lc5146.r84 370.19/346 Lc5146.r84

Sherwood, T. (2000). Where Has All the "Rural" Gone? Rural Education Research and Current Federal Reform. Journal of Research in Rural Education, 16(3), 159-167.

Shimmons, J., Comp. (Apr 1993). Innovative Approaches in Rural Education. Rural Information Center Publication Series, No. 22., 38p. This bibliography provides an introduction to literature regarding strategies for educational improvement within the rural context. Ninety-three journal articles and books cover the following areas: (1) curriculum design and teaching methods, including research reports, case studies of improvement programs, and manuals used in implementing or evaluating changes in curriculum and teaching; (2) educational finance; (3) cooperative partnerships between schools, local businesses, and community services; (4) educating students with special needs; and (5) education and technology. Each entry consists of title, author, publisher, publication date, a brief description, and, when appropriate, call numbers from bibliographic databases such as AGRICOLA and ERIC. Also included are listings of videocassettes and periodicals related to educational improvement and the names and addresses of organizations and regional educational laboratories devoted to educational improvement. (LP) ED361151

Shipman, C., Addington-Hall, J., Barclay, S., Briggs, J., Cox, I., Daniels, L., & Millar, D. (May 2001). Educational opportunities in palliative care: what do general practitioners want? Palliative Medicine, 15(3), 191-196(196). It is important to support general practitioners (GPs) in maintaining and developing their palliative care skills as most of the final year of a patient's life is spent at home under the care of the primary health care team. The training needs and uptake of GPs have been explored, but little is known about how GP educational preferences vary. The aim of this study was to explore the current educational preferences of GPs in different geographical locations as part of an evaluation of an educational intervention. The methods used included postal questionnaires sent to 1061 GPs. Results from 640 (60%) of GPs revealed that half (51%) wanted education in symptom control for non-cancer patients. More inner-city GPs wanted education in opiate prescribing (43%), controlling nausea and vomiting (45%), and using a syringe driver (38%) than their urban and rural colleagues (26%, 29% and 21%, respectively). Increased educational preference and increased difficulty in accessing information was associated with reduced confidence in symptom control. To maximize educational uptake it will be important for educational strategies to be developed and targeted according to variations in demand, and in particular to respond to the need for palliative care education in symptom control for patients suffering from advanced non-malignant disease.

Sinagatullin, I. (2001). Expectant Times: rural education in Russia. Educational Review, 53(1), 37-46.

Sinagatullin, I. M. (1 February 2001). Expectant Times: rural education in Russia. Educational Review, 53(1), 37-45(39). Education in rural Russia has always played a significant role in ameliorating the life of rural communities and enhancing the agrarian sector of the economy. Rural schools constitute 68.8% of all Russia's primary and secondary schools. Unfortunately, it is the rural school that has been badly affected by the current socio-economic crisis. Among a myriad of factors, the efficacy of rural education is largely dependent on teacher preparation. The paper concentrates on the contemporary condition of rural schools, some issues of rural teacher preparation and requirements of the teacher whose mission is to promote quality education in Russia's rural educational institutions.

Skudutyte, R., Aleksejuniene, J., & Eriksen, H. M. (2000). Dental caries in adult Lithuanians. Acta Odontologica Scandinavica, 58(4), 143-147(145). There are few data on the incidence of dental caries in Lithuanian adults. The aim of the present study was to describe caries and treatment experience among 35-44 and 65-74-year-olds, and to relate this to certain selected independent variables (gender, urban/rural residence, drinking water fluoride levels, and years of education). A total of 680 subjects selected based on a stratified random sampling procedure (response rate 52) were examined by one examiner. Dental caries was recorded as DMFT following the WHO recommendations. The results showed that the median DMFT scores were 18 for the 35-44-year-olds (n = 380) with median DT = 2, MT = 5, FT = 7. For the 65-74-year-olds (n = 300) the median DMFT was 24, with DT = 1, MT = 18, FT = 2, respectively. One percent of all 35-44-year-olds and 11 of 65-74-year-olds were edentulous. In the younger age group, statistically significant differences in the DMFT scores were related to gender, urbanization and drinking water fluoride levels. Participants from areas with high fluoride content in the drinking water (>1.5 ppm F/l) had lower DT, MT, and FT values. Females and participants from urban areas had higher numbers of FT. Participants with more years of education had lower DT, MT, and higher FT values. In the elderly, DMFT scores were related to water fluoride levels and years of education. Individuals with more years of education had higher numbers of FT and lower MT values in this age group. Poor oral hygiene was associated with high numbers of DT in both age groups. The data indicate that dental caries is widespread among adult Lithuanians.

Skudutyte, R., Aleksejuniene, J., & Eriksen, H. M. (31 August 2000). Dental caries in adult Lithuanians. Acta Odontologica Scandinavica, 58(4), 143-147(145). There are few data on the incidence of dental caries in Lithuanian adults. The aim of the present study was to describe caries and treatment experience among 35-44 and 65-74-year-olds, and to relate this to certain selected independent variables (gender, urban/rural residence, drinking water fluoride levels, and years of education). A total of 680 subjects selected based on a stratified random sampling procedure (response rate 52%) were examined by one examiner. Dental caries was recorded as DMFT following the WHO recommendations. The results showed that the median DMFT scores were 18 for the 35-44-year-olds (n = 380) with median DT = 2, MT = 5, FT = 7. For the 65-74-year-olds (n = 300) the median DMFT was 24, with DT = 1, MT = 18, FT = 2, respectively. One percent of all 35-44-year-olds and 11% of 65-74-year-olds were edentulous. In the younger age group, statistically significant differences in the DMFT scores were related to gender, urbanization and drinking water fluoride levels. Participants from areas with high fluoride content in the drinking water (>1.5 ppm F/l) had lower DT, MT, and FT values. Females and participants from urban areas had higher numbers of FT. Participants with more years of education had lower DT, MT, and higher FT values. In the elderly, DMFT scores were related to water fluoride levels and years of education. Individuals with more years of education had higher numbers of FT and lower MT values in this age group. Poor oral hygiene was associated with high numbers of DT in both age groups. The data indicate that dental caries is widespread among adult Lithuanians.

Slifkin, R., Popkin, B., & Dalton, K. (2000). Medicare Graduate Medical Education Funding and Rural Hospitals. Journal of Health Care for the Poor and Underserved, 11(2), 231.

Smith, K. (1999). Implementing Systemic Change for Math and Science Education in Rural Appalachia: The Appalachian Rural Systemic Initiative. The Rural educator, 21(2), 3.

Smith, M. U., & DiClemente, R. J. (June 2000). STAND: A Peer Educator Training Curriculum for Sexual Risk Reduction in the Rural South. Preventive Medicine, 30(6), 441-449(449). Background. The incidence of AIDS in rural areas continues to increase rapidly, with teenagers continuing to report high rates of sexual risk behaviors. Unfortunately, there is a dearth of effective HIV prevention programs targeting youth in rural settings where there are often formidable barriers to sex education programs. This paper describes a theoretically based intervention designed to meet the needs of rural youth.Methods. Students Together Against Negative Decisions (STAND) is a 28-session teen peer educator training program implemented in a rural county in a southeastern state, promoting both abstinence and sexual risk reduction. The theoretical foundation of the curriculum includes both Diffusion of Innovations Theory and the Transtheoretical Model, focusing on both individual and community norm change. STAND is teen-centered and skills-based; activities focus on active learning. Educator trainees are selected on the basis of their opinion leadership within their peer group, resulting in a training group of both virgin and sexually active teens, balanced for gender and matched to the racial proportions of the school.Results. Acceptance and participation in STAND suggest that adolescents in rural communities can be accessed through community-based interventions, that they are willing to participate in such intensive programs, and that they perceive the intervention as valuable and enjoyable. Moreover, the STAND program has thrived in a relatively conservative rural environment, and has had a positive impact on adolescents sexual risk taking. Results from a pilot study showed significantly greater increases in condom use self-efficacy (16 vs a 1 decrease among controls) and in consistent condom use (+28 vs +15). Adolescent trainees also reported a sevenfold larger increase in condom use (+213 vs +31) and a 30 decrease in unprotected intercourse compared to a 29 increase among controls.Conclusions. STAND represents a new genre of HIV prevention program, one that utilizes complementary theoretical models to develop a program that targets both individual- and community-level change for rural adolescents. Copyright 2000 American Health Foundation and Academic Press.

Smith, P. (1997). The effectiveness of a preceptorship model in postgraduate education for rural nurses. The Australian journal of rural health, 5(3), 147.

Smolkin, L., & Suina, J. (1999). Cross-cultural Partnerships: Acknowledging the "Equal Other" in The Rural/Urban American Indian Teacher Education Program. Teaching and teacher education, 15(5), 571.

Spence, S. (1997). Improving the Quality of Life for Rural Elderly African American Through Education: A Nontraditional Approach. Educational gerontology, 23(1), 53.

Srinivasan, T. N. (June 2000). Poverty and undernutrition in South Asia. Food Policy, 25(3), 269-282(214). Most of the world's poor reside in South Asia and, within South Asia, a majority reside in rural areas. Policies of South Asian governments have not been cost-effective, nor have they been effective in meeting the needs of the rural poor. Only a development strategy that generates rapid and widely shared growth will eliminate poverty. It is suggested that such a growth strategy will need to emphasize investment in education and health, and ensure that human and physical capital are efficiently utilized. Promoting competition within the economy and with the rest of the world through liberal foreign trade and investment regimes are keys to achieving these results.

Srivastaa, G. (1997). Meaningful Education for Rural Girls. Social welfare, 44(8/9), 18.

Stearns, J., & Stearns, M. (2000). Graduate Medical Education for Rural Physicians: Curriculum and Retention. Journal of Rural Health, 16(3), 273-277.

Stephens, E. (2000). Partners in Rural Education. Forum for Applied Research and Public Policy, 15(1), 93.

Stephens, E. R. (2000). Partners in Rural Education. Paper presented at the FORUM for Applied Research and Public Policy, 15, 1 p93-96 Spr 2000. Thanks to the economies of scale inherent in networks of education services agencies (ESAs), these agencies can provide small rural schools with access to programs, services, and technical assistance that otherwise might be unavailable. Typical core services of ESAs, historic roots, evaluation of ESAs in Iowa and Texas, and trends in ESA funding and responsibilities are discussed. (SV) EJ603970

Stephens, E. R., & Haughey, C. F. (14 Oct 1993). Organizational and Operational Features of State Rural Education Interest Groups., 42pp. Paper presented at the Annual Meeting of the National Rural Education Association (85th, Burlington, VT, October 14-17, 1993). In many states, rural school districts or interested individuals have formed statewide interest groups to influence policy decisions related to rural education. Potential state rural education interest groups were identified through contacts with national and regional education associations and regional educational laboratories. Of 19 identified groups, 13 responded to a survey concerning their goals, operations, and organizational characteristics. Respondent groups had been established between 1974 and 1992. Common purposes include serving as state advocates for rural education, developing and promoting state rural education policies, offering technical assistance to rural educators, and engaging in research and analysis of contemporary issues facing rural education. Findings also covered organizational governance, affiliations with other organizations, composition and size of membership, dues structure, role of the executive officer, other salaried staff, use of contracted services, office or other housing, programs and services, annual budget, sources of revenue, and special assessments. Analysis of the results suggests that the great majority of groups have a common vision and are strongly committed to their mission. However, with a few noteworthy exceptions, the capacity of most groups to exert influence is seriously constrained by inadequate size, lack of adequate and definite financial support, and lack of adequate management and leadership support system. Such deficiencies may be remedied as these very young organizations mature. (SV) ED364371

Stevens, K., & Mulcahy, D. (1997). The TeleLearning and Rural Education Centre: Macro and Micro Dimensions of Small School Research., 28pp. In: The Many Faces of Rural Education. Proceedings of the Annual NREA Convention (89th, Tucson, AZ, September 24-27, 1997); see RC 021 239. The TeleLearning and Rural Education Centre was established in January 1997 at Memorial University of Newfoundland, in one of the most sparsely populated and economically depressed areas of Canada. Of 462 schools in Newfoundland and Labrador, 66 percent are rural and over half have enrollments of under 200 students. The Centre was established to address the educational needs of these small rural schools and improve the quality of educational services to rural communities. These goals will be accomplished through various research and development projects. The Centre acknowledges the long-standing relationship between rural and distance education, which has been formalized in the application of telelearning specifically for geographically isolated classrooms. A major research focus of the Centre at both macro and micro levels involves exploration of teaching, learning, management, and policy issues in small schools in rural areas. At the macro level, this focus is being pursued with research partners in New Zealand, Australia, Finland, Scotland, and Iceland. At the micro level, research and development work is being undertaken in several rural school districts in Newfoundland. The progress of the province's rural education reform over the last 5 years has been closely monitored, with particular attention paid to issues surrounding "school viability" and the combative informed resistance of rural citizens to government efforts to close small community schools. The Centre's teaching and learning initiatives include developing pedagogical approaches for multigrade or multiage classrooms, creating new media resources for effective teaching, and exploring effective ways of integrating new technologies into mathematics and science classrooms. Contains 68 references. (Author/SV) ED413150

Stine, P. (1997). Hands-On Science Education in Rural Pennsylvania. Bulletin of science, technology & society, 17(1), 13.

Stompe, T., Ortwein-Swoboda, G., Strobl, R., & Friedmann, A. (6 March 2000). The age of onset of schizophrenia and the theory of anticipation. Psychiatry Research, 93(2), 125-134(110). The clinical phenomenon called anticipation is usually defined as a decrease in age at onset and/or an increase in disease severity in successive generations of afflicted families. The purpose of this study was to examine variables that might influence anticipation in schizophrenia. A total of 380 Austrian patients, born between 1935 and 1964, met criteria for schizophrenia with ICD-8 or ICD-9, SADS-L and DSM-III-R criteria. The inclusion criteria also required medical records of patients to contain information about the year of birth, season of birth, age at onset, accidents or meningoencephalitic diseases during childhood, first- and second-degree relatives afflicted with schizophrenia, sibship size, sib order, education of patient, age of parents, occupation of parents, loss of parents, and place of residence. A Cox multiple-regression analysis showed three factors as having a significant influence on the age of disease onset, including year of birth (which had the largest influence), family history (sporadic cases showed an onset 2 years later than familial cases) and residence (urban dwellers showed psychotic symptoms approximately 1 year sooner than rural ones). A Kaplan-Meier Survival Analysis showed that younger cohorts had onset approximately 10 years earlier in sporadic and familial cases. This cohort effect might be a major source of bias in studies of anticipation.

Stowitschek, J. J., Lovitt, T. C., & Rodriquez, J. A. (January 2001). Patterns of Collaboration in Secondary Education for Youth With Special Needs: Profiles of Three High Schools. Urban Education, 36(1), 93-128(136). Research on school-to-adult life transitions of youth with special needs has identified collaboration as a crucial process for successful transitions. Depending on how it is defined, collaboration on the education of youth with disabilities between special educators, general educators, parents, students, and community service agency representatives may be considered rich or lean in activity and perceived utility. Profiles of three high schools, two urban and one rural, derived from analyses of administrator, teacher, parent, and student reports, suggest that some consistent patterns exist on the level of collaboration exercised as well as exemplary applications and systemic problems. Recommendations for research and implications for general practice are provided.

Strasser, R. P., Hays, R. B., Kamien, M., & Carson, D. (August 2000). Is Australian Rural Practice Changing? Findings from the National Rural General Practice Study. Australian Journal of Rural Health, 8(4), 222-226(225). ABSTRACTThe National Rural General Practice Study (NRGPS) was the first comprehensive national study covering rural and remote general practitioners throughout Australia. It was undertaken in 1996-1997 and drew on data from existing sources such as the Australian Bureau of Statistics and the Australian Institute of Health and Welfare, together with a postal survey of general practitioners in rural and remote areas. There was a 75 response rate to the survey, which covered professional issues, personal and social issues, personal background, patient issues, recruitment and retention programs and changing health services. Overall, the study findings confirmed those of previous individual State-based studies in the early 1990s and showed that there had been some changes since those previous studies. In particular, access to continuing medical education has improved, the rural medical workforce appears to be ageing, the proportion of women rural doctors is increasing and the projected length of stay in rural practice is decreasing. Whereas in the early 1990s the projection for rural doctor numbers was continuing decline, the NRGPS projected overall numbers in rural practice as staying approximately the same over the next 5 years. In the light of these trends, the challenge is to implement targeted initiatives that improve the recruitment and retention of rural and remote general practitioners.

Subrahamanian, R. (1999). Matching services with local preferences: managing primary education services in a rural district of India. Development in practice, 9(1/2), 68.

Subrahmanian, R. (1 February 1999). Matching services with local preferences: managing primary education services in a rural district of India. Development in Practice, 9(1), 68-77(10). In India, the pressing concern in education is with bringing in at least 32 million children estimated to be out of school, to meet the goal of Universal Elementary Education (UEE). Support for decentralisation of public services is widespread because of the equity and efficiency benefits associated with it. In particular, decentralisation is seen to facilitate the matching of services with local preferences, thus increasing the chances for policy goals to be met. This proposition is examined in the context of research carried out in a village of Raichur district in India, where poor households' 'preferences' with reference to school timings are analysed with a view to reflecting on their implications for education policy and management. The paper attempts to address the following concerns: how homogeneous are local preferences? What if these run counter to policy interests? Can aspects of services be selectively decentralised, or does the 'production' of the sector as a whole require to be rethought? The paper concludes with some thoughts on the importance of processes of 'preference' articulation, and the need to recognise preferences implicit within policy intentions.

Supakankunti, S. (March 2000). Future prospects of voluntary health insurance in Thailand. Health Policy and Planning, 15(1), 85-94(10). Voluntary health insurance schemes in Thailand are still under development and have yet to seriously address the questions of equity and efficiency, while private health insurance is limited to people who can afford the premium. One form of insurance, commonly known as the health insurance card scheme, was first introduced as the Health Card Program in 1983. This program is based on risk sharing of health expenditures, with no cost sharing, in a voluntary health insurance prepayment scheme. With the uncertain performance of the Thai economy, program sustainability and the efficient use of resources are major concerns. The Health Card Program needs enough enrollees to ensure a sufficient pool of risks. This study looks at health card purchase and utilization patterns, using data from Khon Kaen Province, and finds that employment, education levels and the presence of illness are significant factors influencing card purchase. The last factor is related to the problem of adverse selection of the program; families with symptoms of sickness are more likely to buy cards, resulting in greater use of health services. The results also show an improvement in accessibility to health care and a high level of satisfaction among card holders, both key objectives of the program. It is suggested that changes in the health card system could enable it to evolve into a community-based compulsory health insurance scheme for rural areas.

Swaim, P. L. (1995). Introduction to Special Issue on Rural Skills. "Rural Education and Training." Entire issue available from EDRS, request RC 020 673. Paper presented at the Theme issue. Describes research undertaken to improve measures of rural job skills, identify human capital initiatives supportive of rural development, and assess rural access to education and job training. Major themes include complexity of weaknesses and strengths in rural skills development systems, advantages of rural schools, and mutual reinforcement of low worker skills and low rural demand for high-skilled workers. (SV) EJ528302

Swaim, P. L. (1995). Job Training Lags for Rural Workers. "Rural Education and Training." Entire issue available from EDRS, see RC 020 673. Paper presented at the Theme issue. Current Population Survey data indicate that in 1991, only 40% of rural workers had received training on current jobs. Less educated, minority, and Southern rural workers were particularly unlikely to receive training. The nonmetropolitan training rate rose modestly, 1983-91, but less rapidly than the metropolitan rate, suggesting that fewer rural firms adopted high-skill production strategies. (Author/SV) EJ528308

Swift, D., & ERIC Clearinghouse on Rural Education and Small Schools. (1988). Preparing rural students for an urban environment. [Las Cruces, N. Mex.: ERIC Clearinghouse on Rural Education and Small Schools. Ed 1.310/2:296818

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Sahn, D. E., & Stifel, D. C. (December 2000). Poverty Comparisons Over Time and Across Countries in Africa. World Development, 28(12), 2123-2155(2133). We use Demographic and Health Surveys (DHS) to compare ''poverty'' at two or more points in time within and between African countries. Our welfare measure is an index resulting from a factor analysis of various household characteristics, durables, and household heads' education. An advantage of this measure is that for intertemporal and intraregional comparisons, we need not rely on suspect price deflators and currency conversion factors. The wide availability and similarity of questionnaires of the DHS facilitate comparisons over both time and countries. Our results generally show declines in poverty during the previous decade, largely due to improvements in rural areas.

Salako, L. A., Brieger, W. R., Afolabi, B. M., Umeh, R. E., Agomo, P. U., Asa, S., Adeneye, A. K., Nwankwo, B. O., & Akinlade, C. O. (1 August 2001). Article Treatment of Childhood Fevers and Other Illnesses in Three Rural Nigerian Communities. Journal of Tropical Pediatrics, 47(4), 230-238(239). The seeking of healthcare for childhood illnesses was studied in three rural Nigerian communities of approximately 10 000 population each. The aim was to provide a baseline understanding of illness behaviour on which to build a programme for the promotion of prepackaged chloroquine and cotri-moxazole for early and appropriate treatment of childhood fevers at the community level. A total of 3117 parents of children who had been ill during the 2 weeks prior to interview responded to questions about the nature of the illness and the actions taken. Local illness terms were elicited, and the most prevalent recent illness and the actions taken. Local illness terms were elicited, and the most prevalent recent illnesses were `hot body' (43.9 per cent), malaria, known as iba (17.7 per cent), and cough (7.4 per cent). The most common form of first-line treatment was drugs from a patent medicine vendor or drug hawker (49.6 per cent). Only 3.6 per cent did nothing. Most who sought care (77.5 per cent) were satisfied with their first line of action, and did not seek further treatment. The average cost of an illness episode was less than US2.00 with a median of US1.00. Specifically, chloroquine tablets cost an average of US 29 per course. Analysis found a configuration of signs and symptoms associated with chloroquine use, to include perception of the child having malaria, high temperature and loss of appetite. The configuration positively associated with antibiotic use consisted of cough and difficult breathing. The ability of the childs care-givers, both parental and professional, to make these distinctions in medication use will provide the foundation for health education in the promotion of appropriate early treatment of childhood fevers in the three study sites.

Santagata, R., & Stigler, J. W. (1 July 2000). Teaching Mathematics: Italian Lessons From a Cross-Cultural Perspective. Mathematical Thinking and Learning, 2(3), 191-208(118). The video component of the Third International Mathematics and Science Study (TIMSS) provided national-level descriptions of 8th-grade mathematics teaching in 3 countries: Germany, Japan, and the United States. Based on these data, Stigler and Hiebert (1999) argued that teaching is a cultural activity, varying more across cultures than within. This study extends their work, on a small scale, to investigate 8th-grade mathematics teaching in yet another country, Italy. Eleven Italian lessons, from urban and rural schools in northern Italy, were videotaped, translated, transcribed, and analyzed following the same procedures used in TIMSS. They were then compared with German, Japanese, and U.S. lessons videotaped in TIMSS. Analyses revealed Italian lessons to be relatively homogeneous among themselves, yet distinct from those in the other cultures. In particular, Italian lessons were found to include a unique activity, not observed in other countries, in which students and teachers interact at the blackboard, with the rest of the class as the audience. Interviews with Italian education professionals investigated the roots of this activity and supported the cultural nature of Italian teaching. Cross-cultural studies of teaching are useful for revealing practices hidden within a culture and for finding alternative ways of teaching.

Sarachan-Deily, A. B., College of Saint Rose (Albany N.Y.), & United States. Dept. of Education. (1985). Rural education curriculum resource booklet: faculty guide to rural education resources available at the College of Saint Rose. [Albany, N.Y.]: College of Saint Rose. Ed 1.310/2:269205

Sargent, J. D., Dalton, M., Beach, M., Bernhardt, A., Heatherton, T., & Stevens, M. (April 2000). Effect of Cigarette Promotions on Smoking Uptake among Adolescents. Preventive Medicine, 30(4), 320-327(328). Background. The purpose of this study was to evaluate the association between receptivity to cigarette promotions and smoking uptake in a cohort of adolescents.Methods and Measures. This was a prospective cohort study of 480 4th- to 11th-grade students conducted in three rural Vermont K-12 schools. Cigarette use was determined by self-report at baseline, 12 months (survey 2), and 21 months (survey 3). Proportional odds models were used to evaluate smoking uptake as a function of baseline measures of cigarette use, receptivity to cigarette promotions, and confounding factors, including grade, parental education, peer smoking, and family smoking. Adolescents were receptive to cigarette promotions if they owned or were willing to use a personal item bearing a cigarette brand logo cigarette promotional item (CPI). Smoking status was measured using a 6-point ordinal index that combined experience and attitudes: 0 = never smokernot susceptible to smoking, 1 = never smokersusceptible to smoking, 2 = puffer (1 cigarette or less in lifetime), 3 = non-current experimenter (2-99 cigarettes in lifetimenone in past 30 days), 4 = current experimenter, and 5 = smoker (100 cigarettes in lifetime).Results. The 480 students were equally distributed across grade at baseline. Environmental exposure to smoking was high, and 30 were receptive to cigarette promotions at baseline. Higher levels on the smoking index at baseline were associated with higher grade in school, peer smoking, and receptivity to cigarette promotions. One hundred eighty-five students (38.5) had moved to a higher category on the smoking index by survey 3, of whom 30 had become smokers. Receptivity to cigarette promotions at baseline was significantly associated with higher smoking uptake, with 48.7 of receptive students moving up one or more categories on the smoking index adjusted proportional odds 1.9 (95 CI 1.3, 2.9). Acquisition of receptivity to cigarette promotions was also associated with increased smoking uptake, with those becoming receptive in surveys 2 or 3 having significantly higher odds of progression 3.6 (1.8, 7.0) and 2.9 (1.5, 5.5), respectively compared with those who did not change. Conversely, those who were receptive at one point but became non-receptive in surveys 2 or 3 had lower odds of progression 0.4 (0.2, 0.9) and 0.5 (0.3, 1.1), respectively.Conclusions This study supports a close linkage between tobacco promotional activities and uptake of smoking among adolescents beyond baseline descriptions of receptivity to cigarette promotions. Over time, the likelihood of smoking uptake is increased when an adolescent acquires a CPI or becomes willing to use one and is decreased when an adolescent who owns a CPI loses it or becomes unwilling to use it. This provides strong evidence that elimination of cigarette promotional campaigns could reduce adolescent smoking. Copyright 2000 American Health Foundation and Academic Press.

Sarti, E., Flisser, A., & Wijeyaratne, P. (1997). Development and evaluation of a health education intervention against Taenia solium in a rural community in Mexico. The American journal of tropical medicine and hygiene, 56(2), 127.

Sauble, T., & Rhodes, R. (1998). The Effectiveness of Regional Center Cooperatives and Regional Education Cooperatives in Providing Special Education Services to Rural New Mexico. Rural special education quarterly, 17(2), 3.

Schafer, E., & Anderson, P. (1998). Heart*Style: A Worksite Nutrition Education Program in a Rural Setting. Journal of nutrition education, 30(1), 62.

Scherrer-Bannerman, A., Fofonoff, D., Minshall, D., Downie, S., Brown, M., Leslie, F., & McGowan, P. (10 August 2000). Web-based education and support for patients on the cardiac surgery waiting list. Journal of Telemedicine and Telecare, 6(4), 72-74(73). We assessed the effectiveness of two methods of patient education, a printed manual and a Website, provided to patients waiting for cardiac surgery. The four-phase study was conducted over two and a half years, and included urban and rural subjects in Vancouver and the interior of British Columbia. The Website was based on the specially developed patient education manual. A pilot evaluation study was carried out to assess the features of the Website and to ensure it was 'userfriendly', after which it was revised. The two education methods were evaluated using both qualitative and quantitative studies. Findings supported the feasibility and viability of both formats. The Web-based format demonstrated two additional benefits over the print-based format, namely increased social support and decreased anxiety. Other findings included the perception of increased support, lifestyle changes and more positive attitudes towards the impending surgery.

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Tapia, J. E. (1997). Circuit Chautauqua: From Rural Education to Popular Entertainment in Early Twentieth Century America., 232pp. Foreword by Robert A. McCown. In 1874, Methodist minister John Vincent began a Sunday school retreat on the shores of Lake Chautauqua, New York, the mission of which was education. Initial offerings such as Bible reading, biblical geography, and public oration were supplemented with general education and entertainment activities. In the late 19th century, the Chautauqua Movement became a popular form of adult education and entertainment in the United States. Usin g noted lyceum (community-lecture) speakers, such as Teddy Roosevelt and William Jennings Bryan, and local talent, the movement spread throughout the country and was particularly popular in the rural areas of the Midwest. This book provides an overview of early lyceum programs and of adult education in 19th-century America, followed by an examination of the growth of the circuit Chautauqua into big business, from its standardization and commercialization to the specific jobs involved in the program. The Chautauqua lecturer, musical features, dramatic arts, and children's activities are described. Its role in supporting U.S. involvement in World War I and its popularity during the 1920s are detailed, as is its demise, brought on by the Great Depression and the rise of the film industry. Develo ped during a generation that experienced massive social and economic changes, circuit Chautauqua educated people about these changes and helped them deal with the transformation. It also fostered the acceptance of modern forms of mass media such as film and radio. An appendix contains a summary of 20 years of Redpath Chautauqua programs. (Contains a bibliography with 75 references, photographs, and an index.) (TD) ED425880 Available from: McFarland & Company, Inc., Box 611, Jefferson, NC 28640; Tel: 800-253-2187 (Toll Free); Fax: 336-246-5018; Web site: http://mcfarland.com ($35 plus $4.00 shipping).

Tatto, M. (1999). Improving Teacher Education in Rural Mexico: The Challenges and Tensions of Constructivist Reform. Teaching and teacher education, 15(1), 15.

Taylor, S., Belton, L., Campbell, M. K., Benedict, S., Kelsey, K., DeVellis, B., & Tessaro, I. A. (October 2000). Adapting a natural (lay) helpers model of change for worksite health promotion for women. Health Education Research, 15(5), 603-614(612). Social network interventions that utilize informal systems of helping can be an important strategy for health promotion change. This article describes the development, implementation and evaluation of a natural (lay) helping intervention for health promotion change, specifically designed for women in small rural blue-collar worksites. One hundred and four women in four intervention worksites were recruited as natural helpers, and received health and skill-building education over an 18-month period. Qualitative evaluation showed: (1) two patterns of natural helping for women, i.e. participation due to a specific health concern with either themselves or others in their personal networks, and participation due to a larger sense of the importance of health and prevention; (2) over time natural helpers expanded the diffusion of health promotion information from close network members to co-workers and were more likely to be approached by their co-workers for information; (3) group activities at the worksite, particularly around physical activity, increased over time; and (4) because of time constraints at the workplace, written materials were a major way of spreading information to co-workers. This study shows that women can be recruited and trained to diffuse health promotion information and provide support to co-workers for health behavior change.

Teague, M., Talbot, J., & Ward, A. M. (December 2000). Evaluation of a Pilot Project to use Computers in a Rural General Practice Term. Australian Journal of Rural Health, 8(6), 305-309(305). ABSTRACTIn 1998, the Department of General Practice (Faculty of Medicine and Dentistry, University of Western Australia) ran a pilot project to use computers in a sixth year rural general practice term. Students were provided with a laptop computer to take into rural and remote areas throughout Western Australia during their 4-week clinical attachment. An email mailing list was set up for course participants to share experiences and complete set learning activities specifically related to rural general practice. An evaluation of this pilot project found that students felt less isolated on rural attachments, course outcomes were improved and rural preceptors were more involved in the programme. The development of a teaching and learning programme that involves the use of computers in rural general practice for undergraduate students has the potential to improve the quality of their medical education.

Templeton, M., & ConnerKerr, T. (2000). Identifying Fall-Related Risk Factors in a Rural African American Community: A Novel Physical Therapy Education Experience. Physical Therapy Case Reports, 3(6), 267-273.

Tesoriero, F., & Rajaratnam, A. (January 2001). Partnership in education: An Australian school of social work and a South Indian primary health care project. International Social Work, 44(1), 31-41(11). A partnership intended to be of educational mutual benefit has been developed between the School of Social Work and Social Policy of the University of South Australia and the Rural Unit for Health and Social Affairs, Tamil Nadu, India. The challenge of developing a mutually beneficial partnership between north and south, given the inequality in wealth that exists between the two, is a critical component in an ethically based relationship, most especially when it includes a profession that espouses social justice as a central value.

Theobald, P. ([1990). The Impact of Agribusiness on Rural Education., 18p. The dramatic growth of multinational agribusiness corporations has led to all types of rural declinesocial, demographic, institutional, and environmental. Historically, rural inhabitants and rural land have been abused and neglected in the name of progress. Rural development efforts often attract small assembly or light manufacturing plants that can use the nonunionized, low-skill, low-paying labor of farm women. Agribusiness entails farm input industries that provide services and machinery, large-scale incorporated farm operations, and food- processing and marketing firms, whereas small diversified farm oprations utilize more natural methods of maintaining soil fertility, limiting their need for agribusiness. Agribusiness, therefore, has an interest in cultivating the large- scale operation, which drives out smaller farmers, which in turn, closes shops and businesses in small towns, and adds stress to rural schools. Agribusiness chemicals and machines increase soil erosion rates, pollute groundwater, and produce chemically-laden meats, fruits, and vegetables. The rural school curriculum should: (1) promote pride in rural living through literature with rural themes and settings; (2) conduct demographic studies of local neighborhoods; (3) debate the ethics of agribusiness and other capital ventures; (4) address environmental issues by conducting experiments testing groundwater samples and erosion rates; and (5) expose students to rural advocacy organizations. Rural schools should battle the increased emphasis on testing which largely dictates the curriculum. (KS) ED331659

Theobald, P., & Nachtigal, P. (1995). Culture, Community, and the Promise of Rural Education. Paper presented at the Phi Delta Kappan, 77, 2, 132-35 Oct 1995. Redesigning education to recreate an ecologically sustainable community is a critical societal need. Educators should focus not on technological fixes, but on formulating new cultural assumptions. As Wendell Berry realized, genuine improvement will begin only in the country. Rural schools should stop emulating urban and suburban schools and attend to their own place. (14 references) (MLH) EJ513381

Thomas, S., Tandon, S., & Nair, S. (2000). Effect of dental health education on the oral health status of a rural child population by involving target groups. Journal- Indian Society of Pedodontics and Preventive Dentistry, 18(3), 115-125.

Thwala, J., Pillay, A., & Sargent, C. (2000). The influence of urban/rural background, gender, age & education on the perception of and response to dreams among Zulu South Africans. South African Journal of Psychology, 30(4), 1-5.

Tierney, P. T., Dahl, R., & Chavez, D. (June 2001). Cultural diversity in use of undeveloped natural areas by Los Angeles county residents. Tourism Management, 22(3), 271-277(277). National forests and other relatively undeveloped natural areas are some of the most popular tourist attractions. The objectives of this research were to determine the percentage of residents of a major metropolitan area who visit and do not visit undeveloped natural areas; quantify ethnic groups differences in use; and identify barriers for visitation. Logistic regression was used to determine factors that influenced visitation. Results showed that only two in five residents of Los Angeles County visited an undeveloped natural area during the peak summer travel period. Findings clearly demonstrate the complex nature of natural area attraction visitation and the decision to visit a natural area attraction is more than just transportation and income issues. Ethnic group preferences, education, crowding, lack of transportation, ethnic workers, lack of companions who travel to natural areas, finances and perceived discrimination all influenced recreation within undeveloped natural areas. Findings suggest that public agencies and rural tourism organizations must be proactive by creating new programs and expanding existing intervention projects to encourage visitation.

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_____. (1997). Rural business impacts on agricultural education. Australian farm journal, 7(7), 22.

United States. 1975 Dec. 29., & United States. Dept. of State. (1977). Rural education: agreement between the United States of America and Bolivia signed at La Paz December 29, 1975. [Washington]: Dept. of State: for sale by the Supt. of Docs. U.S. Govt. Print. Off. S 9.10:8475 S 9.12:

United States. 1977 Aug. 30., & United States. Dept. of State. (1978). Rural education: agreement between the United States of America and Bolivia, signed at La Paz August 30, 1977. [Washington]: Dept. of State: for sale by the Supt. of Docs. U.S. Govt. Print. Off. S 9.10:8994 S 9.12:

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Vaahtera, M., Kulmala, T., Hietanen, A., Ndekha, M., Cullinan, T., Salin, M.-L., & Ashorn, P. (2 March 2001). Breastfeeding and complementary feeding practices in rural Malawi. Acta Paediatrica, 90(3), 328-332(325). To facilitate optimal growth of newborns, many countries have developed infant feeding recommendations, usually suggesting 4-6 mo of exclusive breastfeeding and then the gradual introduction of complementary foods. We prospectively studied the changes in infant diets and predictors of adherence to national infant feeding recommendations in a cohort of 720 newborn babies in rural Malawi, Sub-Saharan Africa. Monthly interviews of the main guardians indicated that breastfeeding was universal for 18 mo. As most babies were given water or other supplemental foods soon after birth, the exclusive breastfeeding rates were only 19%, 8%, 2% and 0% at ages 1, 2, 3 and 4 mo, respectively. Complementary foods and family foods were introduced at median ages of 2.5 and 6.3 mo, i.e. much earlier than recommended. Better adherence to recommendations was associated with smaller number of children in the family, increased maternal education and some other socio-economic or environmental variables. Conclusion: Exclusive breastfeeding is uncommon and complementary foods were introduced early to newborns among these rural families. Education and family planning may improve adherence to infant feeding recommendations and reduce the incidence of early childhood malnutrition in Malawi.

Van, A., Curtis. (1994). Policy as a Stimulant to Curricular Growth in Rural Education. Paper presented at the Rural Educator, 16, 1, 1-4 Fall 1994. If boards of education in rural areas are going to strengthen education, they need to achieve empowering leadership through written policies that create a clarity of vision, empower subordinates, and emphasize renewal. Empowering leadership allows linkages among stakeholders of education and encourages creative efforts toward improving the learning environment. (LP) EJ495355

Van, A., Curtis. ([1992). Policy as a Stimulant to Curricular Growth in Rural Education., 10p. Rural school boards have a unique opportunity to impact education by involving teachers, administrators, and the community in policy development. To make policy an instrument of empowerment, policymakers should consider the following steps: (1) seeking information from any and all groups that the policy will affect to develop a statement about organizational growth; (2) write statements in the form of super-objectives giving a perspective of the individual's role in the total organizational setting; (3) distributing policies and collecting suggestions for refinement from the school board; and (4) receiving thorough input on all organizational levels culminating in a formal policy statement by the school board. Congruence of expectations and goals is necessary if boards of education wish to empower schools in developing programs and encouraging growth among its faculty. Empowerment is conducive to change because teachers and administrators work together toward common goals. Empowerment promotes positive community attitudes that reduce alienation and increase performance of both students and staff. Based on empowerment and shared decisionmaking, policy development has a greater capacity to fulfill its basic function of improving the learning environment for the learner. The continuing process of policy development and revision involving all constituencies becomes the leadership role of the local board of education. (LP) ED354133

Vandenberghe, V. (1 December 2000). Leaving Teaching in the French-Speaking Community of Belgium: A Duration Analysis. Education Economics, 8(3), 221-239(219). This paper aims toward a better understanding of the factors influencing the decision of young graduates who entered teaching to stay in that profession. The field of research covers secondary education teachers in the French-speaking community of Belgium. The data analyzed comes from an administrative database containing historical records of 50 000 individuals who started teaching between 1973 and 1996. The analysis is carried out assuming a proportional hazard model and using the discrete-time method initiated by Prentice and Gloeckler (Biometrics, 1978, 34, pp. 57-67). One of the main results is that the risk of exit is dramatically more important during the first periods of employment. The fact that this risk tends also to increase over time suggests that the dropout rate among young recruits is higher now than it was in the past. Location and labour market conditions seem to be of little impact.The risk of exit is the same in rural and urban areas and across provinces wherein unemployment rates vary dramatically. Finally, the significant deterioration of pay conditions (in relative terms) since the mid-1980s has had no significant impact on the risk of exit. Of greater importance are supply-side (organizational) elements such as the level of centralization of recruitment decisions or the level of asymmetry between tenure and non-tenure personnel regarding job protection, access to full-time position, etc.

vanderRiet, P., & Mackey, S. (1999). Therapeutic massage: An education program for rural and remote workers in the palliative care field. The Australian journal of rural health, 7(3), 186.

Verhoeff, F. H., Brabin, B. J., Chimsuku, L., Kazembe, P., & Broadhead, R. L. (1 March 1999). An analysis of the determinants of anaemia in pregnant women in rural Malawi a basis for action. Annals of Tropical Medicine and Parasitology, 93(2), 119-133(115). Haematological data are presented on 4104 pregnant women attending the antenatal-care facilities of two hospitals in a rural area in southern Malawi. In this area, malaria transmission is perennial and there is a high prevalence of HIV infection. The local women are exposed to drought and food shortages but experience high fertility rates. Mean (S.D.) haemoglobin (Hb) concentration was significantly lower in the primigravidae \[8.7 (1.6) g/dl] than in the secundigravidae \[9.1 (1.5) g/dl; P 0.0001] or multigravidae \[9.2 (1.5) g/dl; P 0.0001]. Primigravidae also experienced significantly more iron deficiency and malaria than secundi- or multi-gravidae. For all parity groups, the lowest mean Hb levels were observed between 26-30 weeks' gestation. In primigravidae peak prevalence of malaria occurred between 16-20 weeks' gestation (38.6%) and peak prevalence of moderately severe anaemia ( 8 g Hb/dl) between 26-30 weeks' (35.7%). Multigravidae showed little variation in the prevalence of anaemia, iron deficiency and malaria with gestational age. Peak prevalences of malaria were observed in April, in the post-rainy season, with values of 51.4%, 56.0% and 25.3% for primi-, secundi- and multi-gravidae, respectively. Peak prevalences of iron deficiency occurred between April and May and those of moderately severe anaemia between May and June. Mean Hb was lower in adolescent primigravidae than in any other group of pregnant women \[8.6 (1.5) g/dl], including the non-adolescent primigravidae \[8.9 (1.6) g/dl; P = 0.008]. Other factors significantly associated with increased risk of moderately severe anaemia in primigravidae were illiteracy and poor nutritional status (i.e. body mass index 18.5 kg/m2 and mid-upper-arm circumference 23 cm). After forward, step-wise, regression analysis of relative risk (RR) factors and their 95% confidence intervals (CI), variables associated with an increased risk for moderately severe anaemia were iron deficiency (RR = 4.2; CI = 3.0-6.0) and malaria parasitaemia (RR = 1.9; CI = 1.3-2.7) in primigravidae, iron deficiency (RR = 4.1; CI = 2.7-6.3) and mid-upper-arm-circumference 23 cm (RR = 1.8; CI = 1.1-3.0) in secundigravidae, and iron deficiency in multigravidae (RR = 3.1; CI = 4.3-6.9). The basis of anaemia prevention in this population of pregnant women is malaria control and haematinic supplementation, one of the most serious drawbacks being non-compliance. Although the present data are presented according to the World Health Organization's definitions of anaemia, the corresponding cut-off values for Hb ( 11 or 7 g/dl) were not associated with malaria, suggesting that these Hb levels would be less useful indicators in malaria interventions. It is argued that an Hb value of 8 g/dl might be considered for identifying the pregnant women at highest risk, for selective health education to reduce non-compliance.

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Wagy, T. (2001). Cobb, Radical Education in the Rural South: Commonwealth College, 1922-1940. Arkansas Historical Quarterly, 60(1), 102-103.

Walker, D., Muyinda, H., Foster, S., Kengeya-Kayondo, J., & Whitworth, J. (March 2001). The quality of care by private practitioners for sexually transmitted diseases in Uganda. Health Policy and Planning, 16(1), 35-40(36). One of the limited number of strategies available to reduce the spread of human immunodeficiency virus (HIV) infections in sub-Saharan Africa is the effective treatment of other, curable, sexually transmitted diseases (STDs). At present, a large proportion of people with STDs either treat themselves at home or seek treatment from private sector practitioners (PSPs) rather than use publicly funded services. A randomized controlled trial of the efficacy of a behavioural intervention with or without improved STD services is being carried out in Masaka, a rural area of south-western Uganda. The trial involves three groups, each covering six parishes. People living in one group of parishes receive information, education and communication activities (IEC) to increase public awareness regarding STDs and HIV/AIDS. The second group receives the same IEC interventions with improved treatment of STDs by both public and private service providers. The third group receives community development activities unrelated to HIV. In order to improve our understanding of how the quality of care provided by PSPs might be ameliorated, we interviewed 36 PSPs in the trial area, and made an assessment of the care they were providing. We also carried out six focus group discussions with patients to obtain their opinions on private services. PSPs in the intervention arm of the trial, who had attended meetings dealing with the syndromic management of STDs, referred to syndromes 82 of the time compared with 12 in the control arms, a mean difference of 70 (p < 0.001); stocked locally appropriate antibiotics 76 of the time compared with 52, a mean difference of 24 (p < 0.001); and are more likely to prescribe appropriate drugs 82 of the time compared with 27, a mean difference of 55 (p < 0.001). This small study suggests that PSPs can help improve the management of STDs.

Walker, S. F., Ed. (1993). Rural Education. Paper presented at the 14pp. Photographs may not reproduce adequately. This theme issue on rural education focuses on the unique characteristics and problems of rural schools, and discusses how the "top down" and "one size fits all" nature of the last decade of reforms has not taken these into account. To better address the situation of rural and small schools, various strategies are offered that involve distance learning, interagency collaboration, role of rural teacher, specific programs that are working, and a "bottom-up" approach. This issue contains the following articles: (1) "Rural Education: What are the Barriers to School Reform?" (Paul Nachtigal); (2) "Rural School Concerns Get Attention of Congress" (Joe Newlin); (3) "Distance Learning Provides Link for Rural Schools" (interview with Jim Mecklenburger); (4) "Do School Choice Plans Ignore Rural School Needs?" (Dori Nielson); (5) "Minnesota District Models Interagency Collaboration" (Sherry Freeland Walker); (6) "Rural Teachers Play Critical Role in Education Reform" (David Leo-Nyquist); (7) "Teaching in Appalachia Illustrates Extreme of Rural Problems" (Christine Morgenweck); (8) "Rural Schools Work on 'Bottom-Up' Change" (Jacqueline D. Spears); (9) "Rural Schools Lead Reform Effort in Alabama" (Jack Shelton); (10) "A Portrait of Rural Schools"; and (11) "ECS Helping States Bring Rural Schools into Reform Effort" (Chris Pipho). Contains photographs. (TD) ED388469

Walters, B. (March 2001). Does size matter? Is small really beautiful? British Journal of Special Education, 28(1), 35-44(10). The creation of smaller unitary authorities must have an impact on the way services are provided for children with special needs. This study looks at what has happened so far, focusing on the quality of provision and the ways in which available resources are being used within these reorganised contexts.Brian Walters circulated all unitary authorities in England and Wales formed by January 1998 n = 47 with a questionnaire concerning the preparation and provision for special needs in their new Authority. The questionnaire was sent to the senior officer responsible for Special Needs. Some 28 replies were received and follow-up visits for interview were made with 12 senior officers.The findings from both the questionnaires received and interviews conducted indicate both positive and negative outcomes in terms of provision and preparation for change. Service provision was clearly reduced in a significant number of new authorities n = 17 66 particularly for children with sensory impairment and those with emotional and behavioural difficulties.Some special schools were seen to be non-viable in terms of pupil numbers needing a much more regional organisational support, especially for children with emotional and behavioural difficulties and low incidence conditions. On the positive side a realignment of professional boundaries had taken place with management roles being combined and management structures compressed n = 17 66. There was certainly considerable enthusiasm for managing change by both officers and elected members to adopt more efficient streamlined practices in assessment and consultation n = 23 85. However, assessment times had not speeded up n = 14 50. Contacts with parents and other agencies had improved at the local level n = 24 86 and in particular consultation with schools on policy and procedures was much quicker and more effective n = 23 85. Nevertheless there were differences between urban n = 14 and semi-rural n = 14 authorities on local contacts and efficiency at the local level. Opportunities had been created for more strategic planning with inclusion policies to the fore n = 24 88. Inclusion was seen by smaller authorities as a part solution to the shortfall in services and school provision.The viability for very small unitary authorities under 25,000 school population working alone to provide a full range of services and provision was clearly an issue. There is a need for more regional collaboration, or a radical rethink on the form of provision in terms of more inclusive policies. Certainly there was a positive climate with regard to Green Paper issues.The greater autonomy of schools with increased funding for special needs being delegated poses problems for the effectiveness of such small authorities. Size does appear to matter. The smaller the size the more economy of scale issues appear.With Local Education Authorities including unitary authorities now subject to Ofsted inspection, Brian Walters' study is timely.

Wang, S.-J., Fuh, J.-L., Young, Y.-H., Lu, S.-R., & Shia, B.-C. (February 2001). Frequency and predictors of physician consultations for headache. Cephalalgia, 21(1), 25-30(26). We conducted a population-based headache questionnaire survey including questions on physician consultation for headache in Taipei, Taiwan from August 1997 to June 1998. The participants comprised 3377 subjects aged 15 years, of whom 328 (9.7%) had a diagnosis of migraine and 1754 (52%) had a diagnosis of non-migraine headache. Migraineurs had a higher physician consultation rate (once or more in the past year) than the subjects with non-migraine headache (54% vs. 31%, P < 0.0001). When frequency 10 times was taken as 10 times, the analysis showed that migraineurs consulted physicians more often than non-migraine headache subjects (2.36 vs. 0.96, P = 0.04). A small proportion of the subjects with either migraine (12%) or non-migraine headache (6%) accounted for 50% of total consultations within their groups. In addition to old age, low education levels, living in a rural area, migrainous features (nausea and photophobia), and work day loss, predictors of physician consultations also included `having been troubled with headache' (odds ratio (OR) = 1.7) and co-morbidity with hypertension (OR = 1.8) or heart disease (OR = 2.2). Low copayment and unrestricted access to medical care, as well as cultural factors played an important role in the high consultation rates in our headache subjects. Moreover, this study found self-perception of headache impact and co-morbid illnesses were important factors affecting the decision to consult physicians about headache.

Wang, X., & You, Y. (1999). The Historic Change of Social Enlightenment by Education in Rural China. Paper presented at the Shih hs