The Burden of Undiagnosed Hypertension and Associated Risk Factors among Adults in a Rural Community in Imo Sate, South-East Nigeria

Background: Cardiovascular diseases are the leading cause of death globally and hypertension is a major contributor to this burden. Many people with hypertension have poorly controlled blood pressure and up to half of the adults with hypertension are unaware of their hypertensive status due to factors that bother on poor management and poor screening approaches. The implication is that people who have poor access to healthcare especially those in the rural communities are at increased risk of cardiovascular complications and all-cause mortality. Unfortunately, not much has been done to ascertain the burden of undiagnosed hypertension and associated risk factors in rural communities in Nigeria. Methods: We conducted a community-based cross-sectional study in a rural community in Imo State, Nigeria, on burden of undiagnosed hypertension with participants recruited via a multi-stage sampling method. An interviewer-administered questionnaire was used, and standardized instruments were applied to obtain, process and analyze the data. Tests of association between the independent variables and outcome were conducted using logistic regression. P-value of Results: A total of 380 adults participated in the study. The mean age was 44.2 years. The prevalence of undiagnosed hypertension was 35.8%. Logistic regression revealed that age, with the respondents in the age groups 26 - 35 years (OR = 10.647, 1.910 - 59.345, p-value = 0.007), 36 - 45 (OR = 3.680, 1.263 - 10.723, p-value = 0.017), 46 - 55 years (OR = 2.737, 1.114 - 6.727, p-value = 0.039), 56 - 65 years old (OR = 3.384, 1.610 - 7.115, p-value = 0.001);and being married (OR = 3.846, 1.118 - 13.233, p-value = 0.033), were independent risk factors for undiagnosed hypertension. Conclusion: The prevalence of undiagnosed hypertension in the rural population of South-East Nigeria is high. Younger age (26 - 35 years) had the highest odds of risk for occurrence of hypertension. Also being married was identified as a risk factor for undiagnosed hypertension.

Feasibility Study of Assist-Linked Brief Intervention for Substance Use Disorders in a Rural Community of Plateau State, Nigeria

Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear gap in meeting the needs for treatment and care for people with drug use disorders in Nigeria with many users reporting a self-perceived need for treatment and about 40% of them wanting to receive drug treatment but were unable to access such services. Methods: ASSIST questionnaire was used to gather baseline data, and ALBI along with Motivational Interviewing (MI) was used to intervene for 6 weeks following which ASSIST score was repeated and compared with baseline. Results: Majority of the participants were aged 21 - 30 years, mostly males with (61.3%) lacking steady jobs. Lifetime prevalence of any drug use was (88.2%). Three months prevalence was nicotine (72.0%), alcohol (66.7%), cannabis (47.3%), opioids (11.8%) among others. The ASSIST scores were mostly on the severe ranges. ASSIST result after six weeks showed marked reduction. The Mean Difference (MD) in the ASSIST scores after intervention was significant for tobacco, opioids, alcohol, and cannabis. The Cohen’s D effect size was large for tobacco (1.08), alcohol (0.92) and cannabis (0.73) but low for other substances. Conclusion: ALBI along with MI was helpful in combating the menace of substance use.

Medical Morbidity Profile of Adults in a Rural Community in Enugu, Southeast Nigeria: A Cross Sectional Survey

Introduction: People in rural communities are exposed to the risk factors for non-communicable disease as those in urban areas. Correct interpretation and management of symptoms are important in primary care especially in rural communities where diagnostic facilities are not readily available. Materials and Methods: This was a cross-sectional study carried out in a village in Enugu South Local Government area of Enugu State. Thorough medical history was taken from all eligible participants who gave their consent. Data were analyzed using SPSS version 26. Results: Data from a total of 1019 (64.7%) out of 1576 participants were analysed. Fever was by far the most common presenting complaint 580 (56.9%) of all participants and 67.9% of medical complaints seen in the clinic. This was followed remotely by musculoskeletal problems and neurological problems 15.6% and 3.8% of the participants respectively. Across all age groups, febrile illness was more than non-febrile illness except in those 65 years. Generalized body pains 74 (7.3%), back pains 55 (5.1), headache 33 (3.2%) and abdominal pains 24 (2.4%) were the commonest symptoms presented by the participants. About 15 (1.5%) of the population surveyed had had trauma/surgery in the past. This was twice the number who presented to the clinic with symptoms related to injury and trauma 7 (0.7%). Conclusions: Fever and musculoskeletal pains are the dominant medical complaints presented by adults in a rural community clinic. This may be related to the season of the year and the occupation of the population studied.

Rebuilding and Integration of Rural Governance System Based on the Combination of Self-governance,Rule of Law and Rule of Virtue

The proposal that"the rural governance system based on the combination of self-governance,rule of law and rule of virtue should be completed"was put forward in the report of the 19th National Congress of the Communist Party of China.There are many challenges for the development and difficulties for the governance of rural social transformation in the new era,so"the combination of self-governance,rule of law and rule of virtue"is realistically essential,having the objective inevitability and practical possibility.The fundamental and central role of the villagers'self-governance should be brought into full play to construct"the rural governance system based on the combination of self-govermance,rule of law and rule of virtue"under the guidance of the spirit of the 19th National Congress ofthe Communist Party of China,by taking the rule of law as the legal assurance and rule of virtue as the social affection support,managing to complete and optimize the rural governance system,realize the good and right governance in the rural society,boost the modernization construction process of the national governance ability,and realize the great objective of comprehensive rural vitalization of the"stability of the rural areas,development of the agriculture and happiness of the farmers".

Rural Tourism Format Network Mode Based on Community Participation:A Case Study of Jindatian Village of Zhejiang Province

Because of the existing problems, features and demands in China ’s rural tourism development, sustainability in modern rural tourism necessitates the own ca-pability of rural vil ages and the active participation of community residents. The structure of rural community with the impact of rural tourism is analyzed, and the coupling relation between rural tourism development mode and rural community is discussed. With the integration of rural tourism resource and community capability, network of rural tourism formats is organized starting with the possibility and ways of participation of community＆#39;s vil agers, and formats of public resource type, plat-form investment type, smal and micro enterprises type, and general investment type are constructed to realize the positive cycle of rural community factors and tourism development. A case study of Jindatian Vil age demonstrates the feasibility of rural tourism network mode based on community development, which can depend on community＇s capability to realize the sustainable rural tourism, the protection and heritance of rural culture, and the regeneration of rural economy.

Inquiry of Modernization Management of Rural Community Self-organizing on the Perspective of Social Work

The current rural community self-organizing of China is closely related with the rural social stability as well as economic and social development. However, the current rural community self-organizing construction falls far behind the requirements of realistic practice all over China, which greatly affects the advancement of the rural modernization of China. On the other hand, social work provides a unique perspective and method to deal with these problems. Its service philosophy of selfservice as well as its humanitarian value and practical working methods provide reality conformity for the intervention into rural community self-organizing, making it conductive to improving the social relations between rural community residents and possible to realize the mutual development of rural community and rural community residents.

Landscaping Patterns for New Rural Communities——Using Dezhou City of Shandong Province as a Case Study

By combining with the "village consolidation" pattern in the construction of rural communities in Dezhou City,Shandong Province,this study summarized landscaping characteristics of new rural communities,proposed principles to be followed in the landscaping,and discussed proper landscaping patterns for new rural communities.

Rural Carbon Emissions Based on Community Management

Rural community is an effective way to simultaneously achieve manage- ment of ecological resources and protection of natural resources, depending on its management mode based on cooperation, motivation, local experiences and extensi- ble boundary. In the research, carbon emission in community is a kind of ecological resources and negative externality is the cause of increase of rural carbon emission. Compared with governmental ruling and marketing approach, community manage- ment mode proves more effective to solve the problem of negative externality of carbon emission in community. Furthermore, rural carbon, emission was analyzed in detail on basis of community management mode and extending mode of carbon emis- sion in rural areas. In addition, some policies and suggestions were proposed to im- prove community management of carbon emission in rural areas, providing an ef- fective way for low-carbon economy in rural areas.

The Problems Existing in Building of Rural Community in Jilin Province and Corresponding Countermeasures

This paper analyses some problems existing in building of rural community in Jilin Province as follows:the funds for community building are short;the residents show sluggish participation in community;the infrastructure community building is backward;the organizational building of community lags behind;the operating mechanism is in chaos.Finally,corresponding countermeasures and suggestions are put forward as follows:we should strengthen the funds guarantee of government for community building;we should reinforce the quality education for the rural residents;we should speed up the construction of rural infrastructure;we should improve organizational building of rural community.

Research on the Harmonious Development of New Rural Communities under the Perspective of Balancing Urban and Rural Areas

On the basis of offering a definition of New Rural Communities (NRCs), the paper analyzes the values of New Rural Communities and argues that the construction of NRCs is able to contribute to the enhancement of the comprehensive agricultural production capability as well as the development of social productivity. Meanwhile the incomes of the rural residents can be boosted, which denotes the realization of a harmonious society where the achievements of China's reform and development are shared by each citizen. Moreover, the construction of NRCs facilitates the economization of land use and thus improves the overall living standard of the residents, while helping to cut the administrative cost and promote democracy at the primary level. This paper also points out various problems arising during the construction of NRCS in China: blindly following suit in accordance with the modes of the urban communities; lack of funds, which leads to the absence of the supporting mechanisms of NRCs; vague positioning and the ensuing shortage of impetus for continued development. Finally, the paper raises the corresponding measures and suggestions: first, based on reality, make overall planning and scientific arrangement; second, the government should play the dominant role while respecting the principal position of the rural residents and introducing the market mechanism; third, increase science and technology input and attach equal importance to economic and social benefits; fourth, broaden fund-raising channels while completing the supervision mechanism.

Water Supply Dilemma in Nigerian Rural Communities: Looking Towards the Sky for an Answer

Access to safe water supply has great influence on the health, economic productivity and quality of life of the people. But meeting this need is one of the major challenges facing the rural communities of Nigeria today. The purpose of this review paper is to determine whether water supply have contributed effectively to health, social, and cultural development of Nigerian rural communities. Over 70% of households in rural communities do not have access to improved water supply. They rely solely on self-water supply (free source) such as rivers, perennial streams, water ponds and unprotected wells which is susceptible to water borne diseases such as typhoid fever, cholera, dysentery, malaria parasites etc. These rural populations are engaged in farming activities with low income level living in small scattered settlements thus, making provision of piped water supply very difficult. Governments’ interventions towards rural water supply have been through the provision of hand-operated boreholes and wells. These sources yield little or no water during the dry season and are prone to frequent breakdown;leading water crisis and shortages. This situation forces households especially the women and children to spend more time walking longer distances during the dry season to trot water for domestic purposes. Given the fact that the publicly operated water supply have not been able to cope with increasing demand, there is a need for a paradigm shift from the public monopoly of water supply to an innovative approach. Rainwater harvesting technology appears to be one of such alternative approaches.

Research of Spatial Construction Strategy in Chinese New Rural Community

Through the field survey of traditional rural settlement,it has found that the typical spatial construction model shows the duality of matrix and landmark and they are in a relation of reciprocal causality.However,under the impact of urbanization and modernization,this spatial construction model is disappearing,and those natural villages are integrated and reconstructed at a high speed and in a large scale during the construction of new rural communities,leading to a lack of geographical construction system and a damage of ecological living environment.In the perspective of prototype theory,the duality feature should be combined with spatial construction model to guide the inheritance and application of spatial construction model of traditional rural settlements and seek for new spatial development approach for new rural communities based on the sustainable,alternative and transformation strategies.

Significant Differences in Elderly Health between Urban and Rural Communities: A Literature Review

This study aimed to examine measures pertaining to elderly health in urban versus rural settings, and to identify differences in the health of elderly people living in urban and rural communities through a literature review. An electronic literature search was performed using PubMed for English articles published in peer-reviewed journals up to August 2018, with the following search terms: “urban”, “rural”, “comparison of community”, “elderly health”, and “comparison of community health”. A total of 35 articles were extracted for a critical full-text review, and six articles that met the inclusion criteria were subjected to analysis. Measures related to elderly health in urban and rural communities were classified into the following three categories: functional abilities, health, and health perception. Five of the six articles described functional abilities (e.g., social function) and health (e.g., mental health, depression) as categories with significant differences in elderly health between urban and rural communities. The results suggest that elderly health measures related to social function and mental health or depression are more important outcome measures of effective person-centered integrated community care systems from the perspective of community characteristics. As there were only a few articles reporting on elderly health according to differences in environment between urban and rural communities, further investigation is globally warranted.

An empirical analysis on community residents' perception and major influencing factors of rural tourism development

With the rapid development of rural tourism in China,community residents,as important stakeholders in the development of rural tourism,their perceptions and attitudes directly affect the sustainable and healthy development of local rural tourism.Taking the community residents of Xiaogucheng Village in Hangzhou as the research object,using the methods of field interviews and questionnaires,a multiple regression model was established to conduct an empirical analysis on the perception and main factors affecting the development of rural tourism of community residents.The results show that the development of rural tourism in villages with better economic development is not as popular as expected;Where community residents have made ideological progress and are willing to participate in tourism development,the development effect of rural tourism is remarkable;In addition,community residents also hope that their personal abilities can be combined with rural tourism for common development;The destruction of community environment has a slight impact on the development of rural tourism,which shows that the attention is not enough.Finally,based on the analysis conclusion,it provides new ideas and inspiration for the sustainable development of rural tourism:improving the community residents’participation in rural tourism system,establishing the guidance mechanism of community residents’tourism vocational education,and consolidating the achievements of community ecological environment management.

<i>Prosopis</i>L. Invasion in the South-Western Region of Botswana: The Perceptions of Rural Communities and Management Options

This study was aimed to determine the extent to which Prosopis species had invaded four settlements (Bokspits, Rappelspan, Vaalhoek and Struizendam) located in the Kgalagadi Desert south west of Botswana, investigate the perceptions of the communities about the existence of the species in their environment and assess possible control options for the spread of Prosopis plants in the area. Prosopis plants were sampled in 42 quadrats of 625 m2 along a 70 km Prosopis invasion gradient from Struizendam to Rappelspan. Using the Global Positioning System (GPS), the locations of all quadrats were established. The distribution map of Prosopis plants was produced using ArcGIS 9.2 (ESRI Inc.). Questionnaire survey and focused group discussions were used to collect data on the perceptions of rural communities about the species. A total of 342 respondents comprising 139 males and 203 females were interviewed, and four focussed group discussions were conducted. The results indicated that the invasion of Prosopis species was prominent in and around settlements suggesting that anthropogenic activities had a significant role in the spread of Prosopis plants in the area. The perceptions of rural communities about Prosopis plants appeared to be moulded by the impacts of the plants on their livelihoods as well as their micro-economic status. The respondents (71.30%) expressed the view that the invasion of Prosopis species negatively affected the livelihoods of the communities in the study area. They identified eradication as the preferred method of controlling the spread of Prosopis plants. On the contrary, this study recommended the integrated environmental management paradigm as the best options for the control of the spread of Prosopis plants in the area.

Impact Measurement of Community Development Using the Development Wheel： A Case of Madhuwani VDC, Lumbini, Nepal （With Reference to Rural Tourism）

Recent trend on ongoing changes has unfolded the truth that people are the actors of environmental and social changes. The decade following the restoration of multi-party democracy witnessed a number of economic reforms and development initiatives. The adoption of a liberal, market-oriented development strategy led by private sector has helped to stimulate investment and growth. Nonetheless, development efforts have been largely unsuccessful in integrating the vulnerable and marginalized groups. The governance system has remained non-functional because deeply rooted processes of exclusion have compounded failures at the institutional level and in implementation process. The impacts of development may be measured by several means. This research is an earnest effort to bring new innovations in impact measurement of social inclusion programs. The rigorous processes of finding changes over a period of time and assessing the changes in a ＂wheel＂ are interesting parts of the people lead development in the twenty-first century. Indicators of the development wheel are designed by development professionals of Nepal and rating is done by local stakeholders of Lumbini themselves. The study is based on exploratory and descriptive research design. It follows sequences of appreciative inquiry and development wheel preparation to compare the changes that are in vogue in Nepal. The changes are quantified in three continua that depict the community development programs implemented from 2003 through 2006. This measurement invites rigorous planning and inputs （man, money and time） but it is quite easy for local stakeholders that where they are （in development） and in which direction the currently available and future resources should be streamlined.

A Study of a Rudimentary Potable Water System in a Rural Community

A comprehensive study was conducted to evaluate a rural community’s efforts to solve its potable water problem. Residents of St. Margaret village has built a rudimentary water storage facility through their community efforts and run a network of water supply to the households of the village. The study analyzed the water quality of the reservoir for physical, chemical and microbiological parameters by using standard water quality measurements and compared it between the wet and the dry seasons. The results indicate that the temperature and the pH were highest in the month of April. The phosphate level was high during the month of November whereas the dissolved oxygen level was lowest during November. The presence of fecal coliforms and other pathogenic microbes such as Salmonella and Shigella suggested that the water bodies are not safe for human consumption. The survey of the households in the village also revealed that health ailments associated with gastrointestinal tract are common among the people using the water for drinking purpose. The community’s effort in finding solution to their potable water problem has been demonstrated in the design and execution of the rudimentary reservoir in the St. Margaret village. Although majority of the inhabitants of the village have only primary-level education, they were able to carry out a major engineering project.

Cost Comparison and Hydraulic Design of Four Types of Residential Rainwater Harvesting Systems for Small Rural Communities, Considering Natural or Anthropogenic Climate Change Factors

This document presents the technical description and cost comparison of four rainwater harvesting systems for homes, the method for its hydraulic design and an equation to estimate the minimum catchment area, with the goal to supply drinking water to segregated small communities in Mexico considering climate change effects, both natural and anthropogenic. The four Rainwater Harvesting Systems (RHS) introduced in this work are the following: two rigid, one system built with ferrocement and the other built with clay bricks, and two flexible: one is a commercial collector while the other is a system built with a 3/8-inch reinforcing bar mesh and covered with a linear low-density polyethylene geomembrane. The RHS consist in cylindrical containers built with diverse materials, and in the case of rigid RHSs, they can store up to 50,000 liters of water. Also, rigid RHSs have a longer useful life and are more resistant than flexible RHSs, but their cost is notably higher. Rigid RHSs compete in price with commercial rainwater harvesting system brands like Rotoplas, but commercial RHSs disadvantages are their lower durability, storage capacity, and resistance. On the other hand, flexible RHSs are less durable than rigid ones, although, in the case of the rainwater harvesting system made with a 3/8-inch reinforcing bar mesh, the system can be rebuilt and reused and the cost is much lower. The design of the collectors takes into consideration the climate variability of the study area, natural or anthropogenic.

Rural Community Variation in Physician RecruitmentReadiness

The capacity at which a rural community can mobilize resources involved in recruiting physicians has positive implicationsfor community health. The purpose of this study was to assess whether rural communities varied in their physician recruitmentreadiness. Methods： The Critical Access Hospital Community Apgar Questionnaire （CAH CAQ） was the instrument used in this study.Seventy one （71） rural communities in five US states who participated in the Community Apgar Program were included in this researchIn each rural community, the administrator of the critical access hospital and the physician/clinician with recruiting responsibilitiesparticipated individually in a structured interview. A total of 71 administrators and 71 physician/clinicians participated in the study（total N = 142）. Cumulative Community Apgar scores were calculated for each rural community. Descriptive statistics were calculatedfor this measure including means, standard deviations and coefficient of variations. No statistical differences were discerned acrossstate mean cumulative Community Apgar scores. Cumulative Community Apgar scores demonstrated variability within states and inthe aggregate across states. The five rural states included in this study showed similar distributions/patterns of cumulative CommunityApgar scores within their respective states. These distributions/patterns demonstrated variability in the cumulative Community Apgarscores in every state. Likewise, the aggregate distribution of cumulative Community Apgar scores demonstrated variability across thefive states. These rural communities vary in their physician recruitment readiness as measured by the CAH CAQ. As such,improvement efforts need to be customized for the specifics of the individual community. One size does not fit all.

Prevention and Control of Adolescents' Deviant Behavior in Rural Community

Firstly,an analysis is made from the point of view of sociology on traditional modeling logic of prevention and control of adolescents' deviant behavior in rural community,and maintenance and reproduction of this model.The traditional prevention and control model of adolescents' deviant behavior in rural community is diversity-orderly pattern prevention and control system.This system is based on natural economy,especially on agricultural economy."Supervision by public opinion and moral imitation" is the basic operation logic of this system.It contains a compensation mechanism of "bringing up children for the purpose of being looked after in old age" and "favor returning".Then,deconstruction of traditional prevention and control model for adolescents' deviant behavior in rural community is analyzed.Along with advance in rural modern democratic management and legal construction and growing of rural market economy,function of traditional diversity-orderly pattern of prevention and control of adolescents' deviate behavior in rural community is weak and weak in prevention and control of modern rural adolescents' deviant behavior.Finally,modeling ideas of new(coordinative) prevention and control of rural adolescents' deviant behavior are put forward from four aspects,namely,democracy and legal system,community,family and various rural adolescent admittance organizations.