A rural emergency department.

The appropriate use of emergency departments is of growing concern. By knowing which patients are more likely to make inappropriate visits to these departments, efforts can be directed to encourage more suitable care. Our study was done in a rural county hospital in eastern New Mexico. Data were collected from all emergency department visits over a 4-week period. Patient and physician questionnaires were administered to assess aspects of emergency department use, including appropriateness based on published criteria, physicians'' opinion of appropriateness, groups who made inappropriate visits, and the perception of the need for and the urgency of a visit. We found that 32% of visits were inappropriate based on published criteria and 24% were considered inappropriate by physician opinion. Two groups with a high rate of inappropriate visits were Hispanics and Medicaid recipients. Patients and physicians have differing opinions of the urgency of a visit and of how soon medical treatment is required. To decrease the frequency of inappropriate use of emergency departments, educational efforts should be focused on the subgroups with high rates of such use.     

Dementia care in rural China

Dementia is a major cause of disability and has immense cost implications for the individual suffering from the condition, family caregivers and society. Given the high prevalence of dementia in China with its enormous and rapidly expanding population of elderly adults, it is necessary to develop and test approaches to the care for patients with this disorder. The need is especially great in rural China where access to mental healthcare is limited, with the task made more complex by social and economic reforms over the last 30 years that have transformed the Chinese family support system, family values and health delivery systems. Evidence-based collaborative care models for dementia, depression and other chronic diseases that have been developed in some Western countries serve as a basis for discussion of innovative approaches in the management of dementia in rural China, with particular focus on its implementation in the primary care system.     

Energy flows in rural China

A quantitative analysis of major rural energy flows in the People's Republic of China shows that the nation 's countryside still depends predominantly on solar radiation transformed by green plants through photosynthesis into food, feed, fuel, and raw materials. Although a large-scale modernization effort currently under way aims to greatly increase the consumption of fossil fuels and electricity, it is argued that the country should not completely abandon its renewable rural energetics.     

Water quality in rural Australia

Grab samples of drinking water collected from reservoirs and from creeks flowing over pristine land, farmland or land having mixed use were analysed for their physicochemical and microbiological characteristics. A significant difference between sites for conductivity and sites for pH was noted using a two-way anova . No significant interactions were detected between any of the other parameters: Giardia , Cryptosporidium , Escherichia coli , coliforms, plate count, turbidity or rainfall.