Syllabus

Week 1:  May 8, 2000 

1. Examine definitions of the term rural.
2. Explore the the concept of rural from the geographic, social and economic perspectives.
3. Describe the sociocultural characteristics of rural communities.
4. Geographically locate rural communities: international, national, local.
5. Examine the rural community from the perspective of rural culture.
6. Discuss the health issues faced by rural communities and their causative factors.
7. Identify barriers to health care in a rural environment.
8. Describe unique features of Rural Community Health Practice
9. Examine how the Healthy People 2010 objectives relate to rural communities.
10. Examine the role of nurses who work within rural communities.

Rurality
Rural-urban continuum

Global level: remote and rural communities

Applicable community health concepts

• population
• community
• aggregate
• epidemiology

• generalist
• role diffusion
• autonomy
• community visibility
• community ties
• levels of prevention

Rural
Urban
population
community
aggregate
epidemiology
primary prevention
secondary prevention
tertiary prevention

2.  Locate the 
Healthy People 2010
web site on the Internet and bookmark this on your computer.  Look through the document to see what references there are to rural communities or people living in rural areas. Write down these areas for later use and make some notes so you remember what they are about..

3.  Conduct an Internet search to see what you can locate about rural communities from the perspective of geography, issues, industry and demographics 

USE THE WEB BOARD!

Then post one web address on the web board and tell the group why you thought this would be a good reference site for a course called Rural Cultural. Check the sites the other students post and bookmark them for future use.

4.  Print and read the windshield survey found at the link below. Bring this with you to the practice site next week.

Complete Windshield Survey

5.  Go to the CD-ROM that came with your textbook. When you open it up find the menu and then look at the bottom right of that page.  You will see a Tools button. Click on that and locate yet another Windshield Survey and Components and print that page to also bring with you to practice.

2.  Read Chapter 31 in your Stanhope & Lancaster textbook:
Sebastian, J. (2000)
Vulnerability and vulnerable populations: an overview pages 638-665.
 

Read other chapters in your textbook as needed to familiarize yourself with public and community health concepts.

1. Understand the key terms used in understanding the concept of culture and cultural diversity.
2. Evaluate the way in which one's own culture may influence the nursing care of cultural diverse clients.
3. Examine societal factors influencing the need for study and practice of culturally competent nursing.
4. Analyze the role of the nurse as an advocate for culturally competent health care.

• holism
• cultural congruency
• values, belief, practices

• population distribution
• disparity

• Healthy People Objectives

Transcultual Nursing Society

acculturate
assimilate
attitude
belief
culture
cultural competence
cultural diversity
ethnic group
ethnicity
ethnocentrism
ethnomedicine
prejudice
race
racism
stereotyping
subculture
values

Click here for link to a cultural assessment tool

3.   USE THE WEB BOARD

Make a posting on the web board to tell us something about what it was like to use the tool and what you thought about the topics it covered.  Also tell us why you think nurses need to develop cultural competence.
Converse with your classmates about their experience.

4.  Practice Day
Your first practice day is Thursday, May 18.  Details of the practice site and meeting times will be posted on the web board.

Degazon, C. (2000) Cultural diversity and community-oriented nursing practice. In Stanhope & Lancaster, Chapter 7; pages 138 -156

2.  Get out the student handbook provided by the School of Nursing.  Locate the Bachelor of Science in Nursing Curriculum Model. Read the sections describing the model particularly the cultural connectedness concept.
Also read the terminal objectives for the Bachelor of Science Nursing program.

3.  Watch the following videos available on reerve in the FGCU Library:

Community Health Nursing Video Series
Volume 6: Culture in the Community
Media RT 98 .M6 1995

Communication in Nursing Video Series:
Communicating with clients and colleagues from different cultures
RT 23 .M67  1995  v.3
 
 
 
 

Week 3: May 22, 2000

1. Discuss the term health promotion.
2. Explain the three levels of prevention: primary, secondary, tertiary
3. Discuss learning principles that affect health education
4. Identify and utilize the steps in preparing a teaching plan.
5. Write outcome objectives for a health promotion activity.
6. Select content and learning strategies appropriate to the health learning needs of a target audience.
7. Identify ways to evaluate client learning.

Health Promotion Role of Community Nurse
 
 
 
 
 
 
 
 
 
 
 
 

1.  Locate a search engine on the internet.
Type in Bloom's Taxonomy.  When you find some web sites go to them to find the three domains of learning:
Cognitive, Psychomotor, Affective. 
Write definitions for each of these.

2.  Writing outcome objectives is a critical part of education process.  Using the criteria on page 277-78 of your textbook write one objective that you could use for your
health promotion project that is required for this subject. Tell us what is the topic for your health promotion activity.

USE THE WEB BOARD
Post your health promotion topic and the objective you have written for this exercise on the web board by Wed of this week. 

3. **GO TO WEEK 4 READ THE FIRST
ACTIVITY.  SELECT YOUR CULTURAL GROUP AND POST YOUR SELECTION ON THE WEB BOARD AS REQUIRED.

Onega, L. (2000) Educational theories, models, and principles applied to community and public health nursing.  pp266-83.
 

2.  Select 2 references from the bibliography of this chapter, obtain the articles, read and then use them in your health promotion project.

Week 4: May 29, 2000

1. Identify the major cultural groups found in rural America.
2. Identify the parts of the world these cultural groups originate from.
3. Identify dominant languages & explore their practices of communication.
4. Describe gender related roles and taboo behaviors in family systems.
5. Identify group specific workforce issues and migration.
6. Explore specific high risk behaviors and health practices common to groups.
7. Describe real and potential environmental risks to health.
8. Within the cultural groups, identify meaning of food, food rituals and nutritional deficiencies.
9. Describe group beliefs about death, death rituals and expectations.
10. Explore combinations of magico-religious beliefs, folklore, traditional beliefs, and alternative health care that influence health care behaviors for each group.

Click here for a link to Culture Notes from Clark, M. (1999) Nursing in the Community,Appleton & Lange, Stamford, CT
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

-Native American Navajo
-Haitian Americans
-Asian/Pacific Islander
-Mexican America
-Cuban American
-African American
-Puerto Ricans
-White European:
German 
-White European: Italian
 

Research the group with respect to:

Complete by Activity by May 31 12 Noon.   Email an outline of your work to each class member for use in discussion with the practice group on Thursday this week. Be sure to mail also to Professor Nolan. 

2.  Review the Healthy People 2010  objectives that relate to minority health.
Identify initiatives aimed at improved minority health.
 

3.  Practice Day

Your practice day is Thursday, June 1.
Meet at the practice site at 8:30 AM.
Please wear practice attire as specified in the student handbook.

Sebastian, J. (2000)  Vulnerability and Vulnerable Populations: An Overview.
pgs 638-663.
 

2.  Read Chapter 34 in your Stanhope and Lancaster textbook:

Jones, K. et al (2000) Migrant health Issues
pgs 701-713.

Additional References:
Lieberman, L.S. 1991
Native American 
Communication Style

*Trotter, R. T. 1998. A Case of Lead Poisoning from Folk Remedies in Mexican American Communities. . In Understanding and Applying Medical Anthropology. P.J. Brown, ed. Pp. 279-286. Mountain View, CA: Mayfield Publishing.

*Baer, Roberta D. and Marta Bustillo. 1993. "Susto and Mal de Ojo among Florida Farmworkers: Emic and etic Perspectives." Medical Anthropology Quarterly 7 (1):90-100.

*Baer, Roberta D. and Marta Bustillo. 1998. "Caida de Mollera among Children of Mexican Migrant Workers: Implications for the Study of Folk Illnesses." Medical Anthropology Quarterly 12 (2):241-249.

Lieberman, L.S. 1991
Hispanic/Latino
Communication Style And Food types

*Hill, C.E., and H. Matthews. 1981. "Traditional Black Health Beliefs and Practices among Southern Rural Blacks: A Complement to Biomedicine." In Perspectives on the American South. M. Black and J. S. Reed, eds. Pp. 307-332. New York: Gordon & Breach Science Publishers.

*Centers for Disease Control Health Beliefs and Prevention, based on work by Suzanne Heurtin-Roberts and Efrain Reisin. 1998. "Health Beliefs and Compliance with Prescribed Medication for Hypertension Among Black Women-New Orleans 1985-86." In Understanding and Applying Medical Anthropology. P.J. Brown, ed. Pp. 248-250. Mountain View, CA: Mayfield Publishing. 

Coriel, J., D.L. Barnes-Josiah, and A.A.M.Cayemittes. 1996. Arrested Pregnancy Syndrome in Haiti: Findings from a National Survey. Medical Anthropology Quarterly 10(3):424-436

Lieberman, L.S. 1991
Asian/Oriental
Communication Style And Food types

Lieberman, L.S 1991
Hispanic/Latino
Communication Style And Food types

Harwood, A. 1998. The Hot -Cold Theory of Disease: Implications for the Treatment of Puerto Rican Patients. . In Understanding and Applying Medical Anthropology. P.J. Brown, ed. Pp. 251-258. Mountain View, CA: Mayfield Publishing.

Singer, M., F. Valentin, H. Baer, and A. Jia. 1998. 1998. Why Does Juan Garcia Have a Drinking Problem? The Perspective of Critical Medical Anthropology. . In Understanding and Applying Medical Anthropology. P.J. Brown, ed. Pp. 286-309. Mountain View, CA: Mayfield Publishing.

Joos, Sandra K. 1984. "Economic, social, and Cultural Factors in the Analysis of Disease: Dietary Change and Diabetes Mellitus among the Florida Seminole Indians." In Ethnic and regional Foodways in the United States: The Performance of Group Identity. L.K. Brown and K. Mussell, eds. Knoville: University of Tennessee Press.

Greenlee, Robert F. 1944. "Medicine and Curing Practices of the Modern Florida Seminoles." American Anthropologists 46:317-328.

Garbarino, Merwyn S. 1986. "Health." In Big Cypress: A Changing Seminole Community. Pp. 48-55. Prospect Heights, IL: Waveland Press.

Week 5: June 5, 2000

Rural Populations: Health Promotion

1. Describe family demographic trends and their impact on family health.
2. Identify characteristics of rural families that have implications for health promotion.
3. Identify the major indicators of child and adolescent health in rural areas.
4. Discuss public programs targeted to family and child health in rural areas.
5. Develop a framework for assessing the health of families.
6. Assess physical and psychosocial development of children.
7. Examine how community health nurses can covene to reduce family health risks and promote family health.

• What is the family?
• Who make-up the families of rural America?
• Changing demographics of American families:

• family structures
• marriage
• single parent
• divorce
• blended families
• Functions of family
• home environment
• communication
• roles
• values
• socialization
• coping/stress
• reproduction
• Family health
• Sociocultural Influences on Family Health
• cultural diversity & disparities
• assessing growth & development of children
• Family Nursing Roles
• health teacher
• coordinator
• liaison
• care delivery
• family advocate
• consultant

2.  Get out your health assessment textbook. Look in the Appendices for the Denver screening tool. Read over.  You can also look in the back of your community health book for sections and description of the screening tools.

3.  Organize with a friend/relative for access to their child in order to conduct  a child growth and developmental assessment using the Denver tool.

4. Watch the video and look over  the Denver assessment tools and the Denver assessment kit that will be made available at the practice site so you can familiarize yourself with the assessment prior to performing it on a child.

5.  Use the Web Board to talk with each other about the Denver Screening tool  or any other aspect of the course to this point.

2.  Read Chapter 25 in your Stanhope & Lancaster textbook: 
Loveland-Cherry, C. (2000) Family health risks. pp.506-525

3.  Read Chapter 26 in your Stanhope & Lancaster textbook:
Cowan, M. (2000)  Child and adolescent health. pp.526-554.

4.  Click on this web link for a presentation on family and read through it.

Week 6: 

June 12, 2000

Culturally Diverse Populations:Health Promotion

Nutrition & Obesity

1. Examine Healthy People 2010 nutrition objectives.
2. Discuss the epidemiology of nutrition and disease.
3. Recognize how food consumption practices contribute to cultural identity.
4. Discuss the inter-related  factors contributing to obesity.
5. Identify the specific health risks associated with obesity.
6. Conduct nutrition screening to identify risk factors associated with diet 
7. Provide information on nutrient values of ethnic foods to clients.
8. Apply knowledge of obesity, its causes and management  to health promotion activities with clients.

• Nutritional Risk Assessment
• Obesity- definition
• mild
• moderate
• severe
• Obesity in America
• prevalence
• >40 million
• types
• juvenile onset
• adult obesity
• Methods of Diagnosing Obesity
• Body Mass Index (BMI)
• Height & weight tables
• Body Composition (percent body fat)
• skinfold measurements
• waist to hip ratio
• Recommended fat percentages for men & women
• Inter-related causes of obesity
• high caloric consumption
• genetics
• emotional reasons
• pain
• loneliness
• depression
• biological problems
• thyroid
• pituitary
• sedentary lifestyle
• socioeconomic status
• cultural factors
• Health risks associated with obesity
• hypertension
• diabetes
• cardiovascular disease
• cancer
• endocrine problems 
• gall bladder disease
• lung & breathing problems
• arthritis
• premature death
• sleep disturbance
• Other issues associated with obesity
• inability to participate in activities
• Inability to perform jobs
• restricted social opportunities
• reduced opportunities for romantic relationships
• low self-esteem and body-image 
• prejudice and discrimination
• social stigma
• What can be done about obesity?
• over-the-counter
• to be avoided
• prescription medications
• appetite suppressants
• surgery
• stomach stapling
• eating attitude
• balanced diet
• fat reduction
• healthy snacks
• overall attitude
• set short-term goals
• avoid crash diets
• increase activity
• don't give up
• see doctor

Healthy People 2010

2.  Calculate the Body Mass Index (BMI) of yourself and your family members by
going to the following site to calculate your BMI and take the interactive weight quiz:

Weight Self-Assessment
 

3.  Draw the Food Guide Pyramid.  Write in the food groups and the number of recommended servings for each.  Be sure to study the serving size for each of the food groups.  For example, in the bread group 1 slice of bread would be one serving.

4.   USE THE WEB BOARD!   Post by June
16th
This course has a specific focus on culture and the development of cultural connectedness.
You need to be sensitive to the nutrition related issues of various ethnic groups.  Using the same cultural group you selected to research in WEEK 4 do some more in-depth research to identify ANY nutrition related health issues that predominate in the group.  Post and discuss your findings on the web board including  at least one peer reviewed NURSING article as a reference for your colleagues.  Be sure to give us your summary of the article. 

5.  PRACTICE DAY

Your practice day is June 15th.  Meet at the practice site as planned.

1.  Look up the words Diet, Nutrition and Obesity, in the index of your Stanhope & Lancaster textbook.  Go to the pages for every subheading under these words that you find and read them. 

2.  Go to the site below which is a chapter on The Basics of Good Nutrition.
by Henry Ginsberg, M.D.
Read the entire chapter taking particular note of the sections on weight, obesity, diabetes and high blood pressure as these are key areas we are studying in the course.

The Basics of Good Nutrition
 

3.  The following web site contains good information about weight loss and control

    Weight loss and control publications

4.  Read the following research article on treatment programs for obesity:
Roles of mental health professionals in multidisciplinary medically supervised treatment programs for obesity

Hunter et al, (1997)
Southern Medical Journal

5.  Methods of Diagnosing Obesity

Click to Go to site

6.  Download a file that lists many additional references for  Obesity & Nutrition

Week 7: June 19, 2000

        DIABETES

1. Examine the incidence of Diabetes in culturally diverse populations.
2. Explore predisposing factors underlying the predominence of diabetes in these populations.
3. Differentiate the management of Type 1 and Type 2 diabetes.
4. Recognize the impact a chronic disease such as diabetes can have on the individual, family and community.
5. Apply knowledge of pathophysiology, diet and pharmacology in designing health promotion activites for clients with diabetes.

• DIABETES
• general definition
• normal blood sugar
•  60 mg/dl - 120 mg/dl (milligrams of glucose to deciliter of blood)
• Causes of Diabetes
• Normal Hormonal regulation of glucose
• Diabetic handling of glucose
• Types of diabetes
• Type 1
• Type 2
• Gestational diabetes
• Risk factors  for diabetes mellitus
• family history
• fault in immune system
• pregnancy
• insulin resistance
• obesity
• certain drugs, infection, trauma
• Diabetes in cultural groups
• African Americans
• prevalence higher in women
• 18.2% incidence in those aged 40 -74
• genetics risk
• obesity
• higher rate of complications
• Hispanic Americans
• 3x more common in Mexican American (occurring in 24 % of the MA population) and Puerto Rican American (occurring in 26 % of PR population) adults than in non Hispanic whites
• family history prevalence
• high rates of of complications
• Native Americans
• 17.5 % incidence
• 'thrifty-gene theory'
• Diagnosis of diabetes
• Symptoms
• excessive thirst
• frequent urination
• unusual hunger
• weight loss
• Measurements of blood sugar
• fasting blood glucose
• oral glucose tolerance test
• Treatment
• Goal: normalize blood glucose level
• Type 1
• insulin + diet and exercise
• fast-acting insulin
• intermediate-acting insulin
• long-acting insulin
• Type 2
• diet + exercise and oral hypoglycemics
• Sulfonylureas
• acetohexamide (Dymelor)
• chlorpropamide (Diabinese)
• glipizide (Glucotrol)
• glyburide (Micronase)
• tolazamide (Tolinase)
• tolbutamide (Orinase)
• Biguanides 
• metformin (Glucophage)
• Alpha-glucosidase inhibitors
• acarbose (Precose)
• miglitol (Glyset)
• Thiazolidinecdiones
• troglitazone (Rezulin)
• Lifestyle modifications
• diet
• exercise
• counseling
• self-monitoring
• Complications of diabetes
• hyperglycemia & ketoacidosis
• causes
• signs
• increased thirst & urination
• nausea and vomiting
• weakness or fatigue
• ketones in urine
• blood sugar > 300mg/dl
• dehydration
• fruity breath odor
• heavy, labored breathing
• loss of consciousness
• treatment
• insulin & IV
• hypoglycemia
• cause
• signs
• cold, clammy
• tingling sensation
• excessive sweating
• headache
• hunger
• irritability
• impaired vision
• trembling
• rapid heartbeat
• sudden drowsiness
• loss consciousness
• inability to waken
• treatment
• simple sugar- orange juice, fruit, candy
• Infection & diabetes
• Eye disorders
• diabetic retinopathy
• cataracts
• Circulatory & cardiovascular complications
• Foot care & diabetes
• Diabetic neuropathy
• Kidney failure
• Psychological effects
• Diabetes & pregnancy

2.  Write a summary of the exchange system used to formulate nutrition plans for diabetic clients.

3. Draw outlines of the anterior and the posterior views from head to mid thigh  including the arms.  Locate insulin injection sites on the figures. Be sure you understand why site rotation is important for the diabetic client.

4.  Create a 3 column chart to enable you to compare Type 1 and Type 2 diabetes. Outline the following:

age at onset
onset
weight
ketosis
symptoms
complications
prevalence
sex
medication
diet

5.   USE THE WEB BOARD!

Consider the clients you have been seeing at the practice site.  Tell us what you think are the main issues for them in relation to their diabetes and the self management of their diabetes.  You can use a specific case to make your point but keep client confidentiality.

Post by June 23.

• Use a fundamentals nursing textbook and read over the material on injections.
• View the video:  Administering Medications by Injection . (on reserve in the library)
• Practice injection technique on the models. See B. Ali in the department for access to the models and materials.

2.  The following site also offers many publications related to Diabetes that can help you to detail your outline:

Diabetes- Publications Online
NIDDK
 
 
 
 

Week 8:  June 26, 2000

Culturally Diverse Populations:Health Concerns
HYPERTENSION

1. Examine the incidence of hypertension in culturally diverse populations.
2. Explore predisposing factors underlying the predominence of hypertension in these populations.
3. Discuss the management of hypertension.
4. Apply knowledge of pathophysiology, diet and pharmacology in designing health promotion activites for clients with hypertension.

• Hypertension
• what is it?
• demographics
• Classifications:
• Essential Hypertension
• definition
• symptoms
• diagnosis
• treatment
• prevention
• Secondary hypertension
• definition
• symptoms
• diagnosis
• treatment
• prevention
• Mslignant
• Benign
• Categories of Hypertension
• Stage I to IV
• Hypertension in cultural groups
• Risk factors
• African americans
• Hispanics
• American indian
• Identify  the critical modifiable risk factors of hypertension
• high sodium intake
• obesity
• excess alcohol
• low potasium intake
• smoking
• stress

Healthy People 2010
 

2.  Go to the National Heart, Lung and Blood Institute Web Page on:

Your guide to lowering high blood pressure

Work through the pages reviewing the patient compliance test the education resources and the patient handouts.
 

3.  Go through the American Heart Association Web page on high blood pressure:

High Blood Pressure
 
 

4.  Go to this site to Download  patient education sheets for use in your practice:

Tools for Taking Charge
 

5  USE THE WEB 
BOARD!
Post by
Wed.  June    28th

Choose one of the following activities to post:

*Locate and find one professional nursing article (from a nursing journal) that deals with some aspect of hypertension.  Review it for your classmates and provide the reference.  Bring a copy of the original to the practice site with you.

        OR

*Identify one medication that is used to treat hypertension.  Give an overview of action, dose, side effects and nursing implications.  (You have to choose something different from your classmates!)
 

6.  PRACTICE DAY

Your practice day is June 29th.  Meet at the practice site as planned.

Be at the Friendship House by 8:30 sharp.  Bring stethescopes, wear watches etc.  (Bring a cool drink - its hot in there!)

Those students who have already done teaching projects  bring your materials in case we need them. 

Those students who are presenting bring your materials AND RELAX>

 1. Use your pathophysiology book to review content on hypertension
 
 

2.  Read through the following reports to learm more about the problem of hypertension in the American population

Research in Coronary heart Disease in Blacks

The Sixth Report of the Joint National Committee on Prevention, Detection, Prevention and Treatment of High Blood Pressure
 
 

3. Read the following articles:

Heritability of salt sensitivity in Black Americans
 

Socioeconomic factors and cardiovascular disease: A review of the literature

Week 9: July 3

Rural Populations: Health Concerns

1. Identify the health risks of agricultural service workers.
2. Examine the barriers to migrant farm workers and their famiies in securing health care
3. Evaluate legislation that has assisted in the provision of health care services  for migrant farm workers
4. Discuss the role of the nurse in providing care for migrant farm workers and their families.

• Rural Areas & Agriculture
• one of most hazardous occupations
• ranks 4th in number of work related fatalities
• Agricultural service workers include
• farm families
• migrant &seasonal  workers
• Problems occur from
• physical injury- machines
• chemical
• biological hazards
• Presentation
• skin disorders
• respiratory illnesses
• rhinitis
• asthma
• interstitial responses to certain fungi & bacteria:
   "Farmer's Lung"
• respiratory chemical exposure

• Migrant Farm Workers
• lack financial stability
• children work and are at high risk for injury and exposure
• housing is poor
• education is lacking
• access to services is poor
• health problems:
• high incidence of diarrhes
• parasitic infections
• heat stress
• TB
• Migrant Health Act 1962

http://www.atsdr.cdc.gov/cxcx3.html
 
 
 

2. Go to the following governmental web site. 

Play the game and check
your answers:

 www.niehs.nih.gov/kids/azgame.htm
 

2.  Go to page A-180 in the appendices of your textbook. 

Review the: 

Comprehensive Occupational and Environmental Health History

Consider how you might adapt this tool for use with rural farm workers. 

3.   USE THE WEB BOARD

To ask any questions about any aspect of the course.

Migrant Health Issues   p.   701-713
 

2.  The following sites are areas where you can find some information related to environmental/occupational health in the rural area.

http://www.ncfh.org
 

http://web.health.gov/environment

http:web.health.gov/environment/ehpcsites.htm
 

Week 10: July 10, 2000

Rural Health: The Global Issues

1. Develop a global perspective of  rural health through examination of the rural health issues of other countries.
2. Explore the initiatives taken in other countires to address their rural health problems.
3. Identify common issues that characterize rural health on a worldwide basis.
4. Compare the rural health issues of other countries with those of the United States.

Identify 4 countries and see what you can find on rural health issues:
 

• What are the common causes of mortality/morbidity
• What services are available
• What are the health problems/issues identified
• What strategies are planned or described for dealing with the health issues

Label the columns, Health Problems/Issues, Resources, Strategies
 

2.  As you search for information about the country and rural health problems outline what you learn in your chart.

3.  Write a summary of your conclusions about the rural health problems of these 4 countries in relation to the rural health problems of the United States.
 

4. USE THE WEB BOARD 
to ask any questions about exam preparation.

Remember the exam is this Thursday at the practice site.
 

5.     Practice Day

This thursday is our practice day.  Meet at the friendship house as planned  at 8:30 sharp.

(unless you receive an email from me telling you otherwise.  So check your email on Wed.   I am waiting to hear from patty Conor at the clinic.)
 
 

Ottawa Charter for Health Promotion

Federal Office of Rural Health Policy
 

Rural Australia On-line
 

Report of a visit to rural Mexico
 

Global Health Council

Rural Information Center health Service

Irish Institute of Rural Health

Centre for Rural Health, Australia
 

Rural Health in New Zealand & Australia Part 1
 

Rural Health in New Zealand & Australia Part 2