Paediatric outreach services

Paediatric outreach services are provided in Australia and overseas to regional and rural communities. More recently telehealth services have been established to support the delivery of paediatric services and clinical management at distant sites. It is suggested that with the large distances separating centres in Australia that a combination of telehealth clinics and outreach visits may provide the most efficient means of delivering paediatric specialty and subspecialty care to these centres.

Upper limb recovery after stroke: The stroke survivors' perspective

Purpose. This study investigated stroke survivors' perspective of upper limb recovery after stroke. The aim was to determine factors other than medical diagnosis and co-morbidities that contribute to recovery. The objectives were to explore how stroke survivors define recovery, identify factors they believe influence recovery and determine strategies used to maximize upper limb recovery. Method. A qualitative study consisting of three focus groups and two in-depth interviews was conducted with stroke survivors (n = 19) and spouses ( n = 9) in metropolitan, regional and rural Queensland, Australia. Data were analysed using principles of grounded theory. Results. Stroke survivors maximize upper limb recovery by 'keeping the door open' a process of continuing to hope for and work towards improvement amidst adjusting to life with stroke. They achieve this by 'hanging in there', 'drawing on support from others', 'getting going and keeping going with exercise', and 'finding out how to keep moving ahead'. Conclusions. This study provides valuable insight into the personal experience of upper limb recovery after stroke. It highlights the need to develop training strategies that match the needs and aspirations of stroke survivors and that place no time limits on recovery. It reinforces the benefits of stroke support groups and advocates their incorporation into stroke recovery services. These findings can be used to guide both the development and evaluation of stroke survivor centred upper limb training programmes.

Regional patterns of agricultural land use and deforestation in Colombia

An expanding human population and associated demands for goods and services continues to exert an increasing pressure on ecological systems. Although the rate of expansion of agricultural lands has slowed since 1960, rapid deforestation still occurs in many tropical countries, including Colombia. However, the location and extent of deforestation and associated ecological impacts within tropical countries is often not well known. The primary aim of this study was to obtain an understanding of the spatial patterns of forest conversion for agricultural land uses in Colombia. We modeled native forest conversion in Colombia at regional and national-levels using logistic regression and classification trees. We investigated the impact of ignoring the regional variability of model parameters, and identified biophysical and socioeconomic factors that best explain the current spatial pattern and inter-regional variation in forest cover. We validated our predictions for the Amazon region using MODIS satellite imagery. The regional-level classification tree that accounted for regional heterogeneity had the greatest discrimination ability. Factors related to accessibility (distance to roads and towns) were related to the presence of forest cover, although this relationship varied regionally. In order to identify areas with a high risk of deforestation, we used predictions from the best model, refined by areas with rural population growth rates of > 2%. We ranked forest ecosystem types in terms of levels of threat of conversion. Our results provide useful inputs to planning for biodiversity conservation in Colombia, by identifying areas and ecosystem types that are vulnerable to deforestation. Several of the predicted deforestation hotspots coincide with areas that are outstanding in terms of biodiversity value.

Healthy waterways: Healthy catchments - An integrated research/management program to understand and reduce impacts of sediments and nutrients on waterways in Queensland, Australia

The Moreton Bay Waterways and Catchments Partnership, now branded the Healthy Waterways Partnership, has built on the experience of the past 15 years here in South East Queensland (SEQ). It focuses on water quality and the ecosystem health of our freshwater, estuarine and marine systems through the implementation of actions by individual partners and the collective oversight of a regional work program that assists partners to prioritise their investments and address emerging issues. This regional program includes monitoring, reporting, marketing and communication, development of decision support tools, research that is directed to problem solving, and maintaining extensive consultative and engagement arrangements. The Partnership has produced information-based outcomes which have led to significant cost savings in the protection of water quality and ecosystem resources by its stakeholders. This has been achieved by: – providing a clear focus for management actions that has ownership of governments, industry and community; – targeted scientific research to address issues requiring appropriate management actions; – management actions based on a sound understanding of the waterways and rigorous public consultation; and, – development and implementation of a strategy that incorporates commitments from all levels of stakeholders. While focusing on our waterways, the Partnership’s approach includes addressing catchment management issues particularly relating to the management of diffuse pollution sources in both urban and rural landscapes as well as point source loads. We are now working with other stakeholders to develop a framework for integrated water management that will link water quality and water quantity goals and priorities.