LSTA Five Year Plan, 1998-2002, 2002

The LSTA goals for Iowa, FY98-FY02, are as follows: 1. Provide all Iowans with expanded access to information and materials through the State of Iowa Libraries Online (SILO) network. 2. Improve library service to Iowans through knowledgeable, well-trained staff and wellinformed public library trustees and library users. 3. Meet Iowans’ increasing demands for information and library services by identifying and encouraging resource sharing and partnerships. 4. Provide state level leadership and services to accomplish the LSTA Five-Year Plan. The primary objectives of this evaluation are to provide: $ An assessment of the overall impact of Iowa’s LSTA funding and success in achieving the goals identified in the state’s five-year plan. $ An in-depth analysis of two specific goals from the plan: providing Iowans with expanded access to information and materials through the State of Iowa Libraries Online (SILO) network; and improving library service to Iowans through knowledgeable, well-trained staff and well-informed public library trustees and library users. LSTA built on accomplishments made possible with the federal HEA II-B grant awarded to the State Library in 1995. This grant led the way in bringing technology to Iowa libraries by creating an electronic library network for resource sharing. SILO (State of Iowa Libraries Online) became fully functional in 1997. The State Library continued funding SILO with LSTA money when the grant ended. This funding supports the SILO infrastructure, providing equitable access to information through cutting edge technology to Iowans in both small and large, rural and urban, communities. Access to electronic material and information has encouraged public libraries to increase the number of computers and public access to the Internet. LSTA funding was used to increase training opportunities for library staff and trustees. Many programs, such as librarian certification, were strengthened by an increase in continuing education opportunities.

LSTA Five Year Plan Evaluation, 1998-2002, 2002

The LSTA goals for Iowa, FY98-FY02, are as follows: 1. Provide all Iowans with expanded access to information and materials through the State of Iowa Libraries Online (SILO) network. 2. Improve library service to Iowans through knowledgeable, well-trained staff and wellinformed public library trustees and library users. 3. Meet Iowans’ increasing demands for information and library services by identifying and encouraging resource sharing and partnerships. 4. Provide state level leadership and services to accomplish the LSTA Five-Year Plan. The primary objectives of this evaluation are to provide: $ An assessment of the overall impact of Iowa’s LSTA funding and success in achieving the goals identified in the state’s five-year plan. $ An in-depth analysis of two specific goals from the plan: providing Iowans with expanded access to information and materials through the State of Iowa Libraries Online (SILO) network; and improving library service to Iowans through knowledgeable, well-trained staff and well-informed public library trustees and library users. LSTA built on accomplishments made possible with the federal HEA II-B grant awarded to the State Library in 1995. This grant led the way in bringing technology to Iowa libraries by creating an electronic library network for resource sharing. SILO (State of Iowa Libraries Online) became fully functional in 1997. The State Library continued funding SILO with LSTA money when the grant ended. This funding supports the SILO infrastructure, providing equitable access to information through cutting edge technology to Iowans in both small and large, rural and urban, communities. Access to electronic material and information has encouraged public libraries to increase the number of computers and public access to the Internet. LSTA funding was used to increase training opportunities for library staff and trustees. Many programs, such as librarian certification, were strengthened by an increase in continuing education opportunities.

Movimentos sociais e reivindicações populares em torno das empresas de transformação mineral em Barcarena: um estudo da atuação das associações de moradores e trabalhadores rurais

A pesquisa trata da atuação dos movimentos sociais ocorridos no entorno do complexo industrial de Barcarena, após a implantação das empresas Albrás, Alunorte e Pará Pigmentos, que deram origem às associações de moradores e produtores rurais. O objetivo é a identificação dos principais movimentos surgidos e existentes, analisando-os à luz da Teoria dos Novos Movimentos Sociais. A partir de uma pesquisa exploratória, alicerçada no referencial bibliográfico, busca-se ainda verificar as vertentes pelas quais enveredaram os movimentos sociais que deram origem às entidades representativas no município. A pesquisa de campo realizou-se entre os anos de 2003 e 2004 junto a 15 associações existentes em Barcarena e que envolvem 18 comunidades rurais e urbanas, onde se aplicou questionários para verificar como estas encaminhando suas reivindicações e se relacionando com os poderes locais. Foram realizadas ainda entrevistas com técnicos das empresas e da Prefeitura e com antigos moradores. Dentre os resultados da análise de dados, pode-se afirmar há uma diferença entre as aspirações dos movimentos sociais urbanos e rurais, mas as principais reivindicações referem-se a melhoria da infraestrutura, saúde, educação e desenvolvimento agrícola. A identificação dos principais movimentos sociais em Barcarena foi um dos resultados esperados no decorrer da pesquisa, pois não se pode afirmar que exista um típico movimento social em Barcarena que faça contraponto às empresas no sentido de protesto, mas o movimento existe e é bastante ativo nos moldes dos novos movimentos sociais. Conclui-se que no enfrentamento cotidiano entre empresas e comunidades, o que prevalece é a categoria de movimento popular, onde as reivindicações coletivas voltam-se para a melhoria das condições de vida e de aspectos que envolvem seu cotidiano, além, é claro, da defesa de seu modo de produção e reprodução de vida.

The use of online health techniques to assist with the delivery of specialist paediatric diabetes services in Queensland

We have tested an alternative method of delivering health services to regional areas of Queensland. By integrating telepaediatrics into an existing outreach programme for children with diabetes and endocrine conditions, we were able to reduce travel for specialist hospital staff while maintaining (and sometimes increasing) the contact patients had with the specialist team. In the first 28 months, we facilitated 160 patient consultations and 10 education sessions via videoconference through the telepaediatric service. By the end of the study, site visits were taking place annually and routine videoconference clinics were scheduled quarterly for the review of new patients and follow-up. Telepaediatric services in endocrinology and diabetes were established at three levels: the coordination of routine specialist clinics via videoconference; ad hoc patient consultations for collaborative management during acute presentations and at times of urgent clinical need; and the delivery of education to staff and patients throughout the state. The net result was improved access to specialist services from rural and remote areas of Queensland.

Influences on doctors' prescribing: Is geographical remoteness a factor?

Objective: To identify factors influencing the prescribing of medicines by general practitioners in rural and remote Australia. Design: A qualitative study using a questionnaire to determine attitudes about prescribing, specific prescribing habits and comments on prescribing in ‘rural practice’. Setting: General practice in rural and remote Queensland. Subjects: General practitioners practising in rural and remote settings in Queensland (n = 258). Main outcome measures: The factors perceived to influence the prescribing of medicines by medical practitioners in rural environments. Results: A 58% response rate (n = 142) was achieved. Most respondents agreed that they prescribe differently in rural compared with city practice. The majority of respondents agreed that their prescribing was influenced by practice location, isolation of patient home location, limited diagnostic testing and increased drug monitoring. Location issues and other issues were more likely to be identified as ‘influential’ by the more isolated practitioners. Factors such as access to continuing medical education and specialists were confirmed as having an influence on prescribing. The prescribing of recently marketed drugs was more likely by doctors practising in less remote rural areas. Conclusion: Practising in rural and remote locations is perceived to have an effect on prescribing. These influences need to be considered when developing quality use of medicines policies and initiatives for these locations. What is already known: Anecdotal and audit based studies have shown that rural general practice differs to urban-based practice in Australia, including some limited data showing some variations in prescribing patterns. No substantiated explanations for these variations have been offered. It is known that interventions to change prescribing behaviour are more likely to be effective if they are perceived as relevant and hence increasing our knowledge of rural doctors’ perceptions of differences in rural practice prescribing is required. What this study adds: Rural doctors believed that they prescribe differently in rural compared with city practice and they described a range of influences. The more remotely located doctors were more likely to report the ‘rural’ influences on prescribing, however, most results failed to reach statistical significance when compared to the less remotely located doctors. These perceptions should be considered when developing medicines policy and education for rural medical practitioners to ensure it is perceived rurally relevant.

Uncovering a hidden epidemic: A study of the current burden of heart failure in Australia

Background. Australia, like other countries, is experiencing an epidemic of heart failure (HF). However, given the lack of national and population-based datasets collating detailed cardiovascular-specific morbidity and mortality outcomes, quantifying the specific burden imposed by HF has been difficult. Methods. Australian Bureau of Statistics (ABS data) for the year 2000 were used in combination with contemporary, well-validated population-based epidemiologic data to estimate the number of individuals with symptomatic and asymptomatic HF related to both preserved (diastolic dysfunction) and impaired left ventricular systolic (dys)function (LVSD) and rates of HF-related hospitalisation. Results. In 2000, we estimate that around 325,000 Australians (58% male) had symptomatic HF associated with both LVSD and diastolic dysfunction and an additional 214,000 with asymptomatic LVSD. 140,000 (26%) live in rural and remote regions, distal to specialist health care services. There was an estimated 22,000 incidents of admissions for congestive heart failure and approximately 100,000 admissions associated with this syndrome overall. Conclusion. Australia is in the midst of a HF epidemic that continues to grow. Overall, it probably contributes to over 1.4 million days of hospitalization at a cost of more than $1 billion. A national response to further quantify and address this enormous health problem is required.

A survey of e-mentoring among New Zealand midwives

Mentoring is a strategy that may assist the midwifery profession to support new graduates and midwives working in rural and remote areas. We conducted a survey of 1577 New Zealand midwives about their opinions and experiences of mentoring. The questionnaire comprised 33 questions, nine of which were open questions. There was a 44% response rate. While the telephone was commonly utilized by mentors (37%) and mentored midwives (37%), the Internet and email played only a small part. Participants acknowledged the potential of these avenues for communication, but midwives felt that mentoring could be provided only by immediate, face-to-face contact. Nevertheless, e-mentoring could be a viable option and requires further investigation. About one-third of midwives identified geographical isolation as a barrier to being a mentor (38%) and being mentored (36%). The use of e-mentoring could remove the barrier of location and allow the midwife to chose a mentor who meets her needs, rather than because she is the only mentor available.

Can telepharmacy provide pharmacy services in the bush?

Rural and remote community pharmacies service large areas of rural Queensland, and because of the distances involved often do not meet the patients for whom they provide medication. Telepharmacy would improve the quality of pharmaceutical services provided in rural and remote areas, by allowing community pharmacists to have realtime contact with dispensing doctors, aboriginal health workers and patients via a video-phone. We used commercial (analogue) videophones to connect community pharmacists to dispensing doctors, patients in depot pharmacies (i.e. those with no pharmacist) and aboriginal health workers. However, various problems occurred and only 10 video-phone interactions were recorded during the six-month project. In all of the recorded interactions, the video-phone was actually used as a conventional telephone because a video-connection could not be established at the time of the call. (This may have been due to telephone network problems in the rural areas.) Despite these problems, all project participants showed great enthusiasm for the potential benefits of such a service.

Implantation d’une innovation au sein d’une région rurale éloignée au Québec : le rôle d’infirmière praticienne spécialisée en soins de première ligne- une étude de cas multiples

Introduction : La situation de l’accès, de la continuité et de la coordination des services de santé au Canada et au Québec est des plus préoccupantes. Pour contribuer à résoudre ces problématiques, l’élargissement des champs de pratique professionnels a été proposé. Lorsqu’il est question d’élargir le rôle des infirmières, la pratique infirmière avancée (PIA) est fréquemment abordée. Au Québec, ce n’est qu’en 2006 qu’un rôle associé à la PIA en première ligne a pu officiellement être mis en place, celui d’infirmière praticienne spécialisée en soins de première ligne (IPSPL) (Durand, Allard, & Ménard, 2006). L’implantation du rôle d’IPSPL est récente et peut être conçue comme une innovation. Les difficultés liées à l’implantation des rôles de PIA font l’objet d’un consensus. Pour pallier à ces difficultés, il est proposé d’approfondir la compréhension de la façon dont les rôles de PIA sont implantés, et ce, en considérant les contextes. Encore peu de recherches s’intéressent au processus d’implantation du rôle d’IPSPL au Québec, et aucune n’est centrée sur le contexte rural éloigné. But : Cette recherche vise à comprendre le processus d’implantation du rôle d’IPSPL au sein d’une région rurale éloignée du Québec, à travers l’éclairage d’un cadre de référence intégrant les théories de la diffusion de l’innovation et des transitions. Méthode : Cette étude de trois cas se situe dans un paradigme pragmatique, avec des visées descriptive et explicative. Des stratégies de collecte de données mixtes ont été utilisées auprès de personnes provenant du contexte québécois, de la région ciblée et des cas (IPSP, médecins partenaires, DSI, DSP, gestionnaires, personnes soignées et leur famille). Résultats : L’implantation est un processus multidimensionnel, multifactoriel et évolutif. Le contexte, le déroulement, la compréhension, les acteurs et le temps sont des parties intégrantes de l’implantation et sont étroitement inter-reliés. Le déroulement de l’implantation et des transitions se produit simultanément. Discussion : Cette recherche a permis de mettre en lumière la raison pour laquelle le processus d’implantation du rôle d’IPSPL doit être considéré comme un processus complexe. Cette thèse contribue à éclairer la recherche axée sur l’efficacité en permettant de mieux comprendre les différentes composantes de l’implantation. Mots-clés : implantation, rôle, infirmière praticienne, première ligne, rural, éloigné, innovation, transition.

Biopiratería y pueblos indígenas: crítica y realidad

La lucha por la protección de la biodiversidad se está llevando a cabo en varios escenarios, desde las comunidades rurales afectadas que denuncian el saqueo y defienden sus recursos locales, hasta los círculos académicos donde personas sensibilizadas ante el problema se oponen a la devastación.AbstractThe fight for the protection of the biodiversity is being carried out in various scenarios, from affected rural communities that denounce the stealing and defend their local resources, to the academic circles where people sensitized towards the problem are opposed to devastation. The issue of bio-piracy has been little divulged, since the institutions specialized on those topics have carried out their research almost in a “secret” way and so far little is known about their final outcomes. The environment issue has had limited linkage with social reasons related to biodiversity since they weren’t the concern of many organizations. That’s why it is necessary to open a debate about these complex issues but related to the daily life of rural and urban communities nowadays. Furthermore, it is necessary to make a critical analysis of bio-piracy and patent mechanisms, in detriment of indigenous people’s interests.  El tema de la biopiratería ha sido poco divulgado, pues las instituciones más especializadas en dichos temas han trabajado de manera casi «secreta» sus investigaciones y hasta hoy se tiene poco conocimiento de sus resultados finales. El tema ambiental ha tenido poca ligazón con las razones sociales relacionados con la biodiversidad no eran parte importante de muchas organizaciones.De ahí que, es necesario abrir un debate sobre estos temas complejos, pero relacionados con la vida cotidiana de las comunidades rurales y urbanas actualmente. Además, conviene un análisis crítico de la biopiratería y los mecanismos de patentes en detrimento de los intereses de los pueblos indígenas.

Soil-Transmitted Helminths, Poverty, and Malnutrition in Honduran Children Living in Remote Rural Communities

Soil-transmitted helminth (STH) infections are endemic in Honduras, but their prevalence according to the levels of poverty in the population has not been examined. The present cross-sectional study is aimed to determine the role of different levels of poverty in STH prevalence and infection intensity as well as the potential associations of STH infections with malnutrition and anemia. Research participants were children attending a medical brigade serving remote communities in Northern Honduras in June 2014. Demographic data were obtained, and poverty levels were determined using the unsatisfied basic needs method. STH infections were investigated by the Kato-Katz method; hemoglobin concentrations were determined with the HemoCue system; and stunting, thinness, and underweight were determined by anthropometry. Data were analyzed using descriptive statistics and univariate and multivariable logistic regression models. Among 130 children who participated in this study, a high prevalence (69.2%) of parasitism was found and the poorest children were significantly more infected than those living in less poor communities (79.6% vs. 61.8%; P = 0.030). Prevalence rates of Trichuris trichiura, Ascaris lumbricoides, and hookworms were 69.2%, 12.3%, and 3.85%, respectively. In total, 69% of children had anemia and 30% were stunted. Households’ earthen floor and lack of latrines were associated with infection. Greater efforts should be made to reduce STH prevalence and improve overall childhood health, in particular, among the poorest children lacking the basic necessities of life.

Knowledge and use of wild edible plants in rural communities along Paraguay River, Pantanal, Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Commodification of retirement and the emergence of rural gated communities: The associated challenges for rural planning

Abstract:
This paper combines demographic ageing and retirement lifestyles with rural in-migration processes and suggests the emergence of a specific rural form of gated community; namely, park homes. All year round or permanent (as opposed to seasonal) residential mobile homes (resembling detached bungalows in design and appearance) are commonly referred to as 'park homes'. With a growing proportion of the UK population aged 65 and over, combined with increasing longevity, meeting the residential preferences and lifestyle aspirations of an ageing population is potentially 'big business' for the private sector. Park home living, with their resident age restrictions (normally 50 years and over), is increasingly marketed as a retirement option in rural and coastal locations of the UK. However, many areas are often remote with declining populations and limited community services. Operators have sought to tap into retiree aspirations for a 'place in the country' and 'sell' the concept of park home living as a specific form of housing, community and lifestyle. Park homes are frequently marketed as a means to release equity from the sale of a large family home to fund a retirement lifestyle and as friendly communities of like-minded people, always willing to lend support or provide assistance if required. The physical and social composition of such sites represent a form of rural gated community. This paper seeks to identify the rural planning issues which emerge from such developments and asks: who are moving to park home sites and why? do park homes provide those who otherwise could not afford a 'place in the country' the option of rural living? does park home living live-up to residents' expectations of the rural idyll or retirement lifestyle? do they give rise to issues of gentrification and geriatrification of the countryside? what are the prospects for residents to 'age in place'? might ageing residents become financially trapped in such developments giving rise to park ghettoization? what are the associated challenges for rural policy-makers and public service providers?