Análisis y pautas para el mejoramiento socioeconómico de los productores del oeste pampeano

En la zona comprendida entre las isoyetas de 500 mm a 300 mm, perteneciente a la provincia fitogeográfica del Monte, una población rural de 6.845 habitantes, 9 del total provincial, con una densidad de 0,2 hab /km2, habita los cinco departamentos del centro y extremo oeste de La Pampa, cuya superficie abarca el 38 de la provincia. Su economía de subsistencia se desarrolla sobre campos naturales, con una ganadería de bovinos, caprinos, ovinos y equinos. La población presenta un alto grado de dispersión y un significativo aislamiento respecto de los centros más poblados. El objetivo a cumplir, modificar las condiciones de vida de los "crianceros", hace necesaria la aplicación de pautas que permitan convertir estas economías de subsistencia en pequeños emprendimientos ganaderos con aceptables índices de rentabilidad mediante el uso más eficiente del medio y sus recursos. Esta estructura productiva ha de permitir una relación más solidaria entre los ganaderos, una mayor libertad en la toma de decisiones y una mayor independencia económica. La consolidación estable de este proyecto y el logro de sus objetivos redundarán en un mejor manejo del ecosistema, así como en un marcado mejoramiento de la calidad de vida de estos alejados productores rurales.

Análisis y pautas para el mejoramiento socioeconómico de los productores del oeste pampeano

En la zona comprendida entre las isoyetas de 500 mm a 300 mm, perteneciente a la provincia fitogeográfica del Monte, una población rural de 6.845 habitantes, 9 del total provincial, con una densidad de 0,2 hab /km2, habita los cinco departamentos del centro y extremo oeste de La Pampa, cuya superficie abarca el 38 de la provincia. Su economía de subsistencia se desarrolla sobre campos naturales, con una ganadería de bovinos, caprinos, ovinos y equinos. La población presenta un alto grado de dispersión y un significativo aislamiento respecto de los centros más poblados. El objetivo a cumplir, modificar las condiciones de vida de los "crianceros", hace necesaria la aplicación de pautas que permitan convertir estas economías de subsistencia en pequeños emprendimientos ganaderos con aceptables índices de rentabilidad mediante el uso más eficiente del medio y sus recursos. Esta estructura productiva ha de permitir una relación más solidaria entre los ganaderos, una mayor libertad en la toma de decisiones y una mayor independencia económica. La consolidación estable de este proyecto y el logro de sus objetivos redundarán en un mejor manejo del ecosistema, así como en un marcado mejoramiento de la calidad de vida de estos alejados productores rurales.

Air concentration of polybrominated diphenyl ethers around the Great Lakes and the Arctic

Atmospheric PBDEs were measured on a monthly basis in 2002-2004 at Point Petre, a rural site in the Great Lakes. Average air concentrations were 7.0 ± 13 pg/m**3 for the sum of 14BDE (excluding BDE-209), and 1.8 ± 1.5 pg/m**3 for BDE-209. Concentrations of 3 dominant congeners (i.e., BDE-47, 99, and 209) were comparable to previous measurements at remote/rural sites around the Great Lakes, but much lower than those at urban areas. Weak temperature dependence and strong linear correlations between relatively volatile congeners suggest importance of advective inputs of gaseous species. The significant correlation between BDE-209 and 183 implies their transport inputs associated with particles. Particle-bound percentages were found greater for highly brominated congeners than less brominated ones. These percentages increase with decreasing ambient temperatures. The observed gas/particle partitioning is consistent with laboratory measurements and fits well to the Junge-Pankow model. Using air mass back-trajectories, atmospheric transport to Point Petre was estimated as 76% for BDE-47, 67% for BDE-99, and 70% for BDE-209 from west-northwest and southwest directions. During the same time period, similar congener profiles and concentration levels were found at Alert in the Canadian High Arctic. Different inter-annual variations between Point Petre and Alert indicate that emissions from other regions than North America could also contribute PBDEs in the Arctic. In contrast to weak temperature effect at Point Petre, significant temperature dependence in the summertime implies volatilization emissions of PBDEs at Alert. Meanwhile, episodic observations in the wintertime were likely associated with enhanced inputs through long-range transport during the Arctic Haze period.

Evaluation of the healthy village program in Kapit district, Sarawak, Malaysia

Sarawak, Malaysia has a large population of ethnic minorities who live in longhouses in remote rural areas where poverty, non-communicable diseases, accidents and injuries, environmental hazards and communicable diseases all contribute to a lower quality of life than is possible to achieve in these regions. To address these issues and improve the quality of life for longhouse people, the Kapit Divisional Health Office implemented the World Health Organization's Healthy Village programme in 2000. An evaluation was undertaken in 2003 to determine physical and behavioural changes resulting from the programme. The main changes evaluated were those involving smoking habits, exercise habits, health screening, fire safety, environmental improvements and food preparation and hygiene. A qualitative evaluation was conducted using participant observation and key-informant interviews, focus groups and observation. Results indicate that the programme is inspiring changes in various behavioural and physical characteristics of the study population. It is clear that the Healthy Village programme is a widely accepted way of improving health outcomes in longhouses, and that it is succeeding in making beneficial health changes.

Consolidating Security and Development in Colombia: Lessons for Peru and Panama

Colombia's increasingly effective efforts to mitigate the power of the FARC and other illegitimately armed groups in the country can offer important lessons for the Peruvian government as it strives to prevent a resurgence of Sendero Luminoso and other illegal non-state actors. Both countries share certain particular challenges: deep economic, social, and in the case of Peru ethnic divisions, the presence of and/or the effects of violent insurgencies, a large-scale narcotics production and trafficking, and a history of weak state presence in large tracts of isolated and scarcely-populated areas. Important differences exist, however in the nature of the insurgencies in the two countries, the government response to them and the nature of government and society that affects the applicability of Colombia's experience to Peru. The security threat to Panama from drug trafficking and Colombian insurgents --often a linked phenomenon-- are in many ways different from the drug/insurgent factor in Colombia itself and in Peru, although there are similar variables. Unlike the Colombian and Peruvian cases, the security threat in Panama is not directed against the state, there are no domestic elements seeking to overthrow the government -- as the case of the FARC and Sendero Luminoso, security problems have not spilled over from rural to urban areas in Panama, and there is no ideological component at play in driving the threat. Nor is drug cultivation a major factor in Panama as it is in Colombia and Peru. The key variable that is shared among all three cases is the threat of extra-state actors controlling remote rural areas or small towns where state presence is minimal. The central lesson learned from Colombia is the need to define and then address the key problem of a "sovereignity gap," lack of legitimate state presence in many part of the country. Colombia's success in broadening the presence of the national government between 2002 and the presence is owed to many factors, including an effective national strategy, improvements in the armed forces and police, political will on the part of government for a sustained effort, citizen buy-in to the national strategy, including the resolve of the elite to pay more in taxes to bring change about, and the adoption of a sequenced approach to consolidated development in conflicted areas. Control of territory and effective state presence improved citizen security, strengthened confidence in democracy and the legitimate state, promoted economic development, and helped mitigate the effect of illegal drugs. Peru can benefit from the Colombian experience especially in terms of the importance of legitimate state authority, improved institutions, gaining the support of local citizens, and furthering development to wean communities away from drugs. State coordinated "integration" efforts in Peru as practiced in Colombia have the potential for success if properly calibrated to Peruvian reality, coordinated within government, and provided with sufficient resources. Peru's traditionally weak political institutions and lack of public confidence in the state in many areas of the country must be overcome if this effort is to be successful.

Commentary

SCOPUS: no.j

Prevalence of Parkinson’s disease in metropolitan and rural Queensland: A general practice survey

The prevalence of idiopathic Parkinson’s disease (IPD) in Australia is unclear. We estimated the prevalence of IPD, and other forms of parkinsonism, through the study of typical caseloads in general practice. A random sample of general practitioners (GPs) throughout Queensland (401 responses from 528 validated practice addresses) was asked to estimate the numbers of patients with IPD and parkinsonism seen in the preceding year. The estimated prevalence of diagnosed IPD in Queensland was 146 per 100 000 (95% CI = 136–155). A further 51 per 100 000 in the population were suspected by doctors to have IPD without formal diagnosis, whereas another 51 per 100 000 people may have non-idiopathic parkinsonism. Idiopathic Parkinson’s disease was more common in rural than metropolitan areas. Although most GPs were confident in making diagnoses of IPD, the majority had little or no confidence in their ability to treat the disease, especially in its later stages. Support from neurologists was perceived by GPs to be very good in cities, but poor in remote areas.

Across the dividing range - bridging the divides: Pharmacy opportunities across the hospital/community and inter-professional divides in rural and remote Australia

Rural and remote areas of Australia offer many opportunities for innovation in healthcare services. Some true healthcare 'network' models based around rural pharmacy can be established and evaluated. The lines between community and hospital pharmacy are often blurred and communication between health professionals enhanced. The blurring divide between hospital and community pharmacy in rural and remote areas has provided significant advances in practice. Projects have been set up to investigate the feasibility of community pharmacists integrating care for patients. These projects take advantage of the dual roles and the enhanced interaction between pharmacists and other health professionals in the bush. Opportunities for provision of clinical services beyond the traditional supply role have been taken in a number of remote communities

Rural and Isolated Practice Registered Nurse (RIPRN)-Emergency nurses of the Queensland `bush'

The Rural and Isolated practice endorsement for Queensland Registered Nurses has attracted interest from other state health authorities with respect to expanding the scope of practice of nurses working in rural and remote Australia. This discussion article outlines the endorsement program and sheds a spotlight on the program for the emergency and greater nursing community. The paper draws a similarity between rural and emergency nursing and stimulates the notion that other states could look to Queensland's model, for scope of practice expansion in other specialties such as emergency Nursing.

Women's satisfaction with general practice consultations

Objective: To determine women's satisfaction with general practice services. Design: Cross-sectional postal questionnaire conducted during April to September 1996 (part of the baseline survey of the Australian Longitudinal Study on Women's Health). Participants: Women aged 18-22 (n=14739), 45-49 (n=14013) and 70-74 (n=12941) years, randomly selected from the Medicare database, with oversampling of women from rural and remote areas. Main outcome measures: Frequency of use of general practice services; satisfaction with the most recent visit to a general practitioner (CP), prevalence of selected symptoms; preference for a female doctor. Results: The most recent visit to a GP was rated overall as good, very good or excellent by more than 80% of women, with increasing levels of satisfaction with increasing age of the women. However, satisfaction was lower for waiting room time and cost of the visit. A third of the young and middle-aged women living in rural and remote areas were dissatisfied with the cost of the visit. Young women were more likely to prefer a female doctor, and many were dissatisfied with their GP's skills at explaining their problem and giving them a chance to give an opinion and ask questions. The most prevalent symptoms for all women included headaches and tiredness, and many were not satisfied with the health services available to help them deal with these symptoms. Conclusions: Australian women have high levels of satisfaction with GP consultations. However, more effective strategies may be needed to improve communication with younger women, and there is an unmet need for services to help all women deal with some common symptoms. Dissatisfaction with cost of services and women's preference for female doctors have implications for future health policy.

Teaching in rural and remote schools: a literature review

In this paper. the authors examine a wide range of recent research into the preparation and support for teachers working in rural and remote schools. The paper reviews many preservice and inservice initiatives which highlight issues affecting:teaching and learning in schools outside the major metropolitan centres. The work is reviewed from an Australian perspective but evaluates research from throughout the world. The paper concludes that despite a large body of research (Gibson, 1994), that has identified the need for specialised pre-service preparation which accommodates the social and professional differences associated with work in rural and remote areas, the implementation of such programs by teacher training institutions has been sparse, lacking in cohesion and in many cases non-existent. (C) 1998 Elsevier Science Ltd. All rights reserved.

Organisational Factors Contributing to Violations by Rural and Remote Area Nurses during Medication Administration

Medication errors are a leading cause of unintended harm to patients in Australia and internationally. Research in this area has paid relatively little attention to the interactions between organisational factors and violations of procedures in producing errors, although violations have been found to increase the likelihood of these errors. This study investigated the role of organisational factors in contributing to violations by nurses when administering medications. Data were collected using a self-report questionnaire completed by 506 nurses working in either rural or remote areas in Queensland, Australia. This instrument was used to develop a path model wherein organisational variables predicted 21% of the variance in self-reported violations. Expectations of medical officers mediated the relationship between working conditions of nursing staff and violation behaviour.

Falls prevention in rural general practice: what stands the test of time and where to from here?

Objective: General practitioner recall of the 1992-96 'Stay on Your Feet'(SOYF) program and its influence on practice were surveyed five years post-intervention to gauge sustainability of the SOYF General Practice (GP) component. Methods: A survey assessed which SOYF components were still in existence, current practice related to falls prevention, and interest in professional development. All general practitioners (GPs) situated within the boundaries of a rural Area Health Service were mailed a survey in late 2001. Results: Response rate was 66.5% (139/ 209). Of 117 GPs in practice at the time of SOYF, 80.2% reported having heard of SOYF and 74.4% of those felt it had influenced practice. Half (50.9%) still had a copy of the SOYF GP resource and of those, 58.6% used it at least 'occasionally'. Three-quarters of GPs surveyed (75.2%) checked medications 'most/almost all' of the time with patients over 60 years; 46.7% assessed falls risk factors; 41.3% gave advice; and 22.6% referred to allied health practitioners. GPs indicated a strong interest in falls prevention- related professional development. There was no significant association between use of the SOYF resource package and any of the current falls prevention practices (all chi(2)>0.05). Conclusions and implications: There was high recall of SOYF and a general belief that it influenced practice. There was little indication that use of the resource had any lasting influence on GPs' practices. In future, careful thought needs to go into designing a program that has potential to affect long-term change in GPs' falls prevention practice.

Self-Directed Behavioral Family Intervention for Parents of Oppositional Children in Rural and Remote Areas

Twenty-four parents of oppositional preschoolers were randomly assigned to either a self-directed behavioral family intervention condition (SD) or to a waitlist control group (WL). The self-directed parent training program based on self-regulation principles, consisted of a written information package and weekly telephone consultations for 10 weeks. At posttest, in comparison to the WL group, children in the SD group had lower levels of behavior problems on parent report measures of child behavior. At posttreatment, parents in the SD condition reported increased levels of parenting competence and lower levels of dysfunctional parenting practices as compared to parents in the WL condition. In addition, mothers reported lower levels of anxiety, depression, and stress as compared to mothers in the WL condition at posttreatment. Using mother's reports, gains in child behavior and parenting practices achieved at posttreatment were maintained at 4-month follow-up.