Rural and Urban Differentials in Primary Care Management of Chronic Heart Failure: New Data from the CASE Study

Objective: To determine whether primary care management of chronic heart failure (CHF) differed between rural and urban areas in Australia. Design: A cross-sectional survey stratified by Rural, Remote and Metropolitan Areas (RRMA) classification. The primary source of data was the Cardiac Awareness Survey and Evaluation (CASE) study. Setting: Secondary analysis of data obtained from 341 Australian general practitioners and 23 845 adults aged 60 years or more in 1998. Main outcome measures: CHF determined by criteria recommended by the World Health Organization, diagnostic practices, use of pharmacotherapy, and CHF-related hospital admissions in the 12 months before the study. Results: There was a significantly higher prevalence of CHF among general practice patients in large and small rural towns (16.1%) compared with capital city and metropolitan areas (12.4%) (P < 0.001). Echocardiography was used less often for diagnosis in rural towns compared with metropolitan areas (52.0% v 67.3%, P < 0.001). Rates of specialist referral were also significantly lower in rural towns than in metropolitan areas (59.1% v 69.6%, P < 0.001), as were prescribing rates of angiotensin-converting enzyme inhibitors (51.4% v 60.1%, P < 0.001). There was no geographical variation in prescribing rates of β-blockers (12.6% [rural] v 11.8% [metropolitan], P = 0.32). Overall, few survey participants received recommended “evidence-based practice” diagnosis and management for CHF (metropolitan, 4.6%; rural, 3.9%; and remote areas, 3.7%). Conclusions: This study found a higher prevalence of CHF, and significantly lower use of recommended diagnostic methods and pharmacological treatment among patients in rural areas.

STREAM Initiative: support to regional aquatic resources management: a NACA strategy for rural development

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Linking public perceptions of socioeconmic change and marine resource management in rural Maine

Rural coastal regions across the United States are coping with dramatic social and environmental changes. Historically, these areas relied heavily on fishing and marine commerce and these economic activities defined the character of coastal communities. However, shifting ocean and climate conditions, together with inadequate management strategies, have led to sharp declines in harvestable marine resources. These trends, along with increasing competition from aquaculture and international sources of fish, have led to the steady decline of fishing as the central economic activity in many rural coastal communities. (PDF contains 3 pages)

An idealized rural coastal zone management integrating land and water use

Various countries have formulated special integrated coastal zone management (ICZM) strategies which seek to both manage development and conserve natural resources and integrate and coordinate the relevant people sectors and their functions and roles within the bounds of this rich realm. Concerns that may be addressed by ICZM include: 1) Natural resources degradation; 2) Pollution; 3) Land use conflicts; and, 4) Destruction of life and property by natural hazards. Some prevalent sources of environmental impacts (livelihoods) are listed, together with some recommendations to the concerns which they may raise in relation to coastal zone management: agriculture; aquaculture; fisheries; forestry; human settlements; tourism; and, transport industry.

Drinking water issues in Rural India: Need for stakeholders’ participation in Water resources management

Water is the very essential livelihood for mankind. The United Nations suggest that each person needs 20-50 litres of water a day to ensure basic needs of drinking, cooking and cleaning. It was also endorsed by the Indian National Water Policy 2002, with the provision that adequate safe drinking water facilities should be provided to the entire population both in urban and in rural areas. About 1.42 million rural habitations in India are affected by chemical contamination. The provision of clean drinking water has been given priority in the Constitution of India, in Article 47 conferring the duty of providing clean drinking water and improving public health standards to the State. Excessive dependence of ground water results in depletion of ground water, water contamination and water borne diseases. Thus, access to safe and reliable water supply is one of the serious concerns in rural water supply programme. Though government takes certain serious steps in addressing the drinking water issues in rural areas, still there is a huge gap between demand and supply. The Draft National Water Policy 2012 also states that Water quality and quantity are interlinked and need to be managed in an integrated manner and with Stakeholder participation. Water Resources Management aims at optimizing the available natural water flows, including surface water and groundwater, to satisfy competing needs. The World Bank also emphasizes on managing water resources, strengthening institutions, identifying and implementing measures of improving water governance and increasing the efficiency of water use. Therefore stakeholders’ participation is viewed important in managing water resources at different levels and range. This paper attempts to reflect up on portray the drinking water issues in rural India, and highlights the significance of Integrated Water Resource Management as the significant part of Millennium Development Goals, and Stakeholders’ participation in water resources management.

[Ressenya de la] Conferència internacional The Future of the Mediterranean Rural Environment: Prospects for Sustainable Land Use and Management. Menemen (Turquia), del 8 a l'11 de maig de 2000

Crònica de la conferència internacional 'The Future of the Mediterranean Rural Environment: Prospects for Sustainable Land Use and Management' sobre el desenvolupament sostenible de les àrees rurals mediterrànies. La conferència va tenir lloc entre el 8 i l’11 de maig de 2000 a Menemen (Turquia) i va reunir experts de diverses disciplines per establir els problemes principals que afecten la Mediterrània i per debatre mesures concretes de gestió, evitant o minimitzant els efectes negatius dels canvis econòmics, polítics, tecnològics i mediambientals recents

Parròquia i societat rural al Bisbat de Girona, segles XIII i XIV

La parròquia, poc valorada per la historiografia medieval, fou una la institució fonamental per a l'ordenació de la societat rural del bisbat de Girona entre els segles X i XIV. Constituïa un territori ben delimitat, els habitants del qual rebien els sagraments eclesiàstics dels clergues que regien l'església i, a través de l'obreria i dels obrers, participaven en la gestió del temple i de la seva economia. La parròquia va incidir directament en l'ordenació del poblament rural a través tant dels nuclis eclesials o "celleres" com dels masos dispersos pel terme d'una parròquia. A més, la parròquia era una important font de rendes: a través de la documentació generada pel bisbe de Girona, el delme era una renda en mans, sobretot, de senyors feudals, cavallers i importants institucions eclesiàstiques; els clergues parroquials només rebien les primícies i altres drets de menor valor. Finalment, la parròquia contribuí enormement a la configuració de les comunitats rurals de bona part del bisbat de Girona.