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

Wiring the country: Local telecommunications and Australian rural communities

In rural Australia in the early twenty-first century, telecommunications reform has seen the rise of local telecommunications as a new way to wire the country, delivering new technologies and meeting community needs and aspirations. 1his paper discusses the prospects for local telecommunications in light of a research project on online rural communities commissioned by the Telstra Consumer Consultative Council. Based on interviews conducted in three small towns in rural eastern Australia, the paper examines the role of community networking as a new force in telecommunications service delivery, posing questions for local and regional communications policy development.

A feasibility study of email communication between the patient's family and the specialist burns team

We investigated whether the parents of burns patients could capture suitable clinical images with a digital camera and add the necessary text information to enable the paediatric burns team to provide follow-up care via email. Four families were involved in the study, each of whom sent regular email consultations for six months. The results were very encouraging. The burns team felt confident that the clinical information in 30 of the 32 email messages (94%) they received was accurate, although in I I of these 30 cases (37%) they stated that there was room for improvement (the quality was nonetheless adequate for clinical decision making). The study also showed that low-resolution images (average size 37 kByte) were satisfactory for diagnosis. Families were able to participate in the service without intensive training and support. The user survey showed that all four families found it easy and convenient to take the digital photographs and to participate in the study. The results suggest that the technique has potential as a low-cost telemedicine service in burns follow-up, and that it requires only modest investment in equipment, training and support.

Forces of agglomeration and dispersal in rural business networks: a social network analysis

Two concepts in rural economic development policy have been the focus of much research and policy action: the identification and support of clusters or networks of firms and the availability and adoption by rural businesses of Information and Communication Technologies (ICT). From a theoretical viewpoint these policies are based on two contrasting models, with clustering seen as a process of economic agglomeration, and ICT-mediated communication as a means of facilitating economic dispersion. The study’s conceptual framework is based on four interrelated elements: location, interaction, knowledge, and advantage, together with the concept of networks which is employed as an operationally and theoretically unifying concept. The research questions are developed in four successive categories: Policy, Theory, Networks, and Method. The questions are approached using a study of two contrasting groups of rural small businesses in West Cork, Ireland: (a) Speciality Foods, and (b) firms in Digital Products and Services. The study combines Social Network Analysis (SNA) with Qualitative Thematic Analysis, using data collected from semi-structured interviews with 58 owners or managers of these businesses. Data comprise relational network data on the firms’ connections to suppliers, customers, allies and competitors, together with linked qualitative data on how the firms established connections, and how tacit and codified knowledge was sourced and utilised. The research finds that the key characteristics identified in the cluster literature are evident in the sample of Speciality Food businesses, in relation to flows of tacit knowledge, social embedding, and the development of forms of social capital. In particular the research identified the presence of two distinct forms of collective social capital in this network, termed “community” and “reputation”. By contrast the sample of Digital Products and Services businesses does not have the form of a cluster, but matches more closely to dispersive models, or “chain” structures. Much of the economic and social structure of this set of firms is best explained in terms of “project organisation”, and by the operation of an individual rather than collective form of “reputation”. The rural setting in which these firms are located has resulted in their being service-centric, and consequently they rely on ICT-mediated communication in order to exchange tacit knowledge “at a distance”. It is this factor, rather than inputs of codified knowledge, that most strongly influences their operation and their need for availability and adoption of high quality communication technologies. Thus the findings have applicability in relation to theory in Economic Geography and to policy and practice in Rural Development. In addition the research contributes to methodological questions in SNA, and to methodological questions about the combination or mixing of quantitative and qualitative methods.

Questioning the merits and demerits of electronic communication in Social Work

This paper examines the social dynamics of electronic exchanges in the human services, particularly in social work. It focuses on the observable effects that email and texting have on the linguistic, relational and clinical rather than managerial aspects of the profession. It highlights how electronic communication is affecting professionals in their practice and learners as they become acculturated to social work. What are the gains and losses of the broad use of electronic devices in daily lay and professional, verbal and non-verbal communication? Will our current situation be seriously detrimental to the demeanor of future practitioners, their use of language, and their ability to establish close personal relationships? The paper analyzes social work linguistic and behavioral changes in light of the growth of electronic communication and offers a summary of merits and demerits viewed through a prism emerging from Baron’s (2000) analysis of human communication.

Turismo rural y paisaje en zonas de montaña. Propuesta metodológica para identificar sus relaciones en las Sierras Meridionales de la Provincia de Albacete

Las zonas de montaña cuentan con especificidades geográficas y socioeconómicas. En ellas, a partir del patrimonio territorial natural y cultural, se ha producido un considerable impulso del turismo rural, que ha centrado el interés en la valoración de la singularidad y variedad de los paisajes. En este caso se presta atención a las sierras meridionales de la provincia de Albacete. El trabajo se apoya en una metodología que combina el uso de encuestas de preferencias de turistas y técnicas cartográficas a partir de algunas variables del sistema turístico en el medio rural. El trabajo se inserta dentro de los paradigmas del desarrollo local y el desarrollo sostenible, aplicado a los espacios rurales y a las zonas de montaña media del sureste de Castilla-La Mancha. La hipótesis se centra en la consideración del paisaje como elemento medular del turismo rural.

Between Bacchus and Dionysus: European Union policies on rural development: the cases of Nemea and Basto wine regions

A actividade vitivinícola possui um conjunto diverso de características presentes no solo, território e comunidade que fazem parte do património cultural de uma determinada região. Quando a tradição se traduz num conceito como terroir que é formado por características territoriais, sociais e culturais de uma região rural, o vinho apresenta uma “assinatura” que se escreve “naturalmente” no paladar regionalmente identificado. Os vinhos da Região de Nemea, na Grécia e de Basto (Região dos Vinhos Verdes) em Portugal, estão ambos sob a proteção dos regulamentos das Denominações de Origem. No entanto, apesar de ambos serem regulados por sistemas institucionais de certificação e controlo de qualidade, afigura-se a necessidade de questionar se o património cultural e a identidade territorial específica, “impressa” em ambos os terroirs, pode ser protegida num sentido mais abrangente do que apenas origem e qualidade. Em Nemea, a discussão entre os produtores diz respeito ao estabelecimento de sub-zonas, isto é incluir na regulação PDO uma diferente categorização territorial com base no terroir. Ou seja, para além de estar presente no rótulo a designação PDO, as garrafas incluirão ainda informação certificada sobre a área específica (dentro do mesmo terroir) onde o vinho foi produzido. A acontecer resultaria em diferentes status de qualidade de acordo com as diferentes aldeias de Nemea onde as vinhas estão localizadas. O que teria possíveis impactos no valor das propriedades e no uso dos solos. Para além disso, a não participação da Cooperativa de Nemea na SON (a associação local de produtores de vinho) e como tal na discussão principal sobre as mudanças e os desafios sobre o terroir de Nemea constitui um problema no sector vitivinícola de Nemea. Em primeiro lugar estabelece uma relação de não-comunicação entre os dois mais importantes agentes desse sector – as companhias vinícolas e a Cooperativa. Em segundo lugar porque constituiu uma possibilidade real, não só para os viticultores ficarem arredados dessa discussão, como também (porque não representados pela cooperativa) ficar impossibilitado um consenso sobre as mudanças discutidas. Isto poderá criar um ‘clima’ de desconfiança levando a discussão para ‘arenas’ deslocalizadas e como tal para decisões ‘desterritorializadas’ Em Basto, há vários produtores que começaram a vender a sua produção para distribuidoras localizadas externamente à sub-região de Basto, mas dentro da Região dos Vinhos Verdes, uma vez que essas companhias tem um melhor estatuto nacional e internacional e uma melhor rede de exportações. Isto está ainda relacionado com uma competição por uma melhor rede de contactos e status mais forte, tornando as discussões sobre estratégias comuns para o desenvolvimento rural e regional de Basto mais difícil de acontecer (sobre isto a palavra impossível foi constantemente usada durante as entrevistas com os produtores de vinho). A relação predominante entre produtores é caracterizada por relações individualistas. Contudo foi observado que essas posições são ainda caracterizadas por uma desconfiança no interior da rede interprofissional local: conflitos para conseguir os mesmos potenciais clientes; comprar uvas a viticultores com melhor rácio qualidade/preço; estratégias individuais para conseguir um melhor status político na relação com a Comissão dos Vinhos Verdes. Para além disso a inexistência de uma activa intermediação institucional (autoridades municipais e a Comissão de Vinho Verde), a inexistência entre os produtores de Basto de uma associação ou mesmo a inexistência de uma cooperativa local tem levado a região de Basto a uma posição de subpromoção nas estratégias de promoção do Vinho Verde em comparação com outras sub-regiões. É também evidente pelos resultados que as mudanças no sector vitivinícolas na região de Basto têm sido estimuladas de fora da região (em resposta também às necessidades dos mercados internacionais) e raramente de dentro – mais uma vez, ‘arenas’ não localizadas e como tal decisões desterritorializadas. Nesse sentido, toda essa discussão e planeamento estratégico, terão um papel vital na preservação da identidade localizada do terroir perante os riscos de descaracterização e desterritorialização. Em suma, para ambos os casos, um dos maiores desafios parece ser como preservar o terroir vitivinícola e como tal o seu carácter e identidade local, quando a rede interprofissional em ambas as regiões se caracteriza, tanto por relações não-consensuais em Nemea como pelo modus operandi de isolamento sem comunicação em Basto. Como tal há uma necessidade de envolvimento entre os diversos agentes e as autoridades locais no sentido de uma rede localizada de governança. Assim sendo, em ambas as regiões, a existência dessa rede é essencial para prevenir os efeitos negativos na identidade do produto e na sua produção. Uma estratégia de planeamento integrado para o sector será vital para preservar essa identidade, prevenindo a sua desterritorialização através de uma restruturação do conhecimento tradicional em simultâneo com a democratização do acesso ao conhecimento das técnicas modernas de produção vitivinícola.

The quality of care of diabetic patients in rural Malawi: A case of Mangochi district

Background Diabetes mellitus is a global public health problem. In Malawi, the prevalence of diabetes is 5.6% but the quality of care has not been well studied. Objective The aim of this study was to assess the quality of care offered to diabetic patients in Mangochi district. Methods This was a cross sectional descriptive study. Quantitative data were collected using a questionnaire from a sample of 75 diabetic patients (children and adults) who attended the Diabetes Clinic at Mangochi District Hospital between 20012 and 2013. Qualitative data were also collected using semi-structured interviews with eight Key Informants from among the District Health Management Team. Frequencies and cross-tabulation were obtained from the quantitative data. Patients’ master cards were checked to validate results. Clinical knowledge about diabetes, care practices and resources were the themes analysed from the qualitative data. Results Among the 75 participants interviewed, 46 were females and 29 males. The overall mean age was 48.3 years (45.6 for females and 53.3 for males). More than half of patients had little or no information about diabetes (40.0 % (n=30) and 22.7 (n=17) respectively. The majority of patients were taking their medicines regularly 98.7% (n=74). Only 17.3% (n=13) reported having their feet inspected regularly. Fifty-six percent of patients were satisfied about services provision. Some nurses and clinicians were trained on diabetes care but most of them left. Guidelines on diabetes management were not accessible. There were shortages in medicines (e.g. soluble insulin) and reagents. Information Education and Communication messages were offered through discussions, experiences sharing and posters. Conclusion Quality of diabetes care provided to diabetic patients attended to Mangochi hospital was sub-optimal due to lack of knowledge among patients and clinicians and resources. More efforts are needed towards retention of trained staff, provision of pharmaceutical and laboratory resources and health education.

Estratégias comunicacionais para soluções de tecnologia da informação (TI) aplicadas à adequação da paisagem rural ao Código Florestal brasileiro.

O artigo apresenta estratégias comunicacionais para divulgação de soluções de tecnologia da informação (TI), em especial, de software para o domínio de interesse da temática ambiental e florestal, produzidos pela Embrapa.

EL TURISMO Y LA CONVIVENCIA COMUNAL EN UN ÁREA RURAL-COSTERA

En el presente artículo el lector podrá encontrar algunos aspectos  relacionados  con el turismo como actividad económica y su expresión concreta en las comunidades de Tambor y Montezuma de Cóbano, provincia de Puntarenas, Costa Rica. Pero además y es la parte fundamental del mismo se hace referencia aquí al impacto que ha tenido este sector en la convivencia comunal y cotidianidad de esas comunidades. Este impacto se analiza en tres dimensiones específicas: la socioeconómica, la cultural y la ambiental. En síntesis y como producto de los efectos del turismo, la zona analizada sufre una transformación importante que engloba la convivencia comunal; convivencia que en sus manifestaciones generales coincide en cierta medida con el contexto nacional y mundial, pero que también tiene su particularidad. En este sentido, se nota una re-dimensión en la individualidad de actor y sector social, pero además en la totalidad de la convivencia comunal. Esta re-dimensión, si bien es producto de actividades económicas  de sistemas productivos y de nuevas estrategias de desarrollo globalizantes, se manifiesta en lo social, en lo cultural y en la relación sociedad naturaleza ó ambiente a nivel local, como un producto más divertido de la actividad turística.   Abstract: This paper discusses the effects of the tourism industry in the communities of Tambor and Montezuma, Cobano, province of Puntarenas, Costa Rica. If focuses in the impact and tourism in peoples everyday life from on three- fold perspective: socio-economic, cultural and evironmental. Regarding the impact of tourism in the socioeconomic dimensión the study revels an important change in the labor market, which was traditionally related to farming and fishing, now oriented to the production of goods and services for tourists and other economic activities take place in medium and small scales and involve men and women, Young  and adults. They generate different social and interpersonal relations, which contribute to change comunal daily coexistence. In the cultural discussion tourism had changed daily like in these communities and patterns of social coexistence. Among the most significant changes are customs and holidays, clothing styles, the loss of traditional forms of communication, the beginning of different ways of dialoging and new relationships among neighbors, and even of the way people talk and how and whit they eat. In relation to the environment the new ways to relate to nature and of trying to manage and handle the natural resources the awareness and the new attitude in regard to the environmental situation, as well as the wormiest for conservation. For having clean and healthy surroundings, among others, had the collective levels. To summarize as a result of the effects of tourism an important transformation is talking place in the communities under study that coincides with the national and global context to a certain extent, but to also has its own particularities. In this sense, it is noticeable a re-definition of the individuality of each actor and social sector and in the totality of the communal identify as well. Eventhough that redefinition is the result of economic activities, of economic systems and new globalized developmental strategies, also effects in the social and cultural aspects and in the relation men-nature in a local level.