Rural Population Research Articles

Socioeconomic determinants of COVID-19 vaccine acceptance.

The aim of the paper is to evaluate the relative importance of the set of socioeconomic characteristics of population on collective decision on COVID-19 vaccine acceptance. We apply cross-section OLS methods to the municipal-level non-survey data for 145 municipalities in Serbia, on the COVID-19 vaccination rate and socioeconomic characteristics of the population, to evaluate the determinants of cross-municipal variation in vaccine uptake decision. Using the estimated coefficients from the OLS regressions, we apply the standardized beta method to evaluate the relative importance of each factor. Vaccine acceptance in municipalities rises with the average level of education (especially in the female population), age and employment, while being negatively linked to religiosity of people and the proportion of rural population. We also find some evidence on the positive impact of the overall trust in government. Education level has the single largest impact, shaping around 37% of (explained) variation in the vaccination rate across municipalities, a rise in the proportion of people with higher degree by 1% being associated with increase in vaccination rate by 0.36%. Age of population explains 21%, urban-rural structure 13% and religiosity 11% of variation in vaccine acceptance, while employment status and trust in government each explain around 9% of variation in vaccine uptake across municipalities. Effective vaccination promotion strategy should be focused on younger, less-educated, unemployed cohorts, as well as on rural areas and should involve representatives of mainstream religions. Fostering education and strengthening trust in government are some of the key structural factors that may promote efficient collective behaviour in this respect.

Unveiling Health Inequalities: Exploring Metabolic Dysfunction in Rural Roma Communities.

Europe's largest ethnic minority, the Roma, are often confronted with substantial obstacles that result in health disparities. Research indicates that there are elevated rates of both communicable and non-communicable diseases, such as metabolic syndrome (MetS), among Roma communities, often linked to living conditions, limited education, or poverty. This study centers on remote rural Roma settlements in Romania, evaluating the prevalence of metabolic dysfunction, obesity, and liver steatosis while considering socio-economic and lifestyle factors. Over a period of 36 months, local visits to a total of 25 rural Roma communities were conducted, where a medical team gathered information through a standardized questionnaire and conducted a physical exam on every participant. Liver steatosis was also recorded with the help of a portable wireless ultrasound device. Our study included 343 participants, with a predominance of female subjects, representing 72.5% (n = 249) of the patients. The prevalence of obesity, defined by a body mass index (BMI) above 30 kg/m2, was 32.2% (n = 111). Arterial hypertension was found to have a prevalence of 54.1% (n = 185), with de novo hypertension being observed in 19.2% patients (n = 66). Type 2 diabetes mellitus was found in 28.9% patients (n = 99), with 19.5% being de novo cases. The prevalence of hepatic steatosis was 57.2% (n = 111/194). A positive association between metabolic features and at-risk behaviors was found. This study underscores the transition from infectious to metabolic diseases in vulnerable communities and highlights the urgency of targeted public health strategies tailored to the unique needs of rural Roma populations, aiming to mitigate health disparities and promote equitable healthcare access.

Satisfaction with Teleophthalmology Services: Insights from Remote Areas of Taiwan.

During and after the COVID-19 pandemic, teleophthalmology provided access to eye care for rural populations. This study aimed to assess the efficacy of and satisfaction with an integrated real-time videoconferencing module. This project incorporated ophthalmic instruments and telecommunication devices and provided on-site consultations via videoconferencing. Both patients and healthcare providers completed satisfaction questionnaires. From May 2020 to May 2021, this project provided eye care services to 395 patients (aged 6-90 years). The most frequent eye condition was chronic conjunctivitis (n = 197), followed by senile cataract (n = 163), dry eye (n = 103), and refractive error (n = 95). Among them, 40 (10.1%) patients were referred to secondary or tertiary hospitals for further evaluation or treatment. In total, 181 recruited respondents provided good satisfaction scores in all dimensions, including quality of medical care (4.50 of 5.00), financial aspects of care (4.48), supportive attitude toward the project (4.47), quality of service (4.40), and quality of telecommunication (4.40). Women had a substantially more supportive attitude toward the project, and 25 healthcare providers provided low ratings in areas representing the quality of telecommunication (4.04) and user-friendliness of the instrument (4.00). This teleophthalmology system provided efficient and satisfactory eye care to participants in remote communities. However, better internet access and training in instrument use can reduce obstacles to the future implementation of the project.

Independent and joint associations of estimated cardiorespiratory fitness and its dynamic changes and obesity with the risk of hypertension: A prospective cohort.

Our aim was to examine the independent and joint associations of estimated cardiorespiratory fitness (CRF) and its changes and obesity with risk of hypertension in a rural Chinese population. A prospective cohort including 9848 adults without hypertension at baseline was enrolled. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated by logistic regression models. Restricted cubic splines were used to model the dose-response relationship. During 6 years follow-up, 2,019 individuals developed hypertension. A negative association between estimated CRF and hypertension incidence was observed, with the risk being 0.87 (0.84-0.90) per MET increment. For estimated CRF change, the risks of hypertension were 1.50 (1.27-1.77) and 0.75 (0.59-0.97) for decreasers and increasers, respectively, compared to maintainers. Joint analyses showed individuals in the overweight/obesity-fourth quartile of estimated CRF had a 2.08 times higher risk of hypertension than those in the normal weight-first quartile (Pinteraction < 0.05). Those overweight/obesity-decreasers had the highest risk (OR: 2.19, 95%CI: 1.71-2.81; Pinteraction < 0.05) compared to the normal-maintainers. Similar results for abdominal obesity were also observed. Estimated CRF and its dynamic changes showed a negative association with hypertension incidence in the rural Chinese population.

Utah Latina/o/x suicide decedents less likely to die by firearm, even in rural areas: examining population-wide data from the Utah Office of the Medical Examiner.

Suicide death remains a significantly rarer event among Latina/o/x populations compared to non-Latina/o/x populations. However, the reasons why Latina/o/x communities experience relatively lower suicide rates are not fully understood. Critical gaps exist in the examination of Latina/o/x suicide death, especially in rural settings, where suicide death by firearm is historically more common within non-Latina/o/x populations. We tested whether the prevalence of Latina/o/x firearm suicide was meaningfully different in urban and rural environments and from non-Latino/a/x decedents when controlling for age, sex, and a social deprivation metric, the Area Deprivation Index. Suicide death data used in this analysis encompasses 2,989 suicide decedents ascertained in Utah from 2016 to 2019. This included death certificate data from the Utah Office of the Medical Examiner on all Utah suicide deaths linked to information by staff at the Utah Population Database. Compared to non-Latina/o/x suicide decedents, Latina/o/x suicide decedents had 34.7% lower adjusted odds of dying by firearm. Additionally, among the firearm suicide decedents living only in rural counties, Latina/o/x decedents had 40.5% lower adjusted odds of dying by firearm compared to non-Latina/o/x suicide decedents. The likelihood of firearm suicide death in Utah differed by ethnicity, even in rural populations. Our findings may suggest underlying factors contributing to lower firearm suicide rates within Latina/o/x populations, e.g., aversion to firearms or less access to firearms, especially in rural areas, though additional research on these phenomena is needed.

Effects of ambient temperature, relative humidity and absolute humidity on risk of nasopharyngeal carcinoma in China.

Nasopharyngeal carcinoma (NPC) has a unique geographic distribution. It is unknown whether meteorological factors are related to the incidence of NPC. To investigate the effect of ambient temperature, relative humidity (RH), and absolute humidity (AH) on the incidence of NPC, we collected the incidence rate of NPC in 2016 and meteorological data from 2006 to 2016 from 484 cities and counties across 31 provinces in China. Generalized additive models with quasi-Poisson regression and generalized linear models with natural cubic splines were employed respectively to elucidate the nonlinear relationships and specify the partial linear relationships. Subgroup and interactive analysis were also conducted. Temperature (R2 = 0.68, p < .001), RH (R2 = 0.47, p < .001), and AH (R2 = 0.70, p < .001) exhibited nonlinear correlations with NPC incidence rate. The risk of NPC incidence increased by 20.3% (95% confidence intervals [CI]: [18.9%, 21.7%]) per 1°C increase in temperature, by 6.3% (95% CI: [5.3%, 7.2%]) per 1% increase in RH, and by 32.2% (95% CI: [30.7%, 33.7%]) per 1 g/m3 increase in AH, between their the 25th and the 99th percentiles. In addition, the combination of low temperature and low RH was also related to increased risk (relative risk: 1.60, 95% CI: [1.18, 2.17]). Males and eastern or rural populations tended to be more vulnerable. In summary, this study suggests that ambient temperature, RH, and particularly AH are associated with the risk of NPC incidence.

Effectiveness of a Health Belief Model-Based Education Program on Self-Efficacy and Preparedness for Infectious Disasters in Rural Populations.

Health education programs can enhance self-efficacy and disaster preparedness. However, research incorporating the Health Belief Model (HBM) in education for infectious disasters is lacking. Examine the effectiveness of an HBM-based education program on self-reported self-efficacy and self-reported preparedness for infectious disasters in rural populations. In total, 109 eligible participants were allocated to two groups: participants who received HBM-based education (n = 55) or regular education (n = 54), presented at in-person meetings, with individual follow-up conducted on WhatsApp. Self-reported self-efficacy and preparedness for infectious disasters in both groups were measured at 4 and 8 weeks. Participants showed a significant interaction between groups and in time to increase in self-reported self-efficacy and self-reported preparedness to deal with infectious disasters. After 4 and 8 weeks, the groups had statistically significant differences (p≤.001) in all outcome measures. HBM-based education was associated with increased self-reported self-efficacy and self-reported infectious disaster preparedness among the rural population. Follow-up by nurses is essential to implementing continuing health belief education programs to enhance rural populations' self-efficacy and infectious disaster preparedness.

Associations between digital literacy, health literacy, and digital health behaviors among rural residents: evidence from Zhejiang, China

ObjectiveWithin the digital society, the limited proficiency in digital health behaviors among rural residents has emerged as a significant factor intensifying health disparities between urban and rural areas. Addressing this issue, enhancing the digital literacy and health literacy of rural residents stands out as a crucial strategy. This study aims to investigate the relationship between digital literacy, health literacy, and the digital health behaviors of rural residents.MethodsInitially, we developed measurement instruments aimed at assessing the levels of digital literacy and health literacy among rural residents. Subsequently, leveraging micro survey data, we conducted assessments on the digital literacy and health literacy of 968 residents in five administrative villages in Zhejiang Province, China. Building upon this foundation, we employed Probit and Poisson models to empirically scrutinize the influence of digital literacy, health literacy, and their interaction on the manifestation of digital health behaviors within the rural population. This analysis was conducted from a dual perspective, evaluating the participation of digital health behaviors among rural residents and the diversity to which they participate in such behaviors.ResultsDigital literacy exhibited a notably positive influence on both the participation and diversity of digital health behaviors among rural residents. While health literacy did not emerge as a predictor for the occurrence of digital health behavior, it exerted a substantial positive impact on the diversity of digital health behaviors in the rural population. There were significant interaction effects between digital literacy and health literacy concerning the participation and diversity of digital health behaviors among rural residents. These findings remained robust even after implementing the instrumental variable method to address endogeneity issues. Furthermore, the outcomes of robust analysis and heterogeneity analysis further fortify the steadfastness of the aforementioned conclusions.ConclusionThe findings suggest that policymakers should implement targeted measures aimed at enhancing digital literacy and health literacy among rural residents. This approach is crucial for improving rural residents' access to digital health services, thereby mitigating urban–rural health inequality.

Disputes over pastures in the nineteenth-century Balkans

This research aims to contribute to the literature on Ottoman common and by analysing how mid-nineteenth century land codes influenced conflicts regarding common pastures in the Balkans. To accomplish this goal, two sets of primary sources are analysed: legal documents (Land Code of 1858 and Title Deed Regulation of 1859) as well as petition records from the Ottoman Imperial Archives. Case studies of land disputes occurring between commoners and large estate (çiftlik) holders in the Balkans are selected from the years following the enactment of these land codes. This selection enables an examination of the impact of these codes on the arguments presented by the conflicting parties. The central argument of this study points out that the Ottoman Empire’s efforts to codify land laws played a crucial role in shaping the disputes over communal pastures. However, it is equally important to underline that these legal changes did not signify an unqualified victory for private property rights over commons. Instead, the rural population countered landholders’ efforts by employing petitioning as a proactive strategy.

Study of Level of Understanding about the Ergonomics to be Followed in the Rural and Urban Population on Prevention of Various Musculoskeletal Problems

Background: Ergonomics is a vague concept to learn and applying it to day-to-day life will make the work easier with less effort. Urban and rural populations both have different types of work strategies. By understanding ergonomics, modifications will be made, preventing musculoskeletal problems. This research aims to study the level of understanding of the ergonomics to be followed in rural and urban populations for the prevention of various musculoskeletal problems. Objectives: The objectives are to check the awareness level related to ergonomics among rural and urban populations using a self-made questionnaire and find out the common musculoskeletal problems prevailing and possible risk factors related to them. Methods: This was a convenience sampling method that consisted of 91 participants included in this study. 45 from rural and 46 from urban populations were selected based on inclusion and exclusion criteria. The questionnaire was made on the basis of different aspects, which will determine the level of understanding overall. The questionnaire was provided online and in offline mode too. The level of understanding was checked for each population based on responses. Results: Based on the statistical analysis, it was found that the urban population has a higher level of understanding and prevention strategies as compared to the rural population. Conclusion: Findings showed that ergonomics was a new term for the participants, but knowledge and understanding were seen more in urban participants than rural participants.

The Impact of Rural Population Aging on Agricultural Cropping Structure: Evidence from China’s Provinces

Agricultural cropping structure is related to the quality of the agricultural supply system and is a key element of the structural reform of the agricultural supply side. Based on China’s provincial panel data from 2000 to 2021, this paper empirically examines the impact and mechanism of rural population aging on the planting structure of food and cash crops by using a two-way fixed-effects model, which fills the gap in the research on the impact mechanism of the rural population aging on agricultural planting structure. The conclusions of the study show that: as the aging of the rural population deepens, the proportion of food crops planted will further increase, while the proportion of cash crops planted will decrease; agricultural mechanization will promote the further increase of the proportion of food crops planted while the proportion of cash crops planted will decrease in the deepening of the aging of rural population; the aging of the rural population has a more significant impact on the structure of agricultural planting in the eastern region and does not have a significant impact on the central and western provinces. The aging of the rural population has a significant impact on the agricultural planting structure in the eastern region, but not in the central and western provinces. This paper argues that we should fully respect the willingness of agricultural management subjects to choose planting varieties, increase the research, development, and promotion of agricultural machinery, continuously improve the level of farmers’ human capital, and further enhance the degree of organization, scale, and specialization of agricultural production.

Do WHO criteria for gestational diabetes fit a rural population in Tanzania? – A follow-up study assessing mother and child health six years after a pregnancy diagnosed with gestational diabetes

Aims and MethodsIn low- and middle- income countries (LMICs) consequences of gestational diabetes (GDM) is understudied. Using a prospective cohort of mothers (n = 197)and children (n = 251), from rural north-eastern Tanzania, we assessed prediabetes and type 2 diabetes (T2D) prevalence six years after a pregnancy with/without GDM. ResultsThe prevalence of prediabetes (49.4 % vs. 46.4 %) orT2D (20.0 % vs. 16.1 %), p ≥ 0.36, based on fasting plasma glucose (FPG) or HbA1clevels (prediabetes: 16.9 % vs. 13.8 % and T2D 1.2 % vs. 0 %, p = 0.47), andcardio-metabolic health parameters,weresimilar between women with/without previous GDM. These results were supported by similar perinatal outcomes and child health at follow-up.The overall prevalence ofprediabetes/T2D was high, but no differences in other cardio-metabolic risk markers were observed in women with prediabetes/T2D compared to women with normal glucose tolerance. ConclusionsDespite high prevalence of GDM amongTanzanian women, the diagnosis was not associated with adverse pregnancy outcomes, nor with increased risk of prediabetes or T2D at follow-up. FPG and HbA1c may be poor markers for diabetes in this population, and further follow-up studies with longer time intervals are warranted to evaluate which GDM diagnostic criteria are most optimal for women in rural Tanzania and similar LMIC settings.

Demographic Problems in the Northern Regions of the Republic of Kazakhstan

This article aims to analyse demographic and migration processes in Kazakhstan, focusing on identifying their impact on society’s economic, political and social aspects. The work methodology is based on comparisons and system-structural methods, such as control, generalization, systematization, logical analysis, and synthesis. The study used two main groups of indicators for 1990-2021. The first group included comparative indicators, such as the relative size of the population structure, the intensity and relative proportions of the structure, and the proportions of the urban and rural population. The second group included migration indicators, such as the number of arrivals to the settlement, the number of departures from the settlement, and absolute migration growth or balance. The study results reveal regional differences, especially in the context of migration processes. There is a negative balance of internal migration and high rates of population decline in the northern regions. In comparison, the southern regions are experiencing population growth, which poses new economic and social challenges. It is predicted that by 2050, the population of the south of regions will increase significantly. The authors emphasize the importance of an integrated approach to solving demographic problems, including improving well-being, providing affordable health care and developing effective demographic policies. In conclusion, it is noted that successfully overcoming demographic challenges requires balanced economic and social measures.

Global urbanization and ruralization lessons of clean energy access gap

While energy access is improving across economic groups globally, here remains the monumental challenge of clean energy inequality that has further aggravates climate-related problems. To further address clean energy inequality, this study offers novel understanding on the forces behind clean energy access divide associated with urbanization and ruralization by employing the case of the high, low, lower-middle, and upper-middle income economies in the period 2010 to 2021. By using empirical analysis, the results reveal that (i) annual growth in the economy, and (ii) literacy parity between male and female further worsen clean energy access between urban and rural population. Contrarily, innovative activities reduce urban-rural clean energy access by an elasticity of 3.510. These findings, in theory and practice, provide policy insight toward specifically achieving the United Nation's Sustainable Development Goals 7 and 10, and other global challenges.

Modernising tradition: Reinforcing ASWAJA al-Nahdhiyah authority among millennials in Indonesia

The da’wah [invitation to Islamic teachings] movement of Ahl al-Sunnah wa al-Jama’ah al-Nahdhiyah, abbreviated as ASWAJA al-Nahdhiyah, formerly centred around elderly, rural, and traditional populations, has now expanded its influence to encompass the millennial demographic. The evolving landscape of time and technological advancements present novel challenges in effectively communicating the da’wah message to a generation deeply immersed in the digital era. Millennials exhibit distinct communication preferences and characteristics compared to previous generations, necessitating tailored approaches to disseminate da’wah content that resonates with their context and needs. This research aimed to achieve two primary objectives: firstly, to identify emerging forms of new traditions within the ideological reinforcement of ASWAJA al-Nahdhiyah among millennials, and secondly, to analyse the underlying factors contributing to these novel traditions within the millennial context. Employing a qualitative approach, this study utilised nethnography as its methodological framework, seeking to understand cultural experiences encompassing traces, practices, networks, and social media systems. By combining various research approaches for data collection, analysis, and interpretation, the study shed light on the reinforcement efforts that give rise to diverse new traditions. The findings highlighted that the reinforcement endeavours, including the appropriation of media platforms and the emphasis on education, cadre development, and intensive mentorship within millennial domains, significantly contribute to the acceptance and affiliation towards ASWAJA al-Nahdhiyah. Moreover, these efforts serve as a counterforce against the proliferation of radical ideologies, safeguarding the traditional religious views amid the rapid globalisation of religious understanding and transnational da’wah movements in Indonesia.Contribution: This article advanced our understanding of the evolving dynamics within the ASWAJA al-Nahdhiyah movement, particularly its adaptation to contemporary communication channels and its strategic engagement with young audiences amid the changing religious landscape in Indonesia.

Abstract LB391: Deep learning AI predicts HRD and platinum response from histologic slides

Abstract Background: Cancers with homologous recombination deficiency (HRD) can benefit from platinum salts and PARP inhibitors. Standard diagnostic tests, including FDA-approved companion diagnostics, for detecting HRD require molecular profiling, which is not universally available with global testing rates lowest among minority, rural, and other underserved populations. Methods: We trained DeepHRD, a deep-learning platform for predicting HRD from hematoxylin and eosin (H&amp;E)-stained histopathological slides, using primary breast (n=1,008) and ovarian (n=459) cancers from The Cancer Genome Atlas (TCGA). DeepHRD was compared to four standard HRD molecular tests using breast (n=349) and ovarian (n=141) cancers from multiple external and independent datasets, including clinical cohorts with platinum complete response, progression-free survival (PFS) and overall survival (OS) endpoints. Results: DeepHRD detected HRD from held-out H&amp;E-stained breast cancer slides in TCGA with an AUC of 0.81 ([0.77-0.85]; 95% confidence interval). This performance was confirmed in two independent primary breast cancer cohorts (AUC=0.76; [0.71-0.82]). In an external platinum-treated metastatic breast cancer cohort, samples detected as HRD had a higher complete response (AUC=0.76; [0.54-0.93]) with 3.7-fold increase in median PFS (14.4 versus 3.9 months; p-value=0.0019) and hazard ratio (HR) of 0.45 (p=0.0047) after correcting for PAM50 molecular subtype and age at diagnosis. This deep-learning classifier outperformed four genomic HRD tests used in the clinic, including standard HRD score, BRCA1/2, 26-HR gene panel and single-base substitution signature 3 (SBS3). Multiresolution spatial mapping identified morphological features utilized by DeepHRD for detecting HRD, notably enriched for neoplastic and necrotic tissues, and a higher macrophage density. Through transfer learning to high-grade serous-ovarian cancer, DeepHRD-positive samples exhibited better overall survival after TCGA first-line (HR=0.46; p=0.030) and an external neoadjuvant (HR=0.49; p=0.015) platinum-treated cohorts. Conclusion: In summary, DeepHRD exhibits consistent hazard ratios ranging from 0.45 to 0.49 across the three clinical cohorts and captures 1.8- to 3.1-fold more HRD-positive breast and ovarian cancer patients. DeepHRD-positive breast cancer patients that received platinum exhibited better complete response and PFS. Similarly, DeepHRD-positive platinum-treated ovarian cancer patients had a better OS. DeepHRD’s ability to detect HRD from digital H&amp;E slides provides an important precision oncology tool that can be utilized in resource-constrained and underserved areas where genomic testing is generally not existent. Citation Format: Erik N. Bergstrom, Ammal Abbasi, Marcos Diaz-Gay, Loïck Galland, Sylvain Ladoire, Scott M. Lippman, Ludmil B. Alexandrov. Deep learning AI predicts HRD and platinum response from histologic slides [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB391.

Alternative Arrangement for Roof Tops Rural Housing Catching Rain Water in the Semi-Arid

Harvesting rainwater for human consumption through rooftops is becoming an increasingly common practice, especially in regions where there are no community water supplies, such as much of the Indian semi-arid region. The water collection systems installed in this region are based on the construction of cisterns to collect water collected through roofs. In order to contribute to the improvement of the performance of these systems, this work aimed to study the problems preventing the proper functioning of this important water supply and to propose design solutions adapting appropriate technologies for the rural population of the Indian hemisphere, Arid region. The starting point was a field study conducted in the rural community of Namakkal Taluk in Tamil Nadu between 2020 and 2021. The results showed that 80% of the residential buildings surveyed have a water intake system, but only 16% store enough water for a year-round supply. It was found that this low rate is mainly due to unreliable conditions for installation and maintenance of water conduit subsystems (gutters and channels). Based on this finding, and taking into account functional and aesthetic-formal aspects, five alternative devices for rainwater harvesting systems, consisting of roofs, gutters and channels, were developed. In order to simplify and, as a result, reduce the cost, the gutter supports were eliminated, which gave a performance advantage over conventional systems.

Projected changes in rainfall and temperature using CMIP6 models over the Okavango River basin, southern Africa

AbstractThe Okavango River Basin (ORB) which includes a renowned World Heritage site Okavango Delta, contains highly biodiverse ecosystems. Most of its rural population relies on rain-fed subsistence farming. Limited research has been done on future changes in rainfall and temperature in this region. Here, such changes are analysed for the periods 2030–2059 (near term) and 2070–2099 (long term), relative to the historical period 1985–2014. The analysis is based on the Coupled Model Intercomparison Project Phase 6 (CMIP6), under the shared socioeconomic pathways (SSPs) SSP245 and SSP585. The projected changes vary over the ORB. For rainfall, the models project some significant decreasing trends over Ngamiland in the central/southern ORB, but none are significant over the northern ORB. The significant trends during the near term period include those projected by the model average (-30.60 mm/decade) in March–April (MA) under the SSP585 scenario. Some significant decreasing rainfall trends have also been found in December-February (DJF), but none are significant in October–November (ON). DJF is the main growing season whereas ON (MA) is the onset (end) of the rainy season. For temperature, significant warming trends have been found over both Ngamiland and the northern ORB, with the strongest warming in ON particularly during the near term period. For this ON season over the northern ORB, under the SSP585 (SSP245) scenario, the model average projects a warming trend of 0.56 °C/decade (0.67 °C/decade). These findings may help with the management of agricultural activities, water resources and the highly biodiverse ecosystems in the ORB.

Transforming health care delivery: The role of primary health care nurses in rural and remote Australia.

This paper describes the policy context and approaches taken to improve access to primary health care in Australia by supporting nurses to deliver improved integrated care meeting community needs. In Primary Health Care (PHC), the nursing workforce are predominantly employed in the general practice sector. Despite evidence that nurse-led models of care can bridge traditional treatment silos in the provision of specialised and coordinated care, PHC nurses' scope of practice varies dramatically. Nurse-led models of care are imperative for rural and remote populations that experience workforce shortages and barriers to accessing health care. Existing barriers include policy constraints, limited organisational structures, education and financing models. The Australian Primary Health Care Nurses Association (APNA) received funding to implement nurse-led clinics as demonstration projects. The clinics enable PHC nurses to work to their full scope of practice, improve continuity of care and increase access to health care in under serviced locations. We reviewed a range of peer-reviewed literature, policy documents, grey literature and APNA provided sources, particularly those relevant to rural and remote populations. We argue more focus is needed on how to address variations in the scope of practice of the rural and remote PHC nursing workforce. Despite growing evidence for the effectiveness of nurse-led models of care, significant policy and financial barriers continue to inhibit PHC nurses working to their full scope of practice. If their potential to transform health care and increase access to health services is to be realised these barriers must be addressed.

Access restrictions to forest resources, rather than COVID-19 bans, drive the selection of firewood species for bonfires during Festas Juninas in northeastern Brazil

BackgroundThe complex interplay of social and environmental factors shapes ecosystems, potentially leading to harmony or conflict, highlighting the importance of understanding these dynamics for coexistence. In developing countries, firewood serves as a primary energy source and plays a role in cultural-religious rituals and festivities. However, the specific patterns of woody species used for the latter remain poorly understood, including the impact of access restrictions to resources and local bans on practices. Therefore, our research focuses on examining how access restrictions to forest resources and bonfire bans due to the coronavirus disease 2019 (COVID-19) impact the cultural-religious tradition of bonfire making during Festas Juninas (June festivities) in northeastern Brazil.MethodsEthnobotanical fieldwork was conducted in two rural populations in northeastern Brazil between 2021 and 2022. Data were collected through semi-structured interviews, observations, and the guided tour technique. The cultural-religious tradition of bonfire making (i.e., richness of native and exotic firewood species, firewood volume, and the number of bonfires related to this practice) was compared between populations (i.e., differing in access restrictions) and years (i.e., differing in COVID-19-related bans) using Mann–Whitney U tests.ResultsResults revealed significant differences in the richness of native (p value = 0.001) and exotic (p value < 0.001) firewood species for bonfire making due to access restrictions to forest resources. The number of native species used was higher among the population residing in the area with unrestricted access than among those with restricted access, while a greater number of exotic species was used in the population with restricted access. The rest of the variables were not influenced by access restrictions, and no variables were influenced by COVID-19 bans.ConclusionsOur study demonstrated that access restrictions to forest resources, rather than COVID-19 bans, drive the selection of firewood species for bonfires during Festas Juninas in northeastern Brazil. In addition, as populations remain deeply entrenched in cultural-religious practices amid temporary bans imposed by health crises, there is a pressing need for culturally sensitive environmental policies. Fostering socio-ecological resilience demands a comprehensive approach that encompasses not only environmental factors but also cultural dimensions, which wield a pivotal influence on long-term sustainability.