The solitary position of nurses who practise in geographically isolated communities to provide direct health care to a predominantly Aboriginal population characterises nursing in remote areas. Munoz & Mann (1982) described this practice as unique. The uniqueness of this practice, however, has remained shrouded in superficial descriptions featuring service delivery at a one or two-nurse-post, the physical distance of nursing posts from hospital facilities and the autonomy with which nursing is performed. Only glimpses of the reality of nursing practice in a remote area have been revealed through the study of the educational needs of remote area nurses (Munoz & Mann 1982, Cameron-Traub 1987, Philp 1988, Kreger 1991a, Bell, Chang & Daly 1995). A key problem is the lack of a systematic description and detailed analysis of nursing as it is practised in a remote area.The purpose of this study was to explore, describe and analyse nursing practice in a remote area. The research was undertaken at Warburton, an isolated community mainly inhabited by the Ngaanyatjarra people in the Central Desert of Western Australia. An ethnographic design was chosen for this exploratory inquiry into the social and cultural pattern of everyday nursing practice. In a pre-entry study a suitable setting and informants were found. Fieldwork was conducted at the Warburton nursing post by the researcher and involved living on site for a year. Data gathering techniques were participant observation together with interviewing, collection of pertinent documents and the daily chronological recording of fieldnotes, memos and a personal journal. Data analysis was performed concurrently with data gathering. The process followed the Developmental Research Sequence Method by Spradley (1980). Through a cyclical process of data collection and analysis the domains, taxonomies and componential variables in the ++ / culture of remote area nursing practice emerged.Amorphous practice was the overall theme revealed in the underlying cultural patterns that shaped the practice of nursing in the remote area. The term amorphous practice is defined as the changeable nature of practice from nurse to nurse, from situation to situation, from time to time. This was observed in the recurrent differences between nurses in their knowledge, abilities and attitudes as well as in the variability between nurses in their management of client care. Contributors to the phenomenon of amorphous practice were found in three distinct, but inter-related, tributary themes termed detachment, diffusion and beyond the nursing domain. Detachment explained the nurses' feelings of separateness from the usual professional and organisational structures needed for the enactment of nursing. Diffusion encapsulated the broad spread of the nurses' role in remote area practice. Beyond the nursing domain described an unregulated practice considered to be outside the responsibilities of nursing care. The substantive theory of amorphous practice provided a detailed description of how nursing was practised in the remote area. It also explained why it was so different from nursing as it is generally understood by the profession.

Atualmente um dos principais objetivos na área de pesquisa tecnológica é o desenvolvimento de soluções em favor do Meio Ambiente. Este trabalho tem por objetivo demonstrar a reutilização e consequentemente o aumento da vida útil de uma bateria Chumbo-Ácido, comumente instaladas em veículos automóveis, bem como beneficiar locais e usuários remotos onde o investimento na instalação de linhas de transmissão se torna inviável geográfica e economicamente, utilizando a luz solar como fonte de energia. No entanto a parte mais suscetível a falhas são as próprias baterias, justamente pela vida útil delas serem pequenas (em torno de 3 anos para a bateria automotiva) em comparação com o restante do sistema. Considerando uma unidade que já foi usada anteriormente, a possibilidade de falhas é ainda maior. A fim de diagnosticar e evitar que uma simples bateria possa prejudicar o funcionamento do sistema como um todo, o projeto considera a geração de energia elétrica por células fotovoltaicas e também contempla um sistema microcontrolado para leitura de dados utilizando o microcontrolador ATmega/Arduino, leitura de corrente por sensores de efeito hall da Allegro Systems, relés nas baterias para abertura e fechamento delas no circuito e um sistema de alerta para o usuário final de qual bateria está em falha e que precisa ser reparada e/ou trocada. Esse projeto foi montado na Ilha dos Arvoredos SP, distante da costa continental em aproximadamente 2,0km. Foram instaladas células solares e um banco de baterias, a fim de estudar o comportamento das baterias. O programa pôde diagnosticar e isolar uma das baterias que estava apresentando defeito, a fim de se evitar que a mesma viesse a prejudicar o sistema como um todo. Por conta da dificuldade de locomoção imposta pela geografia, foi escolhido o cartão SD para o armazenamento dos dados obtidos pelo Arduino. Posteriormente os dados foram compilados e analisados. A partir dos resultados apresentados podemos concluir que é possível usar baterias novas e baterias usadas em um mesmo sistema, de tal forma que se alguma das baterias apresentar uma falha o sistema por si só isolará a unidade. / Actually one of the main goals in the technology research area is the development of solutions in accordance with our Environment. The objective of this work is to illustrate the reuse and consequently increase of the Lead-Acid Secondary Battery lifecycle, commonly installed in automotive vehicles, as well as to benefit remote areas and users, where the investment in a new electrical infrastructure is unfavorable geographically and economically, using sunlight as a feasible and available alternative solution. However, the most fragile part of the system are the batteries, due to their own short service life (approximately 3 years for the automotive battery), compared with the other equipment within the system. The chance to have a failure is even higher when using a unit which has been serviced before. In order to anticipate and avoid that a single faulty battery could bring the entire system down, the project consider using photovoltaic cells for electricity generation and also has a micro-controlled system for data reading using an ATmega/Arduino microcontroller, current readings using hall-effect sensors from Allegro Systems, relays on the batteries to open and close themselves in the circuit and an alarm system that indicates to the user which battery is faulty as well as needing repair and/or replacement. This project has been installed in Ilha dos Arvoredos SP, a small island with approximately 2.0km far from the coast. Solar cells and a battery string have been installed in order to study the behavior of the batteries. The programming could diagnose and isolate one of the batteries that has been having a failure, to avoid that this same single battery could cause a major failure on the entire system. Due to the restrictions imposed by the geography, the SD card has been chosen for the data storage obtained by Arduino board. Later on the data has been compiled as well as analyzed. The obtained data has shown that it is possible using old and new batteries in a same string, as long as the system will isolate the faulty battery if any of the batteries shows a failure.

The field of telehealth has developed rapidly in recent years. It provides medical support particularly to those who are living in remote areas and in emergency cases. Although developments in both technology and practice have been rapid, there are still many gaps in our knowledge with regard to the effective application of telehealth. This study investigated human colour perception in telehealth, specifically the colour red as one of the key symptoms when diagnosing different pathologies. The quality of medical images is safety critical when transmitting the symptoms of pathologies in telehealth, as distorted or degraded colours may result in errors. The study focused on the use of digital images in teleconsultation, particularly on images showing cellulitis (bacterial skin infection) and conjunctivitis (red eye) as case studies, as both of these pathologies involve the colour red in their diagnosis. The study proposed and tested the use of an image quality scale, which represented the level of image resolution; a red colour scale, which represented the intensity of redness in an image; and a confidence scale, which represented the levels of confidence that telehealth users had when judging the colour red. The research involved a series of experiments using hypothetico-deductive and formal hypothesis testing with two groups of participants, medical doctors and non-medical participants. The experiments were conducted in collaboration with the local National Health Service (NHS) Accident and Emergency (A&E) department at Aberdeen Royal Infirmary (ARI). Medical experts in ophthalmology and dermatology were also involved in selecting and verifying the relevant images. The study found that doctors and non-doctors were consistent in the majority of the experiments. The accuracy of the participants was demonstrably higher when using a colour scale with pictures, more so for the non-doctor group than the doctor group. It also found that the level of accuracy for both doctors and nondoctors was higher when using red colour scale of three divisions than when using a scale of five divisions. This result was supported by previous studies, which used telehealth for diagnosing extreme cases. The study also found that when the image quality was poor the participants had higher error rates and less consistency in their answers. The study found poor correlation between accuracy, confidence and time for both participant groups. The study found that most participants in both doctor and non-doctor groups had high confidence most of the time, whether the accuracy was high or low. It was also found that medical background or clinical experience had no effect on the accuracy level across the experiment sets. In some cases, doctors with no or little experience had higher accuracy than those with greater experience. This result may have significant implications for the feasibility of involving non-doctors in the management of telehealth systems, especially in tasks not requiring medical skills, such as colour classification. This has the potential to provide a considerable saving in resources and costs for healthcare providers. An auto-evaluation system was introduced, and proposed for further study, in order to improve the current telehealth diagnostic protocol and to avoid or prevent errors by making red colour classification more objective and accurate.

This thesis describes a case study of a rural sub district in Thailand, develops a network model for development and makes policy suggestions that stress the importance of participatory governance processes. The aim of this thesis is to learn from a limited case study and explore the extent to which ICT could bridge the gaps in rural and remote areas and thus aid development and empower those who are marginalized by virtue of gender inequality, poverty, lack of education and limited access to resources. The thesis: - Investigates how a case study of rural and remote communities, particularly in North Eastern Thailand, can gain more capacity to: i.) harness and obtain the potential advantages of information and communication technologies and ii.) promote the interconnectedness and network partnership across public, private and community sectors. - Describes the lack of connection across public, private and community sectors and argues for the need to develop and promote the capacity of individuals, groups, organizations, and institutions in these rural areas. In this limited case study, the lack of capacity leads to an inability to use ICT in many sectors that could support community development goals in Thailand. Without access to or the ability to share new information and knowledge across the remote and more developed regions, it is difficult to create success in development projects for individuals and institutions and to mobilize and allocate tangible and intangible resources from the workplace, family, and community. Amidst the flood of information and knowledge globally, including within a nation itself, partnerships among public and private sectors and other stakeholders both inside and outside a community can play a substantial role in harnessing the new technologies to pool information and knowledge, in order to develop the community's capacity and people's capability to achieve their goals sustainably. - Argues that the development gaps in these rural and remote areas could be reduced if the people there are promoted and empowered to be significant and active partners equally able to share and contribute information and knowledge to others outside their communities. The focus of the research is on the powerful knowledge brokers in the society such as the monks, the village leaders, local government officials and the school teachers who know about ICTs. The research focus is not the powerless who (in this case) may not have access to ICT. The thesis points out the way in which the powerful view the shortcomings and barriers to ordinary people having access to computers. As such 'the gaze' (in the sense used by Foucault is upwards at the powerful, not downwards at the powerless. 'Power and knowledge are linked' (Foucault), according to Foucault and this thesis looks only at the way in which the powerful see themselves. Although I argue for participatory governance, my thesis only looks at the powerful. This is in part as a result of my being a member of the knowledge broker stakeholders as I am training to be a Buddhist monk and live in the temple. My thesis makes a contribution, by studying the powerful knowledge brokers, instead of researching the powerless. I have researched issues with the powerful as I was able to access them, in my role as a trainee monk and because of my position in and connections within the community. There are usually two areas in research in Thailand that are not discussed; they are religion and the role of the state. This thesis addresses some causes or sources of difficulties or conflicts that have occurred as a part of the obstacles for the development in selected case study areas, in order to understand what significantly lies underneath the difficulties. This thesis does not engage in a discussion on the diverse needs of the Southern region. Muslims, who live in the five southern provinces adjacent to Malaysia, see themselves as second class citizens compared to others (in particular Buddhists who make up about 95% of the population). This is supported by international criticism of the handling of separatist movements. This thesis is written from the perspective of a Buddhist monk -to- be who lives and works in the Northern area and who is concerned with his case study area. I have been in training to become a monk my entire life as I was brought up in the Buddhist temple. I acknowledge that my experiences contribute to the way that I see the world but that I have tried to be as reflexive as possible. Much of the research draws on my role and position in the society in which I live. I have strived to understand the wider world. To that end, I was trained in the private and public sector in leadership skills in Bangkok Life Insurance Company and in Bangkok Business Administration School including in Naluang Temple, Udorn Thani province. I have been trained to work with the community leaders such as schools and local government officers with a view to help with community development as the temple representative. This thesis does not argue that information and communication technologies (ICTs), in and of themselves, are the means to achieving social justice and socioeconomic being. Instead it argues that they can support and enable the stakeholders to participate in decision making and greater access to information and resources amongst and across local stakeholders - village, school, temple and local government - in the rural areas. I stress that if there is no political willingness and community spirit (social capital) to support this, then information and communication technologies (ICTs) are of no value. 'Thick democracy', in the sense used by Edgar, is dependent on better communication with all the stakeholders. Knowledge management is not about technology alone it is about pooling and sharing ideas so that development opportunities can be developed. Technology is the means to achieve joined-up government. It is not an end in itself. My thesis shows how the lack of ability to work together, and lack of willingness to cooperate amongst some players, undermine the potential of people to access information and resources. I argue that the geographical isolation of rural areas nowadays can be theoretically bridged by investing in telecommunication infrastructure. It is debatable if the state could achieve this alone. Local institutions cannot serve, help and work in partnership with other organizations. They need to be able to work collaboratively, in order to deal with the complexity of problems. Some temples, for instance, lack capacity to apply the local, tacit knowledge of people that is needed for balanced development in the community. A consequence of the isolation of local institutions, in this case study, is that it can lead to insufficient co-operation across community, public and private sectors. Also, it can reduce and demote institutional and social capacity necessary for working together effectively. The aim of this thesis was to establish to what extent ICT can bridge the gaps in rural and remote areas and thus aid development and empower those who are marginalized by virtue of gender inequality, poverty, lack of education and limited access to resources. At the outset the limitations of the small sample are acknowledge and the analysis is limited to the discussion of themes that could have potential relevance, but nevertheless the thesis aims to - Explore the issue of capacity building (by means of a small purposive sample) drawn from 7 rural communities, in North Eastern Thailand; - Consider the themes from the purposive sample to explore the potential development role for information and communication technologies; - Consider the extent to which the technologies (as part of a development process) could support the creation of networks and partnership across public, private and community sectors; and - Describe the themes that emerge in the small sample about the lack of connection across (public, private and community) sectors and argue for the need to develop and promote the capacity of individuals, groups, organizations, and institutions in this purposive sample. The lack of capacity in this small sample indicated that in these communities there is limited capacity to use ICT in many sectors that could support community development goals in this part of Thailand. Perhaps the themes that are evident in this sample could be explored further to assess their more general relevance. It is possible that without access to or the ability to share new information and knowledge across the remote and more developed regions, it is difficult to create success in development projects for individuals and institutions and to mobilize and allocate tangible and intangible resources from the workplace, family, and community. Amidst the flood of information and knowledge globally, including within a nation itself, partnerships among public and private sectors and other stakeholders both inside and outside a community can play a substantial role in harnessing the new technologies to pool information and knowledge, in order to develop the community's capacity and people's capability to achieve their goals sustainably. I argue that the development gaps in these rural and remote areas could be reduced if the people there are promoted and empowered to be significant and active partners equally able to share and contribute information and knowledge to others outside their communities.

Atualmente um dos principais objetivos na área de pesquisa tecnológica é o desenvolvimento de soluções em favor do Meio Ambiente. Este trabalho tem por objetivo demonstrar a reutilização e consequentemente o aumento da vida útil de uma bateria Chumbo-Ácido, comumente instaladas em veículos automóveis, bem como beneficiar locais e usuários remotos onde o investimento na instalação de linhas de transmissão se torna inviável geográfica e economicamente, utilizando a luz solar como fonte de energia. No entanto a parte mais suscetível a falhas são as próprias baterias, justamente pela vida útil delas serem pequenas (em torno de 3 anos para a bateria automotiva) em comparação com o restante do sistema. Considerando uma unidade que já foi usada anteriormente, a possibilidade de falhas é ainda maior. A fim de diagnosticar e evitar que uma simples bateria possa prejudicar o funcionamento do sistema como um todo, o projeto considera a geração de energia elétrica por células fotovoltaicas e também contempla um sistema microcontrolado para leitura de dados utilizando o microcontrolador ATmega/Arduino, leitura de corrente por sensores de efeito hall da Allegro Systems, relés nas baterias para abertura e fechamento delas no circuito e um sistema de alerta para o usuário final de qual bateria está em falha e que precisa ser reparada e/ou trocada. Esse projeto foi montado na Ilha dos Arvoredos SP, distante da costa continental em aproximadamente 2,0km. Foram instaladas células solares e um banco de baterias, a fim de estudar o comportamento das baterias. O programa pôde diagnosticar e isolar uma das baterias que estava apresentando defeito, a fim de se evitar que a mesma viesse a prejudicar o sistema como um todo. Por conta da dificuldade de locomoção imposta pela geografia, foi escolhido o cartão SD para o armazenamento dos dados obtidos pelo Arduino. Posteriormente os dados foram compilados e analisados. A partir dos resultados apresentados podemos concluir que é possível usar baterias novas e baterias usadas em um mesmo sistema, de tal forma que se alguma das baterias apresentar uma falha o sistema por si só isolará a unidade. / Actually one of the main goals in the technology research area is the development of solutions in accordance with our Environment. The objective of this work is to illustrate the reuse and consequently increase of the Lead-Acid Secondary Battery lifecycle, commonly installed in automotive vehicles, as well as to benefit remote areas and users, where the investment in a new electrical infrastructure is unfavorable geographically and economically, using sunlight as a feasible and available alternative solution. However, the most fragile part of the system are the batteries, due to their own short service life (approximately 3 years for the automotive battery), compared with the other equipment within the system. The chance to have a failure is even higher when using a unit which has been serviced before. In order to anticipate and avoid that a single faulty battery could bring the entire system down, the project consider using photovoltaic cells for electricity generation and also has a micro-controlled system for data reading using an ATmega/Arduino microcontroller, current readings using hall-effect sensors from Allegro Systems, relays on the batteries to open and close themselves in the circuit and an alarm system that indicates to the user which battery is faulty as well as needing repair and/or replacement. This project has been installed in Ilha dos Arvoredos SP, a small island with approximately 2.0km far from the coast. Solar cells and a battery string have been installed in order to study the behavior of the batteries. The programming could diagnose and isolate one of the batteries that has been having a failure, to avoid that this same single battery could cause a major failure on the entire system. Due to the restrictions imposed by the geography, the SD card has been chosen for the data storage obtained by Arduino board. Later on the data has been compiled as well as analyzed. The obtained data has shown that it is possible using old and new batteries in a same string, as long as the system will isolate the faulty battery if any of the batteries shows a failure.

Background In remote areas of the Peruvian Amazon there is a high burden of communicable diseases, limited access to health care and a low distribution of registered nurses. Registered nurses are working with indigenous patients in the area, where traditional medicine and practice is common. In order to strengthen the relation between western and traditional practices, intercultural health has been implemented within the public health care. Aim The aim was to describe registered nurses’ experiences of working with indigenous patients in remote health care settings in Loreto region, Peruvian Amazon. Method A qualitative field study with semi-structured interviews was conducted at four health clinics in Maynas and Mariscal Ramón Castilla province. A qualitative content analysis was used when analyzing the data. Findings Three categories were identified in the analysis; Working environment in a remote area, Providing health care for indigenous patients and Including intercultural health in nursing practice. The participants’ daily work with few colleagues and high demand in remote clinics was described. Experiences of working with intercultural health, as well as opportunities and challenges of working with indigenous patients was found. Conclusion The registered nurses work in an area with a high workload, limited resources and geographic isolation. Intercultural implementations were shown to improve intercultural relations, autonomy and health. Challenges between registered nurses and indigenous patients related to communication and different cultures were described. In order to improve the situation and reach the UN Sustainable Development Goals, infrastructural and socio-economic improvements, more resources and health professionals are necessary.

Made available in DSpace on 2016-08-18T17:23:39Z (GMT). No. of bitstreams: 1 Disseratacao_JOSE ISRAEL DE ALMONDES.pdf: 992913 bytes, checksum: 4cd67b48bc8c32fc111f0a2bddeddfe4 (MD5) Previous issue date: 2014-05-13 / This thesis explains about the use of the sun as an energy source, the parameters that characterize the photovoltaic solar energy and a practical application of this energy source in railways for lighting purposes. The Solar Energy presents good results for small-scale applications, especially in remote areas, which can be seen in many regions of Brazil. The thesis also makes a comparison between solar energy photovoltaic and other energy sources, establishing the favorable and unfavorable characteristics of each one, with the objective of lighting the Level Crossings (LCs) in railways. In summary, this thesis studies the feasibility of using solar energy for lighting purposes in railroads located in remote areas. A practical application of this solution is presented. / O presente trabalho explana a respeito da utilização do sol como fonte de energia, os parâmetros que caracterizam a energia solar fotovoltaica e uma utilização prática dessa fonte energética em trechos ferroviários para fins de iluminação. É mostrado que a energia solar presta-se bem a produção em pequena escala em áreas remotas, o que já pode ser visto em muitas áreas do Brasil. O trabalho faz ainda um comparativo entre a energia solar fotovoltaica e as demais fontes de energia, estabelecendo as características favoráveis e contrárias de cada uma delas para iluminação em Passagens de Níveis (PN s) em ferrovias. Em síntese, estuda-se a viabilidade do uso da energia solar para fins de iluminação em ferrovias, estas localizadas em áreas remotas, e é apresentada uma aplicação prática descentralizada dessa solução.

The main purpose of the study was to investigate the library needs and library usage of external students in remote areas. The study emphasised external students' perception of their own library needs. Four distinct areas of research evolved from the purpose of the study: to identify the library service needs of external students; to identify library use by external students; to identify external students' perceptions of library needs; and to identify student status in relation to library use. Information was collected by an interview with former external students, a questionnaire to the libraries involved in the study and by Nominal Group Technique (NGT) sessions with external students. The primary instrument was a questionnaire to the external students in the population under investigation requesting information of their library usage and needs. The population under investigation were external students enrolledin the South Australian College of Advanced Education (SACAE) and resident in Whyalla, South Australia. It was decided to survey the total population rather than a sample because of the small numbers involved. Thirty-five responses were received out of a population of 52, representing a response rate of 69 percent. The results of the survey were analysed using a Statview SE statistical package and a spreadsheet and graphics package, Excel. Frequency distributions were computed to determine the number of respondents who selected each option. The study found that the external students who used libraries tended to use a variety of libraries. Students used not only their own institution's library, but the a range of libraries accessible to them in Whyalla. The study concludes by identifying issues, recommending possible solutions, and identifying areas for further research.

No description available.

Les petites unités de dessalement au point d’usage sont une alternative pour l’accès à l'eau potable des communautés isolées de zones côtières ou insulaires. Dans cette thèse, la distillation membranaire (MD) est le procédé de choix pour l’application visée. De plus, les lieux d’implantation ciblés souffrent souvent d’un manque d’accès à l’énergie, mais la plupart d’entre eux sont exposés à des niveaux élevés de radiation solaire. Afin de réduire les pertes de chaleur du système et d'intensifier le procédé, un module intégrant des membranes planes de MD sous vide (VMD) et un collecteur solaire à plaque plane (FPC) apparaît comme une technologie possible. Cette étude a pour objectifs d’étudier la faisabilité de ce concept et de déterminer les paramètres de l’équipement et les conditions opératoires les plus favorables pour l’application visée en cherchant à réduire la consommation d’électricité (par des panneaux photovoltaïques PV) et améliorer simultanément l’efficacité énergétique et la production d’eau dans l’ensemble du module VMD-FPC. Les analyses de sensibilité et les optimisations multi-objectifs sont effectuées à partir de séries de simulations. La productivité quotidienne peut atteindre 96 L pour une surface de module de 3 m2. Un coût énergétique quasi-constant d’une puissance PV de 4,2 à 5,0 W L-1 est observé, permettant d’ajuster la capacité du système. Pour une puissance PV limitée à 130 W (installation mobile), plus de 30 L de distillat peuvent être obtenus avec une surface de 0,83 m2 par une belle journée d'été à Toulouse, en tenant compte des paramètres de fonctionnement optimisés et des matériaux réels. / Small-scale desalination at the point of use offers a potential access to drinking water to communities living in remote coastal areas or isolated islands. In this dissertation, Membrane Distillation (MD) is the applied technology for the aforementioned application scenario. Moreover, the target places are also often in the lack of stable and centralized heat and power supply, while most of them benefit from high solar radiations. In order to further reduce the system heat loss and to intensify the process, the integration in the same module of flat-sheet distillation membranes for Vacuum MD (VMD) and direct solar heating by flat-plate collector (FPC) appears as a possible option. This study aims to explore the feasibility of this concept and to determine the more favorable design and operating conditions for the target application. The main task in this regard is to reduce electricity consumption (provided by photovoltaic PV panels) and simultaneously improve the energy efficiency and water production throughout the VMD-FPC module. The sensitivity analyses and multi-objective optimizations are conducted based on series of simulations. Results show that the potential daily productivity of the system can reach up to 96 L for a module surface area of 3 m2. A quasi-constant power cost of PV of 4.2 - 5.0 W L-1 is observed, permitting a flexible adjustment of the system capacity. Under a limitation of an average PV power of 130 W, more than 30 L of distillate can be obtained with a surface area of 0.83 m2 on a sunny summer-day in Toulouse, taking the optimized operating parameters and real-world material properties into account.