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Uncertainty around long-term droughts and water scarcity has been increasing as the impacts of El Nino cycles are felt globally. Understanding how the effects of these events are manifested on the ground in communities is particularly important if governments and associated agencies are to respond appropriately. Using a qualitative approach, this paper examines the impacts of drought on two rural towns in Victoria, Australia, and explores what lessons can be drawn from local experiences. The research suggests that previous responses to drought by governments have been largely ineffectual and as such, we question whether there is a need to reshape institutional understandings of what adapting to drought might mean. This research, therefore, seeks to further the discussion surrounding drought impacts and the myriad of challenges associated with it by drawing on locally situated knowledge to inform future decision-making in this evolving field of study. [ABSTRACT FROM AUTHOR]

Background: Stroke is a leading cause of disability and distress, and often profoundly affects the quality of life of stroke survivors and their carers. With the support of carers, many stroke survivors are returning to live in the community despite the presence of disability and ongoing challenges. The sudden and catastrophic changes caused by stroke affects the mental, emotional and social health of both stroke survivors and carers. The aim of this study is to evaluate a Stroke and Carer Optimal Health Program (SCOHP) that adopts a person-centred approach and engages collaborative therapy to educate, support and improve the psychosocial health of stroke survivors and their carers.Methods: This study is a prospective randomised controlled trial. It will include a total of 168 stroke survivors and carers randomly allocated into an intervention group (SCOHP) or a control group (usual care). Participants randomised to the intervention group will receive nine (8 + 1 booster) sessions guided by a structured workbook. The primary outcome measures for stroke survivors and carers will be health-related quality of life (AQoL-6D and EQ-5D) and self-efficacy (GSE). Secondary outcome measures will include: anxiety and depression (HADS); coping (Brief COPE); work and social adjustment (WSAS); carer strain (MCSI); carer satisfaction (CASI); and treatment evaluation (TEI-SF and CEQ). Process evaluation and a health economic cost analysis will also be conducted.Discussion: We believe that this is an innovative intervention that engages the stroke survivor and carer and will be significant in improving the psychosocial health, increasing independence and reducing treatment-related costs in this vulnerable patient-carer dyad. In addition, we expect that the intervention will assist carers and stroke survivors to negotiate the complexity of health services across the trajectory of care and provide practical skills to improve self-management.Trial Registration: ACTRN12615001046594 . Registered on 7 October 2015. [ABSTRACT FROM AUTHOR]