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Abstract Telecommunications offers an alternative or supplement to community-based interventions as a means of extending healthcare services and improving health outcomes in remote settings but can fail to reach target communities and achieve the desired impact if barriers to access are not overcome. We conducted seven focus group discussions and 26 interviews with community health workers, community leaders, and female members of the public who declared that they had or had not previously accessed free audio health messages provided via a mobile platform in two rural communities of Mali, Koulikoro and Bougouni. A content analysis showed that participants accessed and trusted health information from a range of sources, including radio, telephone and television, as well as town criers, local relays and community health centres. Barriers to access faced by women included economic factors, lack of network or electricity, and social factors such as illiteracy, cultural restrictions and being unaware of mobile communication. Through analysis and interpretation of the participants’ responses, we have made recommendations for future campaigns for the dissemination of health-related information for women in remote settings.

Abstract Background In Ecuador, cervical cancer is the third most common cancer among women and the second most common cause of cancer-related death in women. Although HPV represents a serious public health problem worldwide, the information about its prevalence and genotypes in remote communities of Ecuador is limited. The aim of this study was to determine the distribution of HPV genotypes among ethnic minority women from two remote communities of the northwestern region of Ecuador: Afro-Ecuadorians and Chachis (Amerindian group). Methods We included 291 women who responded to a short survey and were screened for HPV by the amplification of the L1 gene and a nested multiplex PCR to detect 14 high risk (HR) genotypes. A survey collected information on ethnicity, age, community access, and sexual and gynecological history. We identified risk factors associated with HPV infection and co-infection using multivariate logistic regression to calculate odds ratio (OR) and Wald 95% confidence intervals (CI). Results Overall, HPV prevalence in the study cohort was 56%, and the five most common HR-HPV genotypes were HPV-58, -16, -68, -39, and -43; however, the distribution of HPV genotypes varied according to ethnicity. We identified lineage A (European variant) for HPV-16 and sublineage A2 for HPV-58 in both ethnic groups. Adjusting for ethnicity, age, community access, and number of sexual partners, we found that Afro-Ecuadorian women were less likely to have an HPV infection than Chachi women (OR: 0.49, 95% CI: 0.25, 0.96), and that participants in communities only accessible by river had 64% less chances of an HPV infection when compared to women in communities accessible by road (OR: 0.36, 95% CI: 0.19, 0.71), and women with 2 to 3 sexual partners had 2.47 times the odds of HPV infection than participants with 0–1 partners (OR: 2.47, 95% CI: 1.32, 4.6). Similar associations were observed with prevalence of co-infection. Conclusions This study provides baseline knowledge regarding the prevalence and distribution of HPV genotypes in ethnic groups of the northwestern coastal Ecuador and essential information for the implementation of appropriate HPV testing and vaccination program to prevent cervical cancer.

Background: Advances in pediatric oncology have significantly increased survival rates, yet have introduced challenges in managing long-term treatment side effects. This study process introduces an interdisciplinary clinical intervention program rooted in the family resilience framework, aimed at improving wellbeing across the cancer trajectory for children and their families, especially those in Canadian communities far from specialized oncology centers with limited access to resources. Methods: Employing an intervention mapping approach, this program collaboratively involves patients, families, professionals, and researchers. It aims to identify vulnerability factors, establish a logic model of change, and devise comprehensive strategies that include professional interventions alongside selfmanagement tools. These strategies, tailored to address biopsychosocial and spiritual challenges, are adapted to the unique contexts of communities distant from specialized cancer treatment centers. A mixed-methods approach will evaluate program effectiveness. Expected results: Anticipated outcomes include the empowerment of families with self-management tools and professional support, designed to mitigate biopsychosocial and spiritual complications. By addressing the specific needs and limitations of these communities, the program strives to improve the overall health and well-being of both undergoing treatment and survivorship phases. Discussion: By focusing on comprehensive care that includes both professional interventions and self-management, this initiative marks a significant shift toward a holistic, family-centered approach in pediatric oncology care for remote communities. It underlines the necessity of accessible interventions that confront immediate and long-term challenges, aiming to elevate the standard of care by emphasizing resilience, professional support, and family empowerment in underserved areas. [ABSTRACT FROM AUTHOR]

Working equids play a central role in mountainous communities, but their work often goes unnoticed by the wider world, with sparse documentation of their role, value, or welfare -- a state which often extends to their human counterparts. Communities living in the remote Manaslu Valley, Nepal, face a number of uncertainties, including extreme weather events due to the seasonal monsoon and, more recently, the construction of a new road network. Using semi-structured interviews, questionnaires, and Equine Assessment Research and Scoping (EARS) welfare assessments, we outline the specific role of pack mules in supporting the lives of local people, explain the nuanced links between human experience and mule welfare, and gain insight into how people living in this volatile environment manage uncertainty and risk. Mule work was felt to be the 'only option' for a sustainable livelihood for most mule owners although, in some cases, mules had enabled respondents to diversify their income. Mule owners with more husbandry experience did not own mules in more positive behavioural states, which may suggest a lack of generational knowledge and support networks. Short-term ongoing risks, such as the monsoon or unstable tracks, had a larger impact both financially and emotionally than the long-term but distant implications of the road construction. Mule owners must constantly balance the risk of working during the monsoon season, when conditions are treacherous but pay was higher, with losing valuable income but keeping themselves and their mules safe; they do, however, have a more mobile option for employment than non-owners. Mules enable a level of resilience and agility for communities living with constant uncertainty and change, which is only beginning to be recognised formally within the sustainable development sphere. Integration of animal welfare into the SDGs would allow humanitarian aid initiatives to strengthen support networks around working equids, which would greatly benefit the mules and humans alike. [ABSTRACT FROM AUTHOR]

Telecommunications offers an alternative or supplement to community-based interventions as a means of extending healthcare services and improving health outcomes in remote settings but can fail to reach target communities and achieve the desired impact if barriers to access are not overcome. We conducted seven focus group discussions and 26 interviews with community health workers, community leaders, and female members of the public who declared that they had or had not previously accessed free audio health messages provided via a mobile platform in two rural communities of Mali, Koulikoro and Bougouni. A content analysis showed that participants accessed and trusted health information from a range of sources, including radio, telephone and television, as well as town criers, local relays and community health centres. Barriers to access faced by women included economic factors, lack of network or electricity, and social factors such as illiteracy, cultural restrictions and being unaware of mobile communication. Through analysis and interpretation of the participants' responses, we have made recommendations for future campaigns for the dissemination of health-related information for women in remote settings. [ABSTRACT FROM AUTHOR]

Background: In Ecuador, cervical cancer is the third most common cancer among women and the second most common cause of cancer-related death in women. Although HPV represents a serious public health problem worldwide, the information about its prevalence and genotypes in remote communities of Ecuador is limited. The aim of this study was to determine the distribution of HPV genotypes among ethnic minority women from two remote communities of the northwestern region of Ecuador: Afro-Ecuadorians and Chachis (Amerindian group). Methods: We included 291 women who responded to a short survey and were screened for HPV by the amplification of the L1 gene and a nested multiplex PCR to detect 14 high risk (HR) genotypes. A survey collected information on ethnicity, age, community access, and sexual and gynecological history. We identified risk factors associated with HPV infection and co-infection using multivariate logistic regression to calculate odds ratio (OR) and Wald 95% confidence intervals (CI). Results: Overall, HPV prevalence in the study cohort was 56%, and the five most common HR-HPV genotypes were HPV-58, -16, -68, -39, and -43; however, the distribution of HPV genotypes varied according to ethnicity. We identified lineage A (European variant) for HPV-16 and sublineage A2 for HPV-58 in both ethnic groups. Adjusting for ethnicity, age, community access, and number of sexual partners, we found that Afro-Ecuadorian women were less likely to have an HPV infection than Chachi women (OR: 0.49, 95% CI: 0.25, 0.96), and that participants in communities only accessible by river had 64% less chances of an HPV infection when compared to women in communities accessible by road (OR: 0.36, 95% CI: 0.19, 0.71), and women with 2 to 3 sexual partners had 2.47 times the odds of HPV infection than participants with 0–1 partners (OR: 2.47, 95% CI: 1.32, 4.6). Similar associations were observed with prevalence of co-infection. Conclusions: This study provides baseline knowledge regarding the prevalence and distribution of HPV genotypes in ethnic groups of the northwestern coastal Ecuador and essential information for the implementation of appropriate HPV testing and vaccination program to prevent cervical cancer. [ABSTRACT FROM AUTHOR]

BackgroundAdvances in pediatric oncology have significantly increased survival rates, yet have introduced challenges in managing long-term treatment side effects. This study process introduces an interdisciplinary clinical intervention program rooted in the family resilience framework, aimed at improving well-being across the cancer trajectory for children and their families, especially those in Canadian communities far from specialized oncology centers with limited access to resources.MethodsEmploying an intervention mapping approach, this program collaboratively involves patients, families, professionals, and researchers. It aims to identify vulnerability factors, establish a logic model of change, and devise comprehensive strategies that include professional interventions alongside self-management tools. These strategies, tailored to address biopsychosocial and spiritual challenges, are adapted to the unique contexts of communities distant from specialized cancer treatment centers. A mixed-methods approach will evaluate program effectiveness.Expected resultsAnticipated outcomes include the empowerment of families with self-management tools and professional support, designed to mitigate biopsychosocial and spiritual complications. By addressing the specific needs and limitations of these communities, the program strives to improve the overall health and well-being of both undergoing treatment and survivorship phases.DiscussionBy focusing on comprehensive care that includes both professional interventions and self-management, this initiative marks a significant shift toward a holistic, family-centered approach in pediatric oncology care for remote communities. It underlines the necessity of accessible interventions that confront immediate and long-term challenges, aiming to elevate the standard of care by emphasizing resilience, professional support, and family empowerment in underserved areas.

Working equids play a central role in mountainous communities, but their work often goes unnoticed by the wider world, with sparse documentation of their role, value, or welfare – a state which often extends to their human counterparts. Communities living in the remote Manaslu Valley, Nepal, face a number of uncertainties, including extreme weather events due to the seasonal monsoon and, more recently, the construction of a new road network. Using semi-structured interviews, questionnaires, and Equine Assessment Research and Scoping (EARS) welfare assessments, we outline the specific role of pack mules in supporting the lives of local people, explain the nuanced links between human experience and mule welfare, and gain insight into how people living in this volatile environment manage uncertainty and risk. Mule work was felt to be the ‘only option’ for a sustainable livelihood for most mule owners although, in some cases, mules had enabled respondents to diversify their income. Mule owners with more husbandry experience did not own mules in more positive behavioural states, which may suggest a lack of generational knowledge and support networks. Short-term ongoing risks, such as the monsoon or unstable tracks, had a larger impact both financially and emotionally than the long-term but distant implications of the road construction. Mule owners must constantly balance the risk of working during the monsoon season, when conditions are treacherous but pay was higher, with losing valuable income but keeping themselves and their mules safe; they do, however, have a more mobile option for employment than non-owners. Mules enable a level of resilience and agility for communities living with constant uncertainty and change, which is only beginning to be recognised formally within the sustainable development sphere. Integration of animal welfare into the SDGs would allow humanitarian aid initiatives to strengthen support networks around working equids, which would greatly benefit the mules and humans alike.

Abstract Integrated renewable energy systems are becoming a promising option for electrification in remote communities. Integrating multiple renewable energy sources allows the communities to counteract the weaknesses of one renewable energy source with the strengths of another. This study aims to model, design and optimize integrated renewable energy systems consisting of solar photovoltaic (PV) panels, wind turbines, a biomass power generator, and storage batteries for applications in remote communities in Canada. Biomass is used as a fuel to produce electricity during periods when solar power and wind power are not capable of meeting the power demand. A methodology is developed to optimize the integrated renewable energy systems design, with the aim of minimizing the net present cost (NPC) and the levelized cost of electricity (LCOE) of the energy systems. Results show that the NPC is $3.61 M and the LCOE is $0.255/kWh for an optimized integrated renewable energy system in a sample remote community that has a peak power consumption of 238.7 kW and an average load demand of 2230 kWh/day. Through the present research, the integrated energy systems are evidenced to be an effective option for electrification in remote communities.

The finite element method was used to study the feasibility of concrete-filled, fiber-reinforced polymer tubes (CFFTs) for small-scale wind turbine towers in remote areas. Although CFFTs have been successfully employed for a variety of structural applications, their use for wind turbine towers is novel and has yet to be investigated in detail. The objective of the study was to identify, for the first time, the most important parameters for design and compare the behavior of CFFT towers versus conventional steel and concrete towers. The model was first validated using experimental results reported in the literature followed by a series of parametric studies to evaluate the importance of several key parameters. In the first phase, the effect of different geometric properties (taper and concrete filling ratio) and reinforcement configurations (FRP laminate configuration, steel reinforcement ratio, and prestressing level) were investigated for cantilever tower models with concentrated lateral loads. A 10 m high CFFT wind turbine tower model was subsequently modeled and studied under different loading configurations. The influence of the height-to-diameter (h/D) ratio on cantilever CFFT models was also studied and a conservative preliminary design that can be refined for specific turbine systems and wind conditions was adopted using the h/D ratio. The CFFT tower model was compared to concrete and steel tubular models with similar geometry to study the advantages of CFFT towers and showed that CFFTs can be an efficient alternative.

Indigenous Peoples in Canada have shown great strength and resilience in maintaining their cultures and ways of life to date in the face of settler colonialism. Centering the Water crises within Indigenous sovereignty and self-determination, we explore the impacts these crises have on community members. Particularly, the continuous failure of the Canadian government to end the Water crises in remote Indigenous communities, Star Blanket Cree Nation, is investigated in this paper. What implications have these Water governance gaps had on Indigenous Peoples' sovereignty and self-determination? We adopted an Indigenist theoretical framework to guide the study. Additionally, a community-based participatory research approach was adopted. To achieve our research goals of investigating the implications of the current Water crises for Indigenous sovereignty and self-determination, specific methods of sharing circles were used to gather knowledge from community members, Elders, and knowledge keepers. The research findings strongly highlight the strength and resilience shown by remote Indigenous communities in the face of the current Water crises and continuous government failure. Solving the current Water crises will involve remote Indigenous communities taking charge of their own Water governance through Indigenous-led Water governance systems. Additionally, taking steps to rebuild trust through genuine reconciliation will be key. Therefore, listening to remote Indigenous communities and taking collaborative action are fundamental. [ABSTRACT FROM AUTHOR]

The finite element method was used to study the feasibility of concrete-filled, fiber-reinforced polymer tubes (CFFTs) for small-scale wind turbine towers in remote areas. Although CFFTs have been successfully employed for a variety of structural applications, their use for wind turbine towers is novel and has yet to be investigated in detail. The objective of the study was to identify, for the first time, the most important parameters for design and compare the behavior of CFFT towers versus conventional steel and concrete towers. The model was first validated using experimental results reported in the literature followed by a series of parametric studies to evaluate the importance of several key parameters. In the first phase, the effect of different geometric properties (taper and concrete filling ratio) and reinforcement configurations (FRP laminate configuration, steel reinforcement ratio, and prestressing level) were investigated for cantilever tower models with concentrated lateral loads. A 10 m high CFFT wind turbine tower model was subsequently modeled and studied under different loading configurations. The influence of the height-to-diameter (h/D) ratio on cantilever CFFT models was also studied and a conservative preliminary design that can be refined for specific turbine systems and wind conditions was adopted using the h/D ratio. The CFFT tower model was compared to concrete and steel tubular models with similar geometry to study the advantages of CFFT towers and showed that CFFTs can be an efficient alternative. [ABSTRACT FROM AUTHOR]

Remote communities are often particularly vulnerable to the effects of climate change in the form of increased risk of hazards such as avalanches, storms, flooding, or landslides. This is due to, for example, nature-dependent livelihoods, large distances from emergency services as well as limited resources and expertise for climate adaptation work. Still, most remote communities are dependent on support from wider society if they are to successfully address the increased challenges that a changing climate entails. This commentary aims to spark a discussion on the controversial issue of relocation of remote communities living in high-risk areas. In the Nordic context, relocation is often avoided (and not discussed) due to many valid reasons, such as the right of each citizen to get state services regardless of where they live, the value of having dispersed settlements, and strong place attachment of remote communities. Nonetheless, we argue that researchers, policymakers and broader society should discuss if living in high-risk areas is still reasonable in the light of climate change? While raising this question often leads to a simplified debate about forced relocation, we aim to contribute to a more nuanced debate. Maybe relocation might indeed be a more resilient and sustainable long-term solution for (some) remote communities. [ABSTRACT FROM AUTHOR]

The absence of economies of scale is a major barrier in use of renewable energy sources in small and dispersed off-grid remote communities. For example, in northern Canada, diesel is currently the main source of electricity and heat generation. Coordination of biomass supply chains could play a key role in improving the cost efficiency and reliability of bioenergy generation through bundled ordering and creation of storage hubs. In this study, a supply chain management model with multiple suppliers and multiple end-user communities is formulated. The proposed model enables us to analyse and compare the outcomes of adopting a cooperative coordination strategy (with a joint pay-off for communities) versus a non-cooperative coordination strategy (with individual payoffs for communities). Other peculiar attributes of the proposed model rest in the addressing of restricted ordering schedules and quantities (due to unavailability of pathways) by advocating nonlinear ordering and distribution costs (to incorporate quantity discounts) achieved through coordinated and/or collective inventories. A real biomass supply chain case study of three northernmost Nunavik communities in Quebec is considered to show the applicability of the model and provide insights for uptake of bioenergy sources in remote off-grid communities. [ABSTRACT FROM AUTHOR]

This article explores how water acts on permeable housing and the documentary infrastructures that mitigate its impact and enable its flows. It does so through consideration of ongoing litigation brought by public housing tenants at the remote communities of Ltyentye Apurte (Santa Teresa) and Laramba in the Northern Territory of Australia for incomplete repairs and unsafe drinking water. I offer a distinction between pragmatist and functionalist housing, as competing concepts for framing, respectively, the impact of entrenched low expectations on remote housing performance and management and the minimum amenity that contemporary housing should provide. The litigation by Ltyentye Apurte and Laramba householders is notable for challenging the habitability standard that remote community housing must meet and for introducing the provision of safe drinking water as a matter of habitable housing. While water searches out cracks and refuses expulsion from the housing assemblage, necessitating repairs and maintenance, such mobility provides a challenge for allocating specific obligations to various settler colonial authorities that are collectively involved in maintaining house function. Drawing on close analyses of a series of legal decisions, the article examines how legal frameworks and intra-governmental funding arrangements are employed to eschew responsibility for safe drinking water inside remote community housing. [ABSTRACT FROM AUTHOR]

Successful transition from education to the workplace is vital for young people, particularly Indigenous students from remote communities, to support their long-term economic and emotional well-being, social inclusion, physical and mental health. This paper reports findings from a three-year study undertaken collaboratively with young people at a remote Aboriginal boarding school. Motivated by the theoretical constructs of Indigenist theory and Funds of Knowledge, this research centres the voices of Aboriginal peoples. A team of Aboriginal and non-Aboriginal researchers worked with young Aboriginal people at the school to develop the method, to collect, and then analyse the data for this strengths-based qualitative study. Currently enrolled young people engaged in yarning with the participants, namely those who were past students from the school. This made it possible to gather stories to better understand the experiences, strengths, and motivations of Aboriginal young people from remote communities and the issues, constraints, and challenges faced when transitioning to life beyond the classroom. The findings highlight what can be improved to prepare Aboriginal people from remote communities for the workplace and for life beyond school—including their existing strengths and knowledge, aspects that occur within the parameters of the school, employer roles, skill development, and enablers of job and life success. [ABSTRACT FROM AUTHOR]

BackgroundBronchiectasis is a chronic pulmonary disorder which is prevalent among Australian First Nations people in the Northern Territory (NT). Current guidelines recommend physiotherapy as part of multi-disciplinary management of children with bronchiectasis, however in our setting, involvement of physiotherapy remains unknown. We thus undertook a retrospective chart audit to examine physiotherapy management of First Nations children (

Poor‐quality and overcrowded housing in remote communities in Australia is widely seen to negatively impact Indigenous children's health and development. Despite widespread reports of, in some instances, quite appalling housing conditions, recent analyses of data from the Longitudinal Study of Indigenous Children (LSIC) found little evidence of adverse housing effects for Indigenous children living in very remote Australia. Given the apparent inconsistency in evidence coming from representative survey data and other accounts, a small‐scale case study was conducted in the Kimberley's Fitzroy Valley to gain greater insights into housing in very remote communities for families with school‐aged children. The LSIC very remote sample is confirmed to offer a good representation of housing conditions in these communities, based on replication of key housing data items in a small survey of Fitzroy Valley parents. While not apparent in those parent surveys, problems of severe overcrowding were highlighted in interviews with community leaders. Other issues raised included delays in maintenance and repairs and a lack of local input into housing management and associated employment, which was seen to disempower communities. [ABSTRACT FROM AUTHOR]

Biomass as an abundant renewable energy source can play a vital role in controlling the greenhouse gas emissions. The distributed nature of biomass and its low energy density have complicated the utilization of this cheap and available source of energy. Governments can stimulate the bioenergy industry and remove barriers for adoption of bioenergy by implementing supporting regulations and incentives. In this paper, two types of government incentives, representing direct and indirect incentives, are analyzed and their efficiencies in fostering bioenergy generation are compared. A Stackelberg (leader–follower) game is proposed to formulate the integration of incentives as a bi-level problem in coordination of biomass supply chains. We further illustrate the applicability of the proposed approach through an empirical case study of three Canadian remote communities. The case study demonstrates the effects of incentives on coordination of biomass suppliers and end-user communities and promoting bioenergy share in electricity generation mix of communities. The findings of this study highlight the importance of government's support, in form of indirect incentives, for provisioning of infrastructure needed for biomass supply and conversion, with a significant impact on increasing the share of bioenergy generation. [ABSTRACT FROM AUTHOR]

Food insecurity increased in Canada during the COVID-19 pandemic; in the Yukon Territory, the Whitehorse Food Bank saw its scope increase significantly as smaller Yukon communities were requesting deliveries of food while travel restrictions were in place. In this qualitative study, the researchers conducted semi-structured interviews with food bank clients in Whitehorse and two smaller Yukon communities, as well as representatives of other organizations that were involved in community food security initiatives. The results revealed five main themes emerging from shared client experiences and impacts from the pandemic: emphasis on the hamper as core food on an ongoing basis, the importance of traditional foods, food insecurity and access, the role of the Whitehorse Food Bank in supporting informal networks in communities, and ideal food situations that focused on an abundance of fresh and landbased foods. The results show some contrast between needs in Whitehorse and needs in smaller, more remote Yukon communities. Because of limited access to fresh foods in communities outside of Whitehorse, merely increasing income supports would not completely alleviate food insecurity for these participants, who they lack physical access as well as economic access to fresh, preferred foods. [ABSTRACT FROM AUTHOR]

In remote communities of Canada, diesel is the primary source of electricity and heat. Promoting sustainable and diverse means of heat and power generation is essential to providing reliable and less carbon-intensive energy supply to remote communities. Among renewable energy sources in Canada, biomass is a major source of energy, with wood pellets being a notable contributor. In this study, using wood pellets in a remote community of Canada is investigated using life cycle analysis (LCA). Furthermore, wood pellet combustion is compared with diesel combustion, the most common fossil fuel in these regions. SimaPro (version 8.4.0.0) was used with Ecoinvent 3 as the primary library because of the nature of the feedstock. Harvesting, transportation, sawmill operation, pelletization, and combustion stages are considered in LCA. In doing so, first, life cycle data related to each of these stages are collected with respect to eight impact categories of global warming, ozone depletion, carcinogenic, non-carcinogenic, smog, respiratory effects, acidification, eutrophication, ecotoxicity, and fossil fuel depletion. The results indicate that pelletization and combustion stages have the greatest environmental impact, specifically in terms of non-carcinogenic effects from pelletization and respiratory effects from pellet combustion. Additionally, when comparing wood pellets to diesel, wood pellet combustion exhibits superior performance across various impact categories, particularly in non-carcinogenic effects. [ABSTRACT FROM AUTHOR]

Power doesn't come for free, but who should pay the cost? On the Aṉangu Pitjantjatjara Yankunytjatjara (APY) Lands in northwest South Australia, Aṉangu households have not historically been billed for domestic energy consumption. The state government has recently introduced a prepayment regime, ostensibly to curb supply costs. Yet extending the norms of customer payment for domestic energy requires significant administrative labour, with limited potential to recoup costs through billing. This article asks: why is enforced commensuration preferable to the status quo? It describes the invention of household energy insecurity via policy reform, including the establishment of a 'compensatory bureaucratic infrastructure' of customer policies, contracts, tariffs, and concessions designed to mitigate the harms produced by the introduction of prepayment. With the status quo deemed untenable and the transition to mainstreaming customer payment apparently inevitable, the article examines how geography and race operate as organising principles for the limits of difference among citizens under late liberal government in remote Australia. [ABSTRACT FROM AUTHOR]

In the spring of 2020, remote Indigenous communities in the far northwestern region of Saskatchewan, Canada, experienced a COVID-19 outbreak that required the collaboration of local leaders, Indigenous governments, and other multi-sectoral organizations. This study shares the stories of those involved in the response and illustrates the challenges, successes, and recommendations for future emergency preparedness. A total of 22 participants were interviewed from the impacted communities, government agencies, and organizations in public health, public safety, and law enforcement between May and August of 2021. Qualitative interviews were analyzed using thematic analysis resulting in the following themes: 1) Challenges, 2) Consequences, 3) Successes, and 4) Recommendations. A final knowledge translation event was held with key stakeholders, including public health professionals and community members, to co-create final recommendations for future public health responses in remote Indigenous communities. Our findings underscored the importance of community leadership, local investment, public health preparedness, and relationship-building between organizations and jurisdictions. Lessons and recommendations from these stories can be applied to future pandemic preparedness in the province. [ABSTRACT FROM AUTHOR]

The construction of evaporative coolers in remote areas can increase the longevity of vegetables, improving food security and the local economy of small farmers in remote, impoverished communities without access to electricity. This work presents a 1:1 scale prototype of an 8 m3 (2.1 × 2.1 × 2.3 m) stabilized adobe evaporative cooler, with a design based on the appropriate technology framework, and it was built as a chamber using double adobe walls, filled with wet sand, to induce evaporative cooling. Furthermore, the paper presents the prototype's performance evaluation. The tests were carried out in the dry and wet states, with different volumes of water. The results show good performance compared with other prototypes, although the optimum watering volume could not be determined because of the high climate variance (outside temperature and humidity) that prevented the repetition of the experiments in identical operating conditions. Stabilized adobe proved to be a good choice for use in the cooler, even when subject to moisture accumulation, indicating an estimated long lifetime for the cooler. The data obtained about the efficiency of evaporative cooling show that the cooler, as expected, has its best performance on the hottest and driest days, reducing the internal temperature (up to 13.24 °C) and managing to keep the internal humidity. The cost, efficiency, durability, and replicability make the proposed evaporative cooler a feasible solution for food preservation. [ABSTRACT FROM AUTHOR]

Purpose of Review: We offer reflections on practitioner service provision for sex offenders when working in remote communities. The social ecological model framework is used to capture the influence on practitioner working at an individual, relationship, community, and societal level. Recent Findings: The social construction and geographic conditions of sexual offending within remote communities present myriad challenges for professionals working in these isolative settings in which they are embedded. Challenges include being the sole expert in a community, unavoidable dual relationships, community anxieties, and restrictive guidelines and assessment measures. Summary: Despite the challenges presented to practitioners operating in remote communities, many opportunities are available for building local and international peer relationships, connecting with the community, individualized treatment for clients, and flexibility in the adaptation of best practice to fit the needs of remote communities while maintaining ethical integrity. [ABSTRACT FROM AUTHOR]

The emergence of Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections among indigenous populations has been reported. Usually, indigenous communities live in extreme poverty and are at risk of acquiring infections. In Brazil, healthcare inequality is observed in this population. To date, there are no reports of CA-MRSA infections, and no active search for asymptomatic S. aureus carriage has been conducted among Brazilian Indians. The aim of this study was to investigate the prevalence of colonization with S. aureus and CA-MRSA among Brazilian Indians. We screened 400 Indians (from near urban areas and remote hamlets) for S. aureus and CA-MRSA colonization. The isolates were submitted to clonal profiling by pulsed-field gel electrophoresis (PFGE), and selected isolates were submitted to multilocus sequence typing (MLST). Among 931 specimens (nasal and oral) from different indigenous individuals in remote hamlets, S. aureus was cultured in 190 (47.6%). Furthermore, CA-MRSA was found in three isolates (0.7%), all SCCmec type IV. PFGE analysis identified 21 clusters among the S. aureus isolates, and MLST analysis showed a predominance of sequence type 5 among these isolates. Our study revealed a higher prevalence of S. aureus carriage among Shanenawa ethnicity individuals (41.1%). Therefore, ethnicity appears to be associated with the prevalence of S. aureus in these populations. [ABSTRACT FROM AUTHOR]

Iodine intake in Haiti has increased in recent years thanks to the "Bon Sel" social enterprise approach to salt fortification and distribution by the market segment. However, it was uncertain whether this salt reached remote communities. This cross-sectional study aimed to assess the iodine status of school-age children (SAC) and women of reproductive age (WRA) in a remote region of the Central Plateau. A total of 400 children (9–13 years) and 322 women (18–44 years) were recruited through schools and churches, respectively. Urinary iodine (UIC) and urinary creatinine (UCC) concentrations were measured in spot samples, and thyroglobulin (Tg) on dried blood spots. Their iodine intake was estimated, and dietary information collected. The median (IQR) UIC in SAC was 130 µg/L (79–204, n = 399), and in WRA, 115 µg/L (73–173, n = 322). The median (IQR) Tg in SAC was 19.7 µg/L (14.0–27.6, n = 370), and in WRA, 12.2 µg/L (7.9–19.0, n = 183); 10% of SAC had Tg > 40 µg/L. Estimated iodine intake was 77 µg/day and 202 µg/day in SAC and WRA, respectively. Iodized table salt was rarely consumed, though bouillon was used daily; this is hypothesized to be a major contributor to dietary iodine intake. Iodine intake in this remote region seems to have improved considerably since the 2018 national survey, though SAC remain at risk. These results point to the potential effectiveness of using social business principles to deliver humanitarian solutions. [ABSTRACT FROM AUTHOR]

The town of Dubreuilville, with a population of just under 1,000, is located in Northern Ontario, Canada, approximately one thousand kilometers North-West of Toronto. The region was previously known for lumber production. When the Canadian lumber market collapsed due to the imposition of duties by Washington, the local mill shut down. Large gold deposits were found nearby, and Dubreuilville became a mining town almost overnight. Half of the population had left by the time the mine opened, and part of the workforce commutes from cities located up to six-hour drives away. With the opening of a second gold mine in the area planned for 2023, Dubreuilville had to prepare to attract and retain more workers for the project to succeed and for the town to prosper. Below is the strategic plan that was prepared by Mayor Nantel and Economic Development Officer Melanie Pilon, with the help of a Laurentian University Management professor and three students. [ABSTRACT FROM AUTHOR]

District heating networks offer promising solutions for remote communities, providing centralized heat supply, improved efficiency, and diverse energy sources, especially with existing diesel generation. Hence, this paper bridges gaps in the existing literature by developing comprehensive dynamic models of combined district heating networks within existing electric power networks in remote communities, which allows identifying challenges and benefits of district heating networks for these communities. It is shown that district heating networks allow utilizing waste energy to enable energy exchanges between the electricity and heating systems, enabling the provision of necessary ancillary services for remote microgrids with renewable energy sources. The presented dynamic district heating network model incorporates particular considerations in remote, northern communities such as soil limitations, extreme cold conditions, and piping insulation to minimize heat loss. It also addresses accurate sizing of heat pumps based on realistic thermal load requirements, weather conditions, and consumer profiles, proposing demand management controls to enhance frequency regulation for the integration of variable renewable energy sources. The main contributions of the paper include detailed dynamic modeling for district heating network operation, heat pump demand response control system design, and a comparative analysis between centralized district heating networks and decentralized electric thermal storage units that have been deployed for thermal supply in remote areas. The presented dynamic models are applied, tested, and validated in an existing electric microgrid at Kasabonika Lake First Nation in Northern Ontario, showcasing the role of a potential district heating network in facilitating renewable energy sources integration in isolated microgrids. • Use diesel generation exhaust for district heating in remote communities. • Use heat pump demand response for frequency control in remote microgrids. • Facilitate renewable energy integration using district heating networks in isolated microgrids. • Compare district heating networks with electric thermal storage units for thermal supply and frequency control in remote microgrids. [ABSTRACT FROM AUTHOR]

Context: Telepathology is a promising tool for remote communities to receive pathology services where professional diagnosis services are inadequate. Aims: We aimed to clarify how effective telepathology was when compared with conventional pathology service among rural communities of Bangladesh. Methods and Materials: We conducted a cross-sectional study in suburban and rural areas of Bangladesh between June and August 2020. We enrolled 117 participants who received both telepathology services from Thakurgaon Eye Hospital and conventional pathology service experience. The participant's satisfaction with the accessibility and perceptions were statistically compared. In addition, we summarized descriptive statistics using the frequencies and percentages of participants' responses. Statistical Analysis Used: Wilcoxon's Signed-rank test using SPSS statistic software version 25.00. Results: Among the study participants, service cost, travel cost, travel time, waiting time, and travel distance were significantly higher for conventional pathology than telepathology (P < 0.001). The majority of participants (94%) were satisfied with the telepathology experience; however, one out of 117 participants was dissatisfied with this service when their travel distance was far away (≥50 km). Among the participants, 91.5% thought that telepathology service was effective for their treatment, and 98.3% wanted to continue this service in their community. On an average, participants saved 58% (95% CI, 53.4–61.5) of cost using telepathology rather than conventional pathology service. Conclusions: Remote under-resourced communities received professional pathology services with less time-consuming and significantly lower costs using the telepathology approach. Where pathology services are absent/insufficient, telepathology is efficacious for primary diagnosis, screening, and referral through professional pathologists for the satisfactory treatment of unreached communities.

The latest IPCC assessment reports (2021, 2022 and 2023) confirm the devastating impacts of climate change are being felt with increasing frequency and intensity, with these impacts causing profound changes in the livelihoods of remote communities. People who are heavily dependent on agriculture, fisheries and forestry are particularly impacted, with risks and vulnerabilities increasing. These communities are already adapting their livelihoods, yet they often face constrained access to critical information, social safety nets, knowledge and skills, and technology, for effective adaptation to climate change. More importantly, they are typically outside the mainstream decision making and socio-economic structures that provide vital support during times of crisis. This article synthesizes analysis of the climate change impacts on, and adaptation by, remote communities living in very different environments – the tropical islands of the South Pacific, the mountains of the Himalaya in Nepal, and the deserts of central Australia. The authors’ analysis informs discussion about the limitations and strengths of local adaptation by remote communities and what strategies can support them build resilience.

The UN Decade of Healthy Ageing urges communities to create environments that support older adults. Yet rural communities may be overlooked and have limited capacity to be supportive. A scoping review was undertaken to determine the state of knowledge of elements of rural communities influencing well-being of older adults in CESW Africa and Latin America. Thematic analysis highlighted three community domains: local environments, community relationships and cultural identity. Findings highlight communities' limited control over external services, infrastructure and formal partnerships that influence well-being of older people. Community capacity to support older persons must be evaluated in light of these constraints. [ABSTRACT FROM AUTHOR]

Global efforts are still under way to ensure sustainable development goal 6 of providing enough clean water to sustain public health in many regions, and especially in the Arctic where the remoteness of communities and the harsh climate make water provision especially challenging. This study aimed to examine the sufficiency, accessibility, and affordability of water supplies in rural Greenland. The state of the water supply was investigated using quantitative data on infrastructure and demographics. Qualitative data on water-related practices and perceptions were collected through fieldwork and interviews in a selection of settlements. Generally, the supply of drinking water was found to be sufficient and affordable for most. However, access was severely constrained by the lack of piping to rural homes (20% were piped). The daily water consumption of residents from un-piped households was between 13 and 23 L/d/cap, i.e. within the basic access level according to WHO, which is in theory not sufficient to sustain public health. Several health risks could be caused by the low daily consumption in un-piped homes, and water saving practices induced by it – i.e. the use of shared handwashing basins, and household water storage, which could lead to degradation of water quality at the point-of-use. [ABSTRACT FROM AUTHOR]

Recent concerns have arisen in Australia regarding detections of the exotic bacterium Ehrlichia canis which has resulted in ehrlichiosis outbreaks. In Australia, it is spread by the tropical brown dog tick Rhipicephalus linnaei, formerly Rhipicephalus sanguineus sensu lato tropical lineage. Previously, the tick has been recorded in South Australia in the Coober Pedy and the Oodnadatta areas. This study, which includes historical specimens data held in historical Australian arthropod collections, along with 10 sampled remote communities, confirms the wide distribution range of this species within the State. E. canis was detected by PCR in the ticks. The percentage of dogs hosting PCR‐positive ticks increased from 2.8% (95% confidence interval [CI]: 0.3 to 9.7) in November–December 2020 to 62.9% (95% CI: 44.9 to 78.5) end of February 2021, initially in two then in seven Anangu Pitjantjatjara Yankunytjatjara lands communities in the far northern regions of South Australia. Our results suggest a rapid spread of the pathogen. No evidence of E. canis was found in nine regional communities. The extended tropical brown dog tick distribution indicates a greater area where E. canis may occur and may require management to minimise the impacts of ehrlichiosis outbreaks. Without the implementation of effective detection and control programs, this extended distribution of R. linnaei is likely to result in the spread of the bacterium to other regions. [ABSTRACT FROM AUTHOR]

• Appropriates managed retreat to theorise the slow withdrawal of government services. • Examines policy history distinguishing between remote communities and homelands. • Argues Australian states are managing a retreat from remote community housing. • Considers the potential of withdrawal for Indigenous sovereignty over remote housing. Managed retreat is part of the planners' analytical toolkit. It considers that human displacements driven by climate change will be more just if they are strategically managed by well-resourced authorities. In contrast to the contradistinction this discourse establishes between the status quo of ad hoc displacement and planned relocation, managed retreat disregards other policies that similarly encourage migration from places the state deems unviable. This article argues that slow withdrawal as managed retreat offers a framework for understanding policies that facilitate the reduction or discontinuation of services that settler colonial states formerly delivered to particular contexts. It does so through historical analysis of state support for housing and essential services infrastructure at Indigenous homelands and remote communities in the Northern Territory of Australia. Slow withdrawal as managed retreat emphasises the geographically differentiated character of state investment, highlights the reconfiguration of obligations for service provision between different levels of government, and considers whether and how 'abandonment' is appropriate 'land back' policy advancing Indigenous sovereignty. The article examines how the settler state withdraws specific supports while remaining present, and it considers the process of slow withdrawal as managed retreat in relation to contemporary demands for greater community control of Indigenous housing. [ABSTRACT FROM AUTHOR]

Safe drinking water and effective sanitation is a basic human right. The health of Aboriginal and Torres Strait Islander Peoples living on traditional Country in remote Australia can be supported or undermined by these essential services. Despite global and Australian commitments to the Sustainable Development Goals, water and sanitation service levels have regularly been identified as unreliable, unsafe, and of a lower standard than non-Indigenous and non-remote settlements. This research sought to identify the optimal conditions to enable consistent delivery of safe water and sanitation in remote Indigenous communities of Australia. Using a combination of literature reviews, interviews with key stakeholder groups and applied research findings, key conditions for improved water and sanitation outcomes were identified. These included technology for water and sanitation that is fit for purpose, people and place; capacity-building, training and ongoing support for local Indigenous service operators; and that all personnel involved in delivery require a level of cultural competency to the local and Indigenous context. These findings are intended to contribute to informing more sustainable water and sanitation outcomes in Indigenous communities. [ABSTRACT FROM AUTHOR]

This research investigates the role air transportation plays in remote community resilience by examining air cargo delivery and flight operations in northern Ontario, Canada. Building off of the Disaster Resilience of Place (DROP) model for community resilience, we develop a high-level interdependency model that shows the interdependencies between community infrastructure systems and air transportation in the unique context of remote communities that rely on air transportation. Air transportation is the only mode of travel available year-round for the 26 remote communities studied. Alternative modes are seasonal (e.g., winter roads) and threatened by climate change. Analysing 6 years of cargo data highlights infrastructure interdependencies in energy, the built environment, and transportation systems. Flight operations data and semi-structured interviews with airline employees advance our understanding of air transportation infrastructure and operating challenges that impact flight reliability and ultimately remote community resilience. [ABSTRACT FROM AUTHOR]

Abstract Objective: To analyse the implicit discourses within the COVID‐19 policy response for Aboriginal and Torres Strait Islander remote communities. Method: This paper uses Bacchi's ‘What is the Problem Represented to Be’ framework to analyse the Emergency Requirements for Remote Communities Determination under Subsection 477(1) of the Biosecurity Act 2015 (Cth). Results: Despite the leadership of community‐controlled health services and regional councils, and the actions of Aboriginal and Torres Strait Islander communities, the policy response constructs Aboriginal and Torres Strait Islander people as vulnerable and mobility as a problem that needs a law and order response. Conclusions: The policy response perpetuates an ongoing paternalistic discourse where Aboriginal and Torres Strait Islander people must be controlled for the sake of their health, informed by notions of Indigeneity as deficient. This stands in contrast with the work of community‐controlled health organisations, advocacy by Aboriginal and Torres Strait Islander people for and against restrictions, and examples of communities protecting themselves. Implications for public health: Unilateral government intervention creates limiting discourses of Aboriginal and Torres Strait Islander people. In contrast, ongoing COVID‐19 responses can build on the strengths of and work done by Aboriginal and Torres Strait Islander families, leaders, and communities.

Global efforts are still under way to ensure sustainable development goal 6 of providing enough clean water to sustain public health in many regions, and especially in the Arctic where the remoteness of communities and the harsh climate make water provision especially challenging. This study aimed to examine the sufficiency, accessibility, and affordability of water supplies in rural Greenland. The state of the water supply was investigated using quantitative data on infrastructure and demographics. Qualitative data on water-related practices and perceptions were collected through fieldwork and interviews in a selection of settlements. Generally, the supply of drinking water was found to be sufficient and affordable for most. However, access was severely constrained by the lack of piping to rural homes (20% were piped). The daily water consumption of residents from un-piped households was between 13 and 23 L/d/cap, i.e. within the basic access level according to WHO, which is in theory not sufficient to sustain public health. Several health risks could be caused by the low daily consumption in un-piped homes, and water saving practices induced by it – i.e. the use of shared handwashing basins, and household water storage, which could lead to degradation of water quality at the point-of-use.

In remote communities of Canada, diesel is the primary source of electricity and heat. Promoting sustainable and diverse means of heat and power generation is essential to providing reliable and less carbon-intensive energy supply to remote communities. Among renewable energy sources in Canada, biomass is a major source of energy, with wood pellets being a notable contributor. In this study, using wood pellets in a remote community of Canada is investigated using life cycle analysis (LCA). Furthermore, wood pellet combustion is compared with diesel combustion, the most common fossil fuel in these regions. SimaPro (version 8.4.0.0) was used with Ecoinvent 3 as the primary library because of the nature of the feedstock. Harvesting, transportation, sawmill operation, pelletization, and combustion stages are considered in LCA. In doing so, first, life cycle data related to each of these stages are collected with respect to eight impact categories of global warming, ozone depletion, carcinogenic, non-carcinogenic, smog, respiratory effects, acidification, eutrophication, ecotoxicity, and fossil fuel depletion. The results indicate that pelletization and combustion stages have the greatest environmental impact, specifically in terms of non-carcinogenic effects from pelletization and respiratory effects from pellet combustion. Additionally, when comparing wood pellets to diesel, wood pellet combustion exhibits superior performance across various impact categories, particularly in non-carcinogenic effects.

Renewable-diesel hybrid systems are increasingly common as remote communities, powered primarily by diesel fuel, seek alternatives to reduce costs and emissions while improving energy autonomy. This study goes beyond plug loads to include options for a northern remote community to eliminate imported fuels used in stationary combustion by displacing diesel electricity while electrifying heating loads. Four scenarios are developed using HOMER for a case study in the Kivalliq region of Canada to examine high renewable penetration potential energy systems, including heating loads. A 1200 km power line extension from a hydroelectricity grid in southern Canada has been proposed in the region. The powerline is compared to on-site renewables, such as wind and solar, and to the base case with increasing carbon prices. The highly seasonal nature of heating loads, and the acute risks of power loss in the winter results in high capacity, but low usage back-up infrastructure requirements. District heating is considered as a novel way to assist in increasing the renewable fraction in remote contexts to minimize fossil fuel back-up requirements. Assuming the grid extension can be developed on budget and that diesel prices inflate, this analysis shows the powerline presents the lowest cost path to full decarbonization, and lower costs than business as usual. Using a combination of local renewables and district heating, 60% renewable penetration could be achieved with comparable net present costs to the powerline. In high priced diesel fuel scenarios, increasing renewable energy either with onsite generation or the power line extension present lower cost options than continued reliance on imported fossil fuels. [ABSTRACT FROM AUTHOR]

The emergence of Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections among indigenous populations has been reported. Usually, indigenous communities live in extreme poverty and are at risk of acquiring infections. In Brazil, healthcare inequality is observed in this population. To date, there are no reports of CA-MRSA infections, and no active search for asymptomatic S. aureus carriage has been conducted among Brazilian Indians. The aim of this study was to investigate the prevalence of colonization with S. aureus and CA-MRSA among Brazilian Indians. We screened 400 Indians (from near urban areas and remote hamlets) for S. aureus and CA-MRSA colonization. The isolates were submitted to clonal profiling by pulsed-field gel electrophoresis (PFGE), and selected isolates were submitted to multilocus sequence typing (MLST). Among 931 specimens (nasal and oral) from different indigenous individuals in remote hamlets, S. aureus was cultured in 190 (47.6%). Furthermore, CA-MRSA was found in three isolates (0.7%), all SCCmec type IV. PFGE analysis identified 21 clusters among the S. aureus isolates, and MLST analysis showed a predominance of sequence type 5 among these isolates. Our study revealed a higher prevalence of S. aureus carriage among Shanenawa ethnicity individuals (41.1%). Therefore, ethnicity appears to be associated with the prevalence of S. aureus in these populations.