Promoting Disposal of Left-Over Opioids After Surgery in Rural Communities: A Qualitative Description Study

Background Patients rarely dispose of left-over opioids after surgery. Disposal serves as a primary prevention against misuse, overdose, and diversion. However, current interventions promoting disposal have mixed efficacy. Increasing disposal in rural communities could prevent or reduce the harms caused by prescription opioids. Aims Identify barriers and facilitators to disposal in the rural communities of the United States Mountain West region. Methods We conducted a qualitative description study with 30 participants from Arizona, Idaho, Montana, Nevada, Oregon, Utah, and Wyoming. We used a phronetic iterative approach combining inductive content and thematic analysis with deductive interpretation through the Precaution Adoption Process Model (PAPM). Results We identified four broad themes: (a) awareness, engagement, and education; (b) low perceived risk associated with nondisposal; (c) deciding to keep left-over opioids for future use; and (d) converting decisions into action. Most participants were aware of the importance of disposal but perceived the risks of nondisposal as low. Participants kept opioids for future use due to uncertainty about their recovery and future treatments, breakdowns in the patient–provider relationship, chronic illness or pain, or potential future injury. The rural context, particularly convenience, cost, and environmental contamination, contributes to decisional burden. Conclusions We identified PAPM stage-specific barriers to disposal of left-over opioids. Future interventions should account for where patients are along the spectrum of deciding to dispose or not dispose as well as promoting harm-reduction strategies for those who choose not to dispose.

Equine-Assisted Activities and Therapies: State-of-the-Art Review

The purpose of this paper is to explore what is known about equine-assisted activities and therapies based on Roy’s adaptation model. Quality of life for vulnerable populations who engage with equine-assisted activities and therapies is considered the main concept here. This state-of-the-art review was conducted from four databases ranging from January 2019 to February 2020. Limited studies examined the effect of equine-assisted activities and therapies on cancer survivors, although preliminary data were promising. The rural context was not extensively examined. Thus, equine-assisted activities and therapies may enhance the quality of life through four adaptation modes.

Community Acceptance of Wind Energy: Lessons from a Case Study on a Local Participatory Project in Pays Des Mauges (West France)

This article focuses on the community acceptance of wind parks in a rural territory in western France, in a country where they are not much developed yet. We hypothetise that their set-up stems from a specific pattern, embedded in the territorial rural context of the case study. Semi-structured interviews with 30 actors aimed to analyse this citizen-led project, in line with their representations of this territory and its sustainable development. Results show that citizen-led investment is not a prerequisite for community acceptance in this case. The sense of a rural place that is fit for technologies kept up to date by the green industry, and the fairness of the process, are the strongest drivers for acceptance of wind energy, in general, in this case. Subsequently, the confidence obtained from previous fundraising actions can foster new participatory wind projects. An early communication with inhabitants, and a construction fit for a rural development that makes sense to the locals can bring an essential sense of trust for energy projects within the community. However, given the different definitions, it seems also critical to assess their true community dimension in order not to jeopardise the sense of fairness if the outcomes are not largely shared.

Interiority of a Disconnected Mind

<p>As the population of New Zealand ages, the rate of people with dementia is also increasing, creating greater demand for specialised dementia facilities. However, few of these are located in the rural context that New Zealand is known for. In addition, as a society we have created a stigma around aged care, and tend to design un-home-like and institutional centres. The importance of creating a space that provides contextual features, appropriate wayfinding and therapeutic characteristics has been overtaken by the need to design for efficiency of staffing requirements. Current settings and the relocation to a more urban living environment increases the confusion for those rural people with dementia, as there is little to prompt their memory or make them feel at home. This thesis proposes the design of a dementia care facility that reflects the lifestyle rural people have come from. It examines how these three aspects: context, wayfinding and therapeutic design can be included to enhance the design of a dementia facility, as well as create a space that is enlivening for the residents.</p>

Interiority of a Disconnected Mind

<p>As the population of New Zealand ages, the rate of people with dementia is also increasing, creating greater demand for specialised dementia facilities. However, few of these are located in the rural context that New Zealand is known for. In addition, as a society we have created a stigma around aged care, and tend to design un-home-like and institutional centres. The importance of creating a space that provides contextual features, appropriate wayfinding and therapeutic characteristics has been overtaken by the need to design for efficiency of staffing requirements. Current settings and the relocation to a more urban living environment increases the confusion for those rural people with dementia, as there is little to prompt their memory or make them feel at home. This thesis proposes the design of a dementia care facility that reflects the lifestyle rural people have come from. It examines how these three aspects: context, wayfinding and therapeutic design can be included to enhance the design of a dementia facility, as well as create a space that is enlivening for the residents.</p>

The Heart of Rural New Zealand

<p>New Zealand rural farming communities are the milieu of the agriculture sector. Despite New Zealand’s heavy economic reliance on agriculture, little is known about the architecture for cultivating community in the rural context. Overall, literature on rural communities reviewed for this thesis presented little direct information concerning community and architecture in the rural context. This study is an investigation of how architecture in the New Zealand rural context can cultivate a greater sense of community through the empirical research of existing rural communities. The sociological and architectural theories of community, as a generalised term in the literature, are analysed as determinants for community in the rural context of Northland, New Zealand through empirical research. The three theories of deprivation, density and development, as well as social interaction opportunities were externally applied to the sample Northland communities of Titoki, Maungatapere and Maungakaramea. Interviews with 18 community members as to their community perception authenticate the variation depicted in the external determinants. Empirical research into the theory of community acceptance analysed the vernacular for rural agricultural and rural community hall architecture. The findings from the empirical research informed the criteria for a case study design in Titoki. The resulting architectural application of these principles from the sociological and architectural theories is a uniquely agricultural rural community building to fulfil the Titoki agricultural community’s needs. This research applies commonly regarded sociological and architectural theories of community to the sample rural context to investigate what and how architecture can enable community. The findings from the sample suggest these theories are determinants for community cultivation in the rural context where architecture is a vehicle for building community. A socially healthy community prospers and is therefore more likely to be economically successful.</p>

The Heart of Rural New Zealand

<p>New Zealand rural farming communities are the milieu of the agriculture sector. Despite New Zealand’s heavy economic reliance on agriculture, little is known about the architecture for cultivating community in the rural context. Overall, literature on rural communities reviewed for this thesis presented little direct information concerning community and architecture in the rural context. This study is an investigation of how architecture in the New Zealand rural context can cultivate a greater sense of community through the empirical research of existing rural communities. The sociological and architectural theories of community, as a generalised term in the literature, are analysed as determinants for community in the rural context of Northland, New Zealand through empirical research. The three theories of deprivation, density and development, as well as social interaction opportunities were externally applied to the sample Northland communities of Titoki, Maungatapere and Maungakaramea. Interviews with 18 community members as to their community perception authenticate the variation depicted in the external determinants. Empirical research into the theory of community acceptance analysed the vernacular for rural agricultural and rural community hall architecture. The findings from the empirical research informed the criteria for a case study design in Titoki. The resulting architectural application of these principles from the sociological and architectural theories is a uniquely agricultural rural community building to fulfil the Titoki agricultural community’s needs. This research applies commonly regarded sociological and architectural theories of community to the sample rural context to investigate what and how architecture can enable community. The findings from the sample suggest these theories are determinants for community cultivation in the rural context where architecture is a vehicle for building community. A socially healthy community prospers and is therefore more likely to be economically successful.</p>