Harnessing the Power of Stories for Rural Sustainability: Reflections on Community-Based Research on the Great Northern Peninsula of Newfoundland

Stories have the power to shape understanding of community sustainability. Yet in places on the periphery of capitalist systems, such as rural and resource-based regions, this power can be used to impose top–down narratives on to local residents. Academic research often reinforces these processes by telling damage-centric narratives that portray communities as depleted and broken, which perpetuates power imbalances between academia and community members, while disempowering local voices. This article explores the potential of storytelling as a means for local actors to challenge top–down notions of rural sustainability, drawing on a community-based research initiative on the Great Northern Peninsula (GNP) of Newfoundland. Five of the authors are community change-makers and one is an academic researcher. We challenge deficiencies-based narratives told about rural Newfoundland and Labrador, in which the GNP is often characterised by a narrow set of socio-economic indicators that overlook the region’s many tangible and intangible assets. Grounded in a participatory asset mapping and storytelling process, a ‘deep story’ of regional sustainability based on community members’ voices contrasts narratives of decline with stories of hope, and shares community renewal initiatives told by the dynamic individuals leading them. This article contributes to regional development efforts on the GNP, scholarship on sustainability in rural and remote communities, and efforts to realise alternative forms of university-community engagement that centre community members’ voices and support self-determination

Bonne Bay - A Treasure and a Resource: Final Report on the Bonne Bay Public Gatherings and Workshop Woody Point and Norris Point October 27 – 29, 2009

Bonne Bay is a small fjord located on the west coast of Newfoundland at the base of the Great Northern Peninsula. Several communities have a strong and enduring relationship with the Bonne Bay marine ecosystem. These communities include: Norris Point, Woody Point, Glenburnie, Birchy Head and Shoal Brook, Rocky Harbour, and Sally’s Cove and Trout River located just outside the entrance to Bonne Bay. There is a strong inshore fishing tradition in the Bonne Bay area including fisheries for lobster, cod, herring, salmon and, more recently, snow crab. The Bay and associated watersheds have seen an important increase in tourism-related activities in the past few decades including recreational salmon and trout fishing, tour boats, kayaking, recreational cod fishing and a growing number of cruise ship visits. This growth in tourism activity has been fuelled not only by the beauty and cultural and ecological richness of the area but also by the fact that Bonne Bay is surrounded by Gros Morne National Park and home to the Bonne Bay Marine Station

Bronchiolitis of Infancy Discharge Study (BIDS):a multicentre, parallel-group, double-blind, randomised controlled, equivalence trial with economic evaluation

Background: There are no randomised trials of peripheral capillary oxygen saturation (SpO2) targets in acute respiratory infection. Two national guidelines recommended different targets for the management of acute viral bronchiolitis. Objectives: To compare the American Academy of Pediatrics guideline target of SpO2 ≥ 90% with the Scottish Intercollegiate Guidelines Network target of SpO2 ≥ 94%. Design: A multicentre, parallel-group, double-blind, randomised controlled, equivalence trial with economic evaluation. Setting: Eight paediatric hospital departments in the UK. Participants: Infants > 6 weeks and ≤ 12 months of age (corrected for prematurity) with physician-diagnosed bronchiolitis admitted to hospital from a paediatric emergency assessment area. Follow-up for 6 months by standardised telephone contacts. Intervention: Infants were randomised to a target oxygen saturation of ≥ 94% (standard care) or ≥ 90% (modified care) displayed by a pulse saturation oximeter (Masimo Corporation Limited, CA, USA). Routine care: All infants received routine care in addition to the study intervention. Infants were eligible for discharge when they exhibited a SpO2 of ≥ 94% in room air for 4 hours including a period of sleep and were also feeding adequately (≥ 75% usual volume). Primary outcome: A total of 615 infants were recruited, of whom 308 were allocated to the standard care group and 307 to the modified care group. The primary outcome was time to cough resolution. There was equivalence at the prespecified variance of ± 2 days [time to cough resolution: standard care group, 15 days; modified care group, 15 days; median difference 1 day (benefit modified), 95% confidence interval (CI) –1 to 2 days]. Secondary results: Return to adequate feeding occurred sooner in infants in the modified care group than in those in the standard care group (19.5 vs. 24.1 hours). This difference was non-equivalent [median difference 2.7 hours (95% CI –0.3 to 7.0 hours) versus prespecified ± 4 hours; post-hoc hazard ratio 1.22 (95% CI 1.04 to 1.44 (p-value = 0.015)]. Parent perspective of the time taken to return to normal was not equivalent, being 12 days in the standard care group compared with 11 days in the modified care group [median difference 1.0 day (95% CI 0.0 to 3.0 days) versus prespecified ± 2 days; post-hoc hazard ratio 1.19 (95% CI 1.00 to 1.41); p-value = 0.043]. At 28 days, SpO2 was equivalent [mean difference 0.11% (95% CI –0.35% to 0.57%), within the 1% prespecified]. The modified care group (55.6%) required oxygen less than the standard care group (73.1%), and for a shorter period (5.7 hours vs. 27.6 hours). Infants in the modified care group were fit for discharge (30.2 hours vs. 44.2 hours, hazard ratio 1.46, 95% CI 1.23 to 1.73; p-value < 0.001) and were discharged (40.9 hours vs. 50.9 hours; hazard ratio 1.28, 95% CI 1.06 to 1.50; p-value < 0.003) sooner than those in the standard care group. There were 35 serious adverse events in the standard care group, compared with 25 in the modified care group. Eight infants in the standard care group and 12 in the modified care group were admitted to a high-dependency unit. By 28 days, 23 infants had been readmitted to hospital in the standard care group and 12 infants in the modified care group. Parents of infants in the modified care group did not experience higher levels of anxiety and, by 14 days, had lost 28% fewer hours to usual activities. NHS costs were £290 lower in the modified care group than in the standard care group, with additional societal costs also being lower in the modified care group. Conclusions: Management of infants to a SpO2 target of ≥ 90% is as clinically effective as ≥ 94%, gives rise to no additional safety concerns, and appears to be cost-effective. Future work could focus on the safety and effectiveness of using intermittent oxygen saturation monitoring in secondary care, and to consider what are safe and effective oxygen saturation targets for children with bronchiolitis managed in primary care. Trial registration: This trial is registered as ISRCTN28405428. Funding: This project was funded by the NIHR Health Technology Assessment programme. Masimo Corporation Limited, CA, USA, kindly provided oxygen saturation monitors with standard and altered algorithms

Citizen Voices for Health: Hearing Local Perspectives on Access to Health Services in Western Newfoundland

Participants are invited to join the audience as part of a live community radio talk show on rural health. The host will interview people involved with a recent Rural Secretariat research project which gathered citizen’s views on barriers and solutions to accessing health care in rural Newfoundland.The show will highlight the main findings and learning’s in an engaging and relaxed setting complete with music, poetry, food and call-in – everything essential for a memorable community radio broadcast. Participants will hear about challenges and successes with the project as well as having an opportunity to contribute their own thoughts and ideas for next steps with the project. The session will be broadcast live though a local community radio station and also webcast – contributing to the overall mobilization of the project findings in the region and beyond. The research being highlighted focuses on the Corner Brook-Rocky Harbour and Stephenville-Port aux Basques Rural Secretariat Regions. Key partners included the Rural Secretariat Regional Councils, the Health Research Unit (MUN), Regional Health Authorities, the Department of Health and Community Services. The research included an extensive survey in the above mentioned regions, a literature scan of potential solutions/ opportunities as well as a series of kitchen table discussions hosted across the regions. The aim of the project is to provide research which can inform policy recommendations made by the Rural Secretariat Regional Council to the Provincial Government

Empowerment of Whom and for What? Financial Literacy Education and the New Regulation of Consumer Financial Services

Financial regulators in many states recently have obtained statuory mandates to enhance consumer financial literacy. This paper investicages the development of policy pursuant to such mandates in the UK and Canada to identify how national regulators in both countries represent financial market place. It finds that regulators in both countries represent financial education as empowerment and responsible consumer behaviour. The paper rekates the tension between empowerment and responsibilization aspects of literacy enhancement to policy goals of expectations of protection. It raises questions about regulators' use of consumer education to responsiblize consumption of financial products and calls for further research on the international growth of financial literacy education as a regulatory project

Incidence and epidemiology of anal cancer in the multicenter AIDS cohort study

OBJECTIVE:: To examine the incidence and risk factors for anal cancer in a multicenter cohort of human immunodeficiency virus (HIV) positive and HIV-negative men who have sex with men followed between 1984 and 2006 (Multicenter AIDS Cohort Study). METHODS:: Prospective analysis using Poisson regression and Cox proportional hazard models and a nested case-control study using conditional logistic regression. RESULTS:: There were 28 cases of anal cancer among the 6972 men who were evaluated. The incidence rate was significantly higher in HIV-positive men than in HIV-negative men (incidence rate = 69 vs 14 per 100,000 person-years). Among HIV-positive men, anal cancer incidence was higher in the highly active antiretroviral therapy (HAART) era than the pre-HAART era (incidence rate = 137 vs 30 per 100,000 person-years). In multivariate analysis restricted to the HAART era, anal cancer risk increased significantly with HIV infection (relative hazard = 4.7, 95% confidence interval = 1.3 to 17) and increasing number of unprotected receptive anal sex partners at the first 3 study visits (P trend = 0.03). Among HIV-positive men, current HAART use did not decrease anal cancer risk. CONCLUSIONS:: HIV-positive men had increased risk of anal cancer. Improved survival of HIV-positive individuals after HAART initiation may allow for sufficient time for human papillomavirus-associated anal dysplasias to develop into malignancies, thus explaining the increased incidence of anal cancer in the HAART era. © 2008 by Lippincott Williams & Wilkins

A symbiont-bearing allogromiid from the Santa Barbara Basin : implications for the early diversification of foraminifera

Author Posting. © American Geophysical Union, 2006. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research 111 (2006): G03002, doi:10.1029/2005JG000158.Our current understanding of paleoecology and paleoceanography is largely based on the superb Phanerozoic fossil record of foraminiferan protists. The early history of the group is unresolved, however, because basal foraminiferans (allogromiids) are unmineralized and thus fossilize poorly. Molecular-clock studies date foraminiferal origins to the Neoproterozoic, but the deep sea – one of Earth’s most extensive habitats and presently a significant fraction of basal foraminiferal diversity— was probably anoxic at that time and, until now, anaerobic allogromiids were unknown. Molecular, cell and ecological analyses reveal the presence of a previously unknown allogromiid inhabiting anoxic, sulfidic deep-sea sediments (Santa Barbara Basin, California, USA). The fact that the new foraminifer harbors prokaryotic endobionts implicates symbiogenesis as a driving force in early foraminiferal diversification.The Wadsworth Center’s Electron Microscopy, Biochemistry, and Molecular Genetics Core facilities, as well as its National Biotechnology Resource for the Visualization of Biological Complexity (supported by a NIH BRTP/NCRR grant) are gratefully acknowledged. Funded by NASA Exobiology NRA-01-01-EXB-057 (to J.M.B.); W. Storrs Cole Memorial Research Award (Geological Society of America, to J.M.B.); NSF DEB0445181 (to S.S.B.)