What are the support needs of nurses providing emergency care in rural settings as reported in the literature? A scoping review.

INTRODUCTION: Australia is a country with a rich history, and unique geography, with nearly one-third of its population living in rural areas. This presents certain challenges to nurses providing emergency care in these regions, as their support needs are different from their urban counterparts. This systematic scoping review aims to determine the support needs of these nurses providing emergency care in rural settings as reported in the literature. Many other countries have large rural populations, and relevant international literature will be considered to allow discussion of the key issues and recommendations for the future of the rural nursing workforce. METHODS: Databases searched included PubMed, Cochrane database, ERIC and Google Scholar using keywords 'rural', 'nurse', 'emergency', 'support needs', 'challenges' and 'Australia', and research from 2012 onwards was examined for relevance. Earlier seminal texts were also included. Reference lists of retrieved articles were searched and citations explored for further relevant research material. The Joanna Briggs Institute's scoping review framework was used. The primary focus was on peer-reviewed research with supplementary grey literature (eg materials and research produced by organisations outside of the traditional publishing channels). International material was used where relevant. RESULTS: Analysis of the literature revealed that the four main areas of concern were a lack of effective graduate training programs or the availability of mentors, poor recruitment and retention numbers, a need for better recognition for the extended role of the rural nurse as a 'nurse generalist' or rural 'specialist' and poor access to role-specific ongoing education. These areas of concern were exacerbated by geographic isolation and a perceived lack of funding. CONCLUSION: Delivering appropriate evidence-based education to this isolated practice community is vital for safe patient care and improves rural nurse satisfaction and retention. There were gaps in current knowledge, and the body of research to date lacks information on the work of emergency nurse practitioners in the rural context, the effectiveness of graduate mentorship programs and the psychosocial aspect of the rural role. Recommendations are for improved role-specific ongoing education and the availability and development of graduate mentoring programs. Further input into recruitment and retention is required, and further research on the needs of rural emergency nurses is recommended.

Dynamics in the global protected-area estate since 2004.

Nations of the world have committed to a number of goals and targets to address global environmental challenges. Protected areas have for centuries been a key strategy in conservation and play a major role in addressing current challenges. The most important tool used to track progress on protected-area commitments is the World Database on Protected Areas (WDPA). Periodic assessments of the world's protected-area estate show steady growth over the last 2 decades. However, the current method, which uses the latest version of the WDPA, does not show the true dynamic nature of protected areas over time and does not provide information on sites removed from the WDPA. In reality, this method can only show growth or remain stable. We used GIS tools in an approach to assess protected-area change over time based on 12 temporally distinct versions of the WDPA that quantify area added and removed from the WDPA annually from 2004 to 2016. Both the narrative of continual growth of protected area and the counter-narrative of protected area removal were overly simplistic. The former because growth was almost entirely in the marine realm and the latter because some areas removed were reprotected in later years. On average 2.5 million km2 was added to the WDPA annually and 1.1 million km2 was removed. Reasons for the inclusion and removal of protected areas in the WDPA database were in part due to data-quality issues but also to on-the-ground changes. To meet the 17% protected-area component of Aichi Biodiversity Target 11 by 2020, which stood at 14.7% in 2016, either the rate of protected-area removal must decrease or the rate of protected-area designation and addition to the WDPA must increase.

Dinámica de los Bienes de las Áreas Protegidas desde 2004 Resumen Países alrededor del mundo se han comprometido con un número de metas y objetivos para tratar los retos ambientales mundiales. Las áreas protegidas han funcionado durante siglos como una estrategia clave en la conservación y juegan un papel importante en cómo se manejan los retos actuales. La herramienta más importante que se usa para rastrear el progreso de los compromisos con las áreas protegidas es la Base de Datos Mundial de las Áreas Protegidas (WDPA, en inglés). Las evaluaciones periódicas de los bienes de las áreas protegidas muestran un crecimiento constante durante las últimas dos décadas. Sin embargo, el método actual, que usa la versión más reciente de la WDPA, no muestra la verdadera naturaleza dinámica de las áreas protegidas a lo largo del tiempo y no proporciona información sobre sitios que han sido removidos de la WDPA. En realidad este método sólo puede mostrar crecimiento o permanecer estable. Usamos herramientas de SIG en una estrategia para evaluar el cambio de las áreas protegidas a lo largo del tiempo con base en doce versiones temporalmente distintas de la WDPA que cuantifican las áreas añadidas o removidas de la WDPA anualmente desde 2004 hasta 2016. Tanto la narrativa del crecimiento continuo de un área protegida como la contra-narrativa de la eliminación de un área protegida fueron exageradamente simplistas. La primera se debe a que el crecimiento ocurrió casi en su mayoría en el dominio marino y la segunda a que algunas áreas eliminadas fueron reprotegidas años después. En promedio se añadieron 2.5 millones de km2 a la WDPA anualmente y 1.1 millones de km2 fueron removidos. Las razones para la inclusión y la eliminación de las áreas protegidas de la base de datos de la WDPA se debieron en parte a temas de calidad de datos pero también a cambios hechos sobre la marcha. Para lograr el 17% del componente de áreas protegidas del Objetivo 11 de Biodiversidad de Aichi para el 2020, el cual se encontraba al 14.7% en 2016, se debe disminuir la tasa de eliminación de áreas protegidas o se debe incrementar la tasa de designación y suma de áreas protegidas a la WDPA.